Impacts of Chronic Illness: Biological Disruption

Impacts of Chronic Illness: Biological Disruption Chronic illness may cause ‘biographical disruption’. Explain what you understand by this term and drawing on the experiences of your patient. Discuss the different ways in which chronic illness impacts on an individual. Medical encyclopaedia defined disruption as the ‘morphologic defect resulting from the extrinsic breakdown of, or interference with, a developmental process.’[1] In other words, it is the interruption or impediment of a progress.[2] Therefore, biographical disruption is described as how the chronic illness can lead to the loss of self-identity or social interaction in an individual.[3] In this report, I will discuss how chronic illness impacts patients in terms of their behaviour, daily lifestyle, relationships with partners or family members and acceptance of their illness as well as how they cope with it.[4] This report will be illustrated based on my patient’s experience, Ali, a 58-year-old retired office worker from Gelang Patah. Onset and Getting a Diagnosis Chronic illnesses are non-communicable diseases which develop gradually over time. They generally cannot be solved instinctively and are barely to be cured ultimately.[5] In most cases, chronic illnesses are more likely to be insidious where the patients have mild or no symptoms. However, the transition between being asymptomatic to having a chronic illness diagnosis can be challenging for the patient. My patient, Ali, was diagnosed with hypertension in year 2010. Hypertension refers to an elevated systolic blood pressure of 140mmHg or greater and diastolic blood pressure of 90mmHg or greater.[6] It is also a risk factor of myocardial infarction, chronic kidney disease, and stroke. It has been determined as the third leading cause of death worldwide by the World Health Organization and given a reputation as a ‘silent killer’.[7] Before Ali was diagnosed with hypertension, he experienced tiredness and nausea every day. He was shocked because has always led a healthy lifestyle and did sports regularly. Thus, he denied the diagnosis that the GP gave him. At first, he did not follow the routine of taking the medicine, but insisted in taking some herbs to relieve the symptoms. However, it showed no improvement in his condition. Then, he started to take his medication as indicated. Few days later, his symptoms were relieved and he accepted the truth that he is suffering from high blood pressure (BP). Before finally accepting his illness, Ali went through a stage of denial which was described by Freud as a way to protect the ego from anxiety, a defence mechanism, by not admitting that he would never return to his previous way of life and require medication for the rest of his life.[8] Coping with chronic illness Managing a chronic illness is far beyond medicating as it also involves how well a patient adapts to the effects of the symptoms in their day-to-day living. It is important how a patient manages his or her health, emotion and daily life as they can determine the efficacy of the treatment given to the patient. Besides, rather than formal healthcare and coping-with-life-changes being core [9][9][8][9][9][9][9][9]domains, they should eliminate health-compromising behaviours by self-regulatory efforts, and adopt health-enhancing behaviours. Ali said, â€Å"I had to adapt by changing my lifestyle including my diet, controlling my temper and reducing heavy workloads. Sometimes I feel that I am weaker than ever, no longer as fit as what I used to think I was. † The large submerged portion of hidden mass of the iceberg corresponds to the undiagnosed cases which are presymptomatic and unapparent.[10] About one-third of population with high BP are not aware that they have it. In other words, the extrinsic problems of what the patients present are the small constitution of the tip of the ice while the undiagnosed hypertensive patients represent the intrinsic complications deep below the surface.[11] Figure 1 Illustration of Iceberg theory[12] In addition, recent studies indicated that 58% of diagnosed hypertensive patients are receiving appropriate treatment and can communicate effectively with health care providers as well as actively self-manage their illness. This shows the difference between the two groups of individual and the success rates to reduce mortality and premature death of hypertension.[13] Chronic illness sufferers have to learn to manage their symptoms to get better. Parson’s sick role model states the obligations, ‘a sick person (patient) must get well as soon as possible’ and ‘must seek professional help’.[14, 15] Hypertension is a preventable disease, thus it is the patients’ duty to accept the medication regime. Therefore, for Ali to get well, he must actively learn to manage his illness at the same time be guided by doctors (professional role).[16] Psychosocial Impacts Relationships with family members and Daily Living Chronic illness brings a vast impact to the patient and the family. Since the onset of Ali’s illness, there have been some marked changes in his relationship with his wife of 33 years, Mira, who has taken up the responsibility to monitor his health. He finds it hard to accept that he is a patient who requires more care and attention from his wife of whom he used to take care. Despite this, Ali mentioned that the strength of his marriage had improved as he described them being closer than ever although he frequently feels frustrated due to his dependency on Mira. He now appreciates her more than before. Furthermore, Ali’s children who are highly educated always show concern for their father by checking up on him and advising him on his daily diet and exercise regime. Stigma and Isolation Stigmatisation commonly occurs with chronic illness. Stigma is described as depreciating a character which then causes the individual to be discounted.