Psychological Reactions to Physical Illness: Stages and Determinants
Psychological Reactions to Physical Illness
The psychological reactions to a disease significantly influence the adaptation process and the patient’s relationship with the healthcare team.
Chronic Psychological Symptoms
- Depression
- Anxiety
- Stress
- Somatization disorder
Depression
Symptoms include disinterest, discouragement, a depressed state, slowed thinking, guilt, weight loss, insomnia, fatigue, and thoughts of death.
Anxiety
Characterized by excessive worry, impatience, irritability, sleep disturbances, and panic attacks.
Somatization
Involves the presence of many symptoms not explained by physical findings, with multiple complaints across various organs.
Post-Traumatic Stress
Features fear, hopelessness, intense horror, memories of the trauma, and physiological discomfort.
Stages of Emotional Response
Denial
Denying the diagnosis, believing it may be wrong, negating the situation, and experiencing feelings of loneliness and isolation.
Health Team Task: Be ready to deliver information, always tell the truth, ask for understanding without pressure, and respect emotions.
Anger or Rage
Frustration and repulsion. Be tolerant, listen, and understand that other relatives may go through the same stage, with feelings of envy and resentment.
Health Team Task: Do not enrage, manage high stress for the team, empathize, and do not take it personally.
Negotiation
Short-term attempts to get more time or change the diagnosis, such as seeking more time in exchange for organ donation.
Depression
Beginning to accept the situation, assuming the diagnosis, experiencing depression and anxiety, and needing space to express themselves.
Health Team Task: Distinguish between clinical depression and common emotional responses, provide emotional support from family, do not abandon, and give space.
Acceptance
Assuming what happens, with the family requiring more support than the patient.
Determinants of Patient Response
Age
Healthcare providers relate to patients of different ages, requiring different language and information in consultations.
- Pediatric Patients: Tendency to neglect patients, but interaction with the caregiver is crucial. As age increases, so does interaction. Children interpret what they hear and can misinterpret information.
- Older Adults: Consult more frequently, have more health problems, many physical and few psychological factors. Stereotypes include being boring, limited, and covered. A more paternalistic model is often used.
Gender
Women consult more for health problems than men, receive more information, receive short answers but ask more questions. Healthcare providers are more involved in the conversation, interrupt doctors less, and men participate more in decision-making.
Why? This happens due to different communication styles.
Socioeconomic Level
Healthcare providers give more information to people from higher social levels, use less technical language, and consultations are longer.
Why? Higher social status individuals ask more questions and express more concerns and fears. Those at the lowest level are much less interested in information.