By William Elwood, Ph.D.
Over the last few years, it seems that almost every ad I encounter includes at least one product or prescription related to a chronic mental or physical condition. Often both, as they insist a medication for the body solves what ails the mind.
A familiar, kindly gentleman has, for years, assured me that the firm he represents can ease the cost and process of obtaining diabetes testing supplies. Another product on the market ameliorates symptoms that differ depending on the TV commercial yet which, based on my rudimentary medical knowledge, are all autoinflammatory diseases. Yet another series of ads features a host of active women, carefree because they wear a certain product because, according to the new adage in the commercial, “urine occurs.”
It is apparent that few medically perfect people exist. In addition to the diseases mentioned above, people deal with depression and severe, persistent mental illness. They strive to stay in recovery. They deal with the mental and physical repercussions of chemotherapy and radiation. They endeavor to reduce or delay dementia. They live with HIV or take prescriptions to reduce the chance of getting infected. They seek help to stop their addiction to nicotine and other substances.
You likely can add to that list yourself, and it has probably occurred to you that living with chronic conditions requires more than taking prescriptions regularly; it requires conscientious change in, and maintenance of, attitudes, thoughts, and behaviors. And as chronic conditions can change over time, people who live with them need to adapt.
Living with a chronic condition requires conscientious change and maintenance in attitudes, thoughts, and behaviors.
Commercials depict but rarely mention an important fact: people with chronic conditions are seldom alone. Those dancing ladies are happily active because they apparently are certain that if their bladders leak, no one will witness it. The characters in dementia commercials usually appear with spouses, children, and grandchildren. Those depicted with autoinflammatory diseases or enduring cancer treatment are cooking, walking, or organizing family dinners by the sea. In short, people with chronic conditions have friends, families, neighbors, coworkers, and health care providers.
As chronic conditions can change over time, people who live with them need to change too.
Exploring the Social Networks that Influence Health Choices
Every human being has multiple social and human networks whose structure and function influence their emotional wellbeing. They also can reinforce or inhibit the multiple behaviors that comprise management of health conditions. To date, NIH-funded research has demonstrated the value of personalized health self-management interventions, advanced affordable technologies, and translated evidence-based practices to community and home settings. We have also learned that people who aptly manage chronic conditions are more likely to report collaborative relationships with health care providers and closeness with friends and family members. Moreover, specific characteristics of support systems (e.g., family cohesiveness, the ability of others to recognize symptoms) relate to more consistent adherence and better possible health outcomes.
Family cohesiveness, others’ ability to recognize symptoms relate to consistent adherence, better health outcomes.
At the same time, however, we lack a more comprehensive understanding of:
- How these relationships work to help people manage their chronic conditions,
- How some relationships get in the way of maintaining their optimal health, and
- How biological changes related to chronic conditions influence individuals and their relationships.
To deepen this understanding, OppNet, which funds extramural research in the behavioral and social sciences, has issued a funding opportunity announcement (FOA) to stimulate basic inquiry into the mechanisms and processes that influence people within their larger social contexts to manage one or multiple conditions over the course of their lives. The long-term goals of this research are to increase our knowledge of the individual and group processes that inform thought and behaviors that reinforce health and optimal well-being to enhance overall human health, reduce illness and disability, and lengthen life.
PAR-16-095Single application due date: December 6, 2016, by 5:00 p.m. of applicant organization
Sally Bowles and Christopher Isherwood might agree, life is not as much a cabaret as a series of chronic conditions.
“Start by admitting from cradle to tomb/Isn't that long a stay…”
English novelist Christopher Isherwood once created a female character who lived in Berlin between the two World Wars. That novel inspired a dramatic stage play, a Broadway musical, and a film. All versions featured Sally Bowles who worked at the Kit Kat Club. The musical is famous for Sally Bowles singing, “Life is a cabaret.” No one knows what became of Sally Bowles. According to Isherwood, Sally left Berlin and sent his semi-autobiographical character a postcard from Rome with no return address. If Sally were alive today, she would be 104. Isherwood would be 111, but he died from prostate cancer at age 81. Isherwood endured cancer treatment and willed his body to medical research. Fictional Sally’s hard-partying life leads me to suppose that she would have had medical sequelae later in life. That leads me to think both might agree that life is not as much a cabaret as it is a series of chronic conditions—and that we need more research on the complex constellation of human relationships and biological processes to understand how people manage their interactions with one another and with chronic disease.
References
Isherwood, C. (1935). Goodbye to Berlin. London: Hogarth Press.
Kander, J., Ebb, F., & Masteroff, J. (1966). Cabaret.
Additional Resources:
Basic Biopsychosocial Mechanisms and Processes in the Management of Chronic Conditions (R21)
Photo Credit: Fotolia/ gustavofrazao
