Long Term Conditions Flashcards
What is a long-term condition?
Those conditions that cannot, at present, be cured but can be controlled by medication and other therapies
What is co-morbidity?
Comorbidity is the co-existence of other conditions with an index condition that is the specific focus of attention.
What is multimorbidity?
Multimorbidity is the co-existence of several conditions where none are considered an index condition that is the specific focus of attention.
What is the Academy of Medical Science’s definition of multimorbidity?
The co-existence of two or more chronic conditions, each one of which is either:
- A physical non-communicable disease of long duration, such as a cardiovascular disease or cancer.
- A mental health condition of long duration, such as a mood disorder or dementia.
- An infectious disease of long duration, such as HIV or hepatitis C.
What is the burden of living with multiple long-term conditions? (6)
- more unscheduled hospital admissions, and for longer periods
- Reduced functional ability and quality of life
- Polypharmacy
- Fragmented care
- poorer health outcomes
- higher mortality rate
What is stigma?
attribute that discredits the individual, denying full social acceptance
What is felt stigma?
direct experience of a negative judgement
What is enacted stigma?
anticipation of a negative judgement
What are the 3 factors of biographical disruption?
- A taken-for-granted state of wellness until the onset of chronic illness that provokes awareness of “bodily states not usually brought into consciousness”
- Disruption to biography – necessitates a “fundamental rethinking of the person’s biography and self-concept”
- Response to disruption – mobilise resources to remodel their biography
What did Williams (2000) observe of biographical disruption? (2)
- Ignores demographic characteristics e.g. age and class - calls for wider personal, cultural, social and economic influences on biography
- Is adult centric - needs to consider experience of children and young adults with chronic illness
Who came up with the biographical disruption theory?
Bury (2000)
Who came up with the Shifting Normalities theory?
Sanderson et al. (2011)
What did Sanderson et al. (2011) argue?
Argue that Bury’s theory of biographical disruption fails to recognize that normalization is a common feature of the illness experience.
What did Sanderson et al. (2011) suggest?
Suggest people present differing perceptions of normality as they fluctuate between disease quiescence and exacerbation.
What are the 6 shifting normalities suggested by Sanderson (2011)?
- Disrupted normality.
- struggling for normality
- fluctuating normality
- returning to normality
- continuing normality
- Re-setting normality
What is an illness narrative?
People attempt to reconcile the disruption between ‘body, self and the world caused by the intrusion of chronic illness
What is Charmaz (1983)’s loss of self theory? (4)
- Argued disruption is one of many ways people experience chronic illness
- Recognized the assault on identity, self-worth and impact on social interaction
- Focused on loss of ‘self’ identity
- ‘Crumbling away’ of previously held images of self
What are the 4 themes of Charmaz (1983)’s loss of self?
- leading restricted lives,
- experiencing social isolation,
- being discredited
- burdening others
what are the impacts of chronic illness in terms of loss? (6)
- Loss of control and personal power – Self-esteem
- Loss of independence
- Loss or change of Role – family, work
- Loss of financial security
- Loss or change of hopes and dreams
- Loss of identity
What is Kubler-Ross (1969)’s view on chronic illness?
Coming to terms with a LTC has been described by many as like the experience of grief and bereavement
How can health professionals support self-management? (6)
- Disease education programmes
- Expert patient programme
- Personalised care planning
- Telehealth
- Personal health budgets
- Shared decision making
What are examples of treatment burdens? (6)
- financial (treatment costs),
- medication (managing, organizing and performing),
- administrative (arranging tasks and appointments),
- lifestyle (changing habits),
- health care (navigating and accessing services),
- time/expense of travel (to attend medical appointments).
What factors influence mental health and wellbeing? (4)
- Life - work pressure, school/education, parenting, celebrations, holidays, carer responsibilities
- Feelings - burnout, diabetes distress, depression, fear of hypos, eating disorder.
- Failings in professional care - technology, education, continuity of care, lack of empathy, or even blame, from professionals.
- Denial.
What are some variables related to better quality of life? (9)
- Age
- Gender
- Marital status/relationships
- Educational level
- Disease duration
- Disease and treatment burden
- Symptom management
- Multimorbidity
- Social support.
