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PubMed1984

Sick-role and attitude towards disease and working life two months after a myocardial infarction.

Sick-role and attitude towards disease and work two months after a first myocardial infarction (MI) were studied in relation to social, psychological and somatic factors prior to, during and after the MI in 201 consecutive male patients. Questionnaires and a brief interview covered psychological and social data. Somatic data were registered in a standardized medical examination. New concepts were introduced after factor analysis of the psychological variables. Two out of three patients displayed avoidance behaviour. Seventy per cent had restricted their everyday activities. The leisure time was dominated by passivity. Over-protection was frequent. Sick-role behaviour was significantly related to emotional upset, preoccupation with the health and self-reported coronary symptoms while the shortage of relationships to somatic and cardiac factors was notable. The patients attributed the onset of MI to work-related factors. Work dissatisfaction was an aspect of a general negative attitude towards life and was more frequent among patients with emotional symptoms. The psychological care ought to be improved in order to prevent long-term disability.

Activities of Daily Living↗
PubMed1975

The sick role and the role of the physician reconsidered.

The main substance of this paper was presented orally at a meeting of the Sick Role, organized and chaired by Andrew Twaddle. It was a commentary on four papers and the oral discussion of them. In response to these the paper first discusses the relation of the sick role to deviant behavior and the motivation to become and remain ill. The position was taken that the author never had meant to confine the category of illness to deviant behavior, though its negative valuation should not be forgotten. Nor had he confined it to cases of acute illness, omitting consideration of chronic and other types. The most important issue, however, concerned the structure of the relation between physician and patient. Though insisting that interaction between them is two-way, not one-way, the author insisted that the relation is basically asymmetrical because of the physician's expertise in health matters, gained through training and experience, and his special fiduciary responsibility for the care of the sick. In this respect the relationship is different from others such as the competitive market or the democratic association, but is comparable to the relation of teacher and student in higher education.

Authoritarianism↗
PubMed1992

Sick-role susceptibility. A commentary on the contemporary data base (1989-1991) and classification system.

A brief review of the historical and current status of the 'sick-role' concept is followed by an extensive literature survey of 526 articles published on the sick role since 1989. The commentary discusses measurement and research issues and then examined the areas of enquiry and trends from a biological, psychological, social and cultural perspective. Questions are raised about the significance of the data base from the view-point of classification and treatment. A descriptive and therapeutic model is proposed.

Culture↗
PubMed1983

The relative impact of status and health variables upon sick-role expectations.

This study deals with the relative impact of socioeconomic status and the level of physical and emotional health upon the sick-role concepts of the laymen in a comprehensive health care system. The selection of variables was guided by our recognition that Parsons' "deviation" model of the sick-role ignores the importance of environmental resources, in particular those that are required for coping with chronic illness and permanent handicaps. No significant differences were found across social classes with regard to serious acute illnesses. By contrast, significant differences between occupational groups were found for chronic illnesses, in which recovery and resumption of independent functioning depend more on the patient's own resources than on professional medical care. The lower the occupational status, the more dependency the patient was allowed. These differences are largely attributable to socioeconomic rather than to cultural resources and to the state of health.

Comprehensive Health Care↗
PubMed1975

The psychiatric sick role and rejection.

One of the most generally accepted assumptions among mental health professionals is that if the mentally ill were accorded the rights and obligations of the sick role, they would be less rejected by the public. This is the first study that could be found in the literature which examines whether or not this assumption is valid. The data strongly suggest that conferring the sick role on the mentally ill does not lessen rejection, but may, in some instances, increase social rejection. A possible interpretation for this striking and unexpected finding is offered.

Adult↗
PubMed2001

Back to the old house? 'Sick role' and biographical narratives of the housing needs of short-stay hospital patients.

This paper examines how decisions are made about the housing needs of short-stay hospital patients. Two narrative types of patients' housing needs are identified. The 'sick role' narrative emphasised patients' ongoing medical needs and tended to prescribe 'sick role' placements in residential care or nursing homes instead of a return home. Conversely, the biographical narrative emphasised the importance of home as an integral element of 'elective biography' (Beck and Beck-Gernsheim, in: Heelas, Lash and Morris (Eds.), Detraditionalization, Blackwell, Oxford, 1996) and thus a highly emotional 'psychic warehouse' (Gurney, Ph.D. Thesis, Bristol, 1996) that was integral to post-discharge recovery and well being.

Aftercare↗
PubMed1990

[Effect of individual patient teaching through home visiting on compliance with sick role behavior in diabetic patients and duration of the effect of the teaching].

In order to determine the effect of individual patient teaching through home visiting on compliance with sick role behavior and the blood sugar level in diabetic patients, to determine if the effectiveness of the education was still present four years later and to inquire as to the effective time for a repeat education program this study was done through two quasi-experimental researches. The subjects consisted of 52 diabetic patients. The results of the study may be summarized as follows: 1. Hypothesis I, in which the compliance with sick role behavior, the knowledge on diabetes and the health belief of the experimental group who received a diabetic education program will be higher than those of the control group who didn't receive the diabetic education, was supported by both studies in 1984 and 1988, confirming the effect on diabetic patients of the individualized education through home visiting: In the 1984 study: Compliance(t = -11.7, p less than .001) Knowledge(t = -5.41, p less than .001) Health belief(t = -4.74, p less than .001) In the 1988 study: Compliance(t = -4.85, p less than .001) Knowledge(t = -2.85, p less than .01) Health Belief(t = -2.99, p less than .005) 2. The Hypothesis II, the blood sugar level of the experimental group will be lower than that of the control, was rejected in both studies, 1984 and 1988. 3. The Hypothesis III, the compliance, knowledge and health belief of the experimental group who received the education program in 1984 will not last till 1988, was supported in part, in compliance and health belief, but not in knowledge. In conclusion those who received the education program twice with an interval of 2 weeks, 4 years ago still had knowledge of diabetes but compliance and health belief had disappeared.

