Week 6 PDF - Istanbul Gelisim University

Name of Department : NURSING Course Code and Name : HEY413E REHABILITATION NURSING Course Week : WEEK 6 Course Day and Time : Tuesday (12:00 to 13:50) Course Credit/ACTS Information : 2 Examination Type and Gradings : Mcqs Instructor’s Name & Sur...

Name of Department : NURSING Course Code and Name : HEY413E REHABILITATION NURSING Course Week : WEEK 6 Course Day and Time : Tuesday (12:00 to 13:50) Course Credit/ACTS Information : 2 Examination Type and Gradings : Mcqs Instructor’s Name & Surname : Dr. Hina Zahoor E-mail & Phone: : [email protected] Instructor’s Room : 305 Office Hours : 9.00 to 5.00 GBS Link : https://gbs.gelisim.edu.tr/ders-detay-5-160-6267-1 ALMS Link : https://lms.gelisim.edu.tr/almsp/u/Home/Index AVESIS Link : https://persis.gelisim.edu.tr/Default.aspx. | WEEKLY LEARNING OUTCOMES | Understand the process of psychosocial adaptation and how individuals adjust to changes due to illness or disability. Identify stressors related to illness and their impact on patients' emotional and physical well- being. Recognize the nature of a crisis and its effects on an individual's mental and emotional state. Analyze how self-concept influences a person’s coping mechanisms during illness or recovery. Comprehend Elisabeth Kübler-Ross' 5 stages of grief and their application to patients facing loss or terminal illness. Develop strategies for providing psychological support in rehabilitation nursing to promote emotional stability and enhance recovery. Apply interventions that address emotional and psychological needs in patients undergoing rehabilitation. Facilitate adaptive coping mechanisms in patients to improve their quality of life during rehabilitation. Evaluate the effectiveness of psychological support methods in improving patient outcomes and well-being  | NOTE | Attendance Attendance is mandatory for all scheduled lectures.  | NOTE | Be Responsible Come to class on time.  | NOTE | Be disciplined Avoid talking to friends in the class.  | NOTE | Show discipline Mobiles are not allowed in the class.  | ABOUT THE LAST LESSON | Goals of Rehabilitation for Chronic Conditions Types of Rehabilitation Interventions Multidisciplinary Approach Key Focus Areas for Different Conditions Recent Rehabilitation Technology Trends  | ABOUT THE TODAY LESSON | Psychosocial Adaptation to Chronic Illness and Disability  | DAILY FLOW | 12.00-12.50 / 1st Hour Psychosocial adaptation Stress Crisis Self concept 13.00-13.50/ 2nd Hour Elisabeth Kübler-Ross’ 5 stages of grief Factors that affect an individual's psychosocial responses to diseases Aims of psychological support in rehabilitation nursing | Psychosocial Adaptation to Chronic Illness and Disability | Disability is defined as the loss of health due to damage or disorder, inherent or acquired deficiency of the bodily, mental, or spiritual functions of the organism. It is also referred to as every damage that occurs in the physical, mental or psychological functions of the human body, and as a result the person is not able to work, to self handle or to communicate with its environment | Psychosocial Adaptation to Chronic Illness and Disability | Disabilities can include for instance, having difficulty seeing,hearing, having speech understood, walking, bathing, dressing,eating, preparing meals, going outside the home, or doing housework having Alzheimer's, dementia, autism, cerebral palsy,or dyslexia. They can be frequently depressed or anxious | Psychosocial Adaptation to Chronic Illness and Disability | Psychosocial adaptation is defined as the process of putting oneself in harmony with the changing circumstances of life so as to enhance one's sense of well-being and long- term survivorship. | Psychosocial Adaptation to Chronic Illness and Disability | Psychosocial Adaptation to Chronic Illness and Disability’s (CID) basic concepts are; stress, crisis, loss and grief, body image, self-concept, uncertainty and unpredictability, quality of life. | Psychosocial Adaptation to Chronic Illness and Disability | Stress: Individuals with CID normally face an increase in both the frequency and severity of stressful situations.  | Psychosocial Adaptation to Chronic Illness and Disability | Increased stress is experienced because of the need to cope with daily threats that include,  one’s life and well-being;  body integrity;  independence and autonomy;  fulfillment of familial, social, and vocational roles;  future goals and plans; and  economic stability | Psychosocial Adaptation to Chronic Illness and Disability | Crisis. The sudden onset of many medical impairments and disabilities (e.g., myocardial infarction, spinal cord injury, traumatic brain injury, amputation) and that of life threatening diagnoses or loss of valued functions (e.g., cancer, vision impairment) is highly traumatic. As such, these conditions constitute a psychosocial crisis in the life of the affected person. | Psychosocial Adaptation to Chronic Illness and Disability | The psychological consequences of crisis are, in contrast, long lasting and may even evolve into pathological conditions such as posttraumatic stress disorder (PTSD).  | Psychosocial Adaptation to Chronic Illness and Disability | Loss and grief: The crisis experienced following the onset of a traumatic or progressive CID triggers a mourning process for the lost body part or function. Patient exhibits feelings of grief, bereavement, and despair. The term chronic sorrow has often been used to depict the grief experienced by persons with CID. | Psychosocial Adaptation to Chronic Illness and Disability | Body image: Body image has been defined as the unconscious mental representation or schema of one’s own body. | Psychosocial Adaptation to Chronic Illness and Disability | CID, with its impact on physical appearance, functional capabilities, experience of pain, and social roles, is believed to alter one’s body image and self concept. | Psychosocial Adaptation to Chronic Illness and Disability | Unsuccessful adaptation, in contrast, is evidenced by experiences of physical and psychiatric symptoms such as feelings of anxiety and depression, psychogenic pain, chronic fatigue, social withdrawal, and cognitive distortions | Psychosocial Adaptation to Chronic Illness and Disability | Self-concept: One’s self-concept and self-identity are linked to body image and are often seen as conscious, social derivatives of it. | Psychosocial Adaptation to Chronic Illness and Disability | The uncertainty and unpredictability of the disease process and its complications affect the individual psychologically. | Psychosocial Adaptation to Chronic Illness and Disability | Medical conditions, such as cancer and MS, that are marked by heightened levels of perceived uncertainty regarding disease symptoms, diagnosis, treatment, prognosis and relationships with family members were found to be associated with decreased psychosocial adaptation | Psychosocial Adaptation to Chronic Illness and Disability | Quality of life (QOL): The ultimate psychosocial outcome in rehabilitation practice is believed to be that of post-CID quality of life. | Psychosocial Adaptation to Chronic Illness and Disability | As a global and multifaceted construct, QOL includes the following functional domains: intrapersonal (e.g., health, perceptions of life satisfaction, feelings of wellbeing) interpersonal (e.g., family life, social activities) extrapersonal (e.g., work activities, housing) | Psychosocial Adaptation to Chronic Illness and Disability | CID-Triggered Responses It’s different for everyone. There’s no perfect way to grieve. Elisabeth Kübler-Ross’ 5 stages of grief Shock/Denial Anger Bargaining Depression Acceptance | Psychosocial Adaptation to Chronic Illness and Disability | Shock/Denial A patient may say, “I don’t believe it. That’s impossible. They probably will show no tears. They may go on with their life- pretending as if nothing happened. Do not push the issue. Tell them that you are there for them. In time, they will come to realize that their world has flipped upside down. Necessary for the healing process. | Psychosocial Adaptation to Chronic Illness and Disability | This short-lived reaction marks the initial experience following the onset of a traumatic and sudden injury or the diagnosis of a life-threatening or chronic disease  | Psychosocial Adaptation to Chronic Illness and Disability | Shock/Denial World becomes overwhelming and meaningless. Life makes no sense. It helps pace feelings of grief. It’s a way of taking in as much as they can handle. Denial will begin to fade and healing will start to take place. Eventually feelings will begin to come to the surface. | Psychosocial Adaptation to Chronic Illness and Disability | Anger Do not tell them, “Don’t be angry!” Anger is often necessary for the healing process. Depending on the situation, a patient may be angry with their parents, doctors, friends, a sibling, a teacher, or with God. Psychological harm can actually be caused by unexpressed anger Let them feel their anger. The more they express their anger in healthy ways, the more it will decrease, and then