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Rheumatic heart disease : the meaning of this illness to patients and their families - a study of male adult patients with rheumatic heart disease admitted to Shaughnessy Hospital (1948-1951) Rykiss, Ben

Abstract

The purpose of this study has been to determine, (1) whether there is a connection between a patient's social and personal background and his susceptibility to rheumatic heart disease, (2) whether emotion-producing conditions affect the development and later recurrences of this disease, (3) what the relationship is between specific social and personal pressures and the course of a rheumatic heart patient's illness, and (4) what the social worker can contribute towards alleviating these emotion-producing conditions affecting the patient's illness. Because of the limitations encountered, e.g. incomplete social histories, it has not been possible to determine the first of these. All patients (25) with rheumatic heart disease who were referred for medical social service at Shaughnessy hospital through a four-year period (1947-1951), have been selected for this study. An analysis of all available records of various branches of the department of veterans' affairs interested in the welfare of these patients, has been made. Material selected has been confined to three broad areas in the patients' lives, (1) early personality formation, (2) social and personal stress surrounding the onset, and (3) social services employed in alleviating emotional stress of patients and their families. The findings of this study indicate that an ever-increasing cycle of social problems affect the rheumatic heart patient, following the onset of his illness. Economic difficulties form the major source of emotional stress, and these in turn affect and are affected, by the earning capacity of physically-limited, chronically-diseased patients. There are indications of personality factors reacting upon the ability of the patients to accept the limitations of their illness and the demands of mature adulthood. Although this study concerns itself only with war veterans, the majority of the findings are applicable to all patients afflicted with rheumatic heart disease. Included here are, (1) the need for adequate resources, e.g. financial grants, convalescent centres, suitable housing, light employment and retraining programmes, (2) the need for more social workers as well as professionally trained social workers to insure proper use of available resources, (3) the need for more research not only with all rheumatic heart patients but with all forms of chronic illness, and (4) the need for preventive measures e.g. through education, and early diagnosis and treatment of social and personal problems. Problems resulting from increased financial grants given to veteran patients undergoing hospital care, and limitations in medical social service recording under the department of veterans' affairs, are two specific findings which are mainly applicable to the veteran.

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