Self Management of Chronic Disease - Assignment Example

? Chronic Illness Number Due Introduction The prevalence of chronic illnesses has increased worldwide and currently it contributes to various health problems. Chronic illness care management usually requires the coordination, collaboration, and integration across teams, professions, and organizations. This is because chronic illness and care is a permanent, irreversible and changes over a long period hence the need for frequent support in various settings and from different health care providers. This paper examines the prevalence of chronic illness and the role of coordinated and multidisciplinary teams in the management of chronic illness. Chronic illnesses Chronic illnesses refer to medical conditions or health problems with associated symptoms or disabilities that require long-term management usually three months or more (Brunner & Smeltzer, 2009). Chronic illnesses may also refer to illnesses that have extended or prolonged course that are unlikely to be resolved immediately and that cure may be absent or rare. Currently, the term chronic illness is gradually fading and it being replaced by the term living with a long-term condition. The import of this approach is to eliminate or reduce emphasis on the disease rather than the person. The magnitude of chronic diseases has been defined and based on the length of illnesses, recurrence, resistance to cure and severity (Power and Orto 2004). The major causes and factors that led to the increased number of people with chronic conditions include decrease in mortality from infectious diseases, lifestyle factors, longer lifespan because of advancement in medicine and improved screening and diagnostic procedures (Ackley & Gail, 2000). Lifestyle habits such as smoking and sedentary lifestyles have contributed to the rise and risk of chronic illnesses and problems such as respiratory diseases, hypertension, cardiovascular diseases, and obesity among others. Characteristics of chronic illnesses Chronic illnesses characteristic revolves around the lives of the patients and their families and its management. Chronic illness management often goes beyond the treatment of medical problems and it goes further to address other related psychological and social problems. This is because living with chronic illness and any disability has the potentially of affecting, changing and altering the identity, roles, body image and lifestyle of people (Carrier, 2009). As a result, these changes and alteration need to be managed to enable people living with chronic illnesses to continuously adapt and for them to be accommodated in the society. Another characteristics of chronic illness is that is develops in different phases over the life span of a person. The phases may include acute periods, stable and unstable periods, flares, and remissions and each phase is normally associated with its inherent physical, psychological and social problems that need various regimens and management (Brunner & Smeltzer, 2009). Successful management of chronic illnesses requires persistent and consistent adherence to therapeutic regimes as failure or any slight deviation from the treatment may increase the risk of patients for developing other complications and it may increase the development process of the disease (Larsen, 2011). Chronic illness may lead to the development other chronic illnesses or conditions hence contributing to high risk of morbidity and mortality among patients. Chronic illness is uncertain and its management is a process of discovery that involves the collaboration of various healthcare professionals who work together with the patient and their families in the provision of various services (Nolte, Knai, & McKee, 2008). Chronic illness management is an expensive and costly as patients often incur a lot of expenses that are related to costs for hospital stays, diagnostic tests, equipment, medications and supportive services. The cost problem is further exacerbated by the fact that most living with chronic illness are not insured or under insured (Larsen, 2011). Prevalence of Chronic Diseases Major chronic diseases in Saudia Arabis include diabetes mellitus, coronary artery diseases, obesity, and systematic hypertension (Kumosani, Alama, & Iyer, 2011). A study conducted in 80 most populous countries concerning the prevalence of diabetes revealed that North America has the highest prevalence rate followed by the Middle East region (Shaw, Sicree and Zimmet 2010). The table below shows the prevalence rate of diabetes selected countries across the world. (Take note of the prevalence rate of diabetes in Kingdom of Saudi Arabia against other countries.) Country Prevalence (2010 statistics) United Kingdom 3.6 percent United States 10.3 percent Australia 5.7 percent India 7.8 percent Japan 5.0 percent Malaysia 11.6 percent Nigeria 4.7 percent South Africa 4.5 percent Saudi Arabia 16.8 percent Pakistan 9.1 percent Argentina 5.7 percent Brazil 6.4 percent Cuba 9.4 percent Source: (Shaw, Sicree and Zimmet 2010) The bulk of chronic illnesses and life threatening diseases occur in adults aged sixty five (65) years and old but they also exists in children, adolescents and young and middle aged adults. It is important to note that, despite the occurrence of numerous chronic illnesses cases in the older age, signs, and symptoms of chronic illnesses may begin in earlier life or even during fetal development (Hogstel, 2001). The prevalence of chronic illnesses can also be attributed to advancements and developments in the field of medicine and in particular, the fields of public health, genetics, immunology, technology and pharmacology which has contributed in the significant decrease in mortality from chronic illnesses (Kane, Priester and Totten 2005). Advancement in medicine has partially contributed to the unprecedented