Promotion of a Healthy Lifestyle and Chronic Diseases - Essay Example

Running Head: Chronic illness Psychology Your name Course name Instructor’s name Date of submission Chronic illness is a state of disease with pathological changes which cannot be revoked, lasting for more than three months and causing permanent disability eventually (Lubkin & Larson, 1978). There is a link between chronic illnesses and family life cycle. Therefore there is a need for a topology that define the psychological demands of the chronic illnesses rather than having only biological criteria that emphasizes only on ways to meet needs of medicines or just formulate a medical treatment. According to Rolland (1987), there are categories that define in a wide way the psychological factors of the chronic illness and the family. They include; onset, outcome and degree of incapacitation of illness. For the onset category, diseases can be divided as having either an acute onset or gradual onset. In this case the affective changes are said to be short term. This requires rapid crisis management skill from families. Gradual onset subjects families to more protracted period of adjustment. The course of a chronic disease is progressive, constant or relapsing/ episodic. Progressive diseases are symptomatic and records severe progress. The family members are faced by a situation whereby the member experiences an increasing disability which keeps on progressing. There seems to be no relief to the demand of the disease and the family caretakers gets exhausted and there are still chances of new tasks arising over time (Rolland, 1987). Constant illness is when an event occurs and later the biological course stabilizes. Although recurrence may occur, it is predictable and therefore the family is exhausted but there are fewer chances of new tasks arising later. Finally the relapsing .episodic course is characterized by alternation of stable period of varying length, low levels or even absence of symptoms. The family strains when there is a crisis and the uncertainty of when next the crisis will occur. Outcome of the illness is characterized by the psychological impact caused by the chronic illness likelihood of causing death or shortening the life span of a member. There are expectations and anticipation grief from the family members and thus living a difficult life (Rolland, 1987).incapacitation is contributed by cognition, sensation, movement, energy production, and disfigurement or medial causes of social stigma. The crisis phase includes any symptomatic period before actual diagnosis and initial period of readjustment and coping after diagnosis and initial treatments plan has been used to classify the problem. In this case, the family and the ill member face several tasks. First they learn to deal with pain, incapacitation, or any other illness related symptoms; adjust and learn to deal with hospital environment and any disease treatment procedures; finally they have to plan and maintain a good relationship with the healthcare individual. Moreover, the family is required to create a meaning of the illness event that maximizes a preservation of sense of mystery and competence; pre illness family illness loss and grieve that goes with it; accept that there is permanent change while linking the past and the future; reorganize to undergo short term crises and finally having a system that is towards any future goals. The chronic phase is the period between initial diagnosis and readjustment period. In this phase, the issues of death and terminal illness predominate and thus it is the third phase. In this phase, psychological construct referred to as the long haul or a day to day phase living with illness is the prerequisite in knowing its meaning rather than knowing the biological behavior of the illness only. In this phase, the individual and the family are psychologically settled with the permanent changes presented by the chronic illness and have come up an ongoing modus operandi. The family goes through a hard time when trying to maintain a normal life while else there is the presence of the chronic illness. When the illness is fatal, for instance massive stroke or dementia, the family is curbed by an exhausting problem which the only hope for a normal life is the death of the ill member. This then brings about the maintenance of maximal autonomy of pull towards mutual dependency and caretaking for all family members (Rolland, 1987). Terminal phase is the time flame where death becomes evidence and dominates the family life. This phase includes issues like separation, death, grief, mourning and resumption of normal family life beyond the loss. The three phases are linked with the critical transition period. In this case, the family reevaluates the appropriateness of the previous life structure in the face of illness related development demands. Transition can receive a big blow from any unfinished business from the previous phase. Family members can find it hard to adapt to the new structures for they become imprisoned by the demands in the chronic phase and thus finding it hard to maneuver through the transition period. This time phases and typology of the typology of the illness play a very important role in psychological development model of the chronic disease. Family development models experiences centripetal periods brought about by chronic illness resembling the arrival of a new family member which subjects the family into centripetal process of socializing with the illness. The family is refocused inwards by the systems, loss of function, demands, practical and affective roles and fear of loss through death (Rolland, 1987). This causes the family not to function as it were doing before; this being the case, adult victims may return to their original families so as to receive intensive care. This puts family members extra autonomy and individuation at risk. The adult life is temporally or permanently distorted by the illness. For a family that was surviving in marginal ways before the illness, may receive added strain that will trigger runaway process leading to an overt family dysfunction (Rolland, 1987). On realization of one’s situation, ill members result to reactive depression. There are higher chances of feeling sorrowful and lonely. They may feel useless in the case of chronic illness (Hallian, 1983) this type of depression is situation specific. This can be accelerated by grief or even how an individual reacts towards bodily deterioration. In this case the only solution is psychogenic whereby interpersonal forms of therapy can be of great help (Hallian, 1983). This also affects the family members as they try to adapt with occurrence mostly during the time shared during mourning and mutual consultation. In most cases, denial is present in both the ill and the family members. This is a major contributor to psychological problems. Loss of independence is also a devastating process. There are restrictions that the decease imposes on individuals. For the case of incurable conditions there is a need for an individual to accept a major adjustment in personal identity for this will lower chances of getting depressed. Chronic illness can also stall developments in the family