Nursing 109

N109: Foundations in Nursing Practice Study Guide

Psychological Factors Probably the most critical factors affecting the individual with a chronic illness are the psychological issues. These issues can exacerbate the physical issues associated with chronic illness. During the assessment, the nurse must directly address the feelings surrounding the chronic illness and the effects the chronic illness has on the individual, family, and community. When a chronic illness produces obvious signs of disability, the individual may be stigmatized. As the chronically ill person attempts to adapt to the condition, he will try to live as normal a life as possible. If these efforts are not successful, psychological issues may develop: • Denial of the chronic illness may cause the individual to avoid seeking care. • Anger may be a common reaction as the individual realizes that he has little control over the illness. • As anger subsides and the individual realizes the inevitability of his situation, depression may develop. • In the search for control over the situation, the individual may regress to previous levels of development or may completely dissociate himself from the condition in an attempt to pretend it is not happening. • The individual’s caregiver may overcompensate in an attempt to protect the chronically ill person from the disease. This behavior may prevent the individual from doing things for himself and being independent. As this happens, the ill individual may begin to believe that he can no longer do anything for himself, and develop a state of learned helplessness. Any of these reactions may be negative, but they may also move the individual toward acceptance of his chronic illness. With this acceptance, the individual is more likely to seek help and learn to manage his disease. Policy and Politics Policies and politics can impact the care and support individuals with chronic conditions receive, such as through health insurance, Medicare, and Supplemental Security Income. Attitudes of Healthcare Professionals It is imperative that healthcare professionals treat each patient as an individual and refrain from devaluing, stereotyping, or labeling patients based on their chronic illness or disability. 3.7 Alternative/Complementary Treatments Some individuals with a chronic illness may wish to seek alternative or complementary treatment to supplement care. This may include ways to reduce stress, such as with massage, acupuncture, or biofeedback. Herbal medications may be used as well. For example, gingko is taken for improving cognitive loss. It is important for the nurse to ascertain whether or not alternative or complementary treatments are being used, as they may alter the plan of care.

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