[17] It happens mainly when the patient is diagnosed with certain diseases and they are treated as abnormal or handicaps. This scenario can lead to unhappy consequences. It is then called as â€Å"deviant conditions† when they are not accepted by the society. However, Ali did not feel stigmatised at all as hypertension is one of the commonest diseases among the population. In Malaysia, the prevalence of hypertension was 42.6% in the year 2006 for the residents aged 30 years and above.[18] Furthermore, some of his friends are having the same illness; they generously shared their experiences, ways to handle the disease and methods to control BP. Changes in lifestyle and Uncertainty Life is full of uncertainties. Chronic illness contributes to unpredictable events due to the nature of the illness that can restrict some patients from leading their normal lifestyle. In addition, asymptomatic illnesses could result in distress in patients and their carers when they do not know when the disease will worsen. For Ali, he is uncertain when the BP might be raised as he knows that elevated systolic pressure above 200mmHg increases the risk of mortality from stroke[19] whereas Mira needs to get ready whenever she realises that Ali is unwell. Ali admits to feeling stressed most of the time as he is afraid that a sudden rise in BP may trouble his family, particularly his wife. Mira spends most of her time with Ali, worrying that something bad will happen to him if she leaves him alone. Uncertainty can persist throughout the course of chronic illnesses, not only at diagnosis or onset. In Ali’s case, this led to the feeling of fear and uncertainty to both Ali and his wife about what could happen to him. Stroke is the main concern for Ali as this thunderclap attack will have a huge impact on his independence and quality of life, forcing him to become a burden for his family members. Conclusion In conclusion, chronic illness is not merely a medical condition but it can cause several forms of biographical disruptions that can significantly affect a patient’s life. ‘Biographical disruption’ is one of the major aspects of living with a chronic illness because it can affect the patient’s role in the family and his or her relationship with the family members. In a wider context, it also impacts their daily life and relationship with their friends, colleagues and the community. It could potentially alter the focus of their life against their wishes and retrain them from succeeding theirs previous plans of life such as employment and hobby. For instance, Ali had thought of delaying his retirement, however, he was restricted from accomplishing jobs that he was being assigned to after being diagnosed with a chronic illness. The ability in performing tasks is diminished. Sometimes they are stigmatised as a ‘disabled’ by society. Each and every chronic illness sufferer will undergo different disruptions and changes in their life. Nonetheless, care, attention and support from the family members and society are essential to reduce the impact of the illness. Additionally, improvement on palliative care is necessary to improve the patients’ quality of life. It is important to note that the healthcare system also plays a big role in understanding the social behaviour that surrounds their patients for an efficient and effective health provision to be given. List of Figures Figure 1 Illustration of Iceberg theory References 1.Farlex, Distruption, in thefreedictionary. 2.Disruption, 2014: Research Narrative. 3.Bury, M. the Social Experience of Living with Chronic Illness and Disability. Concepts of Health and Illness: 2007 [cited 2007; Available from: http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4a-concepts-health-illness/section6. 4.William, S.J., Chronic illness as biographical disruption or biological distruption as chronic illness? Reflections on a core concept. Sociology of health and illness, 2000. 22(1): p. 18. 5.Promotion, N.C.f.C.D.P.a.H. Chronic Diseases. The Power to Prevent, The Call to Control: At A Glance 2009 2009 December 17, 2009 December 17, 2009]; Available from: http://www.cdc.gov/chronicdisease/resources/publications/aag/chronic.htm. 6.Malaysia, M., Clinical Practice Guideliness Management of Hypertension, M.o.H. Malaysia, A.o.M.o. Malaysia, and M.S.o. Hypertension, Editors. 2008: Malaysia. p. 70. 7.Maryon-Davis, D.A. Hypertension – the ‘Silent Killer’. May 2005; Available from: http://www.fph.org.uk/uploads/bs_hypertension.pdf. 8.centre, W.M., Asthma, F.s. N °307, Editor 2013, World Health Organisation: World Health Organisation. 9.Barry, A.M. and C. Yuill, Understanding the Sociology of Health: An Introduction. 2008: SAGE Publications. 10.Sharma, M. Theories of disease causation. 2012 1 Jan 2014 [cited 2012 26 Nov]; Available from: http://www.slideshare.net/monikasharma7739/theories-of-disease-causationppt. 11.Tarafdar, D.M.A. iceberg phenonmenance. Available from: http://wiki.answers.com/Q/Define_the_iceberg_phenomena_of_disease. 12.Ciulla, M.M., G.L. Perrucci, and F. Magrini. Adaptation and Evolution in a Gravitational Environment — A Theoretical Framework for the Limited Re-Generative Post- Natal Time Window of the Heart in Higher Vertebrates. May 22, 2013 13.Beth Collins Sharp, P.D., R.N., Hypertension Care Strategies, in Closing the Quality Gap2004, Agency for Healthcare Research and Quality: US Department of Health Human Services. 14.61% of Malaysians UNHEALTHY. 2012 Tuesday, 12 June 2012]; Available from: http://www.malaysia-chronicle.com/index.php?option=com_k2view=itemid=34769:61-of-malaysians-unhealthyItemid=2#axzz2qjcz5j7l. 15.Scambler, G., Sociology as Applied to Medicine. 6TH ed. 2008, UK: ELSEVIER. 348. 16.Burke-Smith, A. and D.F. McGowan. Introduction to Medical Sociology Available from: http://www.icsmsu.com/exec/wp-content/uploads/2011/12/ABS-Sociology.pdf. 17.Organisation, W.H. 10 FACTS ON OBESITY. 2014; Available from: http://www.who.int/features/factfiles/obesity/facts/en/. 18.Hypertension: Clinical management of primary hypertension in adults. 2011 Aug 2011 [cited 2011; Available from: http://publications.nice.org.uk/hypertension-cg127. 19.Judyta Cielecka-Piontek, Arkadiusz Styszynski, and K. Wieczorowska-Tobis, Knowledge of Risk Factors for Hypertension in the Elderly. Borgis New Medicine, 2004(1): p. 2-4. Social Science SectionPage 1

