COPING WITH

CHRONIC ILLNESS

1
 ▶ To define chronic illness in the context of quality of
life.
GOALS FOR THE
▶ To learn about the impacts of illness on the
PRESENTATION identified patient and the caregiver.
▶ To learn strategies to cope with illness.
▶ To review available resources to maintain
emotional health.
QUALITY OF LIFE AND CHRONIC ILLNESS

3
WHAT IS CHRONIC ▶ “…disorders that persist for an extended period
and affect a person’s ability to function normally.”
ILLNESS? (deRidder et al., 2008, 246).
▶ A chronic illness has the potential to create major
change in a person’s life.
▶ Sometimes this can result in a negative effect on
quality of life and wellbeing.
 HEALTH ▶ Quality of Life is…
RELATED • “…an individual’s perceptions of their position in life
QUALITY OF in the context of the culture and value systems in
LIFE which they live and in relation to their goals,
expectations, standards and concerns (World Health
Organization as stated in Megari, 2013, 141).”
(HRQOL)
- QOL…It is not just the absence of disease.

- It is the inclusion of social, physical and

psychological well-being and positive health
alongside self-rated health status (WHO, 1954 in
Megari, 142)

▶ QOL focuses on the person as a WHOLE.

THE IMPACT OF
ILLNESS ON THE
PATIENT AND THE
CAREGIVER
 ▶ Living with a chronic illness is difficult and poses
challenges
CHRONICILLNESSANDTHEPERSONWITHTHEDIAGNOSIS

FROM:HTTPS:/WWW.CANCER.NET/COPING-WITH-CANCER/MANAGING-EMOTIONS/COPING-WITH-UNCERTAINTY • Feelings of uncertainty

- Recurrence – the what ifs?

- Putting life on hold. Dependency on treatment

- Learning to manage the uncertainty is an important

part of staying healthy.

• Psychological distress
- Feelings of depression / sadness / fear / ?s about
treatment

• Physical limitations
• Dependency on others / feeling of burden (von der
Lippe et al., 2017, 761)
COPING WITH
“It is one’s feelings and beliefs
ILLNESS
regarding illness and treatment that determine
one’s ability to cope
with the challenges they meet.”

(Choen and Biesecker, 2010 in von der Lippe et

al., 2017, 766).
 ▶ Chronic illness affects all aspects of the life of a
healthy partner (Baanders et al., 2007, 305).
CHRONIC ILLNESS
• …The unpredictability of the patient’s condition / the
AND THE anticipation of possibly bad days may force partners
to set aside their own needs, reorganize their lives in
CAREGIVER advance, or it may hinder personal achievements
(Baanders et al., 306).

• Impacts vary based on one’s Social Determinants of

Health (slide 7).
SOCIAL DETERMINANTS OF HEALTH
▶ Aboriginal status
▶ gender
▶ disability
▶ housing
▶ early life income and income
distribution
▶ education race employment
▶ working conditions
▶ social exclusion
▶ food insecurity
▶ social safety net
▶ health services
▶ unemployment
▶ job security
▶ Raphael, D. (2009)
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 ▶The occurrence of disease often challenges an
FINDING
individuals’ beliefs and hopes (Holland &
Reznik, 2005).
•Re-evaluating hope in light of a chronic illness – a loss
of old hopes / the creation of new hopes emerging
(Flemming, 1997 et al., in Duggleby, 2018).
▶Finding meaning and purpose in life is an
important process of hope (Snyder, 2000 as
stated in Duggleby et al., 1212).
• Hope is an important psychological resource that can
be seen as “essential to life” (Elliot and Oliver, 2009 as
stated in Duggleby et al., 2011, 1212).
▶Meaning and purpose can be internally /
externally located – Values and Priorities
 ▶ High levels of perceived life meaning have been
linked to numerous aspects of adjustment in
survivorship, including better health-related quality
MEANINGFULNESS
of life (e.g., Brady, Peterman, Fitchett, Mo, & Cella,
1999) and psychological adjustment (Laubmeier,
Zakowski, & Bair, 2004; McClain, Rosenfeld, &
Breitbart, 2003).

