Chronic Illness

Question 1

Disease

Answer 1

change in bodily structure or function, viewed from pathophysiologic model

Question 2

Illness

Answer 2

Human experience of suffering/dysfunction; Dis-ease

Question 3

Acute Illness

Answer 3

Episodic, patient is inexperienced/passive, cure is usually possible

Question 4

Chronic Illness

Answer 4

Continuous. Patient is frequently an expert and plays an active role in course of the illness. Cure is rare (otherwise why would it be a chronic illness…?)

Question 5

Common emotional consequences of chronic illness

Answer 5

Helplessness, worthlessness (especially if –> unemployment), social isolation (caused by either patient or other people withdrawing), feeling controlled/betratyed by their own body, fear of being perceived as a downer

Question 6

Importance of body image

Answer 6

Feeling attractive and capable is a major source of self esteem that can be restricted in pts with chronic illness; highly visible illnesses can lead to rxns of disgust or withdrawal from outsiders. Loss of sexual function can accompany chronic illness and be a significant detriment for pts

Question 7

Family caregiving

Answer 7

Can be a source of meaning/purpose. Can also be extremely stressful due to high levels of stress and often low support (esp dementia). Elevated risk of physical and emotional health problems for care takers (earlier death) palliated by higher self-efficacy, perceived higher degree of control, and sense of gratitude from patient.

Question 8

Physician expectations of chronic pts

Answer 8

Pt trust is eroded by repeated interactions (sometimes negative) with healthcare system. There is an even stronger need for partnership with provider and ACTIVE patient involvement in developing care plan than typical pt. Patients will frequently be experts of their condition, especially for rare diseases.

Question 9

Societal Responses to Chronically Ill

Answer 9

Chronically ill fly in the face of “just world” hypothesis (good things happen to good people, bad to bad). Some chronic conditions have intense negative stigma, especially those perceived as self-inflicted (AIDS, depression)

Question 10

Need for legitimization

Answer 10

Some conditions (fibro and CFS [lolol]) have poorly defined symptoms and few tests; pts may feel frustrated/misunderstood if there is no “set” diagnosis. Don’t want to be told that they’re malingering/hypochondriac

Question 11

Key Factors affecting pts resposne to illness

Answer 11

Meaning/significance of illness, Severity, visibility, support, cultural beliefs