Chronic health disorders is an illness that persists for a long period. Chronic health disorders include many major diseases and conditions, such as heart disease, cancer, diabetes, and arthritis.
In addition to fully understand reactions to chronic illness requires a consideration of the self, its sources of resilience, and its vulnerabilities.
The self is one of the central concepts in psychology. Self-concept is a stable set of beliefs about one’s personal qualities and attributes. Self-esteem refers to the evaluation of the self-concept—namely, whether one feels good or bad about one’s personal qualities and attributes.
A chronic illness can produce drastic changes in self-concept and self-esteem. Many of these changes will be temporary, but some may be permanent, such as the mental deterioration that associates with certain diseases.
The self-concept is a composite of self-evaluations regarding many aspects of life, which include body image, achievement, social functioning, and the private self.
The Physical Self in Chronic Health Disorder.
Body image is the perception and evaluation of one’s physical functioning and appearance. Body image plummets during illness. Not only is the affected part of the body negatively evaluate, the whole body image may take on a negative aura. For acutely ill patients, changes in body image are short-lived; however, for the chronically ill, negative evaluations may last.
These changes in body image are important.
- First, a poor body image increases risk for depression and anxiety.
- Second, body image may influence how adherent a person is to the course of treatment and how willing he or she is to adopt a co-management role.
- Finally, body image is important because intervention such as exercise can improve the body image.
The Achieving Self.
Achievement through vocational and avocational activities is also an important source of self-esteem and the self-concept.
However, many people derive their primary life satisfaction from their job or career; others take great pleasure in their hobbies and leisure activities.
If chronic illness threatens these valued aspects of the self, the self-concept may be damaged. The converse is also true: When work and hobbies are not threatened or curtailed by illness, the patient has these sources of satisfaction from which to derive self-esteem, and they can come to take on new meaning.
The Social Self.
The aspects of one’s identity or self-concept that are important to or influenced by interpersonal relationships and the reactions of other people. Also it is a person’s characteristic behavior in social situations.
Social resources, such as family and friends, can provide chronically ill patients with badly needed information, help, and emotional support. A breakdown in the support system has implications for all aspects of life. Perhaps for these reasons, fears about abandonment by others are among the most common worries of chronically ill patients. Consequently, family participation in the illness management process is widely encouraged.
The Private Self.
Chronic illness affects the residual core of a patient’s identity, ambitions, goals, and desires for the future. They can delay the adjustment because the patient has an unrealized dream, which is now out of reach, or at least appears to be. For example, the dream of retiring to a cabin on a lake in the mountains may not be viable if the management of a chronic condition requires living near a major medical center.
However, encouraging the patient to discuss this difficulty may reveal alternative paths to fulfillment and awaken new ambitions, goals, and plans for the future.