PSY333H1 Lecture Notes - Lecture 8: Testicular Cancer, Chemotherapy, Melanoma

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Published on 19 Jun 2012
LECTURE 8 Chronic Illness
Midterm viewing:
-Office hours: tomorrow 3:30-5:30 room 4004
-Grading challenges? Submit in writing within 24 hours
Issues surrounding chronic illness
-Quality of life
-Changing self
The Scope Of The Issue…
At any given time 58% of Canadian population has some
chronic condition
-81% of senior population
Accounts for 2/3 of Canada’s health spending
Spectrum of chronic conditions = mild (partial hearing
loss) to severe and life threatening (cancer,
Self-management: patient’s involvement in their
-Medication, changes to their life, coping…
What Is The Impact Of Chronic Disease?
1. Causes premature death
2005: >60% of deaths globally result from chronic
Prevalence rates highest in developed countries
Not being killed off by war so living long for chronic
illness to form
2. Economic and social burden to families, communities and
Direct (health care) + indirect (disability) cost of
chronic disease
o $10 billion diabetes, $18 billion cancer, $20
billion arthritis
3. Compromise quality of life
Quality Of Life
Historically measured only by length of life + signs
of disease
o No consideration of psychological or social
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o Psychological distress often experienced by
chronically ill
Quality of Life: degree to which a person is able to
maximize their functioning?
o Physical: limit activities? Pain? Energy? Ex)
o Psychological: depression? Anxiety? Ex) Cancer
o Vocational: return to work? Ex) Chronis disease
o Social: limit interactions? Intercourse? Ex)
Hearing loss
Why Do We Need To Study Quality Of Life (QOL) Among The
Chronically Ill?
1. Document effects of illness
-Basis for interventions designed to improve QOL
2. Pinpoint which particular problems patients with
particular disease may expect
3. Address impact of treatments on QOL
4. QOL information can be used to compare therapies
5. Inform decision-makers: which treatment maximizes
survival and QOL
How The “Self” Is Changed By The Diagnosis?
How Is The Self changed By Chronic Illness?
Physical self / Achieving self / Social self / Private
Self all make up Mental self
Physical Self
Body Image: perception and evaluation of physical
-Poor body image low self-esteem, increased
likelihood of depression and anxiety
-Influences adherence to treatment and how willing
patient is to adopt co-management role in treatment
-Can be improved through psychological and educational
Achieving Self
Most of us gain a sense of achievement from our jobs
or leisurely activities
o Brokered a deal today
o Saved a patients life
o Got an A on my midterm
o Ran marathon at personal best time
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Illness limits work & non-work activities reduced
Self-concept suffers
Social Self
-Illness limit social interactions
-Hard to rebuild social relationships
-Family and friends = source of self-esteem
-Source of support
-Fears about withdrawal of support among most common
worries of chronically ill
Private Self
Illnesses create need to be dependent on others
o Help with choirs
o Can’t contribute to household income
o Need more emotional support
Loss of independent, strain of imposing on others
reduction in private self
How is the self changed by ___? Small group activity: pick
a disorder and discuss how it affects the various aspects
of self?
Breast cancer:
Physical: body image, loss of femininity (breasts).
Lack of sexual contact because of fear husband won’t
think youre attractive or want to be with you because
you’re not a “female” anymore.
Achieving: loss of hope to do anything because you
feel hopelessness and think you’ll face death soon
Social self: too sad to interact with friends. Want to
be left alone. People think it’s contagious and don't
interact with you.
Private self: feel isolated and not partake in family
activities. Scared to tell daughter to do testing
incase of family hereditary.
Problems Associated With Chronic Illness
Chronic illness raise specific problems on the road
Physical Problems
Two types: Result of illness vs. consequence of
o Disease: chest pain in heart patients, joint pain
in arthritis
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