health psych ch 11

CHAPTER 11 - MANAGEMENT OF CHRONIC ILLNESS

Quality of Life

60% of people will have a chronic health condition at some point in their life
Relationship b/w medical measures and personal assessment
- Weak correlation b/w physician's idea of quality of life and the patient’s idea
Reciprocal (mental/physical health)
- Mental health and physical health impact each other
- Need equal focus on mental and physical

– What is Quality of Life?

– Why Study Quality of Life?

Guides interventions
- Medications that impact QOL
  - More or less important based on one’s values
Evaluates impact of tx
- Illness
- life

Emotional Responses to Chronic health disorders

Acute
Chronic
Crisis phase: adjustment to realizing that this is something that you will deal with for the rest of your life
Denial
- Short-term
  - Beneficial → extra time to adjust
- Long-term
  - Not beneficial → don't want to address the problem
Anxiety
- Short-term
  - Can be helpful → increase motivation
- Long-term
  - Not beneficial → can be debilitating and add to symptoms, tx, etc.
- Anticipatory
  - Even more damaging
  - Stuck on future, catastrophic thinking
  - It is not preparing you for future problems
Depression
- Significance
  - Impact on symptoms, tx, recovery
- Assessment
  - Overlap → developing and worsening depressing can indicate worsening health
- Who is vulnerable?
  - Severity of pain, disability
  - Low quality of life

Personal Issues in Chronic Disease

The Achieving Self

Social Self

Interactions With others
- Friends, family, neighbors
- Someone may too self-conscious to be around others
Emotional support (rehabilitation)
- Chronic health disorders limiting emotional support

Private Self

Coping with Chronic Illness

Coping Strategies

Areas of life
- Fear, physical impact, pain management (12%)
Effective coping strategy
- Depend on disorder
- Flexible vs. predominant copers
  - Flexible: adjust coping strategy to what will actually be beneficial in that moment
  - Predominant: only use their regular strategy

Patients’ Beliefs

Comanagement of Chronic health disorders

Physical rehabilitation

Range of symptoms
- Identify symptoms
Goals of physical rehabilitation
- Crisis onset
  - Train to recognize signs of crisis
- Response
  - How to respond during crisis
- Maintain tx
Comprehensive program development
- Include all components involved
- Adherence issues
Meet the therapist
- Physical
  - Increase muscle mass
- Occupational
  - Relearn daily living skills
- Dieticians
  - What should you be eating and why
  - How are you going to get this in your diet
- Social workers
  - Finding resources

Vocational Issues

Social Interaction Problems

Response from others
- More of a negative response
  - Cancer
  - COVID
  - AIDS
  - Epilepsy
    - What will trigger it → uncomfortability
  - Tourettes
Impact on family & friends
- Can you still do the things you normally would do
Caregiving role
- How much support will someone needs
  - Can be overwhelming
- Caregiver burden
- Will you need a home healthcare nurse

Gender

Females
- Receive less social support
  - Female caregiver role
Males
- Tend to be older in a relationship
- More likely to be disabled with age

Positive Changes

Child

Psychological Interventions & Chronic Illness

Pharmacological
- Drug therapy
- Side effects
Individual Therapy
- Episodic vs continuous
- Collaboration with physician
- Education
Patient Education
- Coping skills training
  - Illness treatment

Relaxation, Stress Management, & Exercise

Social Support