Chapter 13 - Serious and disabling chronic illnesses: causes, management, and coping

what are some common initial reactions to having a chronic condition

shock, then denial

what influences how an individual cope with a health crisis

illness-related factors

background and personal factors

physical and social evnrionment factors

how does illness-related factors influence how one cope with a health crisis

health problem severity

major changes in bodily functions

painful treatments or medications that produce serious side effects

major altercation to daily habit

how do background and personal factors influence how one cope with a health crisis

resilience → better coping

age, gender, social class, philosophical or religious commitments, emotional maturity, self-esteem all affect how one copes

self-blame, more → worse coping

rumination and catastrophizing → worse coping

how do physical and social envrionment factors influence how one cope with a health crisis

hospital environment

social support → helps patients with coping

what are the two types of adaptive tasks in the coping process that need to be identified by those who are ill

tasks related to the illness or treatment

tasks related to general psychosocial functioning

what are the tasks related to the illness or treatment

learning to

1. cope with symptoms or disability of the health problem

2. adjust to hospital environmental and medical procedures or regimens needed to treat the problem

3. develop and maintain good relationships with practitioners

what are the tasks related to general psychosocial functioning

striving to

1. control negative feelings and retain positive outlook for the future

2. maintain good self-image and sense of competence

3. preserve good relationships with family and friends

4. prepare for an uncertain future

what is adaptation?

the process of making changes in order to adjust constructively to life’s circumstances

what is quality of life?

the degree of excellence people appraise their lives to contain

what is a common threat to QoL of those with chronic medical conditions

serious emotional distress: in the form of depression and anxiety

what is asthma

a respiratory disorder involving episodes of impaired breathing when the airways becomes inflamed and obstructed

what are some common asthma triggers?

personal factors

envrionmental conditions

physical activities

what are the main psychosocial factors in asthma

stress can worsen asthma

interpersonal conflict → trigger asthma symptoms

anxiety increases symptom perception

anxiety and catastrophizing worsen impact of more episodes

what is epilepsy

recurrent, sudden seizures that result from electrical disturbances of the cerebral cortex

what are the psychosocial factors in epilepsy?

stigma as epileptics lose control over their body

limited eligibility in jobs due to seizures

emotional arousal may increase the likelihood or severity of epileptic episodes

poor adjustment to epilepsy

stigma → worse adjustment

what is spinal cord injury?

neurological damage in the spine that results in the loss of motor control, sensation, and reflexes in associated body areas

what are the psychosocial aspects of spinal cord injury

difficulty in workplace due to no control over motor actions

discrimination as this feels like a disability

need social support for better recovery, from family and friends while they are not too overprotective

stress from sexual problems

self-deprecating thoughts

difficulty in accessing day to day facilities cause anxiety, stress, and even depression

what is type 1 diabetes

autoimmune disease, body immune system attacks insulin-producing cells, usually in younger people

what is type 2 diabetes

metabolic disorder, body can’t use insulin properly and can’t make enough insulin to keep blood sugar normal

more common in adults

what are the psychosocial factors in diabetes?

support support and self-efficacy determine treatment regimen adherence

stress impairs blood sugar control

depression and stress → lower adherence and glucose control

embarrassment from testing blood glucose levels at public places

forget to take blood glucose testing kit

dietary recommendations may not be consistent with past habitual diet → nonadherence

what is arthritis

musculoskeletal disorder affecting the body’s muscles, joints, and connective tissues near the joints

what are the psychosocial factors in arthritis

stress to the patient and family

arthritis increase risk to emotional distress

pain and interfere with simple daily activities → causing helplessness and depression

depressed individuals cope with arthritis worse

sleep problems

better sense of control → better recovery and better emotional condition of those around the patient

what is alzheimer’s disease

a brain disorder characterized by a deterioration of attention, memory, and personality

what are the psychosocial effects of alzheimer’s disease

inability to do basic tasks → increased feelings of helplessness

disturbances cause stress to family members like accusing family of taking something that never existed

helplessness and stress in caregivers as it is a great deal to take care of people with alzheimer’s disease

what is the conclusion regarding how healthy care giving is

helping and taking care of those with chronic illness can be difficult but also deeply rewarding

what are the educational methods for chronic conditions

providing patients and their families with accurate information about the disease and its prognosis and treatment

what are the social support methods for chronic conditions

support groups or social support from close friends and family help patients adjust to the chronic condition

what are the behavioural methods for chronic conditions

tailoring

CBT

self-management

what are the cognitive methods for chronic conditions

problem-solving training

cognitive restructuring: clients discuss incorrect thoughts and beliefs and learn ways to cope better by thinking more constructively or realistically

what is family therapy

the family of the patient meet as a group and draws on cognitive, behavioural, and interpersonal methods to examine and change interaction patterns among family members

what is collaborative or integrative care approach

a combination of perspectives of multiple providers

Research on adherence to diabetes regimen indicates that

A. most people will carefully administer recommended insulin doses.

B. self-report information regarding adherence tends to be fairly accurate.

C. adherence to the medical aspects of regimen is higher than that associated

with dietary changes.

D. people with diabetes often don’t even try to adhere to their regimen.

E. All of the above

C. adherence to the medical aspects of regimen is higher than that associated