Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:The Culture of Health Care
Unit:An Overview of the Culture of Health Care
Lecture:What is meant by "the culture of health care"
Slide content:Defining Terms: Disease and Illness Disease : malfunction or maladaptation of biologic or physiologic processes. Acute Illness : temporary interruption of health Goal: restore complete health examples: common cold, simple fracture Chronic illness : stable disability or symptoms Goals: minimize symptoms, maximize function examples: diabetes, asthma, back pain 7
Slide notes:Disease and illness are not the same. Arthur Kleinman [ kline-mihn ], in an often cited 1978 article, emphasized the distinction between disease and illness. According to Kleinman [ kline-mihn ], when we talk about disease, were referring to malfunction or maladaptation of biologic or physiologic processes. This is the traditional focus of physicians when they diagnose and treat disease. But Kleinman [ kline-mihn ] emphasizes the importance of illness by referring to the individual experience of the person who's suffering personal, interpersonal, and cultural reactions to disease or discomfort. While disease is determined mainly by biologic and physiologic processes, illness is shaped by cultural factors that govern perception, labeling, explanation, and valuation of the experience. Its also important to understand the difference in health care between acute illness and chronic illness. With an acute illness most of us expect that our symptoms will be short-lived and that eventually we will be restored to our previous normal health. Examples are things like a common cold, a mild infection, or a simple fracture. On the other hand, with chronic conditions such as high blood pressure or diabetes, we expect the condition will last indefinitely. In these situations, the goal cannot be to restore normal health. Rather, the goal of patient and clinician alike is to maintain the highest level of function and the lowest degree of symptoms that can be obtained. Problems can arise when we confuse these, for example when a person with a chronic illness thinks of it as an acute illness and expects to be cured and restored back to their normal state. Part of the management process in these situations is to help a person change their thinking and revise their expectations. For many people with chronic conditions such as diabetes, high blood pressure or asthma, health means that things are pretty stable, symptoms are not too troublesome, and the person is able to get on with their life and function normally, even if this requires medication. 7