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N201 > Chronicity > Flashcards

Chronicity Flashcards

1
Q

Define chronicity.

A

It is an ongoing health condition that at the time of diagnosis, or during the expected trajectory of the condition, will produce one or more of the following current or long term sequelae:

  • limitation of functions appropriate for age and development
  • dependency on meds, technology, diet
  • disfigurement
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2
Q

What are the six characteristics of chronic illness.

A

1) person experiences impaired functioning in more than one dimension
2) dependency on meds and technology
3) unpredictability and uncertainty
4) ongoing diseases symptoms and treatment can interfere with norm activities
5) individuals experience multiple losses
6) unpredictability and uncertainty

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3
Q

Describe the things that are associated with the diagnosis of a chronic illness.

A

Emotional experience
- may involve relief that symptoms are legitimized

HC professionals may be unaware of the impact of the illness

Can signal a scientific dead end

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4
Q

What is the emotional response to chronic illness?

A

FEAR

GRIEF

ANXIETY

GUILT

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5
Q

How might an individual feel prior to being diagnosed with a chronic condition?

A

Uncertain b/c they have no cause

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6
Q

What might happen to symptoms when someone has an undiagnosed chronic illness?

A

symptoms may be minimized or misdiagnosed by health care professionals

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7
Q

How do individuals typically respond emotionally to a diagnosis of chronic illness?

A

Often feel relief that symptoms are legitimized

Highly varied response: depends on the impact of the illness

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8
Q

What are the two ways that fear can be a response to chronic illness?

A

ADAPTIVE: drives you to act, learn, and adapt

MALADAPTIVE: paralyze you, create anger, withdrawal, and strain on relationships

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9
Q

Why might individuals experience grief in response to a chronic illness?

A

Loss of….

  • activities
  • function
  • independence
  • career
  • relationships
  • dreams
  • income
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10
Q

Why might individuals anxiety in response to chronic illness?

A

over uncertainty and treatment

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11
Q

Why might individuals experience guilt in response to chronic illness?

A

Feel like it is there fault

Self blame

Not catching it earlier

Not complying earlier (ex exercise and diet)

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12
Q

What is the most common manifestation of chronic illness?

A

Fatigue

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13
Q

What is the non-pharmacological therapy for fatigue?

A

Exercise, at a level that is manageable

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14
Q

What is one of the things that can disrupt or interfere with social relationships?

A

the stigma associated with the illness

ex: diabetics don’t eat properly, blaming the patient, etc

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15
Q

What could the visibility of the disease cause?

A

Diminished social credibility (seen as invalid)

Stereotyping.

results from altered appearance, restricted mobility, unusual behaviours

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16
Q

What are the 4 things that make up the invisible side of the disease?

A

Fatigue

Pain (b/c HCP often rely on visual confirmation of pain b4 meds)

Limited sympathy and empathy for chronic pain

Emotional turmoil

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17
Q

What did Thorne define as the goals/tasks of individuals regarding chronic illness

A

1) prevent acute episodes
2) manage treatment regimes, meds, and procedures
3) to access HCP
4) to pace and plan activities to reduce fatigue
5) to protect self from anxiety and depression

18
Q

What are three concepts regarding living with chronicity?

A

POWERLESSNESS: (use power resources) uncertainty

ADAPTATION:

  • normalization
  • shifting perspectives

COPING STRATEGIES:

  • approach
  • avoidance
19
Q

Who developed the concept of power resources? What are they?

A

Miller

strengths that individuals possess to manage living with a chronic disease

20
Q

List the 7 power resources

A

1) Knowledge of disease
2) Motivation
3) Positive self concept
4) Physical str and energy
5) Spirituality
6) Psychological stamina and social support
7) Energy

21
Q

At what points does uncertainty occur in chronic disease?

A

at all points: leading up to diagnosis, treatment, and prognosis

22
Q

What are some factors that influence uncertainty. (MISHEL)

A

Severity of illness

Diagnosis and lack of information

Personality factors

Social support

HCP

Demographic variables

23
Q

how does uncertainty vary in chronic vs acute illness?

A

ACUTE: self limiting

CHRONIC: constant.
may dissolve with adaptation

24
Q

What are the 6 attributes of situations leading to uncertainty (McCormick)

A

1) Ambiguity: more than one interpretation
2) Inconsistency
3) Vagueness
4) Unpredictability
5) Lack of information
6) Unfamiliarity

25
Q

List and explain three sources of uncertainty in parents with sick children.

A

DIAGNOSIS:
lack of knowledge, impact on future, etc

SYMPTOMS:
management, interpretation, prioritization

HCP:
lack of confidence in them, too much jargon, no validation

26
Q

List three ways to resolve uncertainty.

A

Acknowledge the circumstances

Seek information

Engage in the transition

27
Q

List three ineffective ways of dealing with uncertainty

A

EMOTIONAL FOCUSED COPING:
anxiousness, angry, instant gratification

AVOIDANCE

DENIAL

28
Q

What can a nurse do for a patient experiencing uncertainty?

A

Assist pt to interpret illness events

Provide psychosocial support

Provide information including alternatives

Advocate for pt

Foster hope (success stories, encouragement, recognize strengths)

Enhance spiritual well being

29
Q

What is normalization?

A

altering one’s sense of normal by constructing a new sense of normal.

find ways to live as normal as possible to minimize social effects

30
Q

What is one of the negative things that normalization can cause?

A

denial or delayed request for assistance.

may cause individual not to follow treatment

31
Q

Describe the shifting perspectives theory by Patterson

A

It explains that wellness and illness shift from foreground to background constantly, especially in chronic illness

Wellness in the foreground: don’t see self as sick

Illness in the foreground: focused on symptoms and management until new norm is achieved

32
Q

List the adaptive tasks for parents who have children with chronic illnesses

A

Accept the child’s condition

Manage the illness on a day to day basis

Meet normal developmental needs

Meet developmental needs of other family members

Cope with ongoing stress and periodic crises

Educate others about the illness

Establish a support system

33
Q

Describe approach coping strategies

A

Behaviours that indicate a willingness to confront the realities of the illness, awareness of personal reactions, and an attempt to deal with them

34
Q

Give some examples of approach coping strategies

A 
seeking information
enhancing spiritual life
self distraction
expressing feelings
seeking social support
35
Q

Describe what avoidance coping strategies are.

A

Behaviours that protect the individual from conscious confrontation with the threat

36
Q

Give some examples of avoidance coping strategies

A

denial, suppression, minimizing symptoms, withdrawal, talking about self, passive acceptance

37
Q

What are some things that help with acceptance of the chronic illness

A

recognition of the illness by HCP

faith in higher power

put illness in context of other losses

find some good in an otherwise neg experience

38
Q

Can mechanical items like a w/c, crutches, or walker be a part of body image?

A

yes

39
Q

What are the 4 phases of readjustment to body image disturbances?

A

1) psychological shock
2) withdrawal
3) acknowledgement
4) integration

40
Q

Explain how chronic illness effects sexuality.

A

fatigue, pain, disability, meds, altered body image, dec self esteem all impact

fearful of intimate relationships

need time to grieve the losses and gradually adjust

41
Q

List the three phases of the relationship development between families living with chronic illness and the HCP

A

1) Naïve trust
2) Disenchantment
3) Guarded alliance

N201 (5 decks)

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