Lady Macbeth Diary

Dear Diary, When I found out Duncan was coming to stay, I was anxious and excited that the king was coming to my castle. It was so perfect, so much had happened with Macbeth and I already told Macbeth about my joy and exited on his achievement. This time he had said that we could speak no further but I thought that meant he wanted to tell me something later. I not knowing what he was thinking come up conclusions. How wrong could I have been? The night of the banquet I have found him standing alone in a room thinking to himself.He said he would proceed no further with my plan. Well, I couldn’t believe it. I felt betrayed by my own husband. His will, was becoming a king but by his actions he would never reach there. To strengthen him up, I told him a few home truths. I said my husband is as weak as a newborn. He isn’t a man yet he cannot make up wise discussions. Anyways, after that he had said what if our plan fails and I then replied we will not fail because when Duncan is asleep you will go to his chamber and do as your fortune says.You will be the next king. After discussion he changed his mind and said he will do the deed. Then after I had given Macbeth the signal to go ahead with our plan. As I waited anxiously for the results, near Duncan`s room, I had to have a drink to give me strength and faith. I then started to imagine what was going on, but at one point I thought he had not done it. I could not have done it because Duncan resembles too much of my father. When Macbeth came back he was carrying two bloody daggers. Some warrior what Macbeth is!He just stood there saying awful and puzzling things and in the end I had to go back to hide the evidence so we could not get blamed for this event that occurred. After that we just washed our hands with water and went to get dressed into our nightgown to make it look like we just woke up. Macbeth was still frightened because of what he had done. Now I just hope Macbeth is king so I can be queen. I a m also concerned about him because he could instantly tell what he had committed, all what we have done can be lost. Love ,

