Behavioral Aspects of Chronic Disease

What is the epidemiologic burden of chronic disease?Six in ten adults in the United States (60% of the population) live with a chronic disease. Four in ten have 2+ chronic disease \n Over 86% of the nations’ health care costs are spent on chronic disease management and Increase in overall spending on patients who have 5 or more medical conditions.

What percentage of the nation's health care costs are spent on chronic disease management?Over 86% of the nation's health care costs are allocated to the management of chronic diseases, reflecting the substantial impact of these conditions on healthcare expenditure.

What demographic factors are strongly correlated with multi-morbidity in chronic disease?Multi-morbidity in chronic disease is strongly correlated with age, lower levels of education, and public health insurance.

What factors contribute to the rise in the prevalence of chronic diseases?The rise in the prevalence of chronic diseases can be attributed to several factors, including: Improved life expectancy and an aging population. Educational campaigns promoting disease testing and surveillance. Better treatment options that are more aggressive and effective.

What are examples of chronic diseases that have seen an increased population prevalence?Diabetes, Cardiovascular events such as stroke and heart attack, Obesity.

What are the four main behavioral/lifestyle factors that contribute to chronic disease in the united states?Tabacco usage and exposure to second-hand smoke. Poor nutrition; diets low in fruit and vegetables and high in sodium and saturated fats. Lack of physical activity. Excessive alcohol use.

how can having a chronic disease impact a person’s behavior?Negative financial impacts, increase in stress, emergence of depression, anxiety, and other mental health conditions. Nonadherence to medical visits (missing medical appointment, medication usage).

What are patient identified barriers stopping them from promoting healthy behaviors?Financial limitations, Addiction/dependence on drugs/alcohol, lack of access to quality nutrition, environmental/Socioeconomic factors, societal stigma and distrust in the healthcare field.

What are some behavioral etiologies?Chronic disease, above health risk behaviors (tobacco, nutrition, physical activity and excessive alcohol use), lack of time, sleep, income for healthy foods, genetics etc.

What are some behavioral consequences of living with chronic medical conditions?Increased risk of depression, Increased incidences of anxiety in chronic disease patients, Insufficient or disturbed sleep, Stages of grief. They can experience multiple ones over time.

What are some increase risk of depression?(about 1⁄3 or 33% of patients with a chronic illness have depression. People must adjust to both the illness and its treatment. Changes the way a person lives, sees themselves, or relates to others.

What are some increased incidences of incidences of anxiety in chronic disease patients?(Chronic obstructive pulmonary disease). COPD patients are 85% more likely to develop anxiety disorders. COPD patients (with anxiety) exhibit self-reported functional limitations, poorer exercise tolerance, and higher frequency of acute exacerbations (sudden worsening of a symptom)

What are some insufficient or disturbed sleep?Insufficient sleep has been linked to an increased risk for type 2 diabetes, obesity, and cardiovascular disease. Chronic disease can cause interrupted sleep due to a host of symptoms and fatigue. When a patient has a sleep concern, make sure to take all details of a sleep history, (sleep hygiene, caffeine, exercise, screens) AND screen for depression. \n What are the stages of grief?DABDA can be applied to patients experiencing chronic illness. Denial, Anger, Bargaining, Depression, Acceptance.

What aspects of physician behaviors positively impact care of patients with chronic conditions?Outcome, Physiology, Overall function, Patient perception of wellbeing.

What part does empathy play on clinical encounters?Having a patient centered approach. More time you spend with the patient is linked to better outcomes. “Being able to talk to my doctor and feeling listened to” is the desired patient sentiment. Increases physician job satisfaction. Being able to achieve this close empathetic connection depends on. Number of patients seen per day/week (too many is bad). How accessible you are for future appointments; scheduling timely follow-up appointment is important in making patients feel like a priority. Tendency to answer patient questions; taking time to give feedback and answer the patient. Variation depending on speciality specific visits

What barriers prevent physicians from achieving ideal communicative approach?Burnout can reduce the level of empathy providers have for their patients. Inattentiveness to patient’s concerns and feelings. Use of medical jargon; goes over patient’s head and they feel they can’t communication - Oversimplification; makes the patient feel insulted. Depersonalization; the physician is not really “present” in the room - Lack of feedback. Stereotyping patients.

What are certain techniques and behaviors that can improve provider communication?Greeting patients, addressing them by their name, saying goodbye. Using both open-ended questions (inviting patient to talk and elaborate on their feelings) and focused questions (“Does lying down make the pain worse”). Active listening and friendly non-verbal communication). Avoiding the use of medical jargon. Giving clear instructions (preferably in writing). Using the “Teach and Repeat” method. Explaining purposes of procedures

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