Chapter Eleven: Management of Chronic Health Disorders Flashcards
Assessments measure the _________ to which a patient’s normal life activities have been compromised by disease & _________
extent, treatment
Treatment with quality of life for certain patients with more _________ diseases will need ______ care like: bathing, dressing, using the bathroom, being mobile, etc. This is because some diseases make those things difficult.
advanced, extra
Components to one’s quality of life:
Physical functioning
Psychological status
Social functioning
Disease or treatment related symptoms
Why study one’s quality of life?
Guides interventions
Helps identify the issues likely to emerge for patients
Assesses the impact of treatments
Used to compare therapies
Can inform decision makers abt care
Def: Denial
defense mechanism by which ppl avoid the implications of a disorder.
Interferes with absorption of treatment
Def: Anxiety
patients become overwhelmed by potential changes in their lives & the prospect of dying.
Interferes with treatment
Anxiety can potentially interfere with treatment
Very prevalent for those with asthma & pulmonary disorders.
Can be mistaken for symptoms of underlying diseases
Def: Depression
complicates treatment adherence & medical decision making
Assesses it in the chronically ill can be complicated
Depression is common with patients that experience ________, cancer patients, & those with heart diseases, and patients with _______ than one chronic disorder
strokes, more
Depression __________ the cause of severe chronic disorders, most notably coronary heart disease.
exacerbates
Those who become depressed about their health disorders….
Experience pain & disability
Experience negative life events
Lack social support
The onset of depression depends on the _________ of the disorder.
severity
Def: Self-concept
stable set of beliefs abt one’s personal qualities
Evaluated by self esteem
Includes one’s body image
Def: body image
Perception & evaluation of one’s physical functioning & appearance.
Poor body image increases risk of depression & anxiety
Influences one’s adherence to treatment & willingness to adopt a co management role.
________ self body image will lead to depression &/or _______
Poor, anxiety
Body image might influence how _________ a person is to the course of treatment & how willing they are to adopt a _________________ role.
adherent, co-management
_____________ is important bc it can be improved thru interventions.
Body image
Effective self-care requires active ___________.
engagement
Def: Achievement
important source of self-esteem & self-concept
Def: social resources
provides info, help, & emotional support
Def: private self
patient’s identity can be affected by chronic health disorders
Coping with chronic health strategies:
Social support or direct problem solving
Distracting
Thinking mainly positive thoughts about the topic at hand
Cognitive escape or avoidance
Behavioral escape or avoidance
Ppl with chronic health diseases use ________ active coping methods, like problem solving, & confrontative coping, & more _________ coping strategies.
fewer, positive
Nature of the health disorder: patients adopt an ____________ model for their disorder
inappropriate
Patient’s beliefs of their health disorder:
Patients blame stress, physical injury, disease causing bacteria, and a God’s will for their disorders
Self blame can lead to guilt, self-recrimination, or depression
They might also believe that they can prevent a recurrence of the disease (especially for cancer patients).
Patients with high self-control or self-efficacy are better adjusted to their circumstances
Controllability of the health disorders:
Patients who have a sense of control or self-efficacy with respect to the disorder are more adaptive.
Experience of control or self-efficacy might prolong life
Ppl with chronic health disorders will usually develop their own _________ abt where their health disorder came from.
theories
Def: physical rehabilitation
Learning:
How to use one’s body as much as possible
How to sense environmental changes to make appropriate accommodations
New physical management skills
Necessary treatment regimens
How to control the expenditure of energy
________ are being used more often for disabled ppl to maximize their daily _____________.
Robots, functioning
Developing a comprehensive rehabilitation program:
Patients need a pain management program
Patients might need training to use adaptive devices.
Chronic health disorders can lead to a __________ in sexual activity.
decrease
Adherence to co-managing chronic health disorders:
Increasing by appropriate education
Predicted by high expectations for controlling one’s health & self-efficacy & knowledge of the treatment regimen
The first step for ____________ is education.
adherence
Vocational issues in chronic health disorders:
Discrimination against the chronically ill
Financial issues arise when patients have to cut back on work
Social interaction problems for co-managing chronic health issues:
Negative responses from others
Impact on the family
Caregiving role
Gender & the impact of chronic health disorders:
Women have more deficits in social support
Married women are more likely to be institutionalized than husbands.
Positive changes in response to chronic health disorders;
Experiencing positive reactions & optimism
Inspiration to act now instead of postponing
Acquiring more empathy & compassion
Feeling stronger & more self-assured
Cons to children having a chronic health disorder
Confused bc the kid doesn’t understand the diagnosis and possible treatment
Cannot follow the treatment regimen without help from the family
Exposed to isolating & terrifying procedures
Exhibits a variety of behavioral issues
Might develop maladaptive coping styles.
How to improve a child’s coping:
Parents can soothe kids emotionally & provide an informal basis for care
Children should be encouraged to take care of themselves
Regular school attendance
Reasonable physical activities
Family therapy & training the family in the treatment regimen will help
Pharmacological interventions of chronic health disorders - prescription of _______________
antidepressants
Individual therapy for CHD:
Can be episodic
Collab with patient’s physical & family is critical
Requires respect for a patient’s defenses
Comprehensive understanding of the ehealth disorders & their modes of treatment are required
Guided by CBT
Coping skills training……
can improve functioning for chronic health disorders
Increases knowledge abt the disorder
Reduces anxiety
Increases patients’ feelings of purpose & meaning in life
Relaxation, stress management, & exercise can:
Relaxation training & acceptance commitment therapy (ACT) are widely used
Mindfulness-based stress reduction (MBSR) improves adjustment to chronic health disorders
Exercise can improve one’s quality of life
Social support interventions:
Family support
Enhances patient’s physical & emotional functioning
Promotes adherence to treatment
Improves course of health disorders
Support Groups
Def: Support Groups
discuss issues of mutual concern that arise as a consequence of health disorders
