Chronic Illness : Impact and Interventions

by Lubkin, Ilene Morof; Larsen, Pamala D.

• ISBN13: 9780763715700
• ISBN10: 0763715700
• Edition: 5th
• Format: Hardcover
• Copyright: 2002-01-01
• Publisher: Jones & Bartlett

Summary

Brandon/Hill Nursing List selection (#177). Emphasizes time courses, trajectories, developmental process, life quality, and the embeddedness of the individual and the caregiver in a social fabric. Previous edition: c1998.

Table of Contents

Foreword	xiv
Preface	xvi
Contributors	xvii
PART I Impact of the Disease	1	(310)
What Is Chronicity?	3	(22)
Ilene Morof Lubkin
Pamala D. Larsen
Introduction	3	(5)
Acute Versus Chronic Disorders	4	(1)
Historical Perspectives	4	(1)
Illness Trajectory	5	(3)
Difficulty Defining Chronicity	8	(1)
Impact of Chronic Illness	8	(7)
Growth and Development Factors	10	(2)
Quality of Life Versus Quantity of Life	12	(1)
Cultural Influences	13	(1)
Social Influences	13	(1)
Financial Impact of Chronicity	14	(1)
Attitudes of Health Care Professionals	14	(1)
Interventions	15	(5)
Professional Education	15	(1)
Legislation	16	(1)
Providing Culturally Competent Care	16	(1)
Models of Chronic Disease Management	17	(2)
Professional and Community Responsibility	19	(1)
Research	19	(1)
Summary and Conclusions	20	(1)
Nursing Diagnosis	20	(2)
Study Questions	22	(1)
References	23	(2)
Illness Roles	25	(28)
Patricia Ryan Lewis
Ilene Morof Lubkin
Introduction	25	(1)
Illness Behavior	26	(3)
The Sick Role	26	(2)
The Impaired Role	28	(1)
Problems and Issues Related to Illness Roles	29	(12)
Criticisms of Parsons' Model	29	(3)
Delay in Seeking Help	32	(1)
Who Seeks the Sick Role?	33	(2)
Role Changes	35	(1)
Secondary Gains	36	(1)
Life-Cycle Differences	36	(2)
Professional Responses to Illness Roles	38	(2)
Lack of Role Norms for the Chronically Ill	40	(1)
Interventions Based on Illness Role Theory	41	(6)
Dealing with Dependency	41	(1)
Role Supplementation	42	(1)
Norms for the Impaired Role	43	(1)
Assisting Those in the Impaired Role	44	(1)
Learning to Deal with Personal Biases	45	(1)
Research Focus	45	(2)
Summary and Conclusions	47	(1)
Nursing Diagnosis	47	(1)
Study Questions	48	(1)
References	48	(3)
Bibliography	51	(2)
Stigma	53	(24)
Coleen Saylor
Marian Yoder
Rosemary J. Mann
Introduction	53	(5)
Social Identity	54	(1)
Stigma as a Discrepancy	54	(3)
Types of Stigma	57	(1)
Chronic Disease as Stigma	58	(1)
Impact of Stigma	58	(5)
Responses of Stigmatized Individuals to Others	59	(2)
Responses of Nonstigmatized People to Stigmatized Individuals	61	(2)
Professional Responses: Attitudes Toward Stigma	63	(1)
Interventions: Dealing with Stigmatized Individuals	63	(7)
Responses Toward Self: Changes in Attitudes	63	(1)
Developing a Support Group of One's Own	64	(1)
Developing Supportive Others	65	(1)
Advocacy	66	(1)
Changing Definitions of Disability	66	(1)
Nonacceptance Versus Nonparticipation	67	(1)
Professional Attitudes: Cure Versus Care	67	(2)
Community Education Programs	69	(1)
Outcomes	70	(2)
Summary	72	(1)
Nursing Diagnosis	72	(1)
Study Questions	73	(1)
References	74	(3)
Chronic Pain	77	(42)
Janet E. Jeffrey
Ilene Morof Lubkin
Introduction	77	(1)
Theories of Pain	77	(1)
Acute Versus Chronic Pain	78	(1)
Problