living with chronic illness william p. wattles, ph.d. psychology 314
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Living with Chronic Illness
William P. Wattles, Ph.D.
Psychology 314
Acute disease
short-term less common than
chronic either die or get well
Chronic illness
A disorder that persists for a long time and is either incurable or results in pathological changes that limit normal functioning.
Chronic illness
Virtually everyone will eventually develop some type of chronic condition.
Chronic illness
Must deal with:– Symptoms of the
disease– Stress of Treatment– Feelings of
vulnerability– Loss of Control– Threat to self-esteem
Examples of chronic illnesses
Cancer diabetes arthritis ALS asthma chronic obstructive pulmonary disease multiple sclerosis
Parkinson’s disease muscular dystrophy sickle cell anemia HIV
Chronic disease
long-lasting common
50% at any point in time 100% at one time or another
Variable course never completely healthy
Coping with Chronic Disease
Attitudes and belief about illness personal traits such as depression and
optimism coping strategies compliance with prescribed regimens social support.
Attitudes and Beliefs
According to both the Theory of Reasoned Action and Health Belief Model attitudes and beliefs predict adaptive behavior.
Social norms attitudes affect facilitating conditions
Personality
Depression may take the energy away needed to adapt to the disease
anxiety may interfere with sleep and other health processes.
Optimism-a generalized expectation that the future looks good-associated with more adaptive behaviors.
Social Support.
Social support presumably serves to buffer the effects of stress for the cancer patient and may improve the prognosis.
The most helpful behaviors seem to be emotional support, sympathy and caring.
Impact of Chronic Illness
Crisis theory – individuals need a state of equilibrium– chronic illness upsets this state– people search for ways to restore
homeostasis– failure to do so results in
anxiety fear stress
Impact on the patient
Psychological functioning– social– physical– mental health
Self-image– positive and negative changes
Coping strategies
Opportunities for psychology
Strategies to improve compliance– “Noncompliance is a substantial problem in
the treatment of chronic illness.” Creation of support groups Dealing with psychological
repercussions Sustaining of personal relationships
Impact on the family
Adult children– change in relationship
Spouse Parents
Diabetes
Diabetes is a disease in which the body does not produce or properly use insulin
Insulin acts to reduce levels of glucose in the blood by interacting in some unknown way with cell membranes.
Diabetes
Diabetes is a disease in which the body cannot properly store and use fuel for energy.The fuel that your body needs is called glucose, a form of sugar.
Glucose comes from foods such as breads, cereals, pasta, rice, potatoes, fruits and some vegetables
The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
Among states having data for 1994 and 2002, the age-adjusted prevalence of diagnosed diabetes increased more than 10% between 1994-2002 (see detailed tables for maps).
In twenty-three states including South Carolina, age-adjusted prevalence was at least 50% higher in 2002 than in 1994.
Prevalence of Diagnosed Diabetes per 100 Adult Population
0
2
4
6
8
10
12
14
16
18
20
1994 1995 1996 1997 1998 1999 2000 2001 2002
year
pe
rce
nt
18-44
45-64
65-74
75+
Total
Age-adjusted
Incidence of Diabetes
The prevalence of diabetes (diagnosed plus undiagnosed) in the total population of people who were 40-74 years of age increased from 8.9% in the period 1976-1980 to 12.3% by 1988-1994.
“The increasing frequency of obesity and sedentary lifestyles in the population, make it likely that diabetes will continue to be a major health problem in the U.S.”
Diabetes is a life-long condition.
High blood glucose levels over a long period of time can cause blindness, heart disease, kidney problems, amputations, nerve damage, and erectile dysfunction.
Good diabetes care and management can delay or prevent the onset of these complications
Type 1 diabetes
Type 1 diabetes occurs when the body makes little or no insulin. It used to be called insulin-dependent or juvenile diabetes.
There is nothing to be done to prevent type 1 diabetes, even early diagnosis will not prevent it.
It is not caused by eating too much sugar.
Type 2 diabetes
Type 2 diabetes occurs when your body can’t use the insulin it makes.
A person with type 2 diabetes, you may be able to keep your blood glucose levels in a target range by healthy eating, exercising and taking diabetes medication.
Adjusting to Diabetes
Type 1 Insulin-dependent Before age 15 underweight equal between men and women requires insulin imperils kidney
Type 2 Noninsulin dependent After age 30 overweight affects more women affects poor more than middle class no injections imperils heart
Incidence of Diabetes
General Population 6.2% African American 13% Latinos 10.2% Men 8.3% Women 8.9%
The good news
People can live a long and healthy life by keeping their blood glucose levels in the target range.
They can do this by: Eating healthy meals Exercising Taking diabetes medication, including
insulin
Insulin-dependent diabetes mellitus (IDDM)
Management very demanding– injections– diet– exercise
Serious costs of failing to comply– blindness– kidney failure– amputation
Lifestyle changes
Eat healthy Eat three meals and a bedtime snack each day. Include a food from each of the food groups at each
meal. If you are thirsty, drink water or diet pop.
If you are overweight, eat smaller portions. Reduce your intake of fat.
Limit sweet and fatty foods.
Cardiac Rehabilitation
Fifty percent survive Major surgery and recovery Lifestyle changes
– diet– exercise– stop smoking
Motivation
Psychological reactions to CHD
Depression Anxiety Anger Fear Guilt Interpersonal
conflict
Coping with Cancer
Approximately 1.25 million people diagnosed with cancer in 1998
Coping with Cancer
Surgery Radiation Chemotherapy Hormonal treatment Immunotherapy
Cancer treatment side effects
Loss of hair burns nausea vomiting fatigue sterility
Survival
More than half of all cancer patients survive at least five years
HIV and AIDS
Relatively new disease
“The virus is not easily transmitted from person to person”– sex– IV drug– blood transfusion
Preventable
AIDS/HIV
1999-IN the U.S., HIV/AIDS fell from 8th to 14th among leading causes of death.
It remained the leading cause of death for black persons aged 25-44.
Alzheimer’s Disease
Degenerative disease of the brain– cognitive impairment– memory loss– personality change
Sure diagnosis only by autopsy
Cause unknown
Alzheimer’s and the family
Enormous cost to the family and society Financial and emotional resources
exhausted Combines with loss of loved one
Chronic stress of providing care for Alzheimer’s patients lowers immune system functioning and increases vulnerability to illness.
The End
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