Holistic Caring Approach to Rheumatoid Arthritis

Introduction

The narration of a story, irrespective of whether it relates to other people or is about oneself, is the same across the world. The advancement of language in human life, both on a personal and evolutionary basis, leads to the intricate use of metaphors and features of speech. This leads to the formation of a narrative. Human societies rely on such symbolic inventories in order to attain a minimum social integration. In such circumstances, narratives convey and comprise an infinite pool of meanings and comprehension. Nonetheless, these are inhibited by linguistic rules and social customs. Language and narrative assist in sustaining and establishing the fabric of everyday life. In addition, they participate prominently in the reparation and refurbishing of meanings when they are in jeopardy. Under circumstances of adversity, individuals often sense a pressing need to re-evaluate and refurbish their personal narratives in an effort to maintain a feeling of identity (Johnson, 1987).

Hence, universal, cultural, and personal levels of human survival are embedded with the narrative threads. Individuals are not only born into complex social narratives, but they also experience, comprehend, and guide their lives as narratives. Whatever human rationality is contained in, it is unquestionably tied up to the story structure and the pursuit for narrative unity. Therefore, individuals recognize themselves inevitably in narratives. In the modern era, the study of narratives has gained considerable awareness in both human and socio-cultural sciences. This is particularly in anthropology and sociology as opposed to medical issues. The study of illness narratives has dual processes in the evaluation of these dynamics. The evaluation of chronic illness narratives may shed light on the characteristics of disrupted experience, as well as its connotations and steps are taken to handle it. However, the investigation of such narratives has the capacity to reveal a broader set of significant issues relating to the bonds between identity, encounters, and late modern cultures (Taylor, 1989).

Literature Review

The literature on the history of medicine defines the significance of illness narratives, specifically focussing on the increase of doctor-patient rapport in modern times. The ability of a doctor to take a history from a client exhaustively was important before the introduction of the biomedical model of illness during the comprehension of disease. This information included the client’s lifestyle, moral attitudes, and the broader environment in which the client lived. Eschewing all but the most fundamental physical evaluation of the client, the aristocratic doctors of the 17th and 18th centuries were required to attend to their client’s narratives and develop management regimens appropriately. Occasionally, this was done through procedures that reinstated the body’s equilibrium. These procedures involved bleeding, cupping, and purging, and they were implausible to bring forth an efficacious result. However, they only served to strengthen the need for the practitioner to focus on attending to the client’s narrative (Lawrence 1994).

The advent of scientific biomedicine was associated with the development of present-day hospitals and laboratories. In this case, the significance of the client’s experience, as well as the narrative of the client, maybe perceived to have diminished. The research and management of disease became alienated from the individual and was situated within the body systems only knowledgeable to the experts. Therefore, the need to listen to clients was reduced to extracting information about the impartial signs and symptoms of the ailment (McSherry & Ross, 2010). In the 19th and 20th centuries, the role of doctors was to interpret these pieces of information into a conclusive diagnosis that connected the disease to certain biological origins and outcomes. This was opposed to the clients’ contexts or lifestyle, as well as their beliefs or values. The 18th-century medicine had been preoccupied with the natural and with the disease as a digression from the individual client’s natural state. On the other hand, the developments in the 19th century became concerned with the normal and disease as a departure from statistical norms. This was free from exact experiences or circumstances (Featherstone, 1992).

Critical Assessment

There are sociological interpretations on the progressive divergence of the medical approach of disease. This is from the amateur experience of illness and the increasing power of the clinical profession in the 20th century. This is in respect to the description of what constitutes and what does not constitute illnesses. The interpretations have highlighted the adverse effects of the recognizable gulf between amateur and professional worlds (Friedson, 1970). In Europe and North America, the notion of a disease as individual pathology had developed into a dominant paradigm by the 1920s. This was indistinguishably linked to the growth of a bounded clinical profession that exercised almost absolute jurisdiction over illness and its management. The hastening of this process with the gargantuan expansion of the medical and surgical management techniques from the 1940s and beyond only tended to reinforce the propensity to render the client passive. Subjective descriptions of the client were virtually irrelevant (Lawrence, 1994).

