Integrated Care

Question 1

Stages of chronic pain?

Answer 1

1. Injury
2. Initial distress (fear, anxiety)
3. Exacerbation of psychological & social problems
   Anger, distrust, entitlement
   Substance abuse
   Learned helplessness, depression, demoralization
4. Acceptance of sick role
   Family patterns develop
   SSDI

Question 2

What is integrated care?

Answer 2

A team-based health care delivery system.

Has been described as “an approach to health care from a biopsychosocial-spiritual perspective, [that is] informed by systems theory”

Provides a comprehensive and systemic interpretation of the impact of biological, psychological, and social influences on individual, couple, and family systems.

Collects biopsychosocial information from relevant systems to effectively assess and treat

IntegratED care – Diverse practitioners working together
NOT IntegratIVE care – multiple and diverse therapies
Collaborative care

Medical Family Therapy

The integration of family therapy into behavioral medicine and biomedicine creating an integrated, team-based health care delivery system.

Health Psychology – how psychological, behavioral, and cultural factors contribute to physical health and illness.

Question 3

Factors Underlying link between heart disease/anxiety/depression

Answer 3

Lack of self-care – poor diet, minimal exercise
Sleep problems – insomnia triples risk for heart failure
Obesity – depressionpoor eating habitsheart dx
Blood vessel changes – depression and anxiety associated with increased production of free radicals and fatty acids
Stress – increased insulin and cholesterol levels, increased blood pressure, effects on immune system

Question 4

Study of 900 adults with cardiac diagnosis – measured for anxiety and depression & followed x 3 years (J Am Heart Assoc. March, 2013)

What did they find?

Answer 4

Anxiety: doubled risk of dying from any cause

Depression + anxiety: tripled risk of dying from any causes
70% of the deaths were related to heart disease