Juvenile idiopathic arthritis Flashcards
1
Q
Factors that influence the interaction of illness:
A
Nature of the illness (sx, systems affected, tx) Child's age/development Child temperament (individual qualities) Culture (beliefs, preferences) Family Health beliefs about illness, tx. Family development Family functioning Socio-economic factors Support Approach to health care relationships.
2
Q
'’Developmental Delays’’ in chronic illness issues:
A
- Usually excluded from definitions/research in ‘‘chronic illness’’
- Adds complexity clinically and in terms of research.
3
Q
Juvenile idiopathic arthritis is
A
-an auto-immune/inflammatory disease, affecting joints.
4
Q
Juvenile idiopathic arthritis onset (age)?
A
- Onset between 18 months and 16 y.o
- 40% between 18-36 months
5
Q
Juvenile idopathic arthritis sx:
A
- Synovium becomes very thick, joints very stiff and painful.
- Sx fluctuate rapidly, can be predictable and unpredictable (Flare up and remission sometime on the same day)
- Affecting MSK function
6
Q
Juvenile idiopathic arthritis high risk of:
A
Uvitis (inflammation of the eyes)
7
Q
Video project saw on the class is to show:
A
- How child in school living with chronic disease must learn self-advocacy
- Sensitize school personnel to the impact of arthritis is significant and variable and the impact on student performance and enjoyment.
8
Q
Toddlers (ages)
A
15-48 months
9
Q
Toddlers: special challenges
A
- Become ‘‘independent’’, rapid development changes
- Challenges for parent to know the ‘‘normal’’
- Toddlers cannot explain easily how they feel (need to see through their behaviors)
- Difficult to console when in pain
- They are Distressed by medical care/intervention
10
Q
School-age: special challenges
A
- Increased independence/competence
- More needs for information about disease and tx
- Illness may affect school performance and extra-curricular choices
- Most of the children want to be ‘‘normal’’; the sense of self is affected by peers.
11
Q
Adolescence: Special challenges
A
- move into independent functioning; role of parent changing/ complex for all (Parental support = better outcomes)
- Activities with peers becomes priority, sense of self may be affected by the disease.
- Increase in ‘‘risky’’ behaviors (eg. Compromise with meds and alcohol, immunocompromise patient with marijuana due to the mold, risk of a fungus infection in the lung)
- Tendency to make decisions based on short-term goals (eg.lifestyle) rather than long-term outcomes.
- HARD for them to telling their teacher about JIA.
12
Q
Chronic illness in childhood consequences:
A
- Require a new definition of ‘‘normal’’
- Can impact on all aspects of family life and child’s life
- Coping or learning to live with the illness as a dynamic process.
- '’qualities’’ of the illness have an impact
13
Q
Eg. of ‘‘qualities’’ of the illness having an impact:
A
- Predictable vs unpredictable
- Degree of symptoms
- Life-threatening?
- Visibility to others
- Degenerative vs ‘‘may go away’’
14
Q
Burden of care for pt/family:
A
- Meds/diets/physio/braces/…
- Needs assistance with ADL
- Degree of risk (diabetes/severe asthma..)
- Frequency of appointments
15
Q
'’Normalization’’
A
- Defined as a family management style
- '’Preferred’’ approach (cultural specific?)
- Associated with good psycho-social outcomes for pt. (not always associated with max adherence to tx)
