Family Illness Trajectory

o Perjalanan suatu penyakit atau aspek psikologisnyau/ pasien dan keluarga. Setiap stagenya
memiliki arti yg bbd u/ keluarga.

1. Stag
e1:

onset penyakit
 Reaksi pasien dan keluarga = penyangkalan, rasa takut, meyakinkan dokter bahwa ada
yang salah
 Peranan dokter = fase prediagnostik ttg pasien dan keluarga, menenangkan mereka

Frequently, the patient and family experience this stage prior to contact with the medical care providers.
But the nature of the onset of symptoms plays an important role in determining the impact the illness
will have on a family, since the meaning of the illness experience begins to be formulated during this
period.

2. Stage 2 : reaksi thd diagnosis-impact phase

 Reaksi pasien dan keluarga = terkejut dan sangat gelisah, khawatir
 Peranan dokter = membuat judgement klinik ttg sbrp banyak pasien dapat menerima
info, mendorong u/ membersihkan nature of illness dan merencanakan u/ coping
The moment of diagnosis of a major debilitating or terminal disease is often remembered by patients
and their families as the single most difficult time of the entire illness experience. The initial response to
such a diagnosis is similar to the initial phase of grief reaction.

3. Stage 3 : usaha terapi utama

 Reaksi pasien dan keluarga = memilih rencana pengobatan dan bertanggung jawab u/
prosesnya, belum siap scr emosional
 Peranan dokter = mempertimbangkan keadaan psikologis pasien dan keluarga,,
memperjelas tanggung jawab dokter dan keluarga

The psychological state of the patient and family is an important determinant of the choice of
therapeutic plans as well as its ultimate success.

Some patient and families are not emotional equipped to undertake some forms of therapy, and other
professional help should be obtained. The critical issue for the physician, patient and family is the
assumption of responsibility for the care. Very early in the treatment plan, a contract needs to be
established the defines responsibility of each party.

4. Stage 4 :adjustment thd outcome - recovery

 Reaksi pasien dan keluarga = depresi, marah, kecewa (dipengaruhi faktor ekonomi) dan
ragu ttg outcome
 Peranan dokter = melayani keluarga dgn bsik dan memberi tahu masalah yg mungkin
muncul

Return from hospital of major therapy initiates a period of gradual movement from the role of being sick
to some form of recovery or adaptation, with corresponding adjustment of relations within the family.
The first task of this phase of illness is to deal with the immediate effects of trauma on the patient and
on family relations.

5. Stage 5 : adjustment thd outcome permanent

 Reaksi pasien dan keluarga = second crisis krn disabilitas dan tak bs menerima kenyataan
 Peranan dokter = antisipasi 2nd crisis dan membantu mrk spy dpt menerima kenyataan

At some point in the family’s adjustment to the illness outcome, often several months after diagnosis
and initial therapy, a second crisis occurs as the family realizes that they must accept and adjust to a
permanent disability.

Pada kasus ini : Stage 4