1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 27 Chronic Illness

2. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Chronic Illness “Insider’s perspective” Focus living with and in spite of illness May view self as “healthy”

3. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Morbidity Four leading causes of chronic health problems  Arthritis  Chronic sinusitis  Deformities and orthopedic impairments  Hypertension

4. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Mortality Leading causes of death Mortality variations among races

5. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Caring, Empowering Perspective Valuing the client’s lived experience Focus on caring, not curing Empowering individuals with chronic illness Experts in own care

6. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Relationships Built on Respect Trust Partnership

7. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Impact of Chronic Illness Physical aspects Psychosocial aspects Spiritual aspects  Uncertainty, powerlessness, biographical disruption Economic aspects

8. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Challenges of Living with a Chronic Illness Preventing and managing exacerbations Symptom management Preventing social isolation Shaping course of the illness Normalizing Ensuring adequate funding

9. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Living with a Chronic Illness Coping Normalizing Managing the illness Role of the family Family caregivers

10. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Approach Coping Strategies Information seeking Obtaining strength from spirituality Diversion techniques Maintaining control Expressing feelings, emotions, concerns

11. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Approach Coping Strategies Using relaxation and positive-thinking techniques Maintain realistic expectations for independence and dependence Maintain social activities Using humor Energy conservation

12. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Normalizing Hide symptoms Engage in pre-illness activities Maintain social relationships

13. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Visible Illness Invisible Illness Decision to disclose or not disclose Risk of stigmatization Risk of discrimination

14. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Managing the Treatment Challenges to adhering to treatment plan  Time  Energy  Money Client’s right to participate or decline treatment

15. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Role of the Family Types of Roles  Rescuing agent  Protective agent  Assisting agent

16. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Family Caregivers Positive rewards Role strain Caregiver burden

17. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Health Promotion and Disease Prevention: The Nurse’s Role Levels of Prevention  Primary  Secondary  Tertiary

18. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Primary Prevention Risk factor modification Immunizations Health education Counseling

19. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Secondary Prevention Early detection of disease Health screening

20. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Tertiary Prevention Rehabilitation and restoration Client education Disease management

21. Copyright © 2003 Delmar Learning, a Thomson Learning companyChapter 27 Health-Promoting Family Nursing Assessment Listening to the family Participatory dialogue Pattern recognition Envisioning action and positive change