they will begin to heal | Psychosocial Adaptation to Chronic Illness and Disability | This reaction is characterized by a panic-like feature on initial sensing of the nature and magnitude of the traumatic event. | Psychosocial Adaptation to Chronic Illness and Disability | Bargaining “What if…” or “If only…” They will want things to go back to how they use to be. Guilt usually will creep up. Let them know that these thoughts/feelings are normal | Psychosocial Adaptation to Chronic Illness and Disability | Depression This reaction, commonly observed among people with CID, is considered to reflect the realization of the permanency, magnitude, and future implications associated with the loss of body integrity, chronicity of condition, or impending death | Psychosocial Adaptation to Chronic Illness and Disability | Feelings of despair, helplessness, hopelessness, isolation, and distress are frequently reported during this time. Although depression has been found to be a widespread reaction among persons with CID. | Psychosocial Adaptation to Chronic Illness and Disability | It’s not always an indication of a mental illness. Sign of great loss and is actually appropriate. Another step to healing. Also remember to be cautious and to use good judgment They may need a counselor depending on the intensity of depression | Psychosocial Adaptation to Chronic Illness and Disability | Signs of Depression Lack of sleep or getting too much sleep Eating too much or not enough Feeling worthless or hopeless Difficulty concentrating Repeated thoughts of death Not joining in things they used to like to do: Not wanting to hang out with their friends anymore, not wanting to play their guitar anymore, etc | Psychosocial Adaptation to Chronic Illness and Disability | | Psychosocial Adaptation to Chronic Illness and Disability | Acceptance This does not mean that everything is “ok” with everything that has happened. It’s accepting the reality that the loss happened and living with the consequences. Let them know that it is okay to continue living their life. Let them know that they may have good days and bad days | Psychosocial Adaptation to Chronic Illness and Disability | | Psychosocial Adaptation to Chronic Illness and Disability | | Psychosocial Adaptation to Chronic Illness and Disability | Emotional reactions to the disease Anxiety, Fear, Anger, Strength-weakness, Sadness, Sorrow, Insufficiency, Failure, Shame Guilt, Hope-despair, Denial, Depression, Projection, Pathological Addiction And Regression | Psychosocial Adaptation to Chronic Illness and Disability | The most common behavioral reactions Support search, being an expert on their own health and disease, hiding, loneliness, social withdrawal or isolation, nonadherence to treatment regimen or refusal of treatment | Psychosocial Adaptation to Chronic Illness and Disability | There are factors that affect an individual's psychosocial responses to the disease. These factors are; 1. Factors related to the patient's physical disease, 2. Factors related to the individual characteristics of the patient, 3. Environmental factors | Psychosocial Adaptation to Chronic Illness and Disability | 1. Factors Related to Physical Illness Sudden or slow onset of the disease, the symptom process can affect an individual's response to the disease. Although some diseases are acute, they are not lifethreatening and the effect of the disease may be short-term, in which case the individual can adapt to his / her former life in a short time. | Psychosocial Adaptation to Chronic Illness and Disability | In chronic diseases, the struggle is continuous and becomes a part of daily life for the person. Disease; it creates stress if it causes disability, prevents it from continuing its daily life activities, and is a lifethreatening disease. Stress in the disease varies according to the severity, duration, disability or disability rate and treatment | Psychosocial Adaptation to Chronic Illness and Disability | 2. Factors related to the patient's individual characteristics (life history and experiences) The individual's own experiences, psychological reactions to the disease, the meaning of the disease, personality types, defense mechanisms and the way of coping affect the reactions. | Psychosocial Adaptation to Chronic Illness and Disability | 3. Environmental Factors Close environment and society's view of the disease, the marital status, the dynamics of family relations, society's value judgments, cultural characteristics affect a person's reactions to the disease. | Psychosocial Adaptation to