Chronic Health Disorders 2.docx

8/21/2019 Chronic Health Disorders 2.docx

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MONIQUE MAVRONICOLAS – COPING WITH CHRONIC HEALTH DISORDERS

1. Introduction

The main objective of this paper is to define chronic health disorders and the

strategies people instil in order to manage these disorders. The aim will be to explore

4 different chronic health disorders and how individuals approach treatment,

compliance and different coping methods whilst living with the disorder.

In order to understand the strategies people use to manage different disorders one

needs to define the meaning of disorders. The American Heritage® tedman!s

"edical #ictionar$ defines disorder as %A disturbance or derangement that affects

the function of mind or bod$, such as an eating disorder or the abuse of a drug. To

disturb the normal ph$sical or mental health of&. 'n the other hand the (orld Health

'rganisation defines a disorder as a noncomminicable disease )*+#s

%*oncommunicable diseases )*+#s, also -nown as chronic diseases, are not

passed from person to person. The$ are of long duration and generall$ slow

progression. The four main t$pes of noncommunicable diseases are cardiovascular

diseases )li-e heart attac-s and stro-e, cancers, chronic respirator$ diseases )such

as chronic obstructed pulmonar$ disease and asthma and diabetes.& ollowing on

the aforementioned definitions of a chronic disorders one could add that a chronic

disorder last over a long duration and tends not to have a cure.

+onsidering that chronic disorders influence so man$ people around the world one

must consider some of the facts pertaining to these disorders and how the$ influence

societ$. *+#s such as heart disease, stro-e, cancer, chronic respirator$ diseases

and diabetes, are the foremost causes of death globall$ and unfortunatel$ most

*+#/s is the imperceptible widespread cause of povert$ within families and

communities. *+#/s affect all age groups in all countries all over the globe, some

however are regularl$ related with older age groups. In 0anuar$ 123 (H' updated

the following -e$ facts regarding *+#/s5

• 67 million people are -illed each $ear due to *+#/s

• 8ow9 and middle9income countries contribute almost three :uarters of *+#

deaths 9 17 million

• 3; million *+# deaths occur before the age of of these ?premature?

deaths occurred in low9 and middle9income countries.• +ardiovascular diseases account for most *+# deaths, or 3 of all *+# deaths.

• Tobacco use, ph$sical inactivit$, the harmful use of alcohol and unhealth$

diets all increase the ris- of d$ing from an *+#.

ollowing on the above facts one could draw conclusion that *+#/s do not ac:uire

enough support and recognition in low9 and middle income countries, however more

importantl$, is the :uestion wh$ these deaths are still occurring and wh$ individualsthat suffer from *+#/s are not %coping& better in toda$/s da$ and age@

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2. Psychology theories and coping strategies

eople are often inclined to develop customar$ characteristics and methods to

manage upsetting emotions andBor unwanted situations. Apart from a person/s

personalit$ personae, one often use these customar$ approaches to calm oneself in

stressful situations. #ue to the individualism and different circumstances and

environment, these coping mechanisms does not alwa$s succeed in assisting the

person with dealing with the problem or the situation. There is a definite affiliation

between one/s emotional :uotient )CD and the t$pe of coping methods one prefers.

Individuals with low CD are inclined to select relativel$ simple and often inefficient

coping methods, often reactive and unconscious rather than well though through.

(hilst individuals with a higher CD often lean to more refined methods, responding

more deliberate and conscious which leads to more proactive methods in most

cases. These methods are often called defence mechanisms as described b$

ps$chotherapists, through their ps$cholog$ theories. Eefore loo-ing at the possible

wa$s individuals could act and lin- their reactions to these ps$cholog$ theories, one

needs to have a brief over view of these theories.

• Eehavioural s$cholog$ Theor$ F based on behaviourism 9 An individual/s

behaviour can be measured, trained and changed and all behaviours are

ac:uired through conditioning. There are 1 t$pes of conditioning5 +lassical

conditioning and operant conditioning. +lassical conditioning wor-s on the

principle of two elements F conditional stimulus and conditional responses

whereas operant conditioning occurs through reinforcement or punishment.• +ognitive s$cholog$ Theor$ 9 How we process information, considering how

the information comes to the person and how the management of this

information leads to response, processes include, perception, attention,

language, memor$ and thin-ing.

• #evelopmental s$cholog$ Theor$ 9 provide a framewor- for thin-ing about

human growth throughout its lifespan including development and learning in

two major fields5 growth in cognitive and social competence.

• Humanist s$cholog$ Theor$ F focus on the basic goodness of human

beings.

• ocial s$cholog$ Theories F assist in understanding and explaining social

behaviour, it is centred on exact social behavioural incident, including group

behaviour, social influence and love to name but a few.