However, though many inquiries have emphasized the overwhelming of the clients’ view by biomedicine, many factors have proceeded to bring amateur narratives back into the spotlight in recent years. The two procedures are critical to note. In the first place, there is the relative decline in the significance of the infections upon which the biomedical paradigm was founded, coupled with the increasing impact of deteriorating and chronic illnesses (Strauss, 1995). The daily experience and medical practice have progressively had to contend with the consequences of an aging population and the associated predominance of degenerative physical and psychosomatic illness. Therefore, administration and care have supplanted treatment and cure (Bury, 1997). Secondly, the health care systems yield to renewed prominence on primary care. In this case, the advanced technological, biomedical care continues to be expensive to afford and is exposed to accumulative questioning and assessment (Strauss, 1995). There has been an active debate within principle care and general practice concerning the value of holistic medicine and of paying attention to the client. This has presented a chance for clients’ narratives to be given the opportunity and attention. This was initiated in Britain during the 1950s (McSherry & Ross, 2010). Currently, illness narratives and connections to history taking in medicine have been linked with measures to improve the care. These measures do not depend on what may be considered as a constricted view of scientific medicine or its assessment and procedures that are evidence-based (Greenhalgh & Hurwitz, 1999).

In contingent narratives, evaluation of illness narratives is involved with those features of the patient’s story or descriptions that are related to beliefs, as well as understanding factors that influence various aspects. These aspects include the inception of the disorder, its emerging symptoms, and the proximate outcomes on the body, personality, and others. Caution should be taken not to transform narratives and stories into ideas, norms, and explanations of illness. Amateur responses to sickness often draw upon and comprise culturally accessible concepts of disease and illness. These concepts robustly influence the molding of narratives. For example, in a study carried out on arthritis by Bury (1982), it was revealed that respondents’ narratives went back and forth between amateur concerns and perceptions and developing familiarity with medically-based ideology. Surprisingly, it was difficult to differentiate where the expert and amateur modes of thinking commenced and terminated (McSherry & Ross, 2010). This was predominantly evident when the issue of causation was deliberated. Patients would often discuss the beginning of the condition with reference to the probable effects of incidents occurring at the time of the commencement, yet maintaining an open mind to stringent medical explanations. A respondent recollected a series of hardships with her seven-year-old son before the beginning of the illness. This led to the collapse of the son in a school where, fortunately, she was an employee (Bury, 1982).

Discussion of personal engagement with the topic or theme

The narrative of this woman’s illness had a number of elements that touched on the issue of beginning and probable causation. The elements also touched on her social condition from which her illness generated another component of hardship. Throughout the experience of her own and her son’s illness, she relied on ideas and forms of amateur knowledge that were frequently difficult to distinguish in terms of distinct spheres of amateur beliefs and medical expertise. Both were required to construct a consequential account of the progressing events, which can be referred to as illness narrative—this incorporated symptoms and outcomes of the illness into a new whole (Hyden, 1997). There has been a detailed study on the beginning of arthritis from a long discussion with another patient. This study showed how contact with medical staff and members of a social group, including co-workers, could present complex settings in which the eventualities of illness onset may arise. In this instance, the progression of symptoms could not be identified as a specific event; however, it is developed over several months. Frequent visits to the general practitioner started to imply that her aches and pains were far much more than usual wear and tear. In one incident, the doctor suggested that the condition could be rheumatoid arthritis and suggested administering aspirin for her symptoms (Burry, 1982).

If contingent narratives define events, their immediate causes, and progressing effects concerning the performativity in daily life, moral narratives present an evaluative dimension into the connections between the personal and social. Here, valuations appear as patients seek to account for and conceivably justify themselves in the changed relations of society, self, and body instigated by illness. If narratives provide an ordering of experience in light of disruptive occurrences, they also provide expression to hidden dynamic relations among individuals and their social contexts (Good, 1994).

