Management of Chronic Illness

Question 1

What are the 3 components of quality of life?

Answer 1

• physical functioning
• psychological status
• social functioning

Question 2

What are 3 assessments that measure the quality of life?

Answer 2

• sickness impact profile (SIP)
• index of activities for daily living (ADL)
• SF 36 Health Survey

Question 3

Explain the Sickness Impact Profile (SIP) (3)

Answer 3

• Can be self or interviewer administered
• Contains 136 items
• 12 categories of everyday activities

Question 4

Explain the SF 36 Health Survey (8)

Answer 4

One multi-item scale measuring 8 health concepts:

1. physical functioning
2. role limitations due to physical health problems
3. bodily pain
4. social functioning
5. general mental health
6. role limitations due to emotional problems
7. vitality
8. general health perceptions

Question 5

What are the pros and cons of denial as a defense mechanism to being diagnosed with chronic illness? (2)

Answer 5

Pros
- useful in controlling initial emotional reactions

Cons
- interferes in ability to monitor condition, seek treatment, and control illness

Question 6

What are some psychological responses to being diagnosed with a chronic illness?

Answer 6

• denial
• anxiety
• depression

Question 7

What is the difficulty in assessing depression in chronic illness patients?

Answer 7

many physical signs of depression may also be symptoms of disease or side effects of a treatment

Question 8

What are regarded as the most stressful events associated with cancer patients? (4)

Answer 8

• fear and uncertainty about the future
• limitations in physical abilities
• appearance and lifestyle
• pain management

Question 9

What are 5 major coping strategies for being diagnosed with cancer?

Answer 9

• direct problem solving
• distancing from chronic illness
• positive focus
• cognitive escape/avoidance - e.g., wishing the situation would go away
• behavioural escape/avoidance - e.g., sleeping, binge eating/drinking

Question 10

What are 3 patient beliefs about chronic illness?

Answer 10

• beliefs about the NATURE of the illness
• beliefs about the CAUSE of the illness
• beliefs about the CONTROLLABILITY of the illness

Question 11

What is a problem associated with patients’ belief about the NATURE of a chronic illness?

Answer 11

believing incorrectly that if they start feeling better, they can stop the medication

Question 12

What is a problem associated with patients’ belief about the CAUSE of a chronic illness?

Answer 12

self-blame for chronic illness which leads to guilt and depression

Question 13

What aspects of the self are impacted by chronic illness? (6)

Answer 13

self-concept
self-esteem
body image
achieving self
social self
private self

Question 14

What are the advantages of physical rehabilitation? (4)

Answer 14

improves:
- activity level
- physical independence
- ability to do daily tasks
- psychosocial adjustment

Question 15

What are the goals of physical rehabilitation?

Answer 15

• learn how to use one’s body as much as possible
• learn how to sense changes in environment to make the needed accomodations
• learn new physical management skills
• learn the necessary treatment regimen

Question 16

What helps a patient adhere to their medical regimen? (3)

Answer 16

• appropriate education
• cognitive and behavioural interventions
• self-efficacy beliefs

Question 17

What issues are caused by chronic illnesses? (5)

Answer 17

• discrimination
• financial impact
• problems with social interaction
• impact on family
• impact on sexuality

Question 18

What is different when the patient with chronic illness is child? (2)

Answer 18

• confusion when coping - they don’t fully understand the nature of the illness
• child cannot follow the treatment regiment by themselves - family must participate

Question 19

How can parents help a child with chronic illness cope better? (4)

Answer 19

• realistic attitudes towards the disorder
• encouraging self-care
• encouraging regular school attendance and reasonable physical activities
• maintain good emotional control

Question 20

What is a child’s initial reaction to a diagnosis of chronic illness? (8)

Answer 20

dependence, embarrassment, loneliness, anxiety

outbursts of temper, pessimism, social isolation, and refusal to take medicine

Question 21

What do parents of children with chronic illness experience? (5)

Answer 21

• anxiety and depression
• grieving
• issues of loss
• guilt
• perception of lack of competence

Question 22

What are the steps of Kaye’s 10 Step Model of informing families about chronic illness?

Answer 22

1. Preparation of info
2. What do the parent and child know? (medical education)
3. Is more info needed?
4. Give a warning (realistic but positive)
5. Allow denial
6. Explain if requested
7. Listen to concerns
8. Encourage ventilation of feelings
9. Summarize
10. Offer further help (referral, support groups)

Question 23

What interventions aid a patient with chronic illness? (6)

Answer 23

• informal communication with a health care professional
• brief psychotherapy
• patient education programs
• coping skills training
• relaxation and exercise
• social support intervention