ch+12+chronic+and+life threatening

8/13/2019 Ch+12+Chronic+and+Life Threatening

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We examine conditions that people live with for lifeand serious conditions that are life threatening

Most illness is acute that is episodic Chronic conditions are constant and can bring about

psychological stress Psychological responses differ depending on the nature

of the symptoms The perception one has of their condition can affect

how well they cope with the condition


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Cancer

People in Canada have about a 1 in 4 chance ofgetting cancer in their lives

Cancer takes many forms and symptoms varyfrom type to type

Oncology is the study of cancer

Oncologists often specialize in only one type ofcancer specific to one site in the body


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Cancer

What all cancers share is the uncontrollablegrowth of abnormal cells

Normal cell division and growth is controlled atthe level of the DNA

Sometimes the genes that control growth aredamaged

This allows the cell to grow uncontrollably


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Cancer When enough uncontrolled cells form a mass,this is a tumour When tumour cells spread through other partsof the body they are metastasized

When diagnosed, many people go throughdenial

This has been shown to have health benefits inthe early stages of cancer

Suffering among cancer patients comes inphysical, psychological and social forms


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Physical problemsFatigue and pain are the two most common

Most people tend to be in more pain than theyneed to be

Patients tend not to take analgesics for fear oftolerance or addiction

Patients forget and also believe that a certainamount of pain should be tolerated


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Psychological distressFear and depression are the two most commonpsychological problems

These can become chronic

There is usually fear that treated cancer may recurand that it may metastasize

Depression tends to be proportional to theprognosis of the disease


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Psychological distress

Depression results in: Poor quality of life Longer hospital stays Lower medical adherence

Higher mortality rate

Intrusive memories are common

These are unwanted thoughts related to illnessor death of friends family or even someone in amovie


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Psychological distressEmotion-focused coping is focusing on ways toreduce the emotional impact of the disease

Problem-focused coping involvesSeeking of information about the diseaseClosely following treatment recommendationsactively addressing the stressors associated with thecancer

The problem-focused approach seems to be moreeffective at reducing depression and anxiety


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Cancer treatment

Common treatments include:Surgeryradiation therapyChemotherapyhormone therapy

Hormones are used to treat breast and prostate cancer

These forms are influenced by certain hormones

(testosterone, estrogens)Surgery can remove tumours but cannot do anythingto cells that have metastasized


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Cancer treatmentRadiation therapy

can shrink tumoursRadiation andsurgery aredesigned to deal with specific sites ofcancer

If cancer has

metastasized thenchemotherapy isused

Harm to healthycells may occur


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Cancer treatmentSide effects include fatigue, nausea, hair loss, oraland gastrointestinal erosion

Social support can influence the progression of thedisease and recovery

Support groups can:Encourage people to express emotionsBuild group cohesion increasing the sense of socialsupportImprove patient communication skillsOffer relaxation training


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DiabetesThis is the seventh leading cause of death inCanadaThe incidence of this disease is increasing (17per 100,000)

People tend to die of complications such as heardisease

Diabetes is when the pancreas produces to littleinsulin

Insulin is needed for cells to get sugar from theblood


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Diabetes

Type I is the production of little or no insulin

Type II is the underproduction or ineffectiveutilization of insulin

Type II is more common in people over the age of 45especially if they are obese


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DiabetesSymptoms:

Type I frequent urination, unusual thirst, extremehunger, weight loss and fatigue

Type II similar to type I but also frequentinfections, cuts and bruises take a long time to heal

Type I sufferers have to take daily insulin

Both types have to closely monitor their bloodsugar and their dietary intake of sugar


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Diabetes

Long-term consequences can include: AmputationCardiovascular diseaseKidney failureNeurological problemsGoing blindStroke

Depression and low blood sugar can feed offeach other (bidirectionally)


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Cardiovascular disease526 per 100,000 died from these conditions in 1996 (mostly

heart attack and stroke)Men are more likely than women to die of heart disease


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Cardiovascular disease3 main conditions can beidentified

Myocardial infarction irreversibledamage to heart muscle (heart attack) -people survive their first but not thesecondCoronary artery bypass graft healthyarteries from other parts of the body aregrafted to the coronary artery to bypass

blocked arteries Angioplasty this involves theunblocking of blocked blood vessels.Balloons or tubes are inserted intoconstricted blood vessels to widen them


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Cardiovascular disease

Anxiety about having another heart attack canlead people to a sedentary lifestyle

This is usually accompanied by weight gain andreduced physical activity

This makes people prone to another heart attack

Depressed patients are four times as likely to die within 6 months of diagnosis


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Atherectomy


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HIV and AIDSSymptoms of HIV (human immunodeficiency virus)

Feverswelling of lymph nodesFatigue

Diarrheasleep sweating yeast infections

HIV breaks down the bodys immune system

This makes it susceptible to other infections


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HIV and AIDSThe only transmission modes are unprotected sex,needles and mother to fetus

AIDS is particularly stressful since most people that

live with it are stigmatized

There are myths about how people can contract this

This social stigmatization can lead to extremedepression similar to post-traumatic stress disorder


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Other chronic conditions andquality of life

Major depression is seen in many arthritis andParkinson sufferersDepression can make Parkinsons Disease worse(motor function and motivation)


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Other chronic conditions andquality of lifeQuality of life refers to the extent to which symptomsand treatment affect a persons physical, social, cognitiveand emotional functioning

Treatments that may alleviate a medical cause of adisease might have negative effects on other aspects of apatients life


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Other chronic conditions andquality of life

Two major things must be considered:

1. Tradeoffs between length of life and quality of life

2. Patients must be integrally involved with decisionsbecause only they know what is important to them


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Death and Dying A logical progression has been suggested to occur whensomeone has been told they are dying

Denial this is a defence mechanism used whentraumatic information is received. People think that thephysician is not being serious

Anger this is sometimes directed at the medical systemor family and friends for not being helpful enough


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Death and DyingBargaining sometimes people try to buy more timeby offering themselves for research or make strongreligious or spiritual commitments

Depression if people become depressed they tend togive up, this often accelerates death

Acceptance at this point, people are likely to be atpeace. Death is viewed as a relief

ch+12+chronic+and+life threatening

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