growth and prevalence of chronic illnesses by extending life expectancy through precision and early detection of chronic illnesses. According to World Health Organization, more than thirty five million people died from chronic illnesses worldwide in 2005 and the figure was poised to rise in future (Nolte, Knai and McKee 2008). Among the deaths, four out every five deaths occurred in low and middle-income countries. The reason for high prevalence and occurrence of deaths because of chronic illnesses in low and middle countries has been linked to the development and progression of chronic illnesses at younger ages coupled with long-suffering and early death than for their counterparts in developed countries who have improved outcomes due to management of the illnesses. In America, seven (7) out of ten (10) American die each year from chronic diseases (Brunner & Smeltzer, 2009). Occurrence of chronic illnesses is a global issue that has affected developed and developing countries. Health research studies and statistics have revealed that chronic conditions are the major cause of health related problems both in developed and in developing countries. Although figures are slightly higher in developed countries, chronic illnesses are the major cause of death for adults in various countries across the globe (Ya, 2000). Impact of Chronic illnesses Chronic illness negatively affects individuals and their families and government resources. For instance, it affects the quality of life of people and their families while at the same time it consumes a greater percentage of most government’s health and social resources (Nuovo, 2007). However, chronic illnesses majorly affect families by contributing to myriad of problems to patients and their families. When a patient has been diagnosed of chronic or life threatening condition, it often has major implications for the health and well-being of the individual and their families. Although chronic diseases can be managed due to advancement in medicine thereby prolonging the life of many people with such illnesses, they consume many resources and affect the quality of life of patients (Ackley & Gail, 2000; Christianson, Taylor and Knutson 1998). Chronic illnesses usually have adverse effects on the health related quality of life of patients and such impacts are likely to vary depending on various aspects of life. Extensive research has been carried out on the impact of chronic illnesses on society and based on age variations. The impacts of chronic illness in families include role reversals, unfulfilled roles, loss of incomes and decrease in family socialization (Brunner & Smeltzer, 2009). Chronic illness can change family roles and alter lifestyle of patients while on the other hand, it can cause stress and fatigue to caregivers and the entire family. It is evident that advancement and success of medicine extends life expectancy of chronically ill patients and currently, majority of individuals living with chronic illnesses live longer. Although this is a positive contribution, extended life of chronically ill patients further makes them more vulnerable to the occurrence of other diseases, conditions, and accidents that may eventually become chronic in the end. For example, a patient who may have succumbed from myocardial infarction in previous years may be affected and forced to continue with heart failure related health care (Nolte, Knai, & McKee, 2008).Chronic diseases are one of the top most six leading causes of death among elderly people or older adults across the globe. In relation to this, impacts of chronic illnesses are likely to affect those people with advance age (Nolte, Knai, & McKee, 2008). Self Care Management Although chronic illnesses are life-threatening, people living with chronic illnesses can receive support and care services that increases their chances of living. Self-care is an important aspect of chronic illness management, it often associated with the behaviour, and lifestyle of people receiving treatment and it generally advocates for zero or no requirement the involvement of health professionals (Bahrer-Kohler, 2009). In relation to chronic illness management, self-care management is focused on the minimization of chronic illness impacts on the health of patients and it majorly assists patients in coping with the psychosocial effects of their illness. Self- care management is achieved through the provision of self-management support (Proctor, Morrow-Howell, & Kaplan, 2006). Self-management support also involves the collaborative and integrated approach to care which can in turn leads to patient activation, education, and empowerment. Multidisciplinary teams in chronic illness management and care refers to the integration and collaboration of professionals from different professions and organization (Glasgow, et al. 2002). For example in the management and care of a patient with type 2 diabetes a general practitioner may establish care plan, an educator can provide self- management education for diabetes. A dietician offers diet assessment and guidance, a podiatrist may offer assessment that is needed to prevent neuropathy and other services of dentist, trainer, ophthalmologist may be required (Nuovo, 2007). Multidisciplinary team approach in chronic illness management and care provides high quality outcomes for patients with chronic illnesses. Importance of Discharge planning Discharge planning refers to the process of activities that involve the patient and a multidisciplinary team working together to facilitate the transition of chronically ill patient from one environment to another (Harris 2005). There is need for a comprehensive discharge plan for chronically ill patients to ensure continuity of care and discharge planning consists of various series of well-defined steps that helps in the achievement of continuity of care. It