Sick role

It has generally been assumed by alcoholism treatment personnel in most industrialized countries that the disease-labeling process and the alcoholic s concomitant acceptance of the "sick" role would facilitate treatment and potentiate the chances of rehabilitation. Some writers... however, question the utility of indiscriminate application of the disease label, not only because it may not be appropriate for all varieties of alcohol-related problems, but also because it may influence the very behavior it attempts to describe. This could come about... by altering the cognitive expectancies held by alcoholics and by those in their immediate social environment, such that the drinker no longer is seen as responsible for his or her behavior. In this view, loss of control over drinking may result more from learned expectations than from physical predispositions, and chronic alcoholism more from a dependency role than from physiological dependence. 

Patient demographics Aging population Females as decision makers Ethnic composition of patients Attitudes and belief systems Beliefs about disease, sick role, and medication-taking... 

People eager to play the sick role seek medical services for, and other benefits from, being sick and disabled hence, they may be of great economic value to doctors and lawyers. Consider how Barsky and Boms describe the clients Physicians in many medical specialties are increasingly confronted by patients who have disabling, medically somatic symptoms and who have al-... 

It is a fallacy to assume that persons called patients are sick, and vice versa. We must distinguish between being ill and being a patient, between having an abnormal biological condition called disease and occupying the social status called the sick role. Although many sick persons are patients, and many patients are ill, it is obvious that a person may be sick and not be a patient, and that a person may be called a patient and not be sick. 

People s reactions to her, e.g. undermining/reinforcing the sick role. 

Unlike malingering, the gain here is usually formulated as an unconscious need to adopt the sick role. In reality, there s usually a mix of primary and secondary gain. Again, you need proof of deliberate feigning or production of symptoms. Specifically assess risks from iatrogenic/self-inflicted medical problems or suicide. Support the medical team to raise their concerns with the patient, explaining ... 

Other children have difficulty shedding the sick role they played while in the hospital to assume the role of student in school. Because they have been necessarily dependent on parents and health care providers, they may be less well equipped to meet the challenges of autonomy, achievement, and peer acceptance valued by their classmates. As a result, some children may replace developmen-tally appropriate goals of independence and achievement with more regressive attempts to maintain caretaking behavior by teachers and peers. Some may feign inability to perform a task to avoid having to do it. 

The hypothesis of Gray and Bonner (31, 32) that 3-acetyl-6-methoxybenzaldehyde, which is found in the leaves of Encelia farinosa and in the soil beneath these plants, is responsible for the suppression of other plant species has not been substantiated by Muller (33, 34). The same is true for the presumed role of trans-cinnamic acid in "soil sickness associated with guayule (Parthenium argentatum), for the amygdalin of peach roots, and for the phlorizin of apple roots or its breakdown products (35), which were thought to be associated with the "soil sickness" of orchards. 

Family dynamics can change radically when one member has a sickness and disability and needs a lot of care. It was difficult for all of us. My relationship with them had been one of rebellion and defiance, typical for a precocious teenager in the 60s and a 20-year-old in the 70s. I didn t want to share their house or their values, but there I was, completely dependent on them again, and they were pretty much stuck with me in this condition. There was nothing to do but submit to this child role. I didn t know if I d get well or not, but I felt stronger after a couple of years, and that had to be good enough. I stayed with my parents for almost three years. 

A. Liposomal amphotericin B was approved by the US. Food and Drug Administration to treat visceral leishmaniasis. Pentavalent antimony compounds, pentamidine, amphotericin B, and aminosi-dine (paromomycin) have all been demonstrated efficacious here. The liposomal amphotericin appears to be better taken up by the reticuloendothelial system, where the parasite resides, and partitions less in the kidney, where amphotericin B traditionally manifests its toxicity. In addition to being better tolerated by patients, it has proved to be very effective in India, where resistance to antimony drugs is widespread. This patient appears to have acquired his infection there, where many infected patients develop darkening of the skin, hence the name kala-azar, or black sickness. Albendazole, an anthelmintic, has no role here. Atovaquone, a naphthoquinone, is used to treat malaria, babesiosis, and pneumocystosis. Pyrimethamine-sulfadoxine is used to treat malaria and toxoplasmosis. Proguanil inhibits the dihydrofolate reductase of malaria parasites and is used in combination with atovaquone. 

Ginger has carminative, diaphoretic, and antispasmodic properties. Traditionally, it is used for colic, flatulent dyspepsia, and specifically for flatulent intestinal colic. Its role in the prevention of motion sickness is also being researched. 

Selective 5-HT3 receptor antagonists have potent antiemetic properties that are mediated mainly through peripheral 5-HT3 receptor blockade on intestinal vagal afferents. In addition, central 5-HT3 receptor blockade in the vomiting center and chemoreceptor trigger zone probably plays an important role. The antiemetic action of these agents is restricted to emesis attributable to vagal stimulation other emetic stimuli such as motion sickness are poorly controlled. 

Medical expectations. Some ill-prepared subjects unconsciously impose a medical model on the experience. They look for symptoms, interpret each new sensation in terms of sickness/health, place the guide in a doctor-role, and, if anxiety develops, demand chemical rebirth - i.e., tranquilizers. Occasionally one hears of casual, ill-planned, non-guided sessions which end in the subject demanding to be hospitalized, etc. It is even more problem- provoking if the guide employs a medical model, watches for symptoms, and keeps hospitalization in mind to fall back on, as protection for himself. 

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