L27 - Experiencing Chronic Illness & Disability

Question 1

Describe the characteristics of chronic illness?

Answer 1

Ongoing, Long-term (3 to 6 months +), caused by non-reversible pathological change with disability

Uncertain, require training on motivation to care for oneself, Palliative treatment to loss and change in life

Question 2

What are the leading chronic illnesses in HK?

Answer 2

Hypertension 
DM
Heart disease 
Hypercholesterolemia
Cataract

Question 3

Age and sex dominant in people with chronic illness in HK?

Answer 3

> 60 years old

Male predom. (53%) over female

Question 4

What factors contribute to increase in chronic illness?

Answer 4

Better medical care (better screening, better emergency treatment) +
Change in lifestyle (sedentary) +
Change in living environment (pollution, crowding) + Population aging

Question 5

3 types of chronic illness?

Answer 5

1) Lived-with Illness = Not life-threatening (e.g. DM, hypertension)
2) Mortal Illness = Life-threatening (e.g. terminal cancer)
3) At-risk Illness = potential risks involved (e.g. family hx of cancer)

Question 6

Define disability?

Answer 6

Any condition of the body or mind (impairment) that makes it more difficult for the person with the condition to do certain activities/ Activity limitation + Participation restriction

Question 7

Define impairment?

Answer 7

any loss or abnormality of psychological, physiological or anatomical structure or function

Question 8

Define activity limitation?

Answer 8

e.g. difficulty seeing, hearing, walking, or problem solving

Question 9

Define Participation restrictions ?

Answer 9

working, engaging in social and reactional activities, accessing health care and preventive services

Question 10

What is the progression from primary aetiological factors to Deprivation?

Answer 10

Primary aetiological factor&raquo_space; physical impairment&raquo_space; Functional limitation and activity restriction&raquo_space; Deprivation&raquo_space; reinforce primary aetiological factors

Physical impairment and Disability (Functional limitation and activity restriction)&raquo_space; change in self-perception or expectations of other&raquo_space; Deprivation

Question 11

What are the adverse effects of Short sightedness as a chronic illness?

Answer 11

Impairment = loss of function 
Disability = compensated by glasses or not?
Deprivation = denied some fields of work

Question 12

How does chronic illness lead to Participation restriction?

Answer 12

Disadvantage and Deprivation because of BARRIERS IN THE ENVIRONMENT

• Disadvantage in seeking work
• Deprived of jobs, peace of mind and self-worth

Question 13

What chronic illnesses in Hong Kong leads to participation restriction?

Answer 13

Restriction in body movement

Seeing and hearing and speech difficulty

Mental illness and mood disorder

ADHD and Autism

Question 14

Age and Sex dominant in people with disability in HK?

Answer 14

> 50% are older than 70

> 50% female due to higher life expectancy

Question 15

What are some challenges that come with managing chronic illnesses?

Answer 15

• Managing symptoms and menifestations
• Coping with medical tech, mastery of new skills
• Overwhelmed by treatment adherence (compliance)
• Interference with job and daily life

Question 16

What is the key in preventing and managing potential medical crisis?

Answer 16

Always be on the lookout for signs that indicate an impending medical crissi

i.e. self -reported feelings of unwellness

Question 17

How does chronic illness impact one’s sense of self?

Answer 17

• Loss of personal independence
• Change in body image
• Impact on sense of self due to interruption in life and immersion in illness

Question 18

How does chronic illness disrupt family and social life?

Answer 18

1) Strains on family members due to the provision of high level of care and support
2) Change in family roles and relationships
3) Withdrawal from key social roles
4) Social isolation

Question 19

What are the different types of uncertainty that occurs in chronic illness?

Answer 19

1) Pre-diagnostic uncertainty = persistence of vague symptoms
2) Trajectory uncertainty = difficulty in predicting the course and outcome of disease
3) Symptomatic uncertainty = daily fluctuations in symptoms

Question 20

What are the costs of being chronically ill?

Answer 20

Cost of healthcare

Indirect cost on the ill and their families

Question 21

List the factors that affect the experience of chronic illness and physical impairment?

Answer 21

Severity of disease
Onset of disease
Stability of disease (how much fluctuation)
Visibility of disease

Question 22

List a few ways to help someone with chronic illness/ disability?

Answer 22

Information support - Dx and treatment discussion

Emphasize patient’s role in and shared responsibility

Offer continuity of care

Empowerment through self-care management

Attentiveness to individuality