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Living with Chronic Illness. William P. Wattles, Ph.D. Psychology 314. Acute disease. short-term less common than chronic either die or get well. Chronic illness.

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living with chronic illness

Living with Chronic Illness

William P. Wattles, Ph.D.

Psychology 314

acute disease
Acute disease
  • short-term
  • less common than chronic
  • either die or get well
chronic illness
Chronic illness
  • A disorder that persists for a long time and is either incurable or results in pathological changes that limit normal functioning.
chronic illness1
Chronic illness
  • Virtually everyone will eventually develop some type of chronic condition.
chronic illness2
Chronic illness
  • Must deal with:
    • Symptoms of the disease
    • Stress of Treatment
    • Feelings of vulnerability
    • Loss of Control
    • Threat to self-esteem
examples of chronic illnesses





chronic obstructive pulmonary disease

multiple sclerosis

Parkinson’s disease

muscular dystrophy

sickle cell anemia


Examples of chronic illnesses
chronic disease
Chronic disease
  • long-lasting
  • common
      • 50% at any point in time
      • 100% at one time or another
  • Variable course
  • never completely healthy
coping with chronic disease
Coping with Chronic Disease
  • Attitudes and belief about illness
  • personal traits such as depression and optimism
  • coping strategies
  • compliance with prescribed regimens
  • social support.
attitudes and beliefs
Attitudes and Beliefs
  • According to both the Theory of Reasoned Action and Health Belief Model attitudes and beliefs predict adaptive behavior.
  • Social norms
  • attitudes
  • affect
  • facilitating conditions
  • Depression may take the energy away needed to adapt to the disease
  • anxiety may interfere with sleep and other health processes.
  • Optimism-a generalized expectation that the future looks good-associated with more adaptive behaviors.
social support
Social Support.
  • Social support presumably serves to buffer the effects of stress for the cancer patient and may improve the prognosis.
  • The most helpful behaviors seem to be emotional support, sympathy and caring.
impact of chronic illness
Impact of Chronic Illness
  • Crisis theory
    • individuals need a state of equilibrium
    • chronic illness upsets this state
    • people search for ways to restore homeostasis
    • failure to do so results in
      • anxiety
      • fear
      • stress
impact on the patient
Impact on the patient
  • Psychological functioning
    • social
    • physical
    • mental health
  • Self-image
    • positive and negative changes
  • Coping strategies
opportunities for psychology
Opportunities for psychology
  • Strategies to improve compliance
    • “Noncompliance is a substantial problem in the treatment of chronic illness.”
  • Creation of support groups
  • Dealing with psychological repercussions
  • Sustaining of personal relationships
impact on the family
Impact on the family
  • Adult children
    • change in relationship
  • Spouse
  • Parents
Diabetes is a disease in which the body does not produce or properly use insulin

Insulin acts to reduce levels of glucose in the blood by interacting in some unknown way with cell membranes.

Diabetes is a disease in which the body cannot properly store and use fuel for energy.The fuel that your body needs is called glucose, a form of sugar.

Glucose comes from foods such as breads, cereals, pasta, rice, potatoes, fruits and some vegetables

The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.
Among states having data for 1994 and 2002, the age-adjusted prevalence of diagnosed diabetes increased more than 10% between 1994-2002 (see detailed tables for maps).

In twenty-three states including South Carolina, age-adjusted prevalence was at least 50% higher in 2002 than in 1994.

incidence of diabetes
The prevalence of diabetes (diagnosed plus undiagnosed) in the total population of people who were 40-74 years of age increased from 8.9% in the period 1976-1980 to 12.3% by 1988-1994.

“The increasing frequency of obesity and sedentary lifestyles in the population, make it likely that diabetes will continue to be a major health problem in the U.S.”

Incidence of Diabetes
diabetes is a life long condition
High blood glucose levels over a long period of time can cause blindness, heart disease, kidney problems, amputations, nerve damage, and erectile dysfunction.

Good diabetes care and management can delay or prevent the onset of these complications

Diabetes is a life-long condition.
type 1 diabetes
Type 1 diabetes occurs when the body makes little or no insulin. It used to be called insulin-dependent or juvenile diabetes.

There is nothing to be done to prevent type 1 diabetes, even early diagnosis will not prevent it.

It is not caused by eating too much sugar.

Type 1 diabetes
type 2 diabetes
Type 2 diabetes occurs when your body can’t use the insulin it makes.

A person with type 2 diabetes, you may be able to keep your blood glucose levels in a target range by healthy eating, exercising and taking diabetes medication.

Type 2 diabetes
adjusting to diabetes
Type 1


Before age 15


equal between men and women

requires insulin

imperils kidney

Type 2

Noninsulin dependent

After age 30


affects more women

affects poor more than middle class

no injections

imperils heart

Adjusting to Diabetes
incidence of diabetes1
General Population 6.2%

African American 13%

Latinos 10.2%

Men 8.3%

Women 8.9%

Incidence of Diabetes
the good news
People can live a long and healthy life by keeping their blood glucose levels in the target range.

They can do this by:

Eating healthy meals


Taking diabetes medication, including insulin

The good news
insulin dependent diabetes mellitus iddm
Insulin-dependent diabetes mellitus (IDDM)
  • Management very demanding
    • injections
    • diet
    • exercise
  • Serious costs of failing to comply
    • blindness
    • kidney failure
    • amputation
lifestyle changes
Eat healthy

Eat three meals and a bedtime snack each day.

Include a food from each of the food groups at each meal.

If you are thirsty, drink water or diet pop.

If you are overweight, eat smaller portions. Reduce your intake of fat.

Limit sweet and fatty foods.

Lifestyle changes
cardiac rehabilitation
Cardiac Rehabilitation
  • Fifty percent survive
  • Major surgery and recovery
  • Lifestyle changes
    • diet
    • exercise
    • stop smoking
  • Motivation
psychological reactions to chd
Psychological reactions to CHD
  • Depression
  • Anxiety
  • Anger
  • Fear
  • Guilt
  • Interpersonal conflict
coping with cancer
Coping with Cancer
  • Approximately 1.25 million people diagnosed with cancer in 1998
coping with cancer1
Coping with Cancer
  • Surgery
  • Radiation
  • Chemotherapy
  • Hormonal treatment
  • Immunotherapy
cancer treatment side effects
Cancer treatment side effects
  • Loss of hair
  • burns
  • nausea
  • vomiting
  • fatigue
  • sterility
  • More than half of all cancer patients survive at least five years
hiv and aids
  • Relatively new disease
  • “The virus is not easily transmitted from person to person”
    • sex
    • IV drug
    • blood transfusion
  • Preventable
aids hiv
  • 1999-IN the U.S., HIV/AIDS fell from 8th to 14th among leading causes of death.
  • It remained the leading cause of death for black persons aged 25-44.
alzheimer s disease
Alzheimer’s Disease
  • Degenerative disease of the brain
    • cognitive impairment
    • memory loss
    • personality change
  • Sure diagnosis only by autopsy
  • Cause unknown
alzheimer s and the family
Enormous cost to the family and society

Financial and emotional resources exhausted

Combines with loss of loved one

Chronic stress of providing care for Alzheimer’s patients lowers immune system functioning and increases vulnerability to illness.

Alzheimer’s and the family