Sr Rekha- INTERVENTIONS

1
PSYCHO - SOCIAL INTERVENTIONS FOR PEOPLE WITH
CHRONIC CONDITIONS

• BY
• Sr.Rekha

2
What is chronic illness? 

• Any ongoing illness one doesnt heal from. People
  with chronic problems can face lots of pain and
  distress or have limits and circumstances brought
  on by the illness or disability. 
• There are different kinds of chronic illnesses
  those which if managed well, dont cause a lot of
  discomfort and distress, illnesses where there is
  little to relieve stress and pain, and others
  which are progressive developing new
  disabilities or eventual death. 

3

• Not all people adjust well to chronic health
  conditions.
• Types of Adjustment Problems in Chronic Illness
• Physicalbeing unable to cope with disability or
  pain.
• Vocationalhaving difficulty revising educational
  and career plans or finding a new job.
• Self-conceptbeing unable to accept ones changed
  body image, sell-esteem, and level of achievement
  or competence.
• Socialhaving difficulty with losing enjoyable
  activities or finding new ones and coping with
  changed relationships as family, friends, and
  sexual partners.
• Emotional experiencing high levels of denial,
  anxiety, or depression.
• Compliancefailing to adhere to the
  rehabilitation regimen.

4
PSYCHOSOCIAL INTERVENTIONS

• Psychosocial interventions, have been shown to
  have a positive effect on the quality of life of
  patients with chronic disease. Such interventions
  have been shown to decrease negative mood (e.g.,
  depression), improve perceived social support,
  facilitate problem-focused coping, and change
  interpretations of experience, as well as
  decrease
• SNS arousal and the release of cortisol from
  the adrenal gland.
• A variety of interventions have been developed to
  deal with the problem associated with chronic
  illness

5
PSYCHO EDUCATION

• The first thing chronically ill people and their
  families need to help them adapt to a health
  problem is correct information about the disease
  and its prognosis and treatment.
• The uncertainity and confusion and its severity
  can be an additional problem.
• Programs that include coping skills training have
  been found to improve functioning of chronic
  diseases.
• Such programs can increase knowledge about the
  disease, reduce anxiety, increase patients
  feelings of purpose and meaning in life, reduce
  pain and depression ,improving coping, increase
  adherence to treatment, and increase confidence
  in the ability to manage pain and other side
  effects.

6

• SUPPORT GROUPS
• Social support groups represent a resource for
  the chronically ill. Such groups are available
  for many patients with chronic illness.
• These support groups discuss issues of mutual
  concern that arise as a consequence of illness.
• They provide people with an opportunity to share
  their emotional responses with others facing the
  same problems. They can satisfy unmet needs for
  social support from family and caregivers or they
  may act as an additional source of support
  provided by those going through the same event.

7
RELAXATION AND BIOFEEDBACK

• Relaxation training is a widely used intervention
  which the chronically ill.
• It can decrease anxiety and nausea from
  chemotherapy and decrease pain for cancer
  patients, combination of relaxation training with
  stress management and blood pressure monitoring
  have proven useful in the treatment of essential
  hypertension and asthma.
• Mindfulness based stress reduction has been used
  to improve adjustment to medical illness.
• It refers to systematic training in meditation to
  enable people to self regulate their reactions to
  stress and the negative emotions that may result.
• Through this one is highly aware and focused on
  the reality of the present moment, accepting and
  acknowledging it without becoming distracted or
  distressed by stress.

8

• Psychologists use stress management techniques
  especially progressive muscle relaxation and
  feedback to help patients control these
  psychological factors and the underlying body
  process.
• Biofeedback is a form of alternative medicine
  that involve measuring a subjects bodily process
  such as blood pressure, heart rate, skin
  temperature, galvanic skin response (sweating)
  and muscle tension and conveying such information
  to him or her in real-time in order to raise his
  or her awareness and conscious control of the
  related physiological activities. Eg Epilepsy

9
COGNITIVE APPROACH

• Cognitive methods can help people change their
  feelings and thought processes.
• cognitive restructuring, helps to think more
  constructively or realistically.
• many chronically ill people and their families
  experience strong feelings of helplessness,
  hopelessness and depression
• diabetes for example, elderly caregivers are two
  to five times more likely to suffer severe-levels
  of depression than younger caregivers.
• Cognitive approaches can help people identify
  distorted thoughts, replace those thoughts with
  more accurate ones, and learn how to increase
  their ability to perform activities, such as by
  scheduling them in reasonable amounts. Cognitive
  methods are very effective in treating depression.

10
INTERNET

• The internet providing interventions in a cost
  effective manner.
• Information about illness can be presented in a
  clear and simple way, information about skills
  for coping with common illness related problems
  or side effects of treatment can be posted at
  appropriate web site for use by patients and
  their families.
• Support groups may be available for patients with
  relatively common disorders

11
EXPRESSIVE WRITING

• Expressive writing have been especially
  beneficial to chronically ill patients.
• A study by Metastasis renal cell Carcinoma
  patients less sleep disturbance
• Improved health of AIDS patients.

12
SOCIAL SUPPORT

• Chronically ill patients who report good social
  relationships are more likely to be positively
  adjusted to their illness.
• It elicit positive reinforcement and emotional
  support from others.
• The importance of social support to adjustment
  has been found for cancer patients, arthritis
  patients, patients suffering from end stage renal
  disease, and patients with spinal Cord injuries
  among others.

13
FAMILY SUPPORT

• Family support of the chronically ill patient is
  especially important, not only because it enhance
  the patients physical and emotional functioning
  but also because it can promote adherence to
  treatment.
• Sometimes family members also need guidance.

14
INDIVIDUAL THERAPY

• The most common intervention.
• There are differences between psychotherapy with
  medical patients and patients with psychological
  complaints.
• Therapy with medical patients is more likely to
  be episodic than continuous.
• Therapy with medical patients more frequently
  requires respect for patients defenses than dose
  traditional psychotherapy.
• The therapist working with a medical patient must
  have a comprehensive understanding of the
  patients illness and its modes of treatment.

15
BRIEF PSYCHOTHERAPEUTIC INTERVENTION

• Several short-term interventions ranging from
  informal communication with a health care
  professional to brief psychotherapy are available
  to alleviate emotional distress in chronically
  ill patients.

16
PREVENTIVE COUNSELING

• Genetics counseling is a communication process
  that deals with the human problems associated
  with the occurrence or risk of occurrence of a
  genetic disorder in a family. This process
  involves an attempt by one or more appropriately
  trained person to help the individual or family.
• HIV prevention counseling is an effective
  public-health intervention because it promotes
  the health status of someone living with HIV and
  plays a role in reducing HIV transmission.
• Client-centered interventions, education
  regarding transmission factors, and
  risk-reduction techniques are the main focus of
  HIV prevention counseling.
• Couples in which one or both partners were HIV
  infected showed a reduction in unprotected
  intercourse with their primary partner after
  counseling and testing.

17
Thank you