Download Adolescents with Chronic Illness

Adolescents with Chronic Illness
( D.M.)
Dr.Turki ALBatti,MD
‫تركي حمود البطي‬.‫د‬
Types of Diabetes
 Type I – insulin dependent diabetes mellitus
(IDDM)
 5-10% of cases have IDDM
 Normally develops in childhood
 Pancreas not producing insulin so need insulin
injections
IDDM - continued
 Ketoacidosis – main acute complication. High
levels of fatty acid in blood leads to kidney
problems and subsequent toxic build-up of
wastes in the blood.
 Symptoms are:
– Chronic thirst, frequent need to urinate, nausea,
vomiting, abdominal pain, and difficulty breathing.
Can lead to coma and death.
Treatment for Diabetes Mellitus
 Diet
 Medication
 Exercise
Diabetic Adherence to Regimen
 80% of patients administer insulin in an
unhygienic manner.
 58% administer the wrong dose of insulin.
 77% test or interpret the glucose levels
incorrectly.
 75% don’t eat the prescribed foods.
 75% don’t eat with sufficient regularity.
Psychosocial Factors
 Social support (adherence )
 Self-efficacy – feel they can handle the
regimen and control the disease.
 Stress – causes less insulin and more glucose
production.
Objectives
 Psychological complications of chronic
Illness
 Developmental complications of chronic
illness
Introduction
 Early adolescence (age range 11-14 yrs.)
 Am I normal
 Mid-adolescence (age 14-16 yrs.)
 Independence/self image
 Late adolescence (age 17-older yrs.)
 Future oriented, intimacy /career goals
Psychological Complications of
Chronic Illness
 Chronic disorder
 Treatment requirements
 Hospitalization
 Surgery or other procedures
Developmental Complications of
Chronic Illness
 Body image issues
 Developing independence
 Relationship with peers
Compliance with Medical
Treatment
 Daily lives
 Mental disorders
 Challenge
Obstacles affecting transition to health care
system for the adolescents
 Dependent behavior
 Immaturity
 Severe illness or disability
 Psychopathology
 Lack of support systems
 Lack of trust in caregivers
 Poor adherence to treatment regiment
 Parental involvement
Obstacles to health care for
family or caregivers
 Excessive need for control
 Emotional dependency
 Parenting styles/overprotective
 Heightened perception of disease severity
 Lack of trust in caregivers
 Denial about the severity of the disease
Data systems
Transition
coordinators
Risk &
protective
factors
Parents
Peer
influences
Training for paediatric
& adult professionals
Healthcare systems
& training structures
Principles
of Adolescent
Medicine
Psychosocial
screening
T
Confidentiality
Info and resources
Longer appointments
Understanding health
condition
Adherence
Selfmanagement
Managing
of
Health
chronic
condition
disease Growing capacity
Promoting
autonomy
for self-care
(Kennedy A & Sawyer SM 2008)