Comm Lecture 12 PDF

Lecture 12 Life-Altering Illness Objectives: 1. Differentiate between acute, chronic, and life-altering illnesses. 2. Differentiate between curative and palliative care. 3. Describe psychological effects of life-altering illness....

Lecture 12 Life-Altering Illness Objectives: 1. Differentiate between acute, chronic, and life-altering illnesses. 2. Differentiate between curative and palliative care. 3. Describe psychological effects of life-altering illness. Terminology Acute Illness Characteristics: Rapid onset of severe symptoms. Typically short duration. Daily functions are interrupted. Examples: H1N1, COVID, flu, gastroenteritis. Impact: Seen as an inconvenience. Chronic Illnesses Characteristics: Symptoms persist over time. Significant and lasting impact on life. Potentially life-threatening or may shorten lifespan. Associated with stages of grief. Lecture 12 1  Requires care and compassion. Examples: Arthritis, fibromyalgia, multiple sclerosis (MS), diabetes, cancer, AIDS, COPD. Life-Altering Illnesses Scope: Includes some chronic illnesses, most of which are life-threatening. Emotional Responses: Feelings of powerlessness and lack of control. Anger, worry, denial, pain, anguish, or acting out. Care Approach: Palliative Care: Focused on comfort rather than curing illness or prolonging life. Improves quality of life for patients and families facing life-threatening conditions. Involves early identification, pain relief, and addressing physical, psychosocial, and spiritual issues (as per WHO). Hospice: Affirms life while recognizing dying as a normal process. Provides symptom relief and holistic care, including emotional, spiritual, and practical support for patients and families. Palliative Care Definition (WHO): "An approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness through the prevention and relief of suffering by means of early identification and Lecture 12 2  impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual." Facility: Hospice centers offer a supportive environment for managing symptoms and providing comfort. Losses Suffered by Patients Types of Losses: Good health. Independence. Body image. Lifestyle. Self-confidence. Relationships. Sexual functioning. Cultural Influences Perspectives on Disclosure: North Americans generally prefer direct disclosure to patients. Cultures like Asian, Iranian, and Mexican families may prefer withholding information from the patient. Caution: Recognize cultural generalizations but avoid stereotyping. Therapeutic Response Key Practices: Acknowledge mood swings and discuss feelings openly. Lecture 12 3  Involve both patient and family in the care process. Encourage and allow patient decision-making. Educate families about the condition and care. Focus on managing the present situation. Management Varies Tailored to individual needs, preferences, and cultural contexts. Therapeutics Across the Life Span Objectives 1. Describe Jean Piaget’s theory of cognitive development. 2. Compare Pavlov’s and Skinner’s theories of cognitive development. 3. Describe Lawrence Kohlberg’s theory about moral development. 4. Discuss Erik Erikson’s eight stages of psychosocial crises. 5. Identify key characteristics associated with infants, children, adolescents, adults, and the elderly. 6. Apply strategies for therapeutic communication in each age category. Theorists in Growth & Development Jean Piaget (1896–1980) Background: Swiss biologist and psychologist. Major influence on child cognitive development. Lecture 12 4  Believed “only education is capable of saving our societies from possible collapse, whether violent or gradual.” Key Concepts: 1. Cognitive Progression: Children’s insights and abstract thinking develop as they grow. Logic differs from adults’. 2. Adaptation Mechanisms: Assimilation: Interpreting events using existing knowledge. Accommodation: Adjusting knowledge to make sense of the environment. 3. Learning Through Interaction: Development occurs through environment interaction using assimilation and accommodation. Tasks must align with a child’s cognitive abilities. Application in Practice: Understand Piaget’s developmental stages to communicate appropriately with children based on their cognitive level. Therapeutic Approach Across Piaget’s Cognitive Periods 1. Sensorimotor Period (Birth to 2 years): Support securely. Prevent hazards (e.g., objects in mouth). Smile, talk, and foster discovery and coordination. 2. Preoperational Period (2–6 years): Use simple commands, games, and imagery. Help grasp basic realities (e.g., praise for behaviors). 3. Concrete Operational Period (7–11 years): Lecture 12 5  Encourage logical thinking. Provide autonomy with decisions. 4. Formal Operational Period (12 years and up): Develop abstract thinking, conservation, and reasoning. Behaviorist Theorists: Pavlov & Skinner Ivan Pavlov (1839–1936) Classical Conditioning: Associating stimuli with involuntary responses (e.g., dog experiment). Example: Anxiety linked to sounds after trauma. B.F. Skinner (1904–1990) Operant Conditioning: Voluntary behavior precedes the reward. Behavior modified by consequences: Positive Reinforcement: Reward follows desired behavior. Negative Reinforcement: Removing unpleasant stimuli. Punishment: Applying unpleasant stimuli for undesired behavior. Lawrence Kohlberg (1927–1987) Moral Development Theory: Moral understanding evolves with cognitive development and experiences. Parallels Piaget’s theories. Stages of Moral Development: 1. Preconventional Level: Morality based on avoiding punishment. Lecture 12 6  2. Conventional Level: Seeking approval and valuing societal norms. 3. Postconventional Level: Guided by ethical principles and individual rights. Erik Erikson (1902–1994) Psychosocial Development: A continuum of eight life stages, each with a crisis that motivates behavior. Stages reflect societal and personal conflicts. Stages of Psychosocial Development: 1. Trust vs. Mistrust (Birth to ~17 months): Focus on security, familiar faces, and positive reinforcement. 2. Autonomy vs. Shame & Doubt (18 months to 3 years): Encourage independence while maintaining routine. 3. Initiative vs. Guilt (3–6 years): Support decision-making and imaginative activities. 4. Industry vs. Inferiority (6–11 years): Promote confidence through encouragement and explanation. 5. Identity vs. Role Confusion (12–18 years): Address identity and peer concerns respectfully. 6. Intimacy vs. Isolation (19–40 years): Emphasize relationship building and decision-making. 7. Generativity vs. Stagnation (40–65 years): Recognize productivity and coping strategies. 8. Ego-Integrity vs. Despair (65–death): Foster respect and autonomy in decision-making. Lecture 12 7  Therapeutic Strategies Across Life Stages Infants (Birth–1 year): Focus on comfort, safety, and engagement. Involve parents in assessments and treatments. Children (1–11 years): Adapt communication for understanding (e.g., simple commands, demonstrations). Be honest and supportive, addressing fears and misconceptions. Adolescents (12–18 years): Respect privacy and autonomy. Avoid judgments about appearance; maintain dignity. Adults (19–65 years): Acknowledge stress and provide clear, informative care. Ensure privacy and build trust. Elderly (65+ years): Allow extra time, emphasize comfort, and use respectful language. Address concerns about autonomy and identity. Lecture 12 8