Chapter 11: Management Of Chronic Health Disorders PDF

Because learning changes everything. ® Chapter Eleven Management of Chronic Health Disorders Copyright ©2021 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.  Chapter Outline...

Because learning changes everything. ® Chapter Eleven Management of Chronic Health Disorders Copyright ©2021 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.  Chapter Outline Quality of life. Emotional responses to chronic health disorders. Personal issues in chronic health disorders. Coping with chronic health disorders. Comanagement of chronic health disorders. Psychological interventions and chronic health disorders. © McGraw Hill 2  Quality of Life Assessments measure the extent to which a patient’s normal life activities have been compromised by disease and treatment. Components. Physical functioning. Psychological status. Social functioning. Disease- or treatment-related symptoms. © McGraw Hill 3  Why Study Quality of Life? Guides interventions. Helps identify the problems likely to emerge for patients. Assesses the impact of treatments. Used to compare therapies. Can inform decision makers about care. © McGraw Hill 4  Emotional Responses to Chronic Health Disorders 1 Denial: Defense mechanism by which people avoid the implications of a disorder. Interferes with absorption of treatment information and compromises health. Anxiety: Patients become overwhelmed by potential changes in their lives and the prospect of dying. Can interferes with treatment. © McGraw Hill 5  Emotional Responses to Chronic Health Disorders 2 Depression: Complicates treatment adherence and medical decision making. Assessing it in the chronically ill can be complicated. People who get depressed. Experience pain and disability. Experience negative life events. Lack social support. © McGraw Hill 6  Coping with Chronic Health Disorders Strategies. Social support or direct problem solving. Distancing. Positive focus. Cognitive escape or avoidance. Behavioral escape or avoidance. Strategies that work: Active coping and coping by using positive responses. © McGraw Hill 7  Patients’ Beliefs about Chronic Health Disorders 1 Nature of the health disorder: Patients may adopt an inappropriate model for their disorder. Cause of the health disorders. Patients may blame stress, physical injury, disease causing bacteria, and God’s will for their disorders. Self-blame can lead to guilt, self-recrimination, or depression. © McGraw Hill 8  Patients’ Beliefs about Chronic Health Disorders 2 Controllability of the health disorders. Patients who have a sense of control or self-efficacy with respect to the disorder are more adaptive. Experience of control or self-efficacy may prolong life. © McGraw Hill 9  Comanagement of Chronic Health Disorders 1 Physical rehabilitation involves several goals. To learn how to use one’s body as much as safely possible. To learn how to sense changes in the environment to make the appropriate physical accommodations. To learn new physical management skills. To learn a necessary treatment regimen. To learn how to control energy expenditure. © McGraw Hill 10  Comanagement of Chronic Health Disorders 3 Adherence. Increased by appropriate education. Predicted by high expectations for controlling one’s health and self- efficacy and knowledge of the treatment regimen. Vocational issues in chronic health disorders. Discrimination against the chronically ill. Financial problems arise when patients have to cut back on work. © McGraw Hill 11  Comanagement of Chronic Health Disorders 4 Social interaction problems. Negative responses from others. Impact on the family. Caregiving role. Gender and the impact of chronic health disorders. Women have more deficits in social support. Married women are more likely to be institutionalized than husbands © McGraw Hill 12  Comanagement of Chronic Health Disorders 5 Positive changes in response to chronic health disorders. Experiencing positive reactions and optimism. Inspiration to act now instead of postponing. Acquiring more empathy and compassion. Feeling stronger and more self-assured. © McGraw Hill 13  Psychological Interventions and Chronic Health Disorders 1 Pharmacological interventions, including prescription of antidepressants. Individual therapy. Can be episodic. Collaboration with physician and family is critical. Requires respect for a patient’s defenses. Comprehensive understanding of the health disorders and their modes of treatment are required. Guided by cognitive behavioral therapy. © McGraw Hill 14  Psychological Interventions and Chronic Health Disorders 2 Coping skills training can improve functioning for those with chronic health disorders. Increases knowledge about the disorder. Reduces anxiety. Increases patients’ feelings of purpose and meaning in life. © McGraw Hill 15  Psychological Interventions and Chronic Health Disorders 3 Relaxation training and acceptance and commitment therapy (A C T) are widely used. Mindfulness-based stress reduction (MBSR) improves adjustment to chronic health disorders. Exercise can improve quality of life. © McGraw Hill 16  Psychological Interventions and Chronic Health Disorders 4 Social support interventions. Family support. Enhances patient's physical and emotional functioning. Promotes adherence to treatment. Improves course of health disorders. Support groups: Discuss issues of mutual concern that arise as a consequence of health disorders. © McGraw Hill 17  End of Main Content Because learning changes everything. ® www.mheducation.com Copyright ©2021 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.