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Coping with Chronic Illness

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Decreased social, recreational involvement, financial ... Info about resources (support groups, respite services) Lazarus' Theory of Stress and Coping ... – PowerPoint PPT presentation

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Title: Coping with Chronic Illness


1
Coping with Chronic Illness
  • Lazarus Theory of Stress and Coping

2
Coping with Chronic Illness
  • Nursing role Facilitate achievement of coping
    tasks
  • Coping Tasks
  • Maintaining sense of normalcy
  • Modifying daily routine, adjusting lifestyle
  • Obtaining knowledge and skill for self care
  • Maintaining positive self-concept
  • Adjusting to altered social relationships

3
Coping with Chronic Illness
  • Coping Tasks (cont)
  • Grieving over losses associated with chronic
    illness
  • Dealing with role change
  • Handling physical discomfort
  • Confronting inevitability of death (make most of
    life)
  • Dealing with social stigma of illness/disability
  • Maintaining sense of being in control
  • Maintaining hope despite uncertain or downward
    course of health

4
Family Caregivers
  • Family Caregivers
  • 21 of caregivers are gt 75 yrs
  • Caregivers of elderly with long-term illness
    usually
  • Spouses
  • Children (usually daughters, daughters-in-law)
  • Other family members
  • Outside sources (when needs exceed family
    resources)

5
Types of Caregivers
  • Care Providers
  • perform direct care
  • Care Managers
  • manage/arrange services to provided by others
  • Often have own careers
  • Often provide psychosocial support,
    transportation, visiting, etc.

6
Impact of Long Term Illness
  • Physiologic/Somatic
  • Psychologic
  • Sexual
  • Social
  • Occupational
  • Financial

7
Impact of Long Term Illness on Families
  • Burden
  • Decreased social, recreational involvement,
    financial difficulties, depression, declining
    personal health
  • May lead to nursing home placement
  • Problems related to home care
  • Financial
  • Competing demands

8
Impact of Long Term Illness on Families
  • Physical Strain
  • Lifting, 24/7 physical care, sleep deprivation,
    chronic fatigue
  • Emotional Strain
  • High incidence of stress-related disorders (HTN,
    heart disease)
  • Manifested as anxiety, anger, guilt, loss of self
  • Could lead to elder abuse

9
Impact of Long Term Illness on Families
  • Role Changes Associated with Caregiving
  • Pre-existing relationships change
  • Take on new duties
  • Role Ambiguity
  • Taking on of new roles (eg. roles traditionally
    fulfilled by spouse)
  • Role Reversal
  • Children caring for parents

10
Nursing Interventions for Family Caregivers
  • Encourage verbalization and acceptance of
    negative emotions
  • Facilitate Realistic expectations re
  • clients illness and expected course
  • Own limitations
  • Common feelings
  • Encourage to accept assistance from others
  • Info about resources (support groups, respite
    services)

11
Lazarus Theory of Stress and Coping
Pschological Stress
Cognitive Appraisal
Health Outcome
  • Coping

12
Lazarus Theory of Stress and Coping
  • Stress
  • Relationship b/w person and environment that is
    appraised by the person as
  • Taxing or exceeding his/her resources
  • Endangering his/her well-being

13
Lazarus Theory of Stress and Coping
  • Cognitive Appraisal
  • Process through which person evaluates whether a
    particular encounter with the environment is
    relevant to his/her well-being and if so, in what
    way(s)
  • i.e., evaluation of the significance or meaning
    of an event to the individual

14
Lazarus Theory of Stress and Coping
  • Two Types of Cognitive Appraisal
  • Primary Appraisal
  • Person evaluates whether he/she has anything at
    stake (i.e., is there potential harm or
    benefit?).
  • Evaluates significance of the event with
    respect to well-being
  • Types of appraisal
  • Stressful harm, loss, threat
  • Challenge opportunity for growth, gain or
    mastery

15
Lazarus Theory of Stress and Coping
  • Secondary Appraisal
  • Evaluates what if anything can be done to
    overcome or prevent harm or to improve the
    prospects of benefit (ie., evaluates coping
    resources and options)
  • Various coping options (e.g., altering the
    situation, accepting it, seeking information) are
    evaluated

16
Lazarus Theory of Stress and Coping
  • Coping
  • Persons constantly changing cognitive and
    behavioral efforts to manage specific external
    and/or internal demand that are appraised as
    taxing or exceeding the persons resources
  • i.e., efforts to master the demands

17
Lazarus Theory of Stress and Coping
  • Two major types of coping strategies
  • Emotion-focused coping
  • Used to control distressing emotions, sometimes
    by altering the meaning of an outcome
  • Likely to be used in situations that are
    perceived not be not amenable to change
  • Problem-focused coping
  • Used to control the troubles person-environment
    relationship through problem-solving,
    decision-making and/or direct action
  • More likely to be used in situations perceived as
    changeable

18
Alterations in Health Role of the Nurse(Bevis)
  • Nursing
  • A process
  • Purpose - promote optimal health facilitate
    maturation and adaptation in clients (individuals
    intrapersonal, groups interpersonal
    community)

19
Nursing System (Bevis)
  • Input
  • Needs, goals problems desires of clients
  • Includes assessment data

20
Nursing System (Bevis)
  • Throughput
  • Theories, concepts, processes used
  • Tools used
  • Problems-solving/decision-making (critical
    thinking)
  • Caring
  • Teaching/Learning (Educator)
  • Communication
  • Management/change (change agent)

21
Nursing System (Bevis)
  • Output
  • Behaviors, services, roles, functions of nurses

22
Life Tasks (Bevis)
  • Stress
  • Forces that press in upon or noxiously stimulate
    the individual. e.g. health problems, medical
    diagnoses, social problems
  • Strain
  • Expresses itself in symptoms, signs or behaviors
    that signal response to stress. E.g., S/S of an
    illness physical assessment findings, behaviors
    (crying)
  • Maturation
  • Process of human development
  • Adaptation/Maladaptation
  • Coping patterns or ways of behaving that can
    head to an interruption or maintenance of health
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