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KMID : 0378019910340120139
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New Medical Journal
1991 Volume.34 No. 12 p.139 ~ p.148
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The Impact of Illness on the Functioning of Individual and Family
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Abstract
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This article has attempted to provide a conceptual base for thinking about the system created at the interface of illness with the family and individual life cycles.
Physical Illness, disability, and injury are. seen as disruptive of biological equilibrium which, in turn, disrupts the affected person´s psychosocial ability ,to function. The disruption is serious enough to render habitual behavior patterns inadequate, a biopsychosocial crisis results which leads to a state of disorganization often accompanied by anxiety, fear, guilt, and. other unpleasant feelings which contribute to further disorganization.
The concept of quality of life has been defined as an evaluation of four domains of human life i.e. physical state, psychological well-being, social integration and functional capacities. Basically, three types of research questions with regard to the efficacy of treatments to patient´s quality of life can be distinguished : (1) documentation of effects after treatment ; (2) comparisons of effects over time of different treatments ; (3) evaluation of effects for individual patients.
In the arena of physical illness, particularly chronic disease, the focus of concern is the system created by the interaction of a disease with an individual, family, or other biopsychosocial system. It is crucial to understand the intertwining of three evolutionary threads : the illness, individual, and family life cycles.
Psychosocial illness types, time phases of illness, and components of family functioning constitute the three dimensions. This model offers a vehicle for flexible dialogue between the illness aspect and family aspect of the illness/family system. In essence, this model allows speculation about the importance of strengths and weaknesses in various components of family functioning in relation to different types of disease at different phases over the illness life course.
The notion of centripetal and centrifugal modes is useful in linking the illness life cycle to the individual and family life cycles. In general, chronic disease exerts a centripetal pull on the family system. Symptoms, loss of function, the demands of shifting or new illness-related, practical and affective roles, and the fear of loss through death all serve to refocus a family inwardly.
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