PSY333 JUNE 13.docx

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University of Toronto St. George
Nevena Simic

PSY333 JUNE 13, 2012 CHRONIC ILLNESS OFFICE HOURS TOMMOROW 330-530 ROMM 4004 WITHIN 24 HOURS, SUMBIT TO TA BY FRIDAY AT 530 OUTLINE ISSUES SURRONDING CHRONIC ILLNESS - QUALITY OF LIFE - CHANGING SELF - ADJUSTMENT The scope of the issue - At any given time 58 percent of the Canadian population has some chronic condition – 81 percent of senior population - Accounts from 2 thirds of canadas health spending - Specrum of c condition = mild parial hearing loss to sever and life threatening cancer and diabetes - Slef managemenbt – patients invilvemnt in their illbess – medication, changes to their life coping.. – treatment cohenice, what patient brings to own condition Chronic conditions are more common amonf lower income candaians waomen and seniors 5 is lowesr, dark blue is no, lighter is one, lightest is multiple, fewer male then female female 6 percent more chronic condition one condition As get older more and more chronic conditions , in adolescen t6 percent have one or more, compared to older adulthoold 36 to 70 of pop has at least one or multoipple cindtions Some effect of gender, age, and ses What is the impact of cd - Range from mild to severe life threatening 1. Casuses premature death - 2005 >60 percent deaths globally result from chronic disease - Prevalence rates highest in developed countries – they live longer 2. Economic and social burden to families, communites and society - Direct (health carre) + indirect (disbailty) cost of chronic disease - 10 billion dollars diabetes 18 bill cancer, 20 billion arthritis - Direct procedures physican, indirect not being able to work social welfare resources 3. Compromise quality of life – not only how long but how well they live Quality of life - Historically measured only by length of life +sings of disease - No consideration of psychological or social effects - Psychological distress often experience by chronically ill (not taken into account) - Stree brought on from having such diagnoses Contd Quality of lide = degree to which a person is able to maximize their function - Not just how many symptoms etcc Sds - Physical – limit activite?pain – coccurent from illness or from treatrment like chemo?energy? - Psychological – depressioin?anxiety - Vocational – return to work, chrons have to use washroom a lot not jobs allow to use washroom everyhtime nature calls, or pilot diabetes, diagnoses of aby vehcical and diagnosed of epiliepsy and liscence revoked for cetain amount of time and has to be control some time before work, - Social – limit interations – even hearing loss can have effect social sit can effect people thinking not listening but actually cant hear, intercourse Why do we need to study qol among the chronicaaly ill 1. Document effects of illness - Basis for interventions designed to improve qol, given speciif areas in which their illness effects quality of life - Look to improve it 2. Pinpoint which particular problems patients with particular disease may expect 3. Address impact of treatments on qol – estabalish treatment beneifical and if casuing more harm theb being good for patients, example treatment has low survivor an low qol therefore not good intervention for diseases 4. Qol info can be used to compare therapies – which better survor rate and which maximixed quality of life 5. Inform desciion makr: which treatment maximizes survival and qol How is the self is changed by te diagnose - 4 main components, - Physical self - Achiveving - Social - Private - Make up what we think of mental health how we conceptualize ourselves - If any threaten by illness then self concept efficacy image of self can suffer Physical self - Body image – perception and evaluation of phsycial functioning – bulimia anorexia are illnesses of body image - Olter illness cause detroriaion in physical which cause metnal to blummet - People with amputatios not being whole anymore - Poor body image  low self esteem, increased likelihiood 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 intervention - Burns are another in which physical self can suffer, like face - Also breast cnacer if removied etc Achieving self - Most of us gain a sense of achievement from our jobs or leisurely activities - Brokered a deal today, save patients life, got an a on mideterm, ran marathon - Illness  limits work and non work  reduced achievement - Slef concept suffers - Example wheelchair before marathon can no linger get achievement from marathon Social self - Illness  limited social ingeractions - Hard to rebuild social relationships - Family and friends – source of self esttemm source of support - Fears about withdrawl of support among most common worries of chronically ill - Once lost difficult to rebuld then afterwords - Can fear loss of support, even though ameriolating stress fear of losing it can compromise even further Private self - Illness create need to be dependent on others - Help with choirs, cant contribute to household income - Need more emotional support - Loss of indepndece, strain of imposing on other  reduction in private self How is self change by ________? (any chronic illness), pick disorder and discuss how it affects the various aspects of the self - Diabetes, insulin, cant go out to events need to monitor a lot etc and etc, weight gain, weight loss, amputation, if lose leg have to cant run, Problems ass with chroic d - Chronic illess raises specifi Phsycial problems - Two types – results of illness vs consequence of treatment - Disease – chest pain in heart patiens, joint pain inarthrities - Treatment – medication for hypertension  drowsiness, weight gain, impotence - Physical rehab – learn how to use body to its fullest - Several goals to rehab - Learn how to sense changes in the enivoronemnt and in themselves so as to make approparitae phsyciall accomodatioans - Learn new phsycal and management skills if necessary - Leatn how to control the expenditure fo energy – Parkinson disease get fatigued quite often, cancer patients nap, does not mean to change entire life routine, may need to change up schedule or lighten up class load to maximize enrgy across clases Vocational problems - Illness may effect/restrict work activies - Paraplegic pharmacist – means wheelcahri bound hard to reach countertops, see midcaiton and see script need readily accessible access to all these things - Flight attendant with seizures – epilepsy from brain tumor no longer to work in flights, how to make a living, with new job be satisfying as old one, - Many chronically ill patients face discriamtion - Cnacer patients are fired/laid off 5x as often as other workers - If kept Moved into less demandin
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