Chronic Illness (FHNIII)

Home > Flashcards > Print Preview

The flashcards below were created by user asavagern on FreezingBlue Flashcards. What would you like to do?

  1. Chronic illness are characterized by one or more of the following:
    • -duration > 6 months
    • -permanent or residual disability
    • -nonreversible pathological changes
    • -need for special rehabilitation
    • -long term medical and/ or nursing care
  2. Chronic illnesses may be relatively stable.
    Some have acute exacerbations resulting in:
    • -loss of control of illness
    • -times of instability with need of medical/ nursing assistance
    • -increased dependence on family members
  3. Disability:
    a limited functional ability as the result of an impairment; it is the term preferred over "handicap"
  4. Sequelae of chronic conditions
    • -limitation of functions; disfigurement
    • -dependence on medications or special diet
    • -current need for medical care/related services
    • -special ongoing treatments at home, work
  5. Major chronic conditions
    • -chronic sinusitis             -Psoriasis
    • -Allergic rhinitis               -Arthritis 
    • -Asthma                        -Orthopedic 
    • -Chronic bronchitits            impairments
    • -Heart disease                -Migraine HA
    • -Hypertension           -Visual impairment
    • -Diabetes                 -Hearing impairment
  6. 50% of adults have 1 or more chronic diseases
    • Each chronically ill person has average of 2 chronic diseases
    • -Related- HTN and CHF
    • -Unrelated- HTN and arthritis
  7. 1/3 of those with chronic illness have limitation in performing ADLs
    - Arthritis
    - Cancer
    - Coronary artery disease 
    - Spinal cord injury
    Highest incidence in people >=age 65
  8. Exact # of children with chronic illness unknown; estimates differ by definition of chronic illness in children
    • -31% of children under 18 years have chronic health condition
    • -Incidence of chronic conditions have not changed
    • -Prevalence of children affected increased d/t increasing survival and enhanced recognition
  9. "Children with special health care needs are" for federal and state programs.
    those who have or are at risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.
  10. Children affected by large number of rare disease, genetic, or prenatal conditions
    - Not stable; subject to acute exacerbations
    • Adults affected by relatively small number of common diseases that increase in morbidity with age.
    • - Generally stable conditions
  11. Any loss of physical/ mental function has major impact on a person's life.
    • -Changes in family roles
    • -Drains major power sources (income, self esteem, autonomy)
    • -Grief over loss of normal function
  12. Engel's Theory of Loss
    • Shock and disbelief over the diagnosis
    • -Unable to accept fact of illness
    • Development of awareness
    • -Aware of lifelong implication of illness
    • -Depression
  13. Engel's Theory of Loss

    -Family and patient provide mutual support in coping with reality of disease.
    • Resolution
    • -Responds to loss with psychological coping
    • -Roles are adjusted to normalize activities of daily living.
  14. Individual response to chronic illness
    -Pattern of coping strategies used in the past
    -Pathophysiology causing the disease
    -Visibility of the disease
    -Degree and type of limitations imposed by the disease
    • -Relationship between the disease and person's functioning in social roles
    • -Amount and type of family support
    • -Pain, fatigue, and fear
  15. Societal response to chronic illness
    -Members of society tend to avoid persons with chronic disease
    • -Impact on patient
    •    -social isolation
    •    -lack of social support
  16. Anselm Strauss et al (1984) studies on tasks/ problems of the chronically ill
    Led to interactional model identifying 7 problems of living with chronic illness:
  17. Anselm Strauss 7 problems of living with chronic illness
    • Managing a medical crisis
    • -Delegation of control to others
    • -Can result in damage to patients' self concept and body image
  18. Anselm Strauss 7 problems of living with chronic illness
    • Carrying out prescribed regimens
    • -Family and/ or family must learn regimens of care
    • -Timing of interventions
    • -Coping with side effects
    • -Learning how to use equipment
    • -Pain management
  19. Anselm Strauss 7 problems of living with chronic illness
    • Controlling symptoms
    • -Learning acceptance of limitations on lifestyle imposed by disease
    • -Redesigning/ timing activities and hobbies
  20. Anselm Strauss 7 problems of living with chronic illness
    • Dealing with lack of monetary resources for treatment
    • -Costly treatments
    • -Limitations on ability to work
    • -Worry, anxiety, and depression
  21. Anselm Strauss 7 problems of living with chronic illness
    Managing the trajectory (disease pattern)

