Discussion of Chronic Illness Taboo
Perhaps I should open a category called How About That?
More and more often it seems that I run across interesting items that are pertinent to patient compliance but are of limited immediate use. And, often the findings are congruent with widely accepted assumptions.
And so it is with …
The Difficulty Of Talking About Chronic Disorders
The essentials follow: A just released survey of more than 1,000 adults commissioned by Evercare (a provider of health plans for people who have chronic illnesses, are older, or have disabilities) found that
- 82 percent of respondents said they knew someone with a chronic illness, but only 34 percent were likely to suggest ways for this person to better manage their care. That’s about the same number who said they’d debate politics (37 percent) or religion (33 percent) with a loved one or friend.
- Respondents were more likely to discourage friends or loved ones from buying the wrong house (65 percent), loan them a large amount of money (56 percent), advise them against taking a job they didn’t think was right for the person (48 percent), and tell them their spouse was unfaithful (41 percent).
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The reasons why many Americans are reluctant to offer advice to chronically-ill friends or family include: They think the person has the situation under control (66 percent); they are not a health care professional (31 percent); they don’t want to seem like a nag (31 percent) or rude (29 percent); they don’t believe the person would listen to them (27 percent); or they didn’t think the matter was that important (15 percent).
Commentary
It seems useful for a clinician to know that most of us are uncomfortable talking to friends and families about their chronic disorders (well, let’s make that it seems useful to know that a survey of 1,000 subjects indicates that most of us are uncomfortable talking to friends and families about their chronic disorders). If nothing else, clinicians should understand the difficulties of developing a social support system and the importance of giving patients enough time to tell their stories - since no one else is likely to do so. Beyond that awareness, however, it is difficult to see how it can be used in day to day clinical practice.
Like I said, How about that?
Source: Chronic Illness Often a Taboo Subject: Survey
Many Losers In Patient Medication Quiz »
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I saw this same study and I’m going to post it on my blog because even with a small sample, people living with chronic illness need to hear this message — that “others”, the “healthy people” don’t know what to say or do.
But, I don’t agree with your conclusion that this isn’t something that clinicians interested in creating more compliance among patience can put into use. I coach people who live with chronic illness about their workplace success (starting with keeping your job!) and we work on the chronically ill person’s behavior. The assumption being it’s hard enough to change your own behaviot — why take on the rest of the world? So, when talking with a patient about the medical condition and its impact, the clinician can pointedly bring up that this is often an isolating experience for MANY people and that the he/she understands that patients have to work hard to communicate with others. The clinician can point out that others are hesitant (and well they should be since all too often they say the wrong thing at the wrong time) to bring up the illness, so the patient might have been social or work experiences if he/she takes an active approach around communication.
Clinicians are very busy and they don’t have to take 20 minutes to listen to each person’s story but it can be very helpful if they bring up difficult subjects and offer straightforward and non-directive suggestions to encourage action.
Rosalind Joffe
Comment by Rosalind Joffe/KeepWorkingGirlfriend.com — October 14, 2007 @ 12:52 pm