Chronic Illness and Disability | Psychological Approach Principles of Rehabilitation Nurse for Patients Empathic attitude towards patient and family Friendly, sympathetic, supportive and communicated in accordance with the principles of ethics, Basic sense of trust should be given, be flexible | Psychosocial Adaptation to Chronic Illness and Disability | The confidentiality of the patient should be respected, Incorrect information and attitudes regarding the illness and worries should be corrected, the patient should be informed | Psychosocial Adaptation to Chronic Illness and Disability | Encourage them to express their feelings and reactions freely such as anger, anger and guilt and to express their thoughts and feelings about the disease. Communication between patients, relatives and social interaction areas should be strengthened. Sickness and sense of self-control in their lives should be developed | Psychosocial Adaptation to Chronic Illness and Disability | Realistic acceptance should be maintained while maintaining hope, Quality of life should be improved by providing psychological and social harmony, | Psychosocial Adaptation to Chronic Illness and Disability | Allow time to adapt to the disease and the new situation in which it lives, What the patient can do Psychosocial support should be provided to the patient, An attitude that supports the patient's selfesteem and self-esteem and encourages to use his / her current power should be adopted | Psychosocial Adaptation to Chronic Illness and Disability | Psychological Support The psychological state of the patient was seen to accelerate the occurrence of the disease or affect process and survival of the disease | Psychosocial Adaptation to Chronic Illness and Disability | Depression develops especially after loss, grief, pain, mourning reactions. Psychological support and treatment can be used in these situations (illness, loss, etc.). Education of Persons with Disabilities is very important | Psychosocial Adaptation to Chronic Illness and Disability | People who have special educational needs should receive special education which aims at: The development of their personality The improvement of their skills and competencies The professional training and their participation in the production process The mutual acceptance by the community and the equal social development. | Psychosocial Adaptation to Chronic Illness and Disability | These programs/education help the person to express his / her feelings and concerns, develop strategies for coping with stress, and help the patient regain his or her damaged self-esteem. | Psychosocial Adaptation to Chronic Illness and Disability | Group therapies may be recommended to the patient. Interviewing people with similar problems and an improved patient helps the patient. It can also be used in medications that regulate the nervous system. The stress and depression levels of the patients' families may be in parallel with those of the patients. Therefore, relatives of patients can also be provided with help. | Psychosocial Adaptation to Chronic Illness and Disability | Aims of psychological support in rehabilitation nursing Reducing psychological pain, Improving the quality of life by providing psychological and social harmony, To correct anxiety, depression and other psychiatric disorders, To develop and increase the feeling that they have their own control in disease and life  | WHAT TO TAKE HOME? | Psychosocial adaptation Stress Crisis Self concept Elisabeth Kübler-Ross’ 5 stages of grief Factors that affect an individual's psychosocial responses to diseases Aims of psychological support in rehabilitation nursing | QUESTIONS AND SUGGESTIONS | ANY QUESTION ?  | RECOMMENDED DAILY STUDIES | McPherson, K, Gibson, BE & Leplege, A 2015, Rethinking Rehabilitation: Theory and Practice, CRC Press, NW, Florida. Hoeman, SP 2008, Rehabilitation Nursing: Prevention, Intervention and Outcomes, 4th edn, Mosby, St Louis, United States  | REFERENCES | 1. Mauk K. L. Current Approaches to Rehabltaton Nursng Practce (L. Ozdemr, H. Sutçu Cicek, Translated). Ankara: Nobel Academc Publshng, 2014. 2. Livneh H, Antonak FR (2005). Psychosocial Adaptation to Chronic Illness and Disability: A Primer for Counselors. Journal of Counseling & Development. Volume 83.  | ABOUT THE NEXT WEEK | Cardiac Rehabilitation Nursing 1  ………….. – ………………………… Since course presentations are private, using the texts and images contained herein on social media or else without permission from the course instructor is against the regulations Law No. 6698.