Chronic Diseases Flashcards
Which are the 12 chronic diseases abundant in Australia?
- Ischaemic Heard Disease (CHD)
- Stroke
- Lung Cancer
- Colorectal Cancer
- Depression
- Type 2 Diabetes
- Arthritis
- Osteoporosis
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- chronic kidney disease
- oral disease
Name 7 modifiable risk factors for chronic diseases
- high blood pressure
- poor diet
- excess weight
- physical inactivity
- tobacco
- Alchohol
- High blood cholesterol
Name the prevalence of risk factors in Australia
(except from diet / exercise)
- tobacco: 17% > 14y
- high blood cholesterol: 50% in >25y
- high blood pressure: 30% > 25y
- alcohol: 10% drink alcohol at risky levels
- excess weight: 60%
The four most expensive chronic dieseases and their cost
- CHD
* 7.74 billion = 10.4% of Health budget* - Oral health
* 7.18 billion = 9.7%* - Mental disorders
* 6.38 billion = 8.6%* - Musculoskeletal
* 5.67 billion = 7.6%*
Which four diseases pose the biggest burden in Australia?
- Cancer
- CHD
- Mental Disorders
- musculoskeletal disorder
What is DALY?
Disability Adjusted Life Years
1993 by world bank
How many life years somebody lost due to sickness and early death
DALY =
YLL (Years of Life Lost Due to Disease)
+
YLD (Years of Life Spent with Disability)
What has changed btw 1990 and 2010?
A larger fraction now caused by ill-health rather than premature death
Not CHD the biggest burden, but Cancer and Musculoskeletal diseases
while both smoking and dietary risk factors among top three, today excess weight took over from high blood pressure
CVD Prevalence
I. heart, stroke and blood vessel disease kills one Australian every ___
II. affects ___ people in Australia
III. how many death in 2008?
IV. How did the prevalence of heart, stroke and vascular diseases change over the last decade?
I. 11min
II. 3.4 millions
III.46,000 (33%)
IV. rise by 18.2%
Name the three categories of risk factors for CVD
- Age, gender, sociocultural risk factors
- biological and lifestyle factors
- Type A behaviour
* show under stress more reactivity (higher blood pressure, catecholamine, corticosteroid levels)*
Name three heart/ blood vessel diseases
- *1. Artherosclerosis**
- blood vessels become narrow by plaque. Brief or incomplete blockage leads to angina pectoris.*
- *2. Ischemia**
- insuffient supply of blood to an organ, usually due to a blocked artery.*
- *3. Myocardial Infarction**
- severe or prolonged block (“heart attack”)*
Medical treatment and rehabilitation
of cardiac patients
• Initial medical treatment for heart attack
– Clot-dissolving (thrombolytic) medication
– Coronary care unit may closely monitor
– Balloon angioplasty: balloon is inflated in artery to open the bloodvessel
– Bypass surgery: diseased vessel replaced by a healthy one
• High anxiety in first few days of coronary care
• Rehabilitation for cardiac patients
– Info on symptoms, medications & risk factors
– Stress management lowers mortality
– Patients may resent the restrictions necessary for recovery
– Exercise is introduced and becomes more vigorous
– Exercise adherence is related to psychosocial adjustment; 50% discontinue in six months
• Only 40% quit smoking - anxious + lower occupational / educational group less likely
Definition Stroke
A disruption in the blood supply to the brain
→ a cerebral artery is blocked by thrombus or embolus
as a consequence the blood vessel either rupture or haemorrage
Risk factors of stroke
Age, gender, and sociocultural risk factors
higher for:
• Men
• Indigenous people
• Those older than 55 years
• Lower socioeconomic groups
• European-born Australians
Lifestyle and biological risk factors for stroke
smoking, hypertension, heart disease, diabetes, obesity, physical inactivity, family history, high red blood cell count and transient ischemic attacks
The effects of stroke and
rehabilitation
• Extent & type of impairment depends on size and
location of lesion
• Improvement is possible, especially for the young,
and in those strokes due to haemorrhages
– Motor impairment is the most common
– Cognitive impairment may include receptive
and expressive aphasia
– Visual disorders are common with right brain
stroke
– Emotional effects may depend on area of the
brain damaged, includes phenomena such as
pseudobulbar lability of affect
Definiton of Cancer
&
4 Types of Cancer
Unrestricted cell proliferation, which may form a malignant neoplasm.
