illness experience, the process of being ill. A commonly used model is Suchman’s stages of illness, comprising five stages: stage I, experiencing a symptom; stage II, assuming a sick role; stage III, making contact for health care; stage IV, being dependent (a patient); and stage V, recovering or being rehabilitated. Each stage is characterized by certain decisions, behaviors, and end points. During stage I, in which a symptom is experienced, the person decides that something is wrong and seeks a remedy. Stage I ends with the person’s accepting the reality of the symptom, no longer delaying any action toward help or denying the symptom (flight into health). During stage II the person decides that the illness is real and that care is necessary. Advice, guidance, and validation are sought. This stage gives the person permission to act sick and to be excused temporarily from usual obligations. The outcome of this stage is acceptance of the role—or denial of its necessity. In stage III, professional advice is sought. Authoritative declarations identify and validate the illness and legitimize the sick role. The person usually asks for help and negotiates for treatment. Denial may still occur, and the patient may “shop” further for medical care or may accept the illness, the medical authority, and the plan for treatment. In stage IV, professional treatment is performed and accepted by the person, who is now perceived as a patient. At any time during this stage the dependent patient may experience ambivalent feelings and may decide to reject the treatment, the caregiver, and the illness. More often care is accepted with ambivalence. The patient has a particular need to be informed and to be given emotional support during this stage. During stage V the patient relinquishes the sick role. The usual tasks and roles are reassumed to the greatest degree possible. Some people do not willingly give up the sick role, becoming in their own eyes chronically ill, or they may, for secondary gain, malinger, acting sick. Most people accept recovery and work toward rehabilitation.
