Block 3 Week 2: Living with chronic illness Flashcards
Define Chronic Illness
Approximate how the proportion of the population living with it
Experience of living with an LTC for which there is no cure but is managed by drugs & other Tx
Often: Preventable, Degenerative, Costly (Gp appointments/ OP/ Bedays)
1 in 3 people live with Chronic Illness
(24% have 2 LTCs & 20% have >3LTCs)
What are the common elevements of illness narratives?
Search for meaning & explanation
Uncertainty/ Unpredictability
Coping & Resillience
What are the common coping stratergies?
1) Denial
2) Normalisation
3) Resignation
4) Accommodation
What is self management and what does it utilise?
Patient actively wants to manage their own condition
Uses lay knowledge- what works for them/ experiences & experties of condition
Self help groups: individual & collective
Self- management: Expert patient- what is it and how can one be defined?
Patients can take the lead in managing their condition
An expert patient is someone:
- Confident & In control of their life
- Partnership: HCP & management of their conditions
- Communicates with HCP & willing to share responsibility for Tx
- Relistic about how their condition affects them & family
- Uses skills & knowledge to lead a full life
What is the expert patient programme?
Peer lead self-management programme
Aims to improve self management
6 weeks for any LTC (some disease specific)
Cover topics: Health eating, Exercise, Pain management, Relaxation, Problem solving, Action Planning
What are the pros and cons of the EPP?
Pros- evidence based:
- Feel symtoms did not interfere with their life
- Better prepared for appt w/ HCP
- Fewer GP appt/ ED visits
Cons:
- Not attractive for all
- Not all able to participate
- Extra pressure on patient organisations
What is the self regulatory model (Leventhal 1980)?
1) Representation of illness: Identity/ Cause/ Consequences/ Timeline/ Cure & Control
2) Coping: or not
3) Appraisal: Was coping effective?
4) Interpretation: Symptoms perception/ Social message
5) Emotional response
Self Regulatory model: Illness Representation
Illness beliefs = patient’s own common-sense understanding of illness
5 Dimensions: These direct illness behaviour
- Identity: What is it?
- Cause: What caused it?
- Time: How long will it last?
- Consequence: How will it impact my life?
- Cure/ Control: How can it be Tx, managed, cured?
What is the clinical application of the self-regulatory model?
Applied to multiple chronic illnesses to understand adaption/ coping
Develops management plan & work with pt
What is Crisis Theory?
People need to find a social & psychological equilbirum
Challanges, setbacks, social influences are important & caninflence coping response
What does living with a chornic condition necessitate?
1) Acceptance
2) Self-efficacy
3) Understanding how thoughts, emotions, suffering & pain behaviours are related
4) MDT approach
What is the pain management programme?
Reinforces message of gate control theory- combination psychological & physical factors can open & close gate
Invovles: clinicians, specialist nurses, physio, psychologists
Types: Intense, residential, 6-8 week spread
What are the pros and cons of the pain management programme?
Pros:
- Patients manage pain rather than pain manges them
- Learn to change perception of pain- deal with unhelpful thoughts
- Management of mood/ stress/anxiety
- Not isolated with condition
Cons:
- Group dynamics
- Stages of change- are they ready to change
- Commitment
- Managing fears
What is Meaning in life?
Enhanced relationship with family & friends
Finding inner strength/ personal resilience
Accepting own vulnerabilities/ limitations
Greater appreciation on living- changed philosophy of life
