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Summary
Suchman proposed five stages of illness behavior, referring to reactions to symptoms. The first stage is the experience of symptoms. Some patients see a doctor at first sign of symptoms whereas others wait until an illness progresses to severe stages. The second stage of illness behavior is the assumption of the sick role, followed by the third stage of medical care contact. The fourth stage is the dependent-patient role, and the fifth is recovery and rehabilitation.
The ways individuals respond to an illness depend on the perception or interpretation of symptoms, including whether pain is a factor. Also important is the tolerance factor: how the patient is able to tolerate different degrees of pain. Knowledge and information also play a role in how the patient perceives and reacts to symptoms. Finally, availability or accessibility of care resources will determine how, when, and whether a person will seek treatment.
The sick role is a psychological and social state whereby the person is actively seeking modes of healing through the healthcare system. When assuming the sick role, the patient is absolved largely from personal responsibility. Although the sick role concept has led to the medicalization or pharmaceuticalization of conditions, it remains an important method by which to conceptualize patient attitudes and behaviors.
Discussion Questions
1. These readings show that illness is socially constructed. Besides the examples given in the text, such as ADHD, what can you think of as a prevalent condition that has been either medicalized (such as addiction) or demedicalized (such as gender identity disorders)? What are the implications in each of these conditions?
2. Why is it important to study the social construction of illness and healthcare? How can learning this help improve cultural competencies in healthcare?
3. Living with chronic illness and disability does result in the loss of social capital, and can exacerbate problems like shame, rejection, and financial insecurity. What types of policies or programs might help individuals overcome these additional problems beyond the root condition?
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