Chapter 13: chronic illness

Question 1

Chronic Illness

Answer 1

• Persist for a long time
• Don’t resolve spontaneously
• Rarely cured completely
• ⅗ of adults over 20 live with chronic medical illness or disorder in Canada
• 4/5 are at risk of developing chronic illnesses
• Tend to see comorbid conditions (more than one condition)

Question 2

Being diagnosed with a chronic illness can result in…

Answer 2

• Disruption and change (identity, location, role, social support, future goals)
• New demands
• Uncertainty
• Ongoing disease management
• After diagnosis you have to “reframe” your life

Question 3

Initial reactions to chronic illness

Answer 3

• Shock
• Emotion-focused coping (can’t let it go on for too long, need to switch with problem-focused coping to deal with the diagnosis) Can include denial, Loss and grief
• Anxiety and depression

Question 4

Crisis Theory

Answer 4

describes factors that influence how people adjust to learning they have a chronic health condition. (illness related factors, Background and personal factors, physical and social environmental factors) and these are influenced by three coping processes (cognitive appraisal, adaptive tasks, and coping skills) which lead to an outcome of crisis

Question 5

Variables related to long term outcomes of diagnosis (crisis theory)

Answer 5

• Illness-related factors
• Background and personal factors
• Gender
• Self-blame (often leads to depression)

Question 6

Background and personal factors (crisis theory)

Answer 6

• Age plays a role. Adolescents understand the disease and fear is related to social consequences. Young adults understand the disease, and fear is related effects on life direction. Middle aged adults fear is related to their predominant role in life. The Elderly’s main concerns centre around the fact that they may not be able to enjoy retirement.
• Gender also plays a role. Females have more concern with how illness affects physical image, and males have more concern with illness that affect physical strength.
• Self-blame

Question 7

Adaptive tasks that are established following cognitive appraisal (crisis theory)

Answer 7

1. Tasks related to the illness or treatment
   - learning to cope with symptoms
   - adjusting to hospital
   - developing good relationships with health care providers
2. Tasks related to psychosocial functioning
   - control negative feelings and retain positive outlook

Question 8

What is Adaptation (outcome of crisis theory)

Answer 8

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

Question 9

What is Quality of life (outcome of crisis theory)

Answer 9

degree of excellence people appraise their lives to contain (tailored for the condition)

Question 10

What is Asthma

Answer 10

a respiratory disorder involving episodes of impaired breathing when the airways become inflamed and obstructed (afflicts >2 million people in Canada)

• Psychological factors: stress, anxiety, suggestion
• Effective Coping Strategies: acceptance, reappraisal, distraction

Question 11

Epilepsy

Answer 11

condition marked by recurrent sudden seizures that results from electrical disturbances of the cerebral cortex (afflicts ~200,000 people in Canada)

• Psychological factors: stigmatizing, emotional arousal, adjustment (more severe epilepsy is the poorer the adjustment).
• Effective coping strategies: support groups, counselling, optimism (tend to adapt better with being diagnosed), gaining control

Question 12

Spinal Cord Injury (SCI)

Answer 12

neurological damage in the spine that results in the loss of motor control, sensation, and reflexes in the associated body areas (afflicts 86,000 people in Canada - with 4,300 new cases per year)

• Psychological Factors: Quality of life (people with SCI have severe pain, poor sleep, and can lose their independence), integration into social/career environments (accommodating to wheelchairs), emotional costs, sexuality (myth that SCI patients can’t have sex)
• Effective Coping Strategies: Family Support (go to problem-solving coping), Counselling and education

Question 13

Alzheimer’s Disease

Answer 13

a brain disorder characterized by a deterioration of attention, memory, and personality (afflicts ~500,000 people in Canada - 900,000 by 2031)
- Psychological Factors: Easily frustrated and angry, as they can’t recall things as easily. Can lead to helplessness and depression over time.

Question 14

Goal of psychosocial interventions

Answer 14

enable patients and families to self-manage condition

Question 15

Self-management programs

Answer 15

provide information to train patients in behavioural and cognitive skills to enhance their ability to carry out their regimens, create and adapt to new behaviours or life roles and cope with emotions
- Being able to care for yourself (medically)

Question 16

Psychosocial interventions

Answer 16

Self-management programs, educational, social support, cognitive methods, behavioural methods, and integrated care approaches.
- Relaxation and biofeedback (effective for patients in pain)

Question 17

Integrated Care Approaches

Answer 17

Rather than multiple health professional, have one who oversees many aspects of care. Ensures coordinated/integrated care.

Question 18

Cognitive Methods (psychosocial interventions)

Answer 18

• Guided imagery, distraction (there’s a difference between the two)
• Problem-solving training
• Cognitive restructuring

Question 19

What does cognitive appraisal lead to (crisis theory)?

Answer 19

It leads to adaptive tasks and coping skills

Question 20

What is the final aspect/stage of the crisis theory?

Answer 20

Moving from Crisis to permanent changes (Mastery, adherence, self care, relationships)