For example, in Williams’ (1984) paper on narrative reconstruction, the redirecting experience because of illness involves taking into account the patient’s beliefs about the etiology of the situation and its role in their lives. However, the amateur narrative that Williams (1984) illustrates brings together moral concerns that link the family background, concurrence of symptoms and biographical incidents, and the specific social contexts in which a part of them happened. A man’s accounts emphasized the occurrences surrounding exposure to noxious substances in the work environment and the beginning of his illness. Through the story, this respondent could describe himself as a dynamic and politically knowledgeable individual, as well as a casualty of circumstance (Williams, 1984).

More significantly, perhaps in the present context, is the illustration of Gill in Williams’s narrative. For Gill, the commencement and progression of illness interacted strongly with other occurrences in her life. This included her daughter’s departure from home, the demise of her husband, and the passing away of her son in a road accident. As time progressed, the understanding of illness to this woman’s life went past the impact of occurrences to include notions of guilt and despondency. It shows how Gill lost religious faith, and thus the illness may illustrate a fall from grace. When the ethical opprobrium suggested by this was too much to cope with, Gill shifted back and forth on various views of the body that included stress and body wearing out (Williams, 1984).

Application to professional practice and/or personal formation

As it can be seen, the story forms insinuating culpability that can be joined with those that absolves the individual from blame and assist in sustaining self-worth. According to Young (1981), consistency in the explanation of illness may not usually be an overriding apprehension in amateur views or social relationships. In the evaluation of a specific narrative of one patient illness called Mrs. Fields, Williams (1984) shows how coping strategies are formulated to optimize normal activities at home. This revealed weakness and a feeling of urgency, which resulted in the pursuit of virtue. Secondly, Mrs. Fields’ recollection of her illness connected her desire to be seen as autonomous with a feeling of orderliness and sanitation in the home. The incapacitating consequence of her illness threatened to undermine her ability to exhibit herself and her house respectfully (Williams, 1984).

Conclusion

Personal narratives are a way through which the connections between self, body, and society are expressed. They are an appealing subject for sociological evaluation, especially in the context of chronic illness. This is wherever biographical reflection or reconstitution may take place against the backdrop of distracting events and experiences.

References

Bury, M.R. (1982). Chronic illness as biographical disruption. Sociology of health and Illness, 4(2): 167-82.

Bury, M.R. (1997). Health and Illness in A Changing Society. London: Routledge.

Featherstone, M. (1992). The heroic and everyday life. Theory, culture and Society, 9(2): 159-82.

Friedson, E. (1970). Profession of Medicine: a study in the sociology of applied knowledge. Chicago: university of Chicago press.

Good, B.J. (1994). Medicine, Rationality and Experience: an anthropological perspective. Cambridge: Cambridge university press.

Greenhalgh, T. & Hurwitz, B. (1999). Why study narrative. British Medical Journal, 318: 48-50.

Hyden, L-C. (1997). Illness and Narrative. Sociology of health and illness, 19(1): 48-69.

Johnson, M. (1987). The Body in the Mind: the Bodily Basis of Meaning, Imagination And Reason. Chicago: university of Chicago press.

Lawrence, C. (1994). Medicine in the Making of Modern Britain 1700-1920. London: Routledge.

McSherry, W., & Ross, L. (2010). Spiritual assessment in healthcare practice. Keswick, England: M & K.

Strauss, A. (1995). Chronic Illness and the Quality Of Life. St Louis: Mosby.

Taylor, A. (1989). Sources of the Self: The Making of the Modern Identity. Cambridge: Cambridge university press.

Williams, G. (1984). The genesis of chronic illness: narrative reconstruction, Sociology of Health Illness, 6(2): 175-200.

Young, A. (1981). When rational man falls sick: an enquiry into some assumptions made by medical anthropologists, Culture, Medicine and Society, 5(4): 317-35.