    -Variable, depending on predictability of illness and ability of patient to cope
  22. Anselm Strauss 7 problems of living with chronic illness
    Preventing social isolation

    • -Dependent on patient response to his/ her tendency to withdraw from friends and society
    • -Patient response to societal withdrawal from her/ him
  23. Anselm Strauss 7 problems of living with chronic illness
    • Normalization
    • -No longer focused on seven problems of the disease itself
    • -Involves working through above task
    • -Occurs when patient and family accept new, relaistic identities and roles
    • -Achieves normalization- optimal level of functioning within the limits by illness
  24. Corbin & Strauss
    -Trajectory Framework describes the experience of chronic illness
    • Further refinement of Strauss's earlier theory is applicable to:
    • -Cardiac illness
    • -Cancer
    • -Multiple sclerosis
    • -Diabetes
    • -Elderly with chronic illness
  25. Corbin & Strauss

    Common phases
    • -Pre-trajectory
    • -Trajectory onset
    • -Crisis phase
    • -Acute phase
    • -Stable phase
    • -Unstable phase
    • -Downward phase
    • -Dying phase
  26. Corbin & Strauss

    • -prior to diagnosis
    • -emphasize prevention
  27. Corbin & Strauss

    Trajectory onset
    -signs and symptoms
  28. Corbin & Strauss

    Crisis phase
    • -life threatening
    • -inpatient care
  29. Corbin & Strauss

    Acute phase
    • -interventions carried out
    • -illness/ complications
  30. Corbin & Strauss

    Stable phase
    -planned interventions
  31. Corbin & Strauss

    Unstable phase
    • -plan not working
    • -managed out-patient
  32. Corbin & Strauss

    Downward phase
  33. Corbin & Strauss

    Dying phase
    -terminal illness
  34. Psychosocial Adaptation to a chronic illness

    -is optimally achieved by maximizing self-control and independence
    -Increased dependence may be necessary during a medical crisis, but restoration to optimal functioning should be accomplished as soon as possible.
  35. Role of Nurse Practitioner in chronic illness:
    • -can provide much needed psychosocial support for the chronically ill patient
    • -can utilize Engel's loss theory and Strauss' 7 tasks to plan theory based interventions for chronically ill patients
  36. General Management
    • -evaluate the patient's self-care abilities
    • -help the patient adjust to limitation imposed by illness
    • -help the patients adjust to change in body image
    • -work to increase self-esteem
    • -assist the patient to express feelings
  37. General Management
    • -assess coping & help the patient practice new coping mechanisms
    • -facilitate the grieving process
    • -promote social interaction
    • -teach the family about the illness
    • -participate with the health care team to devise a comprehensive plan of care
  38. Care at the end of life
    • -Most persons will carry a chronic illness diagnosis at the end of life
    • -Role of the NP:
    •    -Pain management
    •    -Facilitator of hope
    •    -Explore patient expectations about the end       of life
  39. Care at the end of life
    • -Patient/ family communications about care/ prognosis
    • -Clarification of limits of care
    • -Caring for the family
    • -Follow-up and grieving for family
  40. Conclusion
    • -Chronic health conditions involve limitation of functions for patient and family adaptation
    • -FNP role is vital for family adaptation

Card Set Information

Chronic Illness (FHNIII)
2014-06-09 20:01:13
chronic illness
Show Answers:

What would you like to do?

Home > Flashcards > Print Preview