Lecture 19: Coping With Chronic Illness Flashcards
What are the emotional responses to chronic illness?
Denial
Anxiety
Depression
What do chronic illnesses impact?
Physical functioning
Social functioning
Mental health e.g. Feelings of anxiety
Roles e.g. Ability to work, parent etc.
What is denial? (Chronic illness)
This is a common reaction and is often seen by the patient avoiding the implications of the illness e.g. If not severe, it will go away.
Why are chronic patients in denial?
It can help people cope with the initial stages after diagnosis
How is denial bad for chronic patients?
May interfere with making lifestyle changes and taking medicatiom and delay seeing medical help
Why is anxiety an issue for chronic patients?
After diagnosis patients often experience a state of crisis, including anxiety and disorientation
Patients can become overly anxious about symptoms
Why is anxiety a bad thing for chronic patients?
It can cause patients to become fearful of doing activities such as work or exercise
As well as recurring anxiety about the future and possible complications of the illness
It can cause patients to become fearful of doing activities such as work or exercise
As well as recurring anxiety about the future and possible complications of the illness
What are personal issues about chronic illness?
Self concept
What is self concept?
A stable set of beliefs about ones qualities and attributes
What sort of self concepts does a chronic illness change?
Body image
Achievement- work and leisure activities
Social functioning - interactions with friends and family
The private self- goals, desires
How do patients cope with chronic illness?
Despite experiencing psychological reactions to chronic illness, most patients do not seek formal psychological support.
Patients use problem focused coping strategies (i.e. To alter the situation)
And emotion focused coping strategies (i,e, regulating emotional response to a situation)
What is the extent of coping for patients with chronic illness related to?
Avoidance of coping is linked to higher distress
Active coping is linked to good adjustment
Flexible coping is the most adaptive which matches strategy to situation
What influences coping?
Patients beliefs on an illness can guide coping responses. This is because developing a realistic model is an important part of coping.
Other influences are: Identity Cause Consequences Controllability Timeline
In the study of children with asthma, what was discovered about the coping ability of the patients?
Those with a high internal locus of control do better
Why is comanagement important?
Patients must learn to comanage their condition as they have to cope with
Physical problems Impact on sexuality Adherence to treatment regimes Work changes Discrimmination Financial impacts
What are social implications on chronic illness?
Often we receive negative responses from others - e.g. Decisions about disclosure
Chronic illness impacts the whole family
Caregivers may need help
What are some positive experiences that have come about due to chronic illness?
Closer relationships Change in priorities Lifestyle changes Greater appreciation of life Improved empathy
What kind of health care providers are involved in the treatment and care of chronically ill patients?
Doctors Nurses Pharmacists Physiotherapists Occupational therapists Dieticians Social workers Health psychologists
What are some interventions to help with chronic illness patients?
Physical rehabilitation centres which help patients to cope with physical limitations
Community rehabilitation programmes e.g. Cardiac are effective
Identify patients experiencing problems like depression
Pharmacological treatments may be appropriate
We can use individual psychological therapy such as cognitive behaviour therapy
We can have coping skill training- this includes education about illness and problem solving skills
Change maladaptive beliefs about illness to foster adaptive coping
Change beliefs about treatment to encourage adherence
Train how to use problem-focused and emotion focused strategies
Teach how to access social support
Stress management, relaxation, exericsie, mindfulness
Expressive writing
Support for the family
Support groups- on internet or community, can provide social support and enable people to share experiences
Internet interventions e,g, depression.org screens for depression and provides help
Telephone based support programmes.
Why is depression an illness for chronic patients?
Depression affects up to a quarter of chronic disease patients
Often sets in later when full consequences are realised
Can be long term
Affects functioning
Often goes untreated