Illness and Disease

1. Illness and Disease Lawrence Pike

2. Illness and Disease Introduction Topics discussed include: The Clinical Iceberg The Differences between Disease and Illness Doctors and Patients Agenda Illness Behaviour The Sick Role Assessing Illness

3. Illness and Disease Irritable Bowel Syndrome and Dyspepsia, have been associated with stress and anxiety in medical textbooks. In fact, control studies show that this is not the case. However the more anxious sufferers consult their doctor. It is important to consider how this misunderstanding has come about.

4. The Clinical Iceberg 90% of people declare themselves to have been ill in the last 2 weeks 1 in 37 of symptom episodes will be declared to Primary Care. This is the Clinical Iceberg

5. Disease What is Disease? The biological process that doctors use to explain and understand illness

6. Illness and Disease The process of diagnosing disease is central to medical education. This becomes the doctor�s agenda However in at least 25% of GP consultations, no disease specific diagnosis is available We must understand then what the illness means to the patient � the patient�s agenda

7. Illness What is Illness? Definitions vary and patients and doctors will disagree! The patients experience of a physical or psychological disturbance

8. Illness Behaviour Symptoms of Illness may be differently perceived, evaluated and acted upon by different kinds of people. This is sometimes called �Illness Behaviour�

9. Illness Behaviour Culture Presentation Health beliefs Sex Social Class Access to health care Learned behaviour Triggers (home, work, TV, family and friends)

10. The Sick Role Obligations Must seek professional help Make an effort towards recovery Privileges Exempt normal social obligations Not responsible for incapacity

11. Assessing the Illness Patient Centred Approach Understanding the illness in the patient�s terms Responding to patient�s cues Exploring Ideas, Concerns, Expectations and Affect on daily living Guard against making assumptions