Chapter 9 Living with Chronic Illness.pptx

Chapter 8 Living with Chronic Illness What is the difference between acute and chronic illness? Chronic Usually graduated Lengthy indefinite Multiple changes Often uncertain Often uncertain Often indecisive No cure Pervasive Acute Abrupt Onset Limited Duration Single Cause Usually accurate Usually a...

Chapter 8 Living with Chronic Illness What is the difference between acute and chronic illness? Chronic Usually graduated Lengthy indefinite Multiple changes Often uncertain Often uncertain Often indecisive No cure Pervasive Acute Abrupt Onset Limited Duration Single Cause Usually accurate Usually accurate Usually effective Cure Minimal Diagnosis Prognosis Intervention Outcome Uncertainty The context of chronic illness With chronic disease, the patient’s life is irreversibly changed. Neither disease nor its consequences are static. They interact to create illness patterns requiring continuous and complex management. Variations in patterns of illness and treatments with uncertain outcomes create uncertainty about prognosis. The goal is not a cure but maintenance of pleasurable and independent live Chronic Illness as a Crisis Serious chronic illness is a crisis – Disruption and change (identity, location, role, social support, future goals) – Increased demands (ongoing response to illness) – Uncertain outcomes – No cure, requires ongoing management Initial reactions to chronic illness Shock Denial Loss and grief Anxiety and depression – 20-25% experience psychological symptoms If these reactions last too long, they can have an unhelpful effect on the illness Chronic Illness as a Crisis Illness can be considered a crisis because it represents a turning point in an individual’s life. Disruption to established patterns of personal and social functioning produces a state of psychological, social, and physical disequilibrium Adaptation = finding new ways of coping with drastically altered circumstances. Crisis Theory (Moos, 1982) A model describing the factors that affect people’s adjustment to having serious illness. Coping process (3 stages) is influenced by 3 factors – Illness-Related Factors – Background and personal Factors – Physical and Social Environment Factors Coping process influences outcome of crisis The Coping Process Contributing Factors Illness-Related Factors – Degree to which an illness is hidden – Degree to which illness intrudes on lifestyle Background and Personal Factors – Age, gender, social class, philosophical or religious commitments, self-esteem Physical and Social Environment Factors – Social support The Coping Process Cognitive appraisal – Meaning or significance of the illness – Meaning of Illness Questionnaire Adaptive tasks – Formulation of tasks to help cope with illness Illness-related General psychosocial functioning Coping skills – Denial, information seeking, goal setting, recruiting support Outcome of Crisis Adaptation and Adjustment – Physical, vocational, self-concept, social, emotional, compliance Quality of Life – Degree of excellence people appraise their lives to contain – Excellence usually = fulfillment or purpose – Health-related quality of life (physical status and functioning, psychological status, social functioning, disease or treatment-related symptomatology) Psychosocial Interventions Education and support services – Most common intervention to help people adjust – Majority choose not to attend such groups – Current trend to examine other ways of offering support (workbooks, telephone linkups, websites) Psychotherapy, CBT, family therapy, etc – Costly, not always necessary