4 types of cancer:
- *Carcinomas**
- cancers of the skin and organ linings*
- *Lymphomas**
- cancers of the lymphatic system*
- *Sarcomas**
- cancers of the muscle, bone or connective tissue*
- *Leukaemias**
- cancers of the blood forming organs*
*!: *Cancer cells can metastasise - spread through blood or lymph
With which three methods is cancer diagnosed?
- urine / blood (hormones, enzymes)
- radiological imaging (x-ray)
- biopsis
which three methods exist to treat cancer?
- surgery
- internal / external radiaton
- chemotherapy
medi that kills rapidly dividing cells. as a result anticipatory nasea and food aversions.
Name the five most abundant cancers in Australia
colorectal, lung, breast, prostate, melanoma
Diabetes Risk Factors
- Overweight & obesity is rising (in males & females)
- Physical inactivity: over 70% of Australian > 15y did little/ no exercise in 2010–11
- Unhealthy eating
- Tobacco:2.8 million Australians > 14 smoked daily in 2007
- high total cholesterol levels: 50% > 25y in 1999–2000
- high blood pressure: steadily declined btw 1980 - 2000 in urban areas of Australia
Factors of Self Management
Involves the individual engagin in activities that protect & promote health, by:
- being able to make or participate in informed decisions
- building partnerships with others
- managing the impacts on functioning, emotions & interpersonal relationships
- monitoring and managing symptoms and signs of illness and chronic conditions
Define Self Management
“Self-management is the by people
in their own health care. Self-management
incorporates health promotion and risk reduction,
informed decision making, following care plans,
medication management, and working with health
care providers to attain the best possible care and
to effectively negotiate the often complex health
system.”
+
about enabling: that patients can make informed choces, to adapt new perspectives and generic skills…
Common sense model of Self-Regulation (CSM)
Leventhal et al.
5 attributes: identity (name & perceived symptoms), timeline, cause, consequences, cure/controllability
all of them are
- abstract conceptual
- concrete perceptual
Support Services for chronic conditions
include:
- information
- respite centres
- support groups
- promotion of correct care
+
Behavioural methods for compliance
Inital Reactions to a chronic illness
- *1. Shock**
- stunned, behaving in an automatic fashion, feeling a sense of detachment from the situation*
- *2. Encounter reaction**
- disorganised thinking, feelings of loss, grief, helplessness, despair, being overwhelmed by reality*
- *3. retreat**
- use of denial, may be used to control emotions*
4. retreat gradually gives way to reality with adjustment
Crisis Theory
Moos, 1982
Adjustment depends on a variety of three factors:
- *Influencing Factors:**
1. Illness-related Factors
2. Background and personal Factors
3. physical and social environmental factors
Coping
• Begins with a cognitive appraisal
Coping involves carrying out two types of adaptive tasks:
– Tasks related to illness or treatment
• Coping with the symptoms/ disability
• Adjusting to the hospital & medical procedures needed
• Developing & maintaining good relationships with health
practitioners
– Tasks related to general psychosocial functioning
• Control negative feelings & retaining a positive outlook
• Maintain satisfactory self-image & sense of competence
• Preserving good relationships with family and friends
• Preparing for an uncertain future
National Chronic Disease Strategy
Four Key Action Areas
- Prevention across the continuum
- Early detection and early treatment
- Integration and continuity of care
- Self-management
The Common Sense Model of Self-
Regulation (CSM)
Leventhal and colleagues (1992; 2000; 2003)
• Self-regulation = behaviour directed to achievement
and maintenance of personal goals
• Aims to understand the individual’s perception of
illness and how this affects their health behaviours,
illness outcomes, and emotional outcomes
• Individuals are active in trying to understand and
manage their health
Quality of life
is the appraised degree of
satisfaction/excellence a person’s life contains
Name the cognitive adjustments to chronic illness
• Cognitive adjustments to chronic illness include trying
– To find meaning in their illnesses
– To gain a sense of control
– To restore their self esteem
Kubler-Ross proposed a sequence of five
stages:
Denial, Anger, Bargaining, Depression
and Acceptance