involves preparing the patient and their family for subsequent referral of relevant of care or community and home based care programme. The import of discharge planning is to ensure that the needs of patients are met in post-hospital environment (Proctor, Morrow-Howell, & Kaplan, 2006; Babich & Brown, 1991). A key component of discharge planning strategy is the involvement of multidisciplinary collaboration which ensures continuity of care for chronically ill patient. Discharge planning plays a crucial role in self-management of chronic illness with or without professional health care since it provides an environment where care is continued using various approaches. Chronic illness rehabilitation refers to the coordinated sum of interventions required to ensure the best physical, psychological and social conditions that enables patients with chronic illness to resume or preserve their optimal functioning in the society through improved health behaviours that slow or reverse progression of illness (NSW Department of Health, 2007; Noffsinger 2009). The role of chronic illness rehabilitation is for people living with chronic illnesses to achieve optimal physical and psychological function and to enable them self manage their illnesses. Rehabilitation also enables people with chronic illnesses to remain active and engage with their medical teams in relation to their health (Kralik, Paterson and Coates 2010). Role of multidisciplinary team in the support of people with chronic illnesses Healthcare provision and delivery by a well-coordinated and multidisciplinary team of individuals has fronted as one of the best approaches in supporting patients with chronic diseases. Patients suffering from chronic illnesses are likely to benefit from the services of a multidisciplinary team of health care providers due to the existence of broad array of knowledge and wide range of skills (Kralik, Paterson, & Coates, 2010). Team care has been adopted in primary health care settings and in particular, supports and cares of chronically ill patients. In addition, effective team care for chronic illnesses entails the participation of health care professionals beyond the conventional group of individuals working in a single practice or those that are biased towards a particular medical profession. Multidisciplinary team care for chronic illnesses may also involve a combination of various practices such as primary and specialists care or integration of multiple organizations such as a general practice and a community agency (Wagner, 2000; Nolte and McKee, 2008). Majority of chronic disease management programmes in primary care is the involvlment of relevant medical specialists such as nurses, physicians, occupational therapists, physical therapists, social worker, psychologists, speech and language therapists and dietitian (Huber, 2007). The role of nurses in chronic disease teams is to manage and treat the patients through the use of clinical and self-management skills and agreed protocols (McKnight, 2006). The role of pharmacist in chronic illnes care management is to monitor and optimize drug regimens and to reduce or elimate in adverse efffects of drugs on patients (Hogstel, 2001). The intergation of pharmacits in primary chronic care teams also increases the efficacy of drugs through prescion prescription. On the other hand,the role and responsibilities of social workers in chronic care teams particular for elderly people involve acquisation of community resources for the patients and the succesful integration of the patients back into the community (Wagner, 2000). Social workers also offer assistance to medication access, transportation issues and food refferalls. Due to the involvement of multidisciplary likely teams, chronic diseases management requires a good information system that can be effectively shared and used for successful care planning and delivery. Multidisciplinary health care provider teams therefore have the potential of contributing into better treatment of chronic disease (Chantal, et al. 2010). The role of physical therapists is to maximize the patient function by working with patients to improve gross motor skills and to provide modalities for pain management. Occupational therapists usually assist chronically ill patients to gain maximal function in areas that relate to activities of daily living. On the other hand, the role of a speech and language therapists in a multidisciplinary team is to evaluate and treat cognition, communication, swallowing disorders and hearing deficits. Dietician on the other hand is charged with the responsibilities of overseeing the nutritional status of patients and works hand in hand with the physician to provide necessary dietary requirements. Dietician also provides the patient and his or her family with education on diets (Harris 2005). Conclusion Chronic illness affects people of all ages across the globe and it is majorly attributed to obesity, smoking, alcohol use, high blood pressure, sedentary lifestyle, high cholesterol, and poor nutrition. Chronic illnesses pose serious implications for those living with such conditions. Care givers and their families. Multidisciplinary team from various organizations and professions are crucial in chronic illness management as it has the potential of producing high quality outcome for patients. References Ackley, Betty J, and B Ladwig Gail. Nursing diagnosis handbook: an evidence-based guide to planning care 9th . Mosby: Maryland Heights, Mo, 2000. Babich, Karen S, and Linda Brown. Discharge planning: a manual for psychiatric nurses. Thorofare, N.J: SLACK Inc., , 1991. Bahrer-Kohler, Sabine. Self Management of Chronic Disease. London: Springer, 2009. Brunner, Lillian Sholtis, and Suzanne C Smeltzer. Brunner and Suddarth's Textbook of Medical-Surgical Nursing. 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