not only to the ill member but also to the family as a whole. For instance a disabled infant can affect the mother child bearing mastery, or in the case of a young couple, life threatening illnesses can interfere with beginning phase of parenthood. It is also worth noting that, members do not adapt uniformly to the illness (Rolland, 1987). Social support tends to affect the course of chronic diseases in many ways. Different concepts of social support have a specific disease influences (Cohen, 1988). Increase social support improves the diminished health related quality of life and also facilitates management of symptom such as fatigue and cognitive impairment (Bennett, 2001). Social support helps patients perform self care activities like weight management and dietary restriction effectively. According to research conducted by Sarafino (2006), social support decrease stress. They also reduce the chances of the patient’s isolations. If they are isolated there will be an increase in stress and depression. They stated that, men with fewer social contacts were prone to life stress, three year mortality risk, which was four times as high from those who were exposed to social support. Support from relatives, neighbors and friends is said to improve the lowering systolic and diastolic blood pressure (Dressler et al, 1986). The quality of the instrumental and emotional support received improves the patient on higher medication adhere after 10 weeks in 50 hypertension patients who had been guided on healthy living according to research conducted by Stanton (1987). Social interventions help improve self image on the patients and this at the end helps them regain control over a large part of their day to day activities. In many cases this social interventions may help prevent further dysfunction and disability in other parts of the system. The family is obligated to offering information about the disease and its psychological effects (Hallian, 1983). Although different diseases have different symptoms and process of illness, advocating for health promoting behavior and related variables is of great importance in managing chronically ill members (Han, 2003). For patients with cardiovascular diseases, emotional support have a lower cardiac event rate, less coronary stenosis and better physical ability after myocardial infarction (Phennix, 1996). This difference can be attributed to psychosocial typology of cardiovascular diseases. Patients who survive MI feel like they have been given a second chance to live, so the environment they encounter is able to decrease the likelihood of occurrence when social support is available (Rolland, 1987). Spouses for instance living with chronic ill partners take responsibility of taking care of the victim. This increases the distress from the emotional strain of coping with the partner’s illness. Moreover, care giving partner experiences many lifestyle alternations like having to take care of the family and therefore have less time for social activities and personal health care (Schulz & beach, 1999). The ill member tends to have more pronounced health problems and psychological distress and is exposed to increased mortality when compared to spouses of healthy individuals (Bigatti & Cronan, 2002). According to Revenson and Majerovitz (1990), when the care giving partner is socially supported he/she tends to be less prone to depression. However, although they receive support from family members and friends they greatly rely on the ill partner as the primary source of support (Ptacek et al, 1997). Through research, it is evident that social support lowers stress and increases physical functioning among the ill members. So if it is increased, then family members and individual will be able to manage the chronic illness effectively without incapacitating the social sphere on any party. Finally, social support improves the emotional well being of chronic illness victims by ensuring lower anxiety of emotional well being while lack of it is a significant predator of declines in functional status of chronic illness survivors. Social support also decreases psychological distress and increased overall quality of life of the ill member. Social support is significant in dealing with chronic illness in all ages, although it is worth noting that men who suffer less social support tend to suffer in the inside and are very likely not going to report the occurrences (Han, 2003). References Bennett, S.J., Perkins, S.M., Lane, K.A., Deer, M., Brater, D.C., & Murray, M.D. (2001). Social support and health related quality of life in chronic heart failure patients. Quality of Life research, 10, 671-682. Bigatti, S. M., & Cronan, T. A. (2002). An examination of the physical health, health care use, and psychological well-being of spouses of people with fibromyalgia syndrome. Health Psychology, 21, 157–166. Cohen, M.S. (1999). Families coping with childhood chronic illness: A research review. Families, Systems, and Health, 17(2), 149-164. Dressier, W.W., Mata, A., Chavez, A., Viteri, F.E., & Gallagher, P.N. (1986). Social support and arterial pressure in a central Mexican community. Psychosomatic Medicine 48:338—350. Fekete, E.M., Stephens, M.A.P., Mickelson, K.D., & Druley, J.A. (2007). Couples support provision during illness: The role of perceived emotional and responsiveness. Families, Systems and Health, 25, 204-217. Han, K., Lee, P., Lee, S., &Park, E. (2003). Factors influencing quality of life in people with chronic illness. Journal of Nursing Scholarship, 35, 139-144. Halligan, F.G. (1983). Reactive depression and chronic illness: Counseling patients and their families. The personal and Guidance Journal, 61, 401-406 Lubkin, I.M. & Larsen, P.D. (1978). Chronic illness: Impact and interventions. Sudbury, MA: Jones and Bartlett Publishers. Phennix, B.W.J.H., Kriegsman, D.M.W., van Eijk, J.T.M., Boeke, A.J.P., & Deeg, D.J.H. (1996). Differential effect of social support on the course of chronic disease: A criteria-based literature study. Families, Systems and Health, 14, 223-244. Ptacek, J. T., Pierce, G. R., Dodge, K. L.,&Ptacek, J. J. (1997). Social support in spouses of cancer patients: What do they get and to what end? Personal Relationships, 4, 431–449. Richardson, J.C., Ong, B.N., & Sim, J. (2007). Experiencing chronic widespread pain in a family context: Giving and receiving practical and emotional support. Sociology of Health and Ilness, 29, 347-365. Rolland, J.S. (1987). Chronic illness and the life cycle: A conceptual framework. Family Process, 26, 203-221. Revenson, T. A., & Majerovitz, S. D. (1990) Spouses’ support provision to chronically ill patients. Journal of Social and Personal Relationships,7, 575–586. Stanton, A.L. (1987). Determinants of adherence to medical regimens by hypertensive patients. Journal of Behavioral Medicine 10:377-394. Sarafino, E.P. (2006). Health psychology: Biopsychosocial interactions (5th ed.). Hoboken, NJ: Wiley. Schulz, R., & Beach, S. R. (1999). Care giving as a risk factor for mortality. JAMA, 282, 2215– 2219. Townsend, A., Wyke, S., & Hunt, K. (2006). Self-managing and managing self: Practical and moral dilemmas in accounts of living with chronic illness. Chronic Ilness, 2, 185-194. Read More