In aid to understand the above mentioned theories, Table 3 will illustrate some

application to the different theories. A h$pothetical example5 AE+ has just been

informed that he has chronic obstructed pulmonar$ disease )+'# and needs

to stop smo-ing immediatel$.

Psychological

Approach

Possible explanation for

ABC smoking

Possible ways of

reducing/elimination ABC’ssmoking

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Behavioural

Psychology –

focuses on the

immediate

conseuences ofbehaviour

ABC finds smoking

relaxing and satisfying

Find another way of relaxing

that is also satisfying

Cognitive

Psychology – the

explanation is

based on incorrect

believes

ABC does not believe that

smoking could cause this

much harm as his mother

and grandmother has and

still smokes and are in

perfect health

Help ABC to re-examine his

believes about the effects of

smoking

!ocial Psychology

– emphases on the

way people relate toeach other

ABC enjoys smoking with

his work colleges and his

friends it is time they allspend together and makes

him feel like being part of

something

Assist ABC to find a way to be

able to cope with social

situations where others aresmoking

"evelopmental

Psychology – the

ways individuals

change as they

mature in their

lifespan

ABC started smoking at

the age of !" and enjoyed

engaging in #risk$

behaviours such as

smoking% &his behaviour

has now developed intoeveryday living%

Help ABC understand that he

needs to start viewing smoking

differently due to his diagnosis

of C'()

#umanistic

Approach – assist

people to develop

own inner

resources to realise

their potential

&here may be some

fundamental reason

unknown that drives ABC

to smoking

'ffer help and support to assist

ABC in the exploration of his

feelings about *uitting and

maybe look at the reasons why

he$s smoking and other ways to

overcome the habit and need

Table 35 s$chological explanations and interventions for AE+/s smo-ing

In addition to the above listed theories individuals often react in different wa$s to

%protect& themselves against the situation or upsetting emotions the$ find themselves

in, these ma$ include5

• #enial F The individual has either the inabilit$ or chooses to refuse to accept

the realit$ of a specific eventBsituation.

• assive9aggression F The individual has chosen to that the thought or feeling

is not acceptable enough to be allowed direct expression.

• antas$ F The individual will often da$dreaming about how things should be

rather than doing something about the actual realit$.

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• #isplacement F The individual has an unacceptable feeling or thought about a

person, place or thing and redirected this feeling or thought towards a safer

objective.

• Isolation 9 'verwhelming feelings or thoughts about an event are handled b$

isolating their meaning from the feelings accompan$ing the meaning, andfocusing on the meaning in isolation.

• Geaction ormation 9 react to uncomfortable, unacceptable feelings or ideas

that $ou have )but aren!t :uite conscious of reall$, b$ forming the opposite

opinion.

• uppression 9 a conscious form of repression, where one chooses not to

engage or tal- about difficult feelings or thought and decide to put off dealing

with them till a later stage

• Altruism 9 converting uncomfortable feelings and thoughts, b$ helping others

suffering from similar feelings and thoughts who are less far along in dealing

with them than m$self.

• #istraction 9 intentionall$ deciding to put off thin-ing or feeling distressing

thoughts or feelings b$ briefl$ focusing $our attention towards something less

intimidating.

$eaction / "efence

%echanism

Possible explanation for

reaction

Possible ways of helping

ABC to &cope'

"enial – ABC thinks

there must a

mistake

His mother and

grandmother both smoke

+even more than him, and

are both in good health

uggesting a stop smoking

programme and providing ABC

with more information

regarding C'()%

"istraction – ABC

goes out more often

now with his friends

to bars and clubs

ABC finds that going out

with his friends helps him

forget about the C'()

.oing out is a great distraction

but the smoking isn$t helping

try to suggest to ABC that he

needs to find healthier ways of

spending time with his friends

(solation – ABC

never leaves the

house any more

ABC thinks that having

C'() means not having a

life and not being able to do

anything

.ive ABC some information on

how to cope with C'() and

the things he could do in order

to cope better and be able todo all the things he want

These are but a few coping mechanisms that individuals use to cope with unsettling

or threatening information. In Table 1 we explore different possible reactions or

defence mechanisms that AE+ could have had to the unsettling or threatening

information with regards to his +'#.

Table 15 AE+/s possible reactions, explanations and coping strategies

As demonstrated there are a huge number of factors, theories and defencemechanisms that lead to acceptance and management of health. *ow that one has a

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basic understanding of how an individual might react or deal with a situation we can

evaluate the different coping strategies individuals might appl$ in order to manage

chronic health disorders. As mentioned in the introduction, this paper will onl$

explore addition 6 health disorders and possible coping strategies. Throughout the

different health disorders we will explore -e$ coping strategies=educationBinformation, medication, triggers, health and wellbeing as well as support.

