By Marisol Jane T.

Jomaya MAN - I

ILLNESS  a state in which a person s physical, emotional, intellectual, social, developmental or spiritual functioning is diminished or impaired compared with previous experience. not synonymous to disease includes the disease process and the effect of functioning and well being in all dimensions. i.e. CANCER, LEUKEMIA

Types of Illness:
1. ACUTE ILLNESS short duration and is severe, symptoms appear abruptly are intense and often subside after a relatively short period of time.

2. CHRONIC ILLNESS persists usually longer than 6 months and can also affect functioning in any dimension. The client may fluctuate between maximal functioning and serious health relapses that may be life threatening.

(Mechanic 1995) . A chronic disabling disease interferes with ongoing life adaptations by making the performance of routine tasks more challenging.

Issues surrounding its acceptance and management are complex and overwhelming. .y *** Chronic illness is the leading health problem in North America for older adults and children.

.PREVALENCE AND CAUSES OF CHRONIC ILLNESS/CONDITIONS Chronic conditions have become the major cause of health related problems in developed and developing countries giving these countries the dual burden of trying to eradicate infectious diseases while learning to manage chronic conditions.

safer working conditions and greater access for some people to health care. . improved nutrition.Longer life spans because of advances in technology and pharmacology.

. enabling early detection and treatment of diseases.Improved screening and diagnostic procedures.

such as myocardial infarction and AIDS related infections y The tendency to develop single or multiple chronic illnesses with advancing age.Prompt and aggressive management of acute conditions. .

hypertension and cardiovascular diseases. . that increase the risk for chronic illnesses. chronic stress and obesity.y Modern lifestyle factors such as smoking. such as pulmonary disease.

social norms and the opportunities or constraints of community institutions. define and interpret their symptoms. Affected by personal history.ILLNESS BEHAVIOR it involves how people monitor their bodies. social situations. take remedial actions and use the health care system.  Can be used as coping mechanisms view illness as release from responsibilities or view illness as added stressors or burden .

On the other hand.VARIABLES I FL E I G ILL ESS AND ILLNESS BE AVI R INTERNAL PERCEPTION OF SYMPTOMS  If client believes symptoms disrupt their normal routine they are more likely to seek health care assistance than if they do not perceive the symptoms to be disruptive NATURE OF ILLNESS  Clients with acute illness are more likely to seek health care assistance and comply readily with therapy. clients with chronic illness with symptoms which may not be cured but only partially relieved may not be motivated to comply .

.EXTERNAL VISIBILITY OF SYMPTOMS SOCIAL GROUP/SOCIAL SUPPORT  Client reacts more positively when there is social support and at the same time practicing positive health behavior.

CULTURAL BACKGROUND  Culture teaches the person how to be healthy. how to recognize illness and how to deal with it. . Ethnic differences can influence decisions about health care and the use of diagnostics as well as health services.

. client delays treatment and attempt to carry out daily activities.ECONOMIC VARIABLE Because of financial constraints.

For many clients entry into the system is complex and confusing. ** Illness is never an isolated life event.ACCESSIBILITY TO HEALTH CARE SYSTEM Economic variable and seeking health care service are interrelated factors. Client and family must deal with the changes resulting from the illness and treatment .

Chronic illnesses usually involve many different phases over the course of a person s lifetime. Associated psychological and social problems must also be addressed.CHARACTERISTICS F CHRONIC ILLNESS Managing chronic illness involves more than managing medical problems. There can be acute periods. flare ups and remissions. . stable and unstable periods.

Keeping chronic conditions under control requires persistent adherence to therapeutic regimens. One chronic disease can lead to development of other chronic conditions. .

unfilled roles. decreases in family socialization activities and the costs of treatment. .Chronic illness affects the whole family. Family life can be dramatically altered as a result of role reversals. loss of income. time spent managing illness.

The management of chronic illness is expensive. The management of chronic conditions is a process of discovery. The home rather than the hospital is the center of care.The major responsibility for the day to day management of illness falls upon the shoulders of chronically ill people and their families. . Managing chronic conditions is a collaborative process.

health care professionals and the society.Chronic conditions raise difficult ethical issues for the patient. . Living with chronic illness means living with uncertainty.

PRETRAJECTORY PHASE -is a stage wherein a person is at risk for developing chronic conditions because of genetic factors or lifestyle behaviors which increases susceptibility to chronic illness. 2. TRAJECTORY PHASE -is characterized by the onset of symptoms or disability associated with a chronic condition.PHASES OF CHRONIC ILLNESS 1. .

