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Chronic Illness PSYC 4080 Health Psychology Example ► Cardiovascular Disease cardiac rehab improved diet, exercise, wt loss, lower stress need to be _________, come to terms with the fact that your body can’t take the lifestyle you have been leading Example ► Cancer Surgery Radiation Chemotherapy Example ► Diabetes – an insulin _______ disorder strict diet & exercise medical monitoring (frequent & regular Dr. visits) insulin injections (if more serious) Diabetes – Type I ► An ________ disease Immune system attacks the insulin-making cells ► Unable to produce insulin -> insulin dependent ► A control – not a cure Diabetes – Type II ► Previously called ________ Develops in children as well ► Often develops in individuals who are Overweight Sedentary Poor Diabetes ► Long-term complications Cardiovascular disease ►Damaged blood vessels Blindness ►Damaged retina _______ disease ►Leads to renal failure Example ► Human Immunodeficiency Virus (HIV) HIV-1 (AIDS in US) HIV-2 (AIDS in Africa) ► Acquired (AIDS) Immune Deficiency Syndrome Weakened immune system Leaves the body defenseless AIDS ► Patients are living longer Diagnosed in 1984 -> 11 months to live Diagnosed in 1995 -> 46 months to live ► More effective drug therapies ► Early detection ► Lifestyle changes Example ► Alzheimer’s Disease – a degenerative disease of the brain Affects almost ½ of people over 85 in US Definitive diagnosis via autopsy ►Behavioral symptoms of cognitive impairment _______ & tangles of nerve fibers Alzheimer’s Disease ► Early-onset Before age 60 Quite rare Due to genetic defect ► Late-onset After age 65 Related to __________ Example ► Alzheimer’s Disease worst in early stages when patient realizes after that it is increasingly hard on the family as they watch their loved one deteriorate patient longer able to recognize others, may not function towards end The Impact of Chronic Illness ► Chronic illnesses have _________ acute diseases Most CI are not severe or life threatening, but it fatal, cause death only after a lengthy period of illness CI requires adaptation to the way patients live ► Attempts Crisis Theory to explain impact of disruptions ► We need to operate in a state of __________ ► When interrupted by illness, we rely on previously successful ways of responding Crisis Theory ► Crisis -> anxiety, fear, stress -> need to normalize ► Results: Healthy adaptation or Unhealthy adjustment ► The __________ is neither healthy or pathological Impact on the Patient ► Being treated as a “nonperson” ► Worse social & physical functioning ► Poorer mental health ► Greater ____ ► But these vary with the type of illness & patient’s response Impact on the Patient ► Changes in self-perception ► Develop an understanding of the illness ► _______ it into their life ► Often find a positive aspect to the situation 8 Issues 1) Control “I’m tired of this, I want my life back” “Diabetes is controlling my life” Reestablish control 8 Issues 2) Self-image “I’ll never be the same” “I’m damaged goods” __________ & redefine the self 8 Issues 3) Dependency “I’ve always been independent; I hate asking for help” “Since he got sick, my husband won’t do anything for himself” ________ self-reliance & acceptance of some physical dependency 8 Issues 4) Stigma “Everywhere I go, I feel that people are staring at me” “People at work are avoiding me” Develop self-acceptance & _________ to deal with others’ reactions 8 Issues 5) Abandonment “I’ll have no one to take care of me” “My son has deserted me in this nursing home” “I couldn’t live with myself if I didn’t care for my husband myself” Face difficult decisions with _______& sensitivity to others’ needs 8 Issues 6) Anger “I have a scream inside me waiting to get out” Identify & redirect anger; release _________ energy 8 Issues 7) Isolation “Why don’t my friends call me?” “I just want to get away by myself” Appropriate level of meaningful contact 8 Issues 8) Death “What kind of life will I have if I can’t function?” “I need someone to talk to about dying” Existential acceptance & emphasis on quality of life in ____________ Coping Strategies POSITIVE Focus on the positive Seek social support Distance self _________ from the disease NEGATIVE Cognitive/Behavioral avoidance Substance abuse Impact on Couples ► Couples with flexible roles adapt better ► Treatment is not major source of problem It’s the ________ patient & partner’s view of the problem ► Couples can get closer but less satisfied Dependency Invisible support is more effective Impact on the Family ► Adults if sick Illness redefines identity Lose authority to discipline ► Children if sick Illness factors in identity formation Need extra emotional support Lead to _________