Lecture 19: Coping With Chronic Illness

Question 0

What are the emotional responses to chronic illness?

Answer 0

Denial
Anxiety
Depression

Question 1

What do chronic illnesses impact?

Answer 1

Physical functioning
Social functioning
Mental health e.g. Feelings of anxiety
Roles e.g. Ability to work, parent etc.

Question 2

What is denial? (Chronic illness)

Answer 2

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.

Question 3

Why are chronic patients in denial?

Answer 3

It can help people cope with the initial stages after diagnosis

Question 4

How is denial bad for chronic patients?

Answer 4

May interfere with making lifestyle changes and taking medicatiom and delay seeing medical help

Question 5

Why is anxiety an issue for chronic patients?

Answer 5

After diagnosis patients often experience a state of crisis, including anxiety and disorientation

Patients can become overly anxious about symptoms

Question 6

Why is anxiety a bad thing for chronic patients?

Answer 6

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

Question 8

What are personal issues about chronic illness?

Answer 8

Self concept

Question 9

What is self concept?

Answer 9

A stable set of beliefs about ones qualities and attributes

Question 10

What sort of self concepts does a chronic illness change?

Answer 10

Body image
Achievement- work and leisure activities
Social functioning - interactions with friends and family
The private self- goals, desires

Question 11

How do patients cope with chronic illness?

Answer 11

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)

Question 12

What is the extent of coping for patients with chronic illness related to?

Answer 12

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

Question 13

What influences coping?

Answer 13

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

Question 14

In the study of children with asthma, what was discovered about the coping ability of the patients?

Answer 14

Those with a high internal locus of control do better

Question 15

Why is comanagement important?

Answer 15

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

Question 16

What are social implications on chronic illness?

Answer 16

Often we receive negative responses from others - e.g. Decisions about disclosure

Chronic illness impacts the whole family

Caregivers may need help

Question 17

What are some positive experiences that have come about due to chronic illness?

Answer 17

Closer relationships
Change in priorities
Lifestyle changes
Greater appreciation of life
Improved empathy

Question 18

What kind of health care providers are involved in the treatment and care of chronically ill patients?

Answer 18

Doctors
Nurses
Pharmacists
Physiotherapists
Occupational therapists
Dieticians
Social workers
Health psychologists

Question 19

What are some interventions to help with chronic illness patients?

Answer 19

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.

Question 26

Why is depression an illness for chronic patients?

Answer 26

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