UNSTABLE PHASE -is characterized by an exacerbation of illness symptoms.3. 4. . development of complications or reactivation of an illness in remission. STABLE PHASE -indicates that symptoms and disability are being managed adequately.

is characterized by sudden onset of severe or unrelieved symptoms or complications that require hospitalizations for their management.5. . ACUTE PHASE .

6. . CRISIS PHASE -is characterized by a critical or life threatening situation that requires emergency treatment or care.

DOWNWARD PHASE . 8. .7. Symptoms and disability continue to progress despite attempts to gain some control through the treatment and management regimen.marks the worsening of the condition. COMEBACK PHASE -is the period in the trajectory marked by recovery after an acute period.

DYING PHASE .is characterized y the gradual or rapid decline in the trajectory despite efforts to halt the disorder or slow the decline through illness management. it is characterized by failure of life maintaining body functions.9. .

 Severe illness.BEHAVIORAL AND EMOTIONAL CHANGES  Short term. particularly one that is life threatening .IMPACT OF ILLNESS IN CLIENT AND FAMILY 1. can lead to more extensive emotional and behavioral changes such as DABDA  Hopelessness/powerlessness . non life threatening illness evokes few behavioral changes in the functioning of the client and the family.

When a change in body image occurs the following phases is undergone. Some illnesses result in changes in physical appearance and clients and families react differently to these changes. REHABILITATION . SHOCK. ACCEPTANCE. WITHDRAWAL.2. ACKNOWLEDGEMENT. IMPACT ON BODY IMAGE Body image is the subjective concept of physical appearance.

4. . conflicting responsibilities or direct conflict over decision making. ROLE REVERSAL is very common. It leads to stress. parents and children try to adapt to the major changes resulting from a family members illness. IMPACT ON FAMILY ROLES When an illness occurs.

A client whose self concept changes because of illness may no longer meet family expectations. leading to tension or conflict. Important in family relationships or relationship with significant others. It depends in part of body image and roles as well as other aspects of psychology and spirituality. IMPACT ON SELF CONCEPT Self concept is a mental self image of strengths and weaknesses in all aspect of personality.3. .

makes decisions. . give support to individual members and copes with everyday changes and challenges. IMPACT ON FAMILY DYNAMICS Family dynamics is a process by which the family functions.5.

y If a parent in a family becomes ill. . or they delay action because they are reluctant to assume the ill person s roles and responsibilities. family activities and decision making often come to a halt as the other family members wait for the illness to pass.

EMPOWERMENT The purpose of the nurse client relationship is to maintain and restore control to clients. Empowerment is a social process of identification and support of an individual s abilities to attend to one s needs to problem solve and to activate necessary resources to control one s own life. .INTERVENTIONS A.

HEALTH COACHING DISCHARGE PLANNING COLLABORATION SELF MANAGEMENT CONTROL .

 SELF DETERMINATION  ESTABLISHING A SENSE OF MASTERY  CLIENT AND FAMILY EDUCATION  HEALTH SYSTEM NAVIGATION  ADVOCACY .

DECISION MAKING ANTICIPATORY GUIDANCE CULTURAL COMPETENCE .

 Promotion of healthy lifestyle. encouraging the use of safety and disease prevention measures and prevention should begin early in life and continue throughout the life span.PROMOTING HOME AND COMM NITY BASED CARE y TEACHING PATIENTS SELF CARE  One of the goal of nursing in the 21st century is to prevent chronic conditions and care the people affected by them. .

 Patient and family teaching is one of the most significant aspect of nursing care and may make the difference in the ability of patients and their families to adapt to chronic health conditions. .

rather it is important in all settings and throughout the illness trajectory. Collaboration is not limited to hospital settings. nurse and other health care professionals. . family.CONTINUING CARE  Chronic Illness management is a collaborative process between a patient.

y Management at home .

 Nurses should think beyond the individual level to the community and global levels. . this entails wide ranging efforts to assess people for risk factors for chronic illness. In terms of illness prevention and health promotion.

Larsen/Morof Lubkin . 7th edition.Potter and Perry y Fundamentals of Nursing. Kozier y Brunner and Suddarth s Textbook of Medical Surgical Nursing.REFERENCES y Fundamentals of Nursing. Brunner/Suddarth y Chronic illness impact and intervention.

yEND .

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