Malattia cronica e identità. Il ruolo della visibilità, della cronicità, dello stigma e del supporto sociale nei processi di ri-strutturazione dell'immagine di sé in pazienti affetti da Parkinson e Angina Instabile

The specific characteristics of chronic conditions impose a reflection about the social and psychological impact that may entail. In particular, how certain factors can influence the process of restructuring identity, fostering or hindering the integration of the pathology in the identity of the patient. An initial pilot study, carried out by administering a questionnaire built ad hoc to ordinary people and healthcare providers, aimed at detecting the social perception of visibility, gravity, stigma and emotional impact of certain diseases. This study was aimed at identifying two diseases with different degree of visibility of symptoms and led to the choice of Unstable Angina and Parkinson's disease as object of research. A longitudinal, cross-sectional and multi method study was then developed in three stages, to analyze specific dimensions and their role in the restructuring process of identity. During the first phase we contacted 5 patients with Parkinson's disease and 5 with Unstable Angina diagnosed by about 1-3 months and we conducted semi-structured interviews,, then transcribed and analyzed through the analysis of content and the Interpretative Phenomenological Analysis. The second phase provides for the involvement of caregivers, as well as of the same patients of the previous phase. Finally, during the third phase, the same patients to approximately 10-12 months from diagnosis and other 4 patients diagnosed with more than 5 years were contacted. The difference between the two diseases does not seem to be in the visibility of symptoms, but rather in degenerative characterizing Parkinson's. An important role seem to be played also by perceived support and the possibility of using several coping strategies in a flexible manner. This research presents inevitably limits related to the sample size and the method of recruiting participants, as well as compared to the time required to carry out interviews and for their subsequent analysis. However it enabled a more systematic study of the role of some factors that seem to be important in the integration process of the disease in the patient’s identity, which results in a greater psychological well-being and a greater confidence in the management of the disease. It also suggests some important directions in order to develop effective support for patients suffering from chronic disease and for their caregivers.