Howar eI ndi vi dual sLi vi ngwi t hChr oni c I l l nessTr eat edWi t hi nt hei rFami l i esAf t er Di agnosi s? Li t er at ur eRevi ew Chr oni cphysi calandment ali l l nessesar esepar at el yr evi ewedher eduet ot he di f f er encesbet weent het wo.I nt hi spaper , t heywi l lal sobecompar edagai nsteach ot heri nor dert odoacr ossanal ysi sbet weent hedi f f er encesandsi mi l ar i t i eswi t h t hewayi nwhi chf ami l ymember sar et r eat eddependi ngont het ypeofi l l nesst hat t heyhav e. Chr oni cPhysi calI l l ness Chr oni cphysi cal i l l nessv ar yi ni nt ensi t yandt ypes, butt her ei sonechar act er i st i c i ncommon.Thesei l l nessesr ecurt hr ought i me,t ypi cal l yatr andom i nt er v al s.The uncer t ai nt yt hatusual l y comes al ong wi t h a di agnosi s can i nt ensel yi mpact r el at i onshi psandcommuni cat i onwi t hi nt hef ami l y . Mar r i agei st hef oundat i onofmostf ami l i esacr ossdi f f er entcul t ur es. Maki ngsur e t hatt hemar i t al bondst aysst r ongi squi t echal l engi ngwhenamemberoft hef ami l y f acesachr oni cphysi cal i l l ness. Achr oni cphysi cal i l l nessmaychanget heev er y day l i f e and i nt er act i on of t he ent i r ef ami l yt r emendousl yi n or der t o at t empt under st andi nghowt hosewhohav ebeendi agnosedandt r eat edal r eadyconduct ed ar oundr el ev antcommuni cat i onpr ocesses.BashandAr ki nson( 2007)f oundt hat amongcoupl est hatt al kaboutt hedi r ect i onandnat ur eoft hei rr el at i onshi p, coupl es whoar echr oni cal l yi l lexper i encedmor ebenef i tcompar edt ocoupl est hatdi dnot i ncl udesomebodywhohadsomechr oni cphysi cal i l l ness. Thi sl i t er at ur eonl ypr ov es t hati nascenar i owher ei naspousei schr oni cal l yi l l ,i ti sv er yi mpor t antt ouse communi cat i oni nmaki ngeachot herawar eofspeci f i ct hi ngssuchast hei rf eel i ngs abouta cer t ai n si t uat i on,orwhatone expect s orneeds f r om t hei rpar t ner s. Expr essi ngaboutt hest at usoft her el at i onshi pcanbepar t i cul ar l yhel pf ul f orpeopl e whoar echr oni cal l yi l lespeci al l ywheni tcomest oexpr essi ngf ear sr el at edt ot hei r mar r i ageandt hei ri l l ness.
BeanandUmal i( 2009)suggest edt hatasocal l edcol l abor at i v et al ki st heki ndof communi cat i onwhi chi scor r el at edcommonl ywi t hposi t i v er esul t s.Thi sonl ygoes t oshowt hati ti sv er yi mpor t antf oral l mar r i edcoupl est ot al kaboutt hei ri ssuesand si t uat i onal t oget heri nor dert okeept hei rr el at i onshi pv er yst r ongbecauset hese t act i cshav eal r eadybeenpr ov ent obev al uabl ef ort hecoupl e.Shi m andSi mon ( 2015)add t ot hi sf ur t herby expl ai ni ng t hatcoupl es who ar e awar e oft he expect at i onsoft hei rpar t ner sr egar di ngcommuni cat i onwi t hi nt hemar r i agear e mor esuccessf uli n pr ovi di ng suppor tt o oneanot her .Al so,bei ng awar eoft he desi r esoft hei rpar t ner sandbei ngabl et of ul f i l l t hem i si mpor t antt owar dsachi evi ng sat i sf act i oni nt hef unct i oni ngoft her el at i onshi p.Mar i t alshar i ngandcopi ngi snot j ustl i mi t edt ot het al kwi t hi nt her el at i onshi p. Anot herv er ypower f ul wayofdoi ngso i st hr oughnar r at i v es. Nar r at i v esi ssomet hi ngt hati sr ecogni z edst r ongl yandof t enpr ai sedt hr ough l i t er at ur esonchr oni cphysi cali l l nesses.Var i ousst udi es( Fr ee&Chapman,2008; Ot t