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Respond to at least two different colleagues’ postings in one or more of the following ways:

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  • Provide a constructive critique of your colleague’s post. Offer different perspectives on the factors influencing illness with regard to the course of illness.
  • Ask a probing question about why the factors your colleague posted are important.
  • Analyze your colleague’s post and expand on the post with additional services social workers might provide to the illness course your colleague selected.



Petrie, K. J., & Weinman, J. (2012). Patients’ perceptions of their illness: The dynamo of volition in health care. Current Directions in Psychological Science, 21(1), 60–65.


Student: Noryn


Two factors that influence the patient’s and his or her family’s experience of illness are two of the most important spheres in modern life: vocational pursuits (work) and educational pursuits (school).  Work influences the experience of illness in that work is an obligation that most people assume in order to sustain their lifestyles and have financial resources with which to live their lives.  When someone is ill and has to work at the same time, their work is affected which causes dissatisfaction in the person with the illness and can even prevent the person from working at all in extreme cases which leads to depression and anxiety among other mental health issues.

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Work is important to the self-esteem of the vast majority of adults in modern society so any effects of productivity declines due to illness cause self-esteem loss.  Work also makes illnesses worse by causing the person to have to exert themselves beyond their abilities which can cause failures at work that hurt self-esteem or failures that possibly seriously endanger the health of the person. For example, many individuals engage in shift work at night which is dangerous to health. The act of working all night while living a nocturnal lifestyle has serious impacts on illness and exacerbation of illness (Shariat et. al., 2015). School has an effect on illness due to the fact that similarly to work, it has the effect of possibly exacerbating illness due to the stress and pain it inflicts on people with illnesses at all levels of education.  School is normally stressful and becomes much more stressful for people with illnesses who have to suffer due to the physical exertion and mental exertion it involves.  Doing poorly in school as a result of illness can cause low self-esteem due to the importance of education in the average person’s life and other mental health issues.  Children with chronic illnesses tend to do worse in school depending on the severity of the illness.  The children with chronic illnesses have their symptoms exacerbated by school and face behavioral and academic problems as well as physical and emotional problems due to school and illness coinciding (Layte & McCrory, 2013).  School and work both cause issues during diagnosis by adding additional stress during a difficult time for the patient and his or her family that can cause symptoms to worsen.  Both school and work also play a factor in worsening symptoms as school and work add both stress and physical exertion that can be catastrophic for the worsening of the illness.

The medical social work can help with the stages of diagnosis and worsening of the symptoms of the illness.  The social worker can assist the student or worker in getting documentation to help ease their workload at school or work from doctors and other healthcare professionals, even possibly providing documentation themselves with their clinical expertise as an LCSW or as a general case manager of medical social work with an MSW.  The medical social worker can also call on behalf of the patient to different professionals to explain the symptoms and restrictions of activities as a patient advocate.  The medical social worker can also refer the patient to rehabilitation services as well as to help coordinate funding for the rehabilitation services such as PT or OT.  In summary, the medical social worker can help prepare documentation for work and school, advocate on the patient’s behalf by telephone or help coordinate further healthcare services to aid with school and work during these two difficult stages of illness (diagnosis and worsening of symptoms).


Layte, R., &Mccrory, C. (2013). Paediatric chronic illness and educational failure: The role of emotional and behavioural problems. Social Psychiatry and

     Psychiatric Epidemiology,48(8), 1307-1316. doi:10.1007/s00127-012-0609-3

Shariat, A., Tamrin, S. B., Daneshjoo, A., & Sadeghi, H. (2015). The Adverse Health Effects of Shift Work in Relation to Risk of Illness/Disease: A Review. Acta Medica