Model of Filipino Values Essay

Philosophical basis Filipino values are for the most part centered at maintaining social harmony motivated primarily by the desire to be accepted w/in the group the main sanctions against the diverging from these values are the concept of ‘hiya’ roughly translated as a sense of shame and ‘amor propio’ or self esteem. Social approval acceptance by a group and belonging to a group are major concerns. Caring about what others will think say or do are strong influences on social behavior among Filipinos. According to the anthropologists LEONARDO MERCADO the Filipino worldview is basically nondualistic.based on his linguistic analysis of Filipino value terms like loob (Cebuano buot ),he includes that Filipinos desire harmony not only in interpersonal relationships but also with nature and religion while still remaining nondichotomous. Joenalyn & mayeth Models of the Filipino values F.landa jocano identified two models of the Filipino value system.the first is the exogenous model or the foreign model,while the second is the indigenous model of the traditional model .the foreign model is described to be a â€Å"legal and formal†model while the indigenous model is described as a â€Å"traditional and non formal’model or guide but is deeply embedded in the subconscious of the Filipinos.the foreign model was inherited by Filipinos from western cultures,particularly from the Spaniards and the Americans. Lovely, Amancia, & HANNAH ELEMENTS AND COMPOSITION Based on studies ,surveys opinions,anecdotes and other literature made by experts and researchers in relation to Filipino social values or Filipino core values along with the Filipino character or Filipino identity of a person or an individual known as the Filipino,the Filipino value system are found to possess inherent key elements,among them are optimism about the future pessimism with regards to present situation and events the concern and care for other people the existence of friendship and friendliness the habit of being hospitable religious nature respectfulness to self and others respect for the female members of society the fear of god and abhorrence of acts of cheating and thievery.the core values of Filipinos specially upholds the following items;solidarity of the family units security of the Philippine economy orientation to small groups personalism the concepts of†loob†or†kalooban†(meaning â€Å"whats inside the self†the inner self†or the â€Å"actual personal feelings of the self),the existence and maintenance of smooth interpersonal relationships and the feelings or needs of others (known as pakiramdam).in a larger picture,these values are grouped into general clusters or†macroclusters†namely,the relationship cluster the social cluster the livelihood cluster the inwardness cluster and the optimism cluster.

What Is an Acronym Definition and Examples

An acronym is a  word formed from the initial letters of a name (for example, NATO, from North Atlantic Treaty Organization) or by combining initial letters of a series of words (radar, from radio detection and ranging). Adjective: acronymic. Also called a  protogram. Strictly speaking, says lexicographer John Ayto, an acronym denotes a combination pronounced as a word . . . rather than as just a sequence of letters (A Century of New Words, 2007). An anacronym is an acronym (or another  initialism) for which the expanded form isnt widely known or used, such as OSHA (Occupational Safety and Health Administration). Etymology From the Greek, point name Pronunciation AK-ri-nim Examples and Observations Acronyms and AbbreviationsThe difference between acronyms and abbreviations is this: acronyms are proper words created from the initial letter or two of the words in a phrase, and they are pronounced like other words (cf. snafu, radar, laser, or UNESCO). By contrast, abbreviations do not form proper words, and so they are pronounced as strings of letters, for example, S.O.B., IOU, U.S.A., MP, lp, or tv.I have a couple of lists that I can refer to throughout the day, but I dont have the official FAT book yet. Yes, it really is called the FAT (Federal Acronym and Terms) book.Acronymic TextspeakMany acronyms meant to be written have wormed their way into spoken language--just ask your BFF, or the co-worker who prefaces everything with FYI. Lately, this is also the case for Internet slang.NIMBYNIMBY: from Not In My Back Yard--for a person who opposes anything scheduled to be built near his or her residenceFEMARe-branding FEMA (Federal Emergency Management Agency) doesnt fix the problem; it just puts a new acronym on it.The Ancient Roots of AcronymyAcronymy has ancient roots, as illustrated by the early Christian use of the Greek word ichthys meaning fish as an acronym for IÄ“sous Christos, Theou Huios, SÃ… tÄ“r (Jesus Christ, Gods son, Savior). In English, the first known acronyms (as opposed to plain old initialisms) cropped up in the telegraphic code developed by Walter P. Phillips for the United Press Association in 1879. The code abbreviated Supreme Court of the United States as SCOTUS and President of the as POT, giving way to POTUS by 1895. Those shorthand labels have lingered in journalistic and diplomatic circles--now joined by FLOTUS, which of course stands for First Lady of the United States. Sources Keith Allan and Kate Burridge,  Euphemism and Dysphemism. Oxford University Press, 1991Douglas Quenqua, Alphabet Soup.  The New York Times, September 23, 2011David MarinBen Zimmer, On Language: Acronym.  The New York Times Magazine, December 19, 2010