enson&Scot t ,2005;Di ckson&Wal ker ,2006)st r esst hepr i mar yi mpor t anceof communi cat i ngwi t hnar r at i v esf ort heheal i ngpr ocessoft hef ami l y .Nar r at i v esar e v er ybenef i ci alsi ncet heyal l ow st udi esandr esear cht ocapt ur esomeper sonal account s ofdi sease,l et t i ng t he i l lper son actas a gat ekeeperoft hei rown i nf or mat i onr egar di ngt hei ri l l ness.Ot t ensonandScoot( 2005)st at et hatt hosewho ar edeal i ngwi t hchr oni cphysi cali l l nessesar emor el i kel yt oshar eact i v el yi ft hei r per cept i onsandf eel i ngsar econf i r medbyot her s,especi al l yf ami l yandf r i ends. Some chr oni ci l l nesses r esul tt o a negat i v e soci al st i gma,and r ecei vi ng conf i r mat i ont hatpeopl ewi l l t ur noutt ober espect f ul i sv er yi mpor t anti nget t i ngt he pat i entt oshar eandopenupr egar di ngt hei rexper i ences. St or yt el l i ngandnar r at i v es hel pf ami l i est o ef f ect i v el ycommuni cat er egar di ng t hechangest hatt heyhav e exper i enced and hav et aken pl ace i nt he f ami l y .Ot t enson and Scoot( 2005) concl udedt hatt hechangi ngi dent i t ywhi l ef aci ngt hei l l nessnev erst ops.I nf act , i t i sendl esswheel ofdev el opment . Shar i ngvi anar r at i v esi ncasesofdi f f er entchr oni c physi cali l l nesshast hepossi bi l i t yofexper i enci ngbet t ercommuni cat i oni nt he f ami l ybecauset hepat i entcanconci sel yandcl ear l yexpl ai nwhati scur r ent l ygoi ng onwi t ht hem f r om t hei rper sonalper spect i v e.
Thi s can si gni f i cant l y hel pt he f ami l y det er mi ne whatt he pat i enthas been t hr ough,whi l eunder st andi ng new i dent i t i est hatar eemer gi ng.Howev er ,Losch ( 1982)poi nt s outa v er yi mpor t antpar adox expl ai ni ng t hatpat i ent s may be empower edbyexpl ai ni nganar r at i v eaccountoft hei rst or y , andot her smayal sof eel anxi ousf r om r emember i ngt hosemoment swi t hi nt hei rl i f e.Asexpl ai nedbyGr et hel andSat chki nson( 1992) , whent hepar t i ci pant susedcommuni cat i oni nr educi ngt he f eart hatt heyf eelr egar di ngt hei ri l l ness,t heywer emostl i kel yt ocommuni cat e r egar di ngt hei ri l l nessbet t er . Wi nsyandDent on( 2006)showt hatnar r at i v esar ev er y i mpor t anti nmeet i ngt heexpect at i onsandunder st andi ngoft hef ami l ymember s whent heyexper i encechr oni ci l l ness.Mostof t en, peopl ewi l l al sof aceexpect at i ons f ort hei rf ami l ymember s wi t houtev en expr essi ng t hem v er bal l y ,l eavi ng t hem conf usedmor eof t enr egar di ngt hedi r ect i ont hatt heyneedt ot ake.Howev er , af or m ofst or yt el l i ngornar r at i v ei ncasesofchr oni cphysi cal i l l nessmayal sor ef l ectsome oft heunf ul f i l l edneedsoft hepat i ent s, hel pi ngf ami l ymember st odet er mi net hem. Ont heot herhand,achr oni cment ali l l nesscanbequi t edi f f i cul tf orf ami l i est o dealwi t h, gi v eni t snegat i v esoci alconnot at i onsi nmostsoci et i esal lov ert hewor l d t oday .Af ami l ymembersuf f er i ngf r om chr oni cment ali l l nessmayl eadt oconst ant moni t or i ngandcar e,dependi ngont hei nt ensi t yandt hei l l ness.Assuch,f ami l i es mayendupf i ndi ngi tdi f f i cul tt odealwi t hunder st andi ngt hedi agnosi sofchr oni c ment ali l l nessduet ot henumberofchal l engespr esent ed.( Smi t h, 2009) .
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