quiz 1: module 1 part A Flashcards
chronic illnesses increase in frequency with?
increase in age!
chronic illnesses are found in all socioeconomic, ethnic, cultural and racial groups. But, certain diseases..?
occur more frequently in certain groups than others
what is a barrier to preventative screening for chronic illness?
poverty, cultural/language barriers, social or geographic location
do all chronic conditions have effect on QOL?
no, some have little effect on QOL
others create disability or perceived disruption
many chronic conditions cause:
pain and fatigue
some degree of disability is usually present when?
in severe or advanced chronic illness
what is acute illness
curable, relatively short disease course
chronic illness?
prolonged trajectory, conditions are generally incurable
adjustment to chronic illness is affected by?
personality before the illness, unresolved anger or grief, suddenness, extent, duration of lifestyle changes, family and individual resources for stress, stage of lifecycle, previous experience
chronic condition defintion
health problems associated with symptoms or disabilities that require longer management over three months or longer
-generally long and require a systematic approach to treatment
what is a chronic condition a result of?
illness, or persistent communicable infectious disease, or genetic factors, or injury, or health-limiting behaviours
what is a disability?
restriction or lack of ability to perform an activity in a normal manner, consequences of impairment in terms of individuals functional performance or activity
what is impairment?
loss or abnormality of psychological or physiologic or anatomic structure or function at the organ level
secondary conditions/ disorders are?
any physical, mental, or social disorders resulting directly or indirectly from an initial disabling condition, a condition to which a person with a disability is more susceptible because of having a primary disabling condition
what does management of chronic conditions consist of?
- learning to live with symptoms and coming to terms with life changes
- self care
chronic illness should be viewed as..
SUBJECTIVE, more than a simple matter of functional impairment or discomfort
prevalence and cause of chronic conditions in canada?
16 million + live with chronic disease, 3/5 over age of 25 have at least one, account for 89% of deaths yearly, predicted to increase by 15%
biggest four chronic diseases?
cardiovascular disease
cancer
COPD
diabetes
leading cause of death in canada?
CV disease, then cancer
factors that contribute to rising costs of chronic disease in Canada?
- aging population
- longer life with chronic disease
- rising treatment costs
- economic inflation and new technology
how many canadian kids have chronic illness
30% age 6-11
why are chronic diseases becoming more prevalent globally?
- lower infant mortality and increased life expectancy due to successful public health measures, medical advances and technology
- improved screening and diagnostic procedures and aggressive management
- tendency for the development of single or multiple chronic diseases with age
- lifestyle factors and consumption patterns
2/3 of canadians have at least..
1 modifiable risk factor for chronic disease: smoking, physical inactivity, poor nutritional habits, or obesity
what are some challenges of living with chronic conditions?
- alleviating and managing symptoms
- psychologically adjusting to and accommodating disabilities
- carrying out regimens are prescribed
- validating self-worth and family functioning
- managing threats to identity
- finding meaning in illness experience
- establishing support
- dying with dignity and comfort
characteristic #1 of chronic conditions
managing chronic illness involves more than management of medical problems
-identity, emotions, role changes, self-concept, depression
characteristic #2 of chronic conditions
chronic conditions usually involve many different phases over the course of a persons life
characteristic #3 of chronic conditions
an important component of chronic disease management is adherence to therapeutic regiments
-isnt uncommon for people to alter their dosage etc
characteristic #4 of chronic conditions
one chronic disease can lead to the development of another
characteristic #5 of chronic conditions
chronic illness affects the whole family
characteristic #6 of chronic conditions
major responsibility for everyday management of chronic illness falls upon the shoulders of chronically ill people and their families
characteristic #7 of chronic conditions
learning to manage chronic conditions is a developmental process
characteristic #8 of chronic conditions
managing chronic conditions is a collaborative process
characteristic #9 of chronic conditions
medical management of chronic conditions is expensive
characteristic #10 of chronic conditions
chronic conditions raise difficult ethical issues for the patient, health care professionals, and society
characteristic #11 of chronic conditions
living with chronic illness means living with uncertainty
what is patersons shifting perspectives model on understanding chronic illness?
chronic illness lived according to peoples situations and needs rather than according to predictable stages or phases
millers way of understanding chronic illness
chronic illness as an experience that challenges ones perceptions of power
what are corbin and strauss chronic illness trajectory model
- pretrajectory phase
- the trajectory phase
- the stable phase
- the unstable phase
- the acute phase
- the crisis phase
- the comeback phase
- the downward phase
- the dying phase
what is the pretrajectory phase`
person is at risk for developing a chronic condition for whatever reason
trajectory phase
characterized by the onset of symptoms or disability associated with chronic condition. diagnostic tests and uncertainty need emotional support
stable phase
symptoms and disability are being managed, person doing well
unstable phase
exacerbation of illness symptoms, development of complications, ADLs interrupted, more tests, new regimens
acute phase
sudden onset of severe or unrelieved symptoms or complications that require hospitalization for their management
crisis phase
critical or life-threatening situation that requires emergency treatment
comeback phase
period in the trajectory marked by recovery after an acute period. learning how to live with or overcome disabilities
downward phase
marks the worsening of a condition, disease continues to progress despite attempts to gain control of treatment. doesnt mean imminent death
dying phase
gradual or rapid decline in the trajectory despite efforts to halt the disorder or slow decline
nursing care of people living with chronic conditions?
direct care: assessing physical status, providing wound care, managing and overseeing med regimens
-mostly supportive care unless person is hospitalized
is every chronic condition life threatening?
no, and not every person passes through each phase of chronic conditions
care by phase: applying the nursing process, Step 1
identifying the trajectory phase
-assessment to determine the stage and needs
care by phase: step 2
establishing goals, must be collaborative and consist with abilities, desires, motivations
care by phase: step 3
establishing a plan to achieve desired outcomes, realistic and mutually agreed upon
care by phase: step 4
implementing the plan and interventions, possibly: providing direct care, advocacy, teaching, counselling, referral, case management
care by phase: step 5
evaluating the effectiveness of interventions, maintaining stability while preserving the persons control over their life, identity, and goals
why is teaching self care important
educated people are more likely to be concerned about their health and more likely to manage symptoms and recognize the onset of complications and seek care
what should teaching look like in the hospital with chronic conditions
focused on what the person needs to know about the condition in order to manage once discharged to home
6 interrelated elements of improving chronic illness care?
- community resources/policies
- organization of health system
- self-management support
- delivery system design and structure
- decision support and evidence-based care
- integrated clinical info systems
the meaning of self-management study findings
qualitative study that found self management is a complex, multidimensional process that people use to create order from the disorder
-four themes
4 themes of self management
- recognizing and monitoring the boundaries
- mobilizing resources
- managing the shift in self-identity
- balancing, pacing, planning, prioritizing
who should self-management be viewed by?
nurses and clients offer differ in their view of what is meant by self management
-person with illness is the perspective it should be viewed by