Community Health Nursing↗
PubMed1986

Pathways to patienthood: sick role and labeling perspectives.

Two leading sociological theorists of mental illness, Parsons and Scheff, depict the mentally ill as enacting a deviant social role which sets them apart from others. For each of these writers, persons so identified internalize the social definition of themselves which then serves as a guide for their future behavior. This social imagery specifies what kinds of people the mentally ill are, why they behave as they do and how to react to them in both the evaluative and interactional sense. Divergence between the theoretical perspectives arises chiefly over the nature of the cues which set resocialization in motion and the content of the cultural imagery incorporated into the individual's self-conception when he enters the mental illness role. In a study of psychiatric patients and the general public, we test a series of hypotheses which are derived from Parsons' sick role and Scheff's labeling theories of mental illness. As a result of the research, both the theories are found wanting for patients and the symptomatic public alike did not view themselves negatively which is what one would expect according to labeling and patients and the public both were reticient to seek out professional assistance for their symptoms and problems, a find contrary to sick role theory. Suggestions for modifications of the theories are offered.

Humans↗
PubMed2005

Observations of shipboard illness behavior: work discipline and the sick role in a residential work setting.

In this article, the author reports on a small-scale ethnographic study of illness behavior in a residential work setting, a large merchant cargo ship with a multinational crew. Although parallels with previous observational work on illness behavior in residential settings (where illnesses result in treatment only if there is a break in accommodation to symptoms) exist, it is clear that type of setting is pivotal in shaping illness careers. Here, accommodation to symptoms was overlain by the economic imperative to keep the ship functioning: Management feared that the right to the sick role would allow "malingering," whereas workers feared adoption of the sick role would exclude them from employment. In the latter case, the worker might experience illness or disability in a manner parallel to a Marxist analysis of the product of workers'labor: as an alien object of control and oppression, grounds for his or her removal from the workforce.

Employment↗
PubMed1989

[An experimental study on the development of a program for the promotion of compliance with sick role behavior in hypertensives].

This experimental study was undertaken to gauge the possibility of application and extension of a program for hypertension care to be operated by Community Health Practitioners. Four community health posts were selected. Two places were experimental groups and the other two control groups. The study was carried out from April 1987 to March 1988. In this study the hypertensives were screened from a group of adults who were over 20 years old. The rate of prevalence was 10.7% in the experimental group, and 11.1% in the control group. The hypertension care program was composed of three parts: regular care by CHPs, reinforcement of education and family support for the changing of health beliefs. The data for this analysis is based on 109 the hypertensives, with 78 from the experimental group and 31 from the control group. After the program was completed, the results obtained were as follows: 1) Sick role behavior compliance in the experimental group were significantly higher than the control group. 2) Blood pressures were decreased in both systolic and diastolic in the experimental group. Diastolic pressure was strikingly decreased from those of the control group and showed statistical significance (p less than 0.05). 3) In the experimental group, benefits, perceived family support and family support behavior were high, out benefits was significantly higher than those of the control group (p = 0.000). Sensitivity, seriousness and barriers were high in the control group, but not statistically significant. 4) In conclusion, it is revealed that hypertension care program developed in this study has an effect of decreasing blood pressure and promoting sick role behavior compliance.

Adult↗
PubMed1996

The sick role of proponents and opponents of complementary medicine.

Three different samples of patients completed a questionnaire aimed at assessing to what extent Parsons postulates for the sick role were adopted. Most patients did not agree with the first two postulates, namely that a sick person is liberated from part of his/her responsibility and that he/she cannot consciously decide to stop being ill. There was, however, agreement with the third postulate, that a sick individual is expected to seek help in order to get better. Amongst the total sample, the views of the sub-populations of proponents and opponents of complementary medicine showed little and those of chronic versus acute cases some discrepancies. From these findings hypotheses can be derived which could be formally tested through future investigations.

Adult↗
PubMed1975

Survival, and a modicum of indulgence in the sick role.

Serendipitously occasioned, interim findings from an exploratory study "which-as Whitehead once said of William James's pragmatism-'chiefly starts a log of hares for people to chase.'"3 The data, collected in a 1965 community survey of health, show that no indulgence in the sick role apparently entails greater mortality risk than does a modicum of such indulgence.

Adolescent↗
PubMed2002

Clinical relevance of the sick role and secondary gain in the treatment of disability syndromes.

There are many controversial disability syndromes, representing medicolegal and social dilemmas for a variety of medical disciplines. Health care professionals are at a loss to cure these patients, and judges and disability review boards struggle to be fair while at the same time trying to understand the basis and appropriateness of the ever-growing claims of disability. Various models describe the illness behavior in these syndromes, and a recent model proposed that deals with the sick role, gain, and illness behavior in a social context is considered for its application to psychotherapy. One finds that despite the utility of such a model in describing the patient's behavior, using this knowledge to alter the behavior remains a difficult challenge for the psychotherapist.

Persons with Disabilities↗