Individual Coping Strategies

By Group A1b

Illness or Disease
People usually do not make a distinction between illness and disease. These two terms seem to mean the same thing and are often used interchangeably. Disease is an objectively measurable pathological condition of the body. Tooth decay, measles, or a broken bone are examples. Illness is a feeling of not being normal and healthy. Illness may, in fact, be due to a disease. However, it may also be due to a feeling of psychological or spiritual imbalance.

Severity of illness
Severity of illness (SOI) is defined as the extent of organ system derangement or physiologic decompensation for a patient.

Its scale is divided into:

Minor Moderate Major Extreme

The SOI class is meant to provide a basis for evaluating hospital resource use or to establish patient care guidelines.

What is a severe disease?

There is no official medical definition of a severe disease

Severe diseases are non-contagious diseases whose physical and social symptoms can have a severe impact on sufferers' abilities to lead normal everyday lives. A person with Crohn's disease, for example, is not only likely to experience severe stomach aches and uncontrollable urges to go to the bathroom, they usually have to map any social outings around the availability of public toilets, significantly restricting their lives.

A Catastrophic illness ?

is a severe illness requiring prolonged hospitalization or recovery. Examples would include:

coma cancer leukemia heart attack stroke

These illnesses usually involve high costs for hospitals, doctors and medicines and may incapacitate the person from working, creating a financial hardship.

How can a doctor diagnose a severely ill

-

A Libyan pediatric doctor:

I define a severely ill patient at my clinic when he is presented with severe dryness (Gastritis), loss of appetite, and doesnt drink. The patient is in coma, or is presented with meningitis (intense headache & fever), pyelonephritis, Bronchopneumonia (infection of the lung)

A Libyan hematologist doctor:

I follow the performance status, which is a scale from 0 5, 0 being a minor illness and 5 a severe illness, where the patient is in hospital and needs support.

The Impact of Severe Illness On the Individual

Initial Impact
Shock Denial Loss and grief Anxiety and depression
20-25% experience psychological symptoms

Must adjust to:

Symptoms of the disease Stress of Treatment Feelings of vulnerability Loss of Control Threat to self-esteem Financial Concerns Changes in family structure

If these reactions last too long, they can have an negative effect on the illness

The Impact of Severe Illness On the Family

Must adjust to:
Increased stress Change in the nature of the relationship Change in family structure/roles Lost income all have impact

Different issues for different relationships

Adult children of ill parents Spouse of ill person Parents of ill children

Chronic Illness as a Crisis

Illness is a crisis because it is a turning point in an individuals life. Disruption to established patterns of personal and social functioning produces a state of psychological, social, and physical disequilibrium Adaptation = finding new ways of coping with drastically altered circumstances. Restore equilibrium.

Crisis Theory (Moos, 1982)

A model describing the factors that affect peoples adjustment to having serious illness.

Coping process (3 stages) is influenced by 3 factors Illness-Related Factors Background and personal Factors Physical and Social Environment Factors

Coping process influences outcome of crisis

The Coping Process

Mental judgment Meaning or significance of the illness Threat and coping ability Adaptive tasks Formulation of tasks to help cope with illness Illness-related Impairment, treatment, hospital General psychosocial functioning Selfperception, self-esteem

Coping skills Denial, information seeking, goal setting, recruiting support, catharsis

Crisis Theory of Chronic Illness A Model

Background and Personal Factors

Illness-related Factors

Cognitive Appraisal

Adaptive Tasks

Coping Skills

Outcome of Illness

Physical and Social Environmental Factors

Note: From Moos (1982)

Adherence

Resources:
http://en.wikipedia.org/wiki/Severity_of_illness http://www.ucb.com/rd/info-centre/severe-diseases http://anthro.palomar.edu/medical/med_1.htm http://en.wikipedia.org/wiki/Catastrophic_illness

www.cc.nih.gov/ccc/patient_education/pepubs/cope chron.pdf