NSG 4055 Week 1 Discussion
I think that the factors listed can have varying impacts on a person, based in part on their particular chronic illness. For example, a patient with HIV might feel a greater impact of stigma and social isolation, whereas the stroke victim might deal with altered mobility and fatigue. The patient with Crohn’s disease might feel that chronic pain and fatigue are the prominent factors. Having said that, I think that of the factors listed, stigma is the worst factor a person can experience because stigma has no direct relationship to any particular disease process. This is an issue created by others and is a social aspect rather than a physiological aspect of an illness.
Acquired Immune Deficiency Syndrome (AIDS) is probably the perfect example of how stigma can have such an impact on people who have it. I can clearly remember in the eighties, when AIDS was gaining notoriety, the world’s blood supply was at risk because none of it had been tested as part of the acquisition process. This led to many hemophiliacs contracting HIV due to tainted blood transfusions. There was also a high incidence of HIV infections in the homosexual community (Moalusi & Judgeo, 2014). A person’s sexual orientation should not be cited as a causative factor; however, while the hemophiliac who contracted HIV was portrayed as a victim, the homosexual was portrayed as having some culpability, and some people even used their religious beliefs to condemn the homosexual and cited scripture and “god’s wrath” as the reason for their exposure to the disease (Stokell, 2009). The reality is that nobody knew what HIV was at the time or exactly how it was transmitted. The stigma associated with AIDS got so bad that national legislation was passed to protect those with the disease from being compelled to reveal their diagnosis to anyone. The subject of stigma and AIDS was the subject of the movie Philadelphia in which actor Tom Hanks earned an Oscar award for his portrayal of an attorney who contracted AIDS and lost his job because of his diagnosis (IMDb.com, 1993).
Considering a twelve-year-old versus a seventy-five-year-old with chronic illnesses, I think that the illness trajectory of the twelve-year-old would have a greater focus on illness management from a preventative standpoint, whereas the seventy-five-year olds trajectory might focus more on a symptomatic treatment with prevention taking a back seat. In the emergency room where I work, we typically see children with acute issues that might have chronic illnesses (i.e., the type one diabetic who presents with nausea, vomiting, and diarrhea), where our plan of care will be controlling the symptoms of his acute illness while being mindful of his blood glucose during treatment, and reinforcing the need to continue insulin therapy during the illness regardless of food intake. In the seventy-five-year-old patient, we might see peripheral vascular disease secondary to diabetes. In this case, we must provide education on why blood sugar control is critical to reducing the effects of PVD in the hope of improving circulation and maintaining the viability of the patient’s extremities.
NSG 4055 Week 1 Discussion
Choose one strength and one weakness of Parsons’s sick role. Do you agree with them? Why or why not? Justify your answers with the readings or articles from the South University Online Library.
A strength of the Parsons sick role model is that “to be ill is inherently undesirable, and hence there is an obligation to try to get well (Segall, 1976, p. 163). This statement places an obligation on the patient to try to get well and is coupled with another aspect of the model in which the sick person is obligated to seek out technically competent help. This is an obvious strength in that the sick person must take an active role in getting well by finding a physician to help him or her. There is some contradiction in the model, however, in that the sick person is obligated to seek help but has no responsibility to attain wellness. I think that seeking help should include an obligation to follow the directions of that help to attain wellness.
One weakness of Parsons’s sick role model is that “the occupant of the sick role is exempt from responsibility, as it is beyond his control” (Segall, 1976, p. 162). This idea that the sick person has no responsibility is (to me) like saying that a diabetic cannot be held responsible for controlling their blood sugar through diet and exercise because it is beyond their control. This is a ridiculous idea because it has been well-established that proper diet and exercise can contribute to a lower A1C and improve a diabetic patient’s health (Whittaker, 2010).
References
IMBb.com. (1993). Philadelphia. Retrieved April 18, 2015, from http://www.imdb.com/title/tt0107818/
Moalusi, K. P., & Judgeo, N. (2014). My secret: The social meaning of HIV/AIDS stigma. SAHARA-J, 11(1), 76-83. doi:10.1080/17290376.2014.932302
Segall, A. (1976). The Sick Role Concept: Understanding Illness Behavior. Journal of Health and Social Behavior, 17(2), 162-162.
Stokell, S. (2009). Stop the AIDS stigma. Slave River Journal
Whittaker, K. (2010). Diabetes. Nursing Standard, 25(10), 59-60. Retrieved from http://search.proquest.com/docview/807479949?accountid=87314
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Question 
There are many factors that affect chronic illness—chronic pain, stigma, social isolation, altered mobility, or fatigue. Utilizing your learning from your readings and the South University Online Library resources, respond to the following questions:
Based on the research, which of these factors has the greatest impact on a patient? Why? Contrast at least two ways the factors would affect a twelve-year-old with the way they would affect a seventy-five-year-old.
Consider the twelve-year-old and the seventy-five-year-old have a chronic. How does the chronically ill patient’s illness trajectory influence the plan of care?