Coping with chronic illness Flashcards
What does WHO define a chronic illness as?
A disease of long duration and slow progression
Common examples include heart disease, stroke and cancer.
Has a major impact on quality of life
What are some statistics around chronic illness?
1 in 3 people in the developed world are living with a chronic illness.
15 million people in England have a chronic illness
What are some current problems with chronic illness?
Improvements in treatments means people are living longer - more strain on the NHS
Treatments needs to shift from cure to management
Patients often suffer to adjust and cope, balance the demands of illness with everyday life and often have issues of multimorbidity
What are the main stressors in chronic illness?
Medical - symptoms, illness, treatment, investigations
Personal - interferes with life, limitations, social construct of disbaility
Living with a chronic illness without reasonable adjustments
What is coping?
Cognitive and behavioural efforst to manage external or internal demands that are seen as taxing or above the resources of that person.
What does Amrosio 2015 say are some key stages of living with chronic illness?
Disavowal - experiencing a lack of control and normality
False normality - the experience of partial control as adjustments become part of routine, but is not long term sustainable
The new normal - acceptance of illness and the appropriate changes needed, less vulnerable to distress
Disruption - expsure to stressful situation (illness related or not) interputs the normal coping mechanisms.
What are the three different elements of coping?
Coping skills
Coping styles
Coping stratergies
What is meant by coping skills?
Similar to responses
The behavioural and cognitive methods used to manage a situation and its emotional impact. Problems solving in nature
What is meant by coping stratergies?
Responses adapted to a particular stressor.
Actions determined by a coping skill
E.g more positive coping skill is more likley to go to the doctors when ill
What is meant by coping style?
The tendency to respond to stressful situations in certain ways.
What are the different focuses of coping skills?
Problem focuses - what to do about the problem (cognitive)
Emotional focused - a persons reaction to a stressor, e.g acceptance, negative self talk,
Appraisal focused - how a person understands and appraises the situation - logical anaylsis, wishful thinking, preparation, dread
What are the four different coping styles according to van Schaik and van Wersch 2004?
Appraoch
Reappraisal
Emotional regulation
Avoidance
What is meant by approach as a coping style?
Seeks out the stressor to find out more information, adapt and solve the problem
What is meant by reappraisal as a coping style?
Changing the way you think about a stressful situation to make it motivational or beneficial. Is no longer apprasied as a threatning situation
What is meant by emotional regulation as a coping style?
A persons ability to recognise and cope with their own emotions, not letting them affect their logic or decision making
What is meant by avoidance as a coping stratergy?
Adapting behaviours that allow a person to deny the existence of a stressor.
How does information seeking fit into coping stratergies of chronic illness?
Doctors often underestimate the amount of information a patient needs
Information desire varies by person if they are a monitor or a blunter
Information source is important
Sometimes too much information or incorrect information can be maladaptive
What is the use of denial in coping with chronic illness?
Refusal to accept the diagnosis or new limitations on life
Desire to continue as normal
Can reduce short term anxiety
Long term denial can affect adherence
What are the different types of illness behaviour?
Avoidance
Normalising - is ageing an illness?
resignation - illness seen as new centre of life
Accommodation - illness is not seen as central to life
What is considered the best type of coping strategy for controllable and non-controllable illness?
controllable - problem focused
non-controllable - emotional focused
What are some predictors of how well a patient will cope with an illness?
Timing of illness - teenage years, just about to be married etc, other stressors
External resources - social support, finances
Internal resources - individual beliefs and coping styles
What are some examples of external resources in stress coping?
The presence and the quality of these resources is important
Social context - additional life stressors or lack of
Social companionship
Professional support
Emotional support
Informational support
Instrumental (physical) support.
What are some effects of social support?
Associated with health promoting behaviour and wellbeing, often changes patient persepctives and reduces stress
However, can also be maladpative.
What are some examples of internal resources in regards to stress coping?
Prior experiences
Beliefs
Learned helplessness - illness cause and cure seen as external
Locus of control - percieved ability to influence own life
Self efficacy - belief that they can complete tasks
Social skills related to help seeking
Psychological flexibility
Thinking style - optimisim
