Impaired Role Behavior Related to Illness
Following illness or surgery, the person may not regain complete health; he may remain chronically ill. He then reaches a state where he gets neither better nor worse, but is no longer viewed by himself or by society as being ill. He may even be disabled by a condition that imposes a restriction on activity and provokes social prejudice and stigma. Examples of such conditions include blindness, deafness, and cases in which some body part or function is congenitally or surgically absent or malfunctioning.
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The disability may or may not be obvious, but the person considers himself well most of the time. He has emotionally resolved the crisis that surrounded the disability, but he has limited ability to carry on usual roles and resposibilities. For the disabled person who is not experiencing illness, social pressures serve to aid in maintaining normal behavior within the limits of his potential. This situation is called impaired role behavior.
The behavior of the person depends on his perception of his disability as well as on the perceptions of others. Some persons who are chronically ill or congenitally or surgically disabled will remain in the sick role indefinitely. Such persons have not resolved the crisis of illness; the person with impaired role behavior has.
Characteristics of Impaired Role Behavior differ from those of the sick role. Thomas suggests that impaired role behavior is an extension of the sick role. The disabled person, however, is not considered by society to be exempt from normal behavior or responsibilities within the limits of his condition. He is expected, as far as possible, to improve or modify his life situation in the light of his disability, to make the most of his remaining capabilities to overcome the disability, and to accept limits realistically. The person is then considered rehabilitated and no longer in the sick role.
The behavioral responses of the disabled person also depend on his feelings of being accepted or rejected. Schutz describes the basic human need to be included rather than excluded from others, to feel lovable, worthwhile, significant, competent, and responsible. The disabled person desires and needs to have some close relationships with nondisabled persons and needs to be accepted by others for what he or she is, in spite of the disability.
Disability often forces the person to modify his self-concept and self image. New and different body sensations, changed appearance or body functions, and changed or reduced abilities challenge the person`s self-confidence. He may feel shame, worthlessness, and inferiority, often to a degree not justified by the condition. Negative responses from others intensify low self-esteem, and a negative self-image results, for everyone learns to incorporate the image that others have of him into his self-concept.
The disabled person is expected to learn to adjust and respond to being dependent on the aid of others to complete tasks or meet his needs, in spite of the American cultural emphasis on self-reliance and independence. The person is expected to share in the management of his medical condition and be involved in decisions regarding his treatment and care. He will be asked to explain his disability to others, often revealing considerable personal information, and accept that he is an object of curiosity medically and socially. He recognizes that by means of these explanation, he is helping to reduce social stigma, pity, and prejudice, and this will eventually permit him greater opportunities to realize his potentialities.
The primary reason for considering impaired role behavior is that some people are neither ill-and therefore governed by sick-role norms-nor healthy in the usual sense. The well-adjusted disabled person views himself as physically or psychosocially restricted rather than ill.
In contrast, not accepting one`s disability and its attendant limitations, he is helping to reduce social stigma, pity, and prejudice, and this vention of further illness, and performance of social roles. Such a person is considered deviant in his behavior in that he remains in the sick role.
References :
Wright, Beatrice, Physical Disability: A Psychological Approach. New York: Harper & Row, Publishers, 1960.
Gordon, Gearald, Role Theory and Illness. New Haven: College and University Press, 1966.
Thomas, Edwin, “Problems of Disability from the Perspective of Role Theory”, Journal of Health and Human Behavior, 7: No. 1, 1966.
Schutz, William, FIRO : A Three Dimensional Theory of Interpersonal Behavior. New York: Holt, Rinehart & Winston, Inc., 1960.
Murray, RB and Zentner JP., Nursing Concepts for Health Promotion, Second Edtion, Prentice-Hall, Inc, Englewood Cliffs, N.J, 1979.
