Nursing theories
open access articles on Nursing theories and models
APPLICATION OF SUCHMAN’S STAGES OF ILLNESS MODEL
Introduction
- Man is a social being.
- Social factors play important role in health.
- Social conditions and not only promote the possibility of illness and disability, they also enhance prospect for disease prevention and health maintenance.
- Health life style and the avoidance of high-risk behaviour, advance the individual’s potential for a longer and healthier life.
- The recognition of the fact that the health of an individual is more than biological phenomena has brought in to the forefront the significance of behavioural dimension of health.
Mr. AS, a 73 years old, Muslim, male patient admitted in ---ward of ---Hospital with a diagnosis of prostate cancer. Data regarding psychosocial aspects of his life and illness were collected through inSeptember 9, 2013rt. But later he was found to be reluctant to talk ...as he was frequently expressing his financial troubles which could not be helped by anyone related to him
Cancer Prostate
Prostate cancer is the fifth most common type of cancer in men and its incidence rises with advancing years. It occurs in 1 in 10 in the men living to the age of 70 years. Early clinical features are indistinguishable from those of BPH and the gland may feel normal on digital examination. The PSA may be elevated (>4 ng/ml). As the tumour grows locally it may produce bladder neck obstruction, obstruct the ureters and rapidly lead to renal impairment. In late disease rectal examination shows the prostate to be large, hard and irregular. Rectal ultrasound may show the spread of the cancer and this should also be used for directing needle or aspiration biopsy. Prostatic biopsy is important in giving prognostic information- prognosis being poorer with poorly differentiated tumours.
Therapy depends on staging. Early disease is treated with local radiotherapy and more advanced disease by orchidectomy and hormone therapy with oestrogen. It has been suggested that all men over the age of 50 years should be screened by rectal examination, transrectal ultrasound and PSA measurement.
PatientProfile
General information
- Name : Mr. AS
- Age : 73 years
- Gender : Male
- Marital status : Married
- Place : ---/ ----
- Hosp. No. : ------
- Date of admission : 1-4-08
- Ward/Unit : --------
- Education : No formal education
Culture & life-style
- Religion : Islam, Muslim, believes in 'Durgas', and has gone there too.
- Food habits : four time in a day & Non-vegetarian once in a day
Socioeconomic condition
- Lower socioeconomic status
- Occupation
- Fisher man for 12 years
- He was a beedi worker for 10 years
- went to gulf and worked there for 4 years
- Cook for 35 years
- His son is in Gulf country, but earns only Rs.5000/month
- His residence is about 80 km away from ----,
- to and fro journey costs rs.50/ person
Role in the family
- Head of the family, earning member, and father
- These role are affected due the illness “ everything is disturbed at home”
Social Support Network
- Patient has poor social support network
- There is no one to support him financially for treatment of his illness
- His daughter visited him twice in the hospital, no other person visited him or enquired him about his illness after coming in the hospital
Patient complaints (on the first meeting)
- Pain at the genital area (on catheterization)
- Urine tube needs to be removed
- No taste for anything he eats
- No money in hand to pay the hospital bill
- No sleep at night
Identification of patient needs |
Collection, observing/ performing activities relating to caring |
Interpretation and analysis |
Needs arising from present illness and the consequent response to cope with |
·
“I have pain at genital region” |
· Patient’s main complaints are pain, irritation at the site of urinary catheter, and sleep disturbance ·
He was a cook, working most of his life in night
time for marriage parties |
Basic physical needs |
· He
is advised not to take bath till the end of
radiotherapy to avoid skin excoriation at the site |
· He
says is a practicing Muslim |
Needs related to life style |
· He
is a non-vegetarian |
· His life style related needs hindered in this hospital environment |
Needs related to habits |
· He
does not take tea or coffee |
· As he has any regular habits of taking tea or coffee or drinking alcohol |
Individual’s knowledge and experience of illness |
Patient’s Knowledge of
Present illness |
·
Patient has understanding of the illness as his
illness is serious. |
Experience of illness |
What has been his past
experience with illness? |
·
Patient has consulted many folk doctors for minor
illness and never satisfied with them.
·
Patient has accepted the illness as some thing which
he does not deserve. |
Knowledge of formal and alternative therapies |
· He
has adequate information about formal and folk
medicines |
He had tried alternative medicines and found to have no benefit in his illness |
Knowledge at
present and future course of action. |
·
Patient says he has one month duration of x-ray
treatment |
·
Patient has only partial knowledge of his illness
and treatment plans |
Coping with the illness and its outcome (Patient and family) |
·
“What will we do?” |
·
Patient is not showing adaptive responses |
Analyse the
individuals and family’s views on |
·
“Doctor People come and asks how you are? (he
explains sarcastically), nothing else” |
He is not satisfied
with the psychological attention given to him by
nurse or doctor |
Distinguish between the meanings of the patient, doctor, nurse |
Patient: “they
are not asking me anything” |
Patient wants to know about his illness, and course of treatment, but doctor is preoccupied with the patient’s educational status. Nursing staff is
bothered whether they may convey wrong message to
the patient. |
Observe the patient, doctor and nurse interaction |
What patient says has
reason. |
The mutual interaction among the treating team and patient is missing in this situation |
Suchman’s Stages of illness Model
Conclusion
Mr. AS has been suffering form Prostate cancer for the last 1 year. But his symptoms started about 4 years back. For about 3 years he tried folk remedies based on the advice of other people. He approached medical advice when his symptoms aggravated. He is currently undergoing radiotherapy for prostate cancer and medications for diabetes and other symptoms. This case study helps to understand the psychosocial aspects of illness development and application illness behaviour model in nursing practice.
References
- Guptha MC, Mahajan B. Text book of Social Medicine, 3rd Edn. JayPee, ND,2003
- Coe RM. Sociology of Medicine. McGraw-Hill Inc. New York, 1978.