• Briefly describe stages of illness behaviour as described by Suchman:  The symptom experience stage  Assumption of the sick role  The medical care contact stage  The dependent patient role  The operative phase  The post-operative phase  The recovery and rehabilitation  The terminal phase • Briefly discuss the stressful experiences associated with hospitalisation and contact with other health facilities under the following headings:  Loss of privacy  Loss of independence  Depersonalisation and the loss of identity

1. THE PATIENT AND THE
HOSPITAL
STUDY UNIT 9.2
BY C SETTLEY

2. LEARNING OUTCOMES
- Briefly describe stages of illness behaviour as described by Suchman:
- The symptom experience stage
- Assumption of the sick role
- The medical care contact stage
- The dependent patient role
- The operative phase
- The post-operative phase
- The recovery and rehabilitation
- The terminal phase
- Briefly discuss the stressful experiences associated with hospitalisation and contact -
with other health facilities under the following headings:
- Loss of privacy
- Loss of independence
- Depersonalisation and the loss of identity

3. 8 STAGES OF ILLNESS
BEHAVIOR. PAGE 201
1) The symptom experience stage
- Realization that something is wrong
- Self medication to alleviate symptoms
2) Assumption of the sick role
- Acknowledgement of sickness
- “off sick” at work
3) The medical care contact stage
- Doctors visit
- Sickness is substantiated by the medical doctor or
sangoma

4. 8 STAGES OF ILLNESS
BEHAVIOR
4) The dependent patient role
- The sick person becomes the patient
- Subjected to diagnoses, sick role and treatment
5) The operative phase
- Mystery surrounding the disease
- Bodily functions
- Previous operations
6) The post operative phase
- Acute phase: the conscious and unconscious state
- Sub- acute phase: when the patients consciousness
overrules the subconscious
- The will to survive becomes dominant

5. 8 STAGES OF ILLNESS
BEHAVIOR
7) Recovery and Rehabilitation
8) The terminal phase
Symptom
experience
Role
assumption
Medical care
contact
Dependent
patient
Operative
phase
Post operative
phase
Recovery and
rehab
Terminal

6. STRESS ASSOCIATED
WITH HOSPITALIZATION
PAGE 203
LOSS OF PRIVACY
- Patients who demand single rooms
- Contagious diseases
- Facilities are shared
- Restriction of visiting hours
- Information shared among medical team
- Important aspects during handovers

7. STRESS ASSOCIATED
WITH HOSPITALIZATION
LOSS OF INDEPENDENCE
- Responsibility towards own health some what taken over
by medical team
- Patient may become unable to see to own care
- Social roles compromised
- Responsibilities are compromised
- Valuables and clothing. Referred to as ‘stripping’

8. STRESS ASSOCIATED
WITH HOSPITALIZATION
DEPERSONALISATION AND THE LOSS OF IDENTITY
- When patients are being referred to as a medical disease,
the number of their bedroom, organs, procedures
- Reduces patient’s self-esteem, humanity

9. Study unit 9.3
PATIENT RELATIONSHIPS IN HOSPITAL

10. PATIENT RELATIONSHIPS
IN HOSPITAL
THE PATIENT AND
THE DOCTOR
- Medical staff become
important to a patient
once admitted
- Doctor contact and
communication
- Privacy
- Doctors rounds
- Sometimes Patients are
frightened to approach
doctors themselves
THE PATIENT AND THE
NURSING PERSONNEL
- Nursing profession
responsible for 24 hour
care of patients
- Nurses have administrative
and educational roles to
fulfill at the same time
- Obliged to delegate
- Estrangement due to
perception of public

11. PATIENT RELATIONSHIPS
IN HOSPITAL
THE PATIENT AND HIS/HER
FELLOW- PATIENTS
- Relationships are
formed
- Speculation about
complaints, treatment,
etc
- Variety of norms

12. PATIENT RELATIONSHIPS
IN HOSPITAL
THE NURSING PROFESSIONAL AND THE
PATIENT’S FAMILY
- Difficult to define
- Family must be regarded as clients
- The patient is the primary client
- The family is the secondary client
- Interference in progress of health
- Potential threat to nursing professionals
- They share the same objective- recovery of the patient
- Value to family participation
- Family members expect nurses to be available at all times.
Makes it difficult to pay equal attention to all patients
- Complaints about Domestic problems

13. PATIENT RELATIONSHIPS
IN HOSPITAL
THE NURSING PROFESSIONAL AND THE
PATIENT’S FAMILY
- The silent family
- Minimal/no active force
- The routine family
- Some or other direct action
- Wants nursing personnel to be aware of them
- May constitute a potential threat
- They may have complaints, and become emotional and may interfere with the
treatment
- Routine: these family members are accepted as more or less part of the routine; in
other words they are not too pleasant, but still tolerable
- The crisis family.
- Direct threat to medical team/nursing staff
- Intrude on privacy between the patient and the nursing staff
- Eg when asking the family member to leave the ward, it might end in conflict

14. REFERENCE
Du Toit, D.A. & Van Staden S.J. (2009). Nursing Sociology. 4th
Edition. Pretoria: Van Schaik