Eearing in mind that these ae the suggested coping strategies and not necessaril$

the wa$ that all people cope with chronic disorders.

Asthma 9 %Asthma attac-s all age groups but often starts in childhood. It is a disease

characteried b$ recurrent attac-s of breathlessness and wheeing, which var$ in

severit$ and fre:uenc$ from person to person. In an individual, the$ ma$ occur from

hour to hour and da$ to da$. This condition is due to inflammation of the air passages

in the lungs and affects the sensitivit$ of the nerve endings in the airwa$s so the$

become easil$ irritated. In an attac-, the lining of the passages swell causing the

airwa$s to narrow and reducing the flow of air in and out of the lungs.& definition of

Asthma according to (H' )http5BBwww.who.intBrespirator$BasthmaBdefinitionBenB.

Individuals who suffer from asthma are not often thought of as an individual that has

a chronic health disorder due to the wa$ people have been managing their asthma in

order to enjo$ ever$da$ life. +hronic asthma however could cause pain, fatigue,

stress and a great disruption to ever$da$ life.

As with an$ other chronic disorder, no one should be in denial about having asthma.

All treatment and management of asthma starts with the individual ta-ing

responsibilit$ of their own health and wellbeing with the support of those around

them. There are various coping methods one could use to manage the disorder

• Cducation 9 The best wa$ to manage chronic asthma is through education on

and how the disorder wor-s. The most important :uestions to as- would be=

what triggers the individual/s asthma@ How are the$ affected b$ the triggers@

#o the$ re:uire medication to relieve the attac-@ Are there factors that could

be avoided in order to prevent the attac-s@

• "edication F "ost people use inhalers as asthma relievers. ractitioners will

describe different t$pe of inhalers to different patients depending on the

diagnosis. There are other preventer medicines that could also be

administered in the form of a tablet )leu-otriene receptors antagonists and

theoph$llines, that assist with the inflammation of the airwa$s. 'ne could also

be prescribed oral steroids that are powerful anti9inflammator$ preventer that

assists one the individual to regain control over the asthma. 8ong term use of

steroids have serious side effect and are onl$ used for short term periods to

reduce the inflammation of the airwa$s and gain control over the asthma

again. Apart from the aforementioned there are more medication and medical

treatments that could assist in the control or temporar$ relief of asthma.

• Triggers F Triggers are generall$ things that causes irritation to the lungs.

There is a range of triggers that could affect individuals, these differ fromperson to person. Irritations such as respirator$ tract infections, allergens,

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airborne irritants, medication, emotions, foods containing sulphides, weather

conditions, food allergies and exercise. Individuals should be encouraged to

identif$ their triggers that sets attac-s off and attempt to avoid such triggers.

• Health and (ellbeing F eeping fit and health$ is essential to asthma. Cating

health$ and ta-ing additional supplements could assist in preventing minorailments. "ost asthma sufferers are prone to attac-s during exercise and

must be aware of their limitation, however this does not mean that individuals

are not able to enjo$ sport and exercise. wimming for instance could be a

-e$ exercise that could improve lung capacit$.

• upport F There are some valuable support groups available for people who

suffer from asthma= Asthma J, CA )Curopean ederation of Asthma and

Allerg$ Association, the Aspergillums website, Eritish 8ung oundation and

E'HG )Eritish 'ccupational Health Gesearch oundation. All of the stated

groups have websites that are highl$ informative, apart from professional

bodies, support starts at home. Having one/s famil$ understand and support

one/s asthma is probabl$ the best support one could get. Informing one/s

friends on how to handle a situation is just as important.

Diabetes F (ith more than 6.1 million people )#iabetes J in the Jnited ingdome

being diagnosed with diabetes there is still an additional ;62 222 people who has the

disorder but un-nowingl$. (hen an individual/s pancreas doesn/t produce insulin or

not enough of it, to assist the bod$/s cells with glucose absorption. The management

of diabetes would depend on whether the individual has t$pe 3 or t$pe 1 diabetes.

•

Cducation F "a-ing sure one is aware of the t$pe )T$pe 3 or T$pe 1 ofdiabetes one has is ver$ important, with t$pe 3 the bod$ produces no insulin

to unloc- the cells and with t$pe 1 diabetes there is not enough insulin or the

insulin in the bod$ is not wor-ing properl$. (hen newl$ diagnosed with

diabetes, one might have a number of :uestions about how it wor-s, what

happens when $our blood sugar gets too high and various other :uestion. The

best wa$ to understand how to manage the disorder is to -now as much as

possible about the disorder. nowing the facts and being able to ignore the

m$ths that surround diabetes is extremel$ important. The *H offer suitable

courses on diabetes that will assist in education and support.