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MEANING MAKING
▶ …effortsto understand a stressor and to incorporate
Talk with a counselor or social
worker at the hospital.
Find a support person, support
group or communities online.
▶ Meaning making is …believed to be important in a
person’s psychological adjustment through the
disease experience (Lepore, 2001; Moadel et al.,
1999).
that understanding into one’s global meaning system
(Park & Folkman, 1997).
• i.e. individuals typically believe that their lives are
predictable, ordered, and meaningful (Epstein, 1991;
Janoff-Bulman, 1989) and that the world is coherent
and fair or just (Davis & Nolen-Hoeksema, 2001;
Lerner, 1980).
- These ideas are challenged in light of new diagnosis /
crisis.
 ▶ Sometimes chronic illness can be a vehicle for personal
growth:
MEANING MAKING
CONTINUED • (a) it challenges our perceptions of life change /
posttraumatic growth,
• (b) it provides a deepened sense of meaning in life, and
….God / affiliation with a
religious/spiritual institution. • (c) It may restore core beliefs such as a just world (Bower et
al., 2005; Brennan, 2001; Holland & Reznik, 2005 as stated in
…being a good steward of Parks et al., 2008, 864).
resources and in exercising
frugality
• Core Beliefs may include:
• Dependability.Reliability.Loyalty.Commitment.
…family is of fundamental
importance • Open-mindedness.Consistency.Honesty.Efficiency

…maintaining a healthy
▶ Improved relationships, increased self-confidence and
work/life balance coping skills, and higher levels of spirituality and
appreciation for life (Stanton et al., 2006; Tomich &
Helgeson, 2004).
BEING PRACTICAL
 SEEK OUT
AND ASK FOR
SUPPORT
• Formal Supports

• Informal supports
 PRACTICE:
MINDFULNESS BASED
HTTPS://THEMI
STRESS REDUCTION
NDFULNESSSU
John Kabat-Zinn (1982)

MMIT.COM/SES
MBSR
•“a treatment for psychological distress, depressive
symptoms and anxiety for people with chronic disease.”
Bohlmeijer et al, 2009, 539).

SIONS/9-POWE
• Non-judgementally observe emotions, sensations, or
cognitions.

RFUL-MEDITATI
• Moment-to-moment awareness

ON-TIPS-JON-K
PRACTICE:
MEDITATION

Pema Chodrun
• “Meditation gives us the opportunity to
have an open, compassionate
attentiveness to whatever is going on.
The meditative space is like the big sky
— spacious, vast enough to
accommodate anything that arises.”
(Chodrun, 2018)
• https://www.lionsroar.com/5-reasons-to-
meditate-september-2013/
APPS

Insight Timer Headspace

 ▶ AAMAC
• http://www.aamac.ca/e/
• http://www.aamac.ca/e/a_34main.cfm
RESOURCES

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DISCUSSION

This Photo by Unknown Author is licensed under CC BY-SA-NC

BIBLIOGRAPHY

▶ Baanders, A. N. and M. J. W. Heijmans (2007). "The impact of chronic diseases: the partner's
perspective." Family & Community Health 30(4): 305-317.

▶ Bohlmeijer, E., et al. (2010). "The effects of mindfulness-based stress reduction therapy on mental
health of adults with a chronic medical disease: a meta-analysis." Journal of Psychosomatic Research
68(6): 539-544.

▶ de Ridder, D., et al. (2008). "Psychological adjustment to chronic disease." Lancet 372(9634): 246-255.

▶ Duggleby, W., et al. (2012). "Hope, older adults, and chronic illness: a metasynthesis of qualitative
research." Journal of Advanced Nursing 68(6): 1211-1223.

▶ Helgeson, V. S. and M. Zajdel (2017). "Adjusting to Chronic Health Conditions." Annual Review of
Psychology 68: 545-571.

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BIBLIOGRAPHY
▶ Raphael, D. (2009). Social Determinants of Health: Canadian
Perspectives, 2nd edition. Toronto: Canadian Scholars’ Press.
▶ von der Lippe, C., et al. (2017). "Living with a rare disorder: a
systematic review of the qualitative literature." Molecular Genetics &
Genomic Medicine 5(6): 758-773.
▶ Park, CL., Edmondson, D., Fenster, JR. and Blank, TO. (2008). “Meaning
making and psychological adjustment following cancer: the
mediating roles of growth, life meaning, and restored just-world
beliefs.” J. Consult Clinical Psychology. 76(5):863-75.
▶ Megari, K. (2013). "Quality of Life in Chronic Disease Patients." Health
Psychology Research 1(3): e27.
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