Bulgarica, 42(1), 63-72. doi:10.1515/amb-2015-000


Student: Sarah


Every patient has a different emotional or psychological response to illness. Illness perceptions are frameworks or working models that patients construct to make sense of their symptoms and medical conditions. While each patient’s cognitive representation of his or her illness guides behavior directed at managing their condition (Leventhal, Nerenz, & Steele, 1984), an illness perception comprises a number of interrelated beliefs about illness and what it means for the patient’s life. The major components include how the illness was caused, how long it will last, what the consequences of the illness are for the patient’s life and family, the symptoms that are part of the illness, and how the condition is controlled or cured. According to Petrie & Weinman, (2012) patients build models of their illness based on previous personal or family experiences with their disease, information they received from the media, or general practitioners. Furthermore, adherence problems often arise because there is a poor fit between the patient’s model of the illness and the nature of the treatment recommendation (Current Directions in Psychological Patients’ Perceptions. (n.d.).
Health is determined by several factors including genetic inheritance, personal behaviors, access to quality health care, and the wide-ranging external environment, such as the quality of air, water, and housing conditions. In relation to a patients emotional or psychological stress, patterns of behavior can include anxiety and depression during the onset of illness in both the beginning and later stages of an illness. Heart attack patients for instance, who believe that their disease had been caused by their lifestyle, are more adherent to lifestyle-change advice, whereas those who identified stress or genes as fundamental causes, were much less inclined to make these changes (Weinman & Petrie, 2000). In another example, Halm, Mora, and Leventhal (2006) have shown that patients who perceive their asthma as only present when they experience symptoms are much less likely to take daily pre-venter medication than other patients who recognize their asthma as a more permanent condition.
Two factors that can affect a patient’s course of life beyond family include social support and work environment. A social determinant of health is the extent, strength, and quality of our social connections with others. Social support has been linked to better prognoses and survival following significant illnesses, such as myocardial infarction, stroke, and certain types of cancer such as stage three or four, including melanoma (Berkman & Glass, 2000). Lack of social support, complications with treatment, and fear of loneliness can appear within the beginning stages of an illness and can impact how the patient feels supported throughout their care. Whereas one’s work environment, particularly exposure to job stress, has been linked to the onset of several conditions, including cardiovascular disease, musculoskeletal disorders, and mental illness (Marmot & Wilkinson, 2006). Furthermore, the cognitive part of leaving work due to an illness assesses people’s perceptions of trust, sharing, and reciprocity of feelings both in and out of the workplace (Harpham, 2002). Thus, the relationship between job stress and health is likely to be reciprocal. For example, the onset of subtle illness symptoms may result in the worker switching to a less demanding job. It is important to note, however, that the relevance and magnitude of the associations between social-environmental variables and health outcomes can vary at different stages of the disease process for each individual. That being said, the onset of illness impacts how the patient perceives the diagnosis, and adherence to treatment, particularly if they want to go back to work.
Medical social workers can intervene in many ways. The goal is to move from crisis management to incorporating the illness into the family’s daily lives. One of the most obvious applications of examining illness perceptions is the identification of patients who are at risk of coping poorly with the demands of their illness. Identification of at-risk patients offers the potential to intervene with the goal of improving illness adjustment, treatment, and outcome (Karamanidou et al., 2008).  The fit between the patient’s view of his or her illness and its prescribed treatment is a crucial area for interventions designed to improve adherence. Often the difficulty is to develop effective methods that provide patients with a complete understanding of how and why their treatments match with their illness. Medical social workers must develop successful interventions that can have powerful effects on a patient’s knowledge of his or her treatment and subsequent adherence to the treatment (Karamanidou et al., 2008).


Berkman L, Glass T. (2000). Social integration, social networks, social support, and health. In:
Berkman L, Kawachi I, editors. Social Epidemiology. New York: Oxford University
Press; 137–173.


Current Directions in Psychological Patients’ Perceptions. (n.d.). Retrieved from

Halm, E. A., Mora, P., & Leventhal, H. (2006). No symptoms, no asthma. The acute episodic
disease belief is associated with poor self-management among inner-city adults with
persistent asthma. Chest, 129, 573–580.

Harpham T, Grant E, Thomas E. (2002). Measuring social capital within health surveys: Key
issues. Health Policy and Planning. 17(1):106–111.

Karamanidou, C., Weinman, J., & Horne, R. (2008). Improving haemodialysis patients’
understanding of phosphate-binding medication: A pilot study of a psychoeducational
intervention designed to change patients’ perceptions of the problem and treatment.
British Journal of Health Psychology, 13, 205–214.

Leventhal, H., Nerenz, D. R., & Steele, D. J. (1984). Illness representations and coping with
health threats. In A. Baum & J. Singer (Eds.), A handbook of psychology and health (Vol.
4, pp. 219– 252). Hillsdale, NJ: Erlbaum.

Marmot MG, Wilkinson RD, editors. (2006).Social Determinants of Health. Oxford, England:
Oxford University Press.

Petrie, K. J., & Weinman, J. (2012). Patients’ perceptions of their illness: The dynamo of volition
in health care. Current Directions in Psychological Science, 21(1), 60–65.

Weinman, J., Petrie, K. J., Sharpe, N., & Walker, S. (2000). Causal attributions in patients and
spouses following a heart attack and subsequent lifestyle changes. British Journal of 
 Health Psychology, 5, 263–273.

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