• "edication F eople with t$pe 1 diabetes will re:uire medication andBor

insulin. The medication assist the individual to maintain a low blood glucose

level. The t$pe of medication $ou re:uire will depend on $our own individual

needs and situation.

• Health and (ellbeing F eeing that T$pe 1 diabetes is a progressive condition

, man$ individuals find that despite -eeping to a health$ diet, ph$sical activit$

and ta-ing $our diabetes medication regularl$, controlling diabetes becomes

harder and harder to manage and control their blood sugar levels

• Cmotional upport F 8iving with diabetes might have a emotional impact on

an individual specificall$ when diabetic life event ta-e place )diagnosis,starting insulin, and on developing complications. "ost individuals find a wa$

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of coping with the emotional distress b$ tal-ing to famil$ and professionals.

The$ often educate themselves more in order to understand the %new&

diabetic life event. 'thers might not be this luc-$, some individuals suffer from

depression. pea-ing to a counsellor face9to9face might be of great help, then

the best route to ta-e would probabl$ be to go through $our K.• #iabetes J suggests the following tips for living with diabetes F

o *ot to panic F contacting the diabetes team will assist $ou with all $our

:ueries and the steps that is needed on $our parto Alwa$s ta-e insulin and B or diabetes medications F even if $ou don!t

feel li-e eating.

o Testing $our blood more often and be aware of the sings of

h$pergl$caemia.

o Avoid deh$dration, and eat little and often.

o If $ou don!t feel li-e eating, are feeling sic- or can!t -eep an$ food

down, replace meals with snac-s or drin-s containing carboh$drates,which will provide energ$.

Multiple Sclerosis (MS) – " is a chronic condition of the central nervous s$stem. Them$elin )the coating around the nerve fibres are damaged, causing a variet$ of s$mptoms.

According the " societ$ there are more than 322 222 individuals in the Jnitedingdom living with ", with a woman to men ration of 653 . There are different t$pesof "5 relapsing remitting " )GG", secondar$ progressive " )",

primar$ progressive " )", benign " )E" and " in children. The copingstrateg$ will depend on the t$pe of " the individual has.

• Disease modiying treatments F Although there/s no cure for ", there are

some treatments )disease modif$ing drugs #"# that could assist to reduce

the fre:uenc$ and harshness of relapses, unfortunatel$ this onl$ wor-s for

individuals with GG" and not for ". The *H currentl$ have 32

licensed #"#/s listed, unfortunatel$ all of them are not alwa$s available.• !"ercise F ta$ing health$ and doing regular exercise is alwa$s helpful and

could improve some of the s$mptoms and the effects of " that some

individuals encounter. Cxercise could improve $our overall health, -eep $ou

mobile and as active as possible, decrease the ris- of heart disease in some,improve muscle strength and assist with weight management in conjunction

with a health$ diet.• Physiotherapy – (ith the assistance of a ph$siotherapist, individuals with

" could improve their movement and other functions that the$ have ph$sical

difficulties with. h$siotherap$ could also assist in other health related issuesli-e 9 balance, posture and fatigue, bladder problems, pain and muscle

spasms and stiffness. The *H might not offer $ou continued ph$siotherap$

but give $ou a limited number of sessions.

#. $onclusion

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http://www.mssociety.org.uk/node/482http://www.mssociety.org.uk/node/484http://www.mssociety.org.uk/node/483http://www.mssociety.org.uk/node/486http://www.mssociety.org.uk/node/486http://www.mssociety.org.uk/node/485http://www.mssociety.org.uk/node/482http://www.mssociety.org.uk/node/484http://www.mssociety.org.uk/node/483http://www.mssociety.org.uk/node/486http://www.mssociety.org.uk/node/485


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+oping strategies are a dail$ necessit$ for individuals suffering with chronicdisorders. Ta-ing control of one/s life in such a manner that it ma-es a difference inever$da$ experiences is the essence of coping with the disorder. Approaching thedisorder with adaptabilit$ and confidence allows one to develop new s-ills and habitsthat wor-s best for the individual. "a-ing smart choices about where one focus one/s

time and energ$ is essential to assist the individual to live a better life.

Geferences

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#isorder. )n.d.. The American Heritage® tedman!s "edical #ictionar$. Available at

http5BBdictionar$.reference.comBbrowseBdisorder accessed on 4 ebruar$ 123

*oncommunicable diseases F available at

http5BBwww.who.intBmediacentreBfactsheetsBfs6BenB accessed on 4 ebruar$ 123

+oping trategies and #efence "echanisms5 Easic and Intermediate #efences F

available at http5BBwww.mentalhelp.netBpocBviewLdoc.php@t$peMdocNidMO

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Chronic Health Disorders 2.docx