BSS: Coping with chronic illness Flashcards
What is the WHO detention of chronic disease?
- A disease that has a long duration and is the result of a combination of genetic, physiological, environmental and behavioural factors
What makes chronic disease treatment different to acute disease care?
- Chronic disease treatment is focused more on management of symptoms rather than a cure for the disease.
> Improvements in treatment mean people may live with a condition for many years
Describe the model that links stress and ill health?
What are some of the main stressors for chronic illnesses?
- symptoms
- medical consultation processes
- investigations
- diagnosis
- treatment
- interference in daily life
- any adjustments that have to be made to an individuals life
Define coping.
- Cognitive & behavioural efforts to manage external &/or internal demands that are appraised as taxing or exceeding the resources of the person
What are the two main situations when coping strategies will be needed?
- everyday life, daily stresses and hassles (seem small compared to major events)
- major life events
What is the self regulatory model?
What does it explain?
- Explains adjustment at diagnosis &throughout course of disease
- Health behaviours are dueto representations of disease that are constructed based on knowledge & past experience
- Beliefs differ across &within different diseases based on perceived severity/threat
How would we use the self regulatory model to apply to real life situations?
What are the 2 ways in which coping methods can be classified?
– Problem-focused v. Emotion-focused
– Approach v. Avoidance
Describe Problem focussed and Emotion focussed.
What have studies indicated?
- Problem-focused: Doing something practical to tackle the problem e.g. taking medication, seeking medical advice, seeking information
- Emotion-focused: Doing something to manage your emotions
e.g. venting negative feelings, seeking social support, positive reappraisal, avoidance
> Matching the stressor and the strategy is important
– Controllable → problem-focussed
– Not controllable → emotion-focussed
Describe Approach and Avoidance coping.
- Toward or away from the stressor/related emotions?
What are some pros and cons of information seeking and avoidance?
Information seeking :
ü Can reduce uncertainty and increase sense of control
ü Can promote adherence
× Too much information can increase anxiety (blunters)
× Different patients will want/benefit from different amounts and types of information
Denial :
ü Can be beneficial in short term, by minimising anxiety and distress
× Prolonged denial impacts on adherence
× Prevents patients ‘coming to terms’ with their disease
What are the 5 stages of grief? How does this link to coping?
> not fixed!
– Denial
– Anger
– Bargaining
– Depression
– Acceptance
* The stage a person is at could influence their ways of coping at that time
Outline 3 individual differences and how they would respond generally to a diagnosis.
- optimistic - positive thinking style
- hardy personality - sees change as a challenge, demonstrate commitment and control - see change as normal aspect of life, not a threat. They can remain healthy even under stress
- negative affect - linked to increased symptom perception
- Outline the illness related adjustments that would need to be made with a chronic disease
- Outline the adjustments that would need to be made in terms of general tasks of those with a chronic disease?
- – Living with symptoms & pain
– Learning about treatments & management – Relationships with health care professionals - – Managing social & emotional consequences
– Preserving self-image, competence & mastery
– Preparing for an uncertain future
What are the 3 cognitive processes proposed that aid adjustment to chronic disease?
- search for meaning - understand why it has happened and its impact, regain order and purpose
- regain mastery - gain control over event and life (or beliefs) e.g. that they can control of their symptoms or that the healthcare professionals will take good control
- enhance self esteem - comparison with people perceived as less fortunate
- What does ‘response shift’ mean in regards to adjusting to chronic disease?
- What does ‘reality matching’ mean in regards to adjusting to chronic disease?
1.
– Change in perspective & priorities in life
– Realign goals to fit with new situation
- Maladaptive outcomes can occur when appraisals don’t match reality. Frustration and disappointment arise when uncontrollable events are deemed controllable.
- more favourable outcomes occur when appraisals match reality
What does adjustment to chronic illness involve?
> Process to help achieve a positive view of the self & the world in the face of the new problem
Likely to take some time – will involve assessing new information, developing adaptive views, re-evaluating priorities
Brings about change in:
– Role/Identity
– Functioning/ Isolation
– Social support
– Future (biographical disruption)
What factors can complicate adjusting to chronic disease?
- limited previous experience of chronic illness/ little awareness
- decisions need to be made quickly about treatment etc, things happen fast paced so cant think about what is best option
- unpredictability and uncertainty about prognosis and diagnosis
- additional external stressors unrelated to disease that are overall increasing stress levels
Define self management.
- Anything that promotes the active involvement of a patient in managing their condition
Why is self management difficult for some patients?
- Lifestyle changes are more difficult to make than changes that are illness-specific
- Patients may not see immediate benefits
- Must become part of patient’s normal daily life
- Will require adjustment
What factors can make self management easier?
- Self-efficacy - belief they can do it
- Environmental factors
– Supportive healthcare providers
– Social support
– Safe physical environment (e.g. housing, air quality)
Outline some effects (pro and cons) of social support on adjusting to life with a chronic disease.
PROS
- encourages health promoting behaviour
- improves psychological wellbeing
- can reduce stress directly or by changing the patients perspective e.g. increased optimism, taking coping suggestions on board
- Most effective when the social support matches what the patient feels they need and want from it
CONS
- Social relationships do not guarantee social support > can be source of stress and compromise patient wellbeing
