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Living with Chronic Illness
William P. Wattles, Ph.D.
Psychology 314
Acute disease
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short-term
less common than
chronic
either die or get well
Chronic illness

A disorder that
persists for a long
time and is either
incurable or results
in pathological
changes that limit
normal functioning.
Chronic illness

Virtually everyone
will eventually
develop some type
of chronic condition.
Chronic illness

Must deal with:
– Symptoms of the
disease
– Stress of Treatment
– Feelings of
vulnerability
– Loss of Control
– Threat to self-esteem
Examples of chronic illnesses
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Cancer
diabetes
arthritis
ALS
asthma
chronic obstructive
pulmonary disease
multiple sclerosis
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Parkinson’s disease
muscular dystrophy
sickle cell anemia
HIV
Chronic disease
long-lasting
 common

50% at any point in time
 100% at one time or another

Variable course
 never completely healthy

Coping with Chronic Disease
Attitudes and belief about illness
 personal traits such as depression and
optimism
 coping strategies
 compliance with prescribed regimens
 social support.

Attitudes and Beliefs
According to both the Theory of
Reasoned Action and Health Belief
Model attitudes and beliefs predict
adaptive behavior.
 Social norms
 attitudes
 affect
 facilitating conditions

Personality
Depression may take the energy away
needed to adapt to the disease
 anxiety may interfere with sleep and
other health processes.
 Optimism-a generalized expectation
that the future looks good-associated
with more adaptive behaviors.

Social Support.
Social support presumably serves to
buffer the effects of stress for the
cancer patient and may improve the
prognosis.
 The most helpful behaviors seem to be
emotional support, sympathy and
caring.

Impact of Chronic Illness

Crisis theory
–
–
–
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individuals need a state of equilibrium
chronic illness upsets this state
people search for ways to restore
homeostasis
failure to do so results in
anxiety
 fear
 stress

Impact on the patient

Psychological functioning
–
–
–

Self-image
–

social
physical
mental health
positive and negative changes
Coping strategies
Opportunities for psychology

Strategies to improve compliance
–
“Noncompliance is a substantial problem in
the treatment of chronic illness.”
Creation of support groups
 Dealing with psychological
repercussions
 Sustaining of personal relationships

Impact on the family

Adult children
–
change in relationship
Spouse
 Parents

Diabetes

Diabetes is a
disease in which the
body does not
produce or properly
use insulin

Insulin acts to
reduce levels of
glucose in the blood
by interacting in
some unknown way
with cell
membranes.
Diabetes

Diabetes is a
disease in which the
body cannot
properly store and
use fuel for
energy.The fuel that
your body needs is
called glucose, a
form of sugar.

Glucose comes from
foods such as
breads, cereals,
pasta, rice,
potatoes, fruits and
some vegetables

The cause of
diabetes continues
to be a mystery,
although both
genetics and
environmental
factors such as
obesity and lack of
exercise appear to
play roles.

Among states
having data for 1994
and 2002, the ageadjusted prevalence
of diagnosed
diabetes increased
more than 10%
between 1994-2002
(see detailed tables
for maps).

In twenty-three
states including
South Carolina,
age-adjusted
prevalence was at
least 50% higher in
2002 than in 1994.
Prevalence of Diagnosed Diabetes per 100 Adult Population
20
18
16
14
18-44
percent
12
45-64
65-74
10
75+
Total
8
Age-adjusted
6
4
2
0
1994
1995
1996
1997
1998
year
1999
2000
2001
2002
Incidence of Diabetes

The prevalence of
diabetes (diagnosed
plus undiagnosed) in
the total population
of people who were
40-74 years of age
increased from 8.9%
in the period 19761980 to 12.3% by
1988-1994.
“The increasing
frequency of obesity
and sedentary
lifestyles in the
population, make it
likely that diabetes
will continue to be a
major health problem
in the U.S.”
Diabetes is a life-long condition.

High blood glucose
levels over a long
period of time can
cause blindness,
heart disease,
kidney problems,
amputations, nerve
damage, and
erectile dysfunction.

Good diabetes care
and management
can delay or prevent
the onset of these
complications
Type 1 diabetes
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Type 1 diabetes
occurs when the
body makes little or
no insulin. It used to
be called insulindependent or
juvenile diabetes.
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There is nothing to
be done to prevent
type 1 diabetes,
even early diagnosis
will not prevent it.
It is not caused by
eating too much
sugar.
Type 2 diabetes

Type 2 diabetes
occurs when your
body can’t use the
insulin it makes.

A person with type 2
diabetes, you may
be able to keep your
blood glucose levels
in a target range by
healthy eating,
exercising and
taking diabetes
medication.
Adjusting to Diabetes
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Type 1
Insulin-dependent
Before age 15
underweight
equal between men
and women
requires insulin
imperils kidney
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Type 2
Noninsulin dependent
After age 30
overweight
affects more women
affects poor more than
middle class
no injections
imperils heart
Incidence of Diabetes
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General Population
6.2%
African American
13%
Latinos 10.2%
Men 8.3%
Women 8.9%
The good news

People can live a
long and healthy life
by keeping their
blood glucose levels
in the target range.
They can do this by:
 Eating healthy
meals
 Exercising
 Taking diabetes
medication,
including insulin
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Insulin-dependent diabetes
mellitus (IDDM)
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Management very
demanding
–
–
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injections
diet
exercise
Serious costs of
failing to comply
–
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blindness
kidney failure
amputation
Lifestyle changes
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Eat healthy
Eat three meals and a
bedtime snack each
day.
Include a food from
each of the food groups
at each meal.
If you are thirsty, drink
water or diet pop.
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If you are
overweight, eat
smaller portions.
Reduce your intake
of fat.
Limit sweet and fatty
foods.
Cardiac Rehabilitation
Fifty percent survive
 Major surgery and recovery
 Lifestyle changes
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diet
exercise
stop smoking
Motivation
Psychological reactions to CHD
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Depression
Anxiety
Anger
Fear
Guilt
Interpersonal
conflict
Coping with Cancer

Approximately 1.25
million people
diagnosed with
cancer in 1998
Coping with Cancer
Surgery
 Radiation
 Chemotherapy
 Hormonal treatment
 Immunotherapy
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Cancer treatment side effects
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Loss of hair
burns
nausea
vomiting
fatigue
sterility
Survival
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More than half of all
cancer patients
survive at least five
years
HIV and AIDS

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Relatively new
disease
“The virus is not
easily transmitted
from person to
person”
–
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sex
IV drug
blood transfusion
Preventable
AIDS/HIV
1999-IN the U.S., HIV/AIDS fell from 8th
to 14th among leading causes of death.
 It remained the leading cause of death
for black persons aged 25-44.
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Alzheimer’s Disease
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Degenerative
disease of the brain
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cognitive impairment
memory loss
personality change
Sure diagnosis only
by autopsy
Cause unknown
Alzheimer’s and the family
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Enormous cost to
the family and
society
Financial and
emotional resources
exhausted
Combines with loss
of loved one

Chronic stress of
providing care for
Alzheimer’s patients
lowers immune
system functioning
and increases
vulnerability to
illness.
Final Exam
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82 multiple choice
questions
Need calculator to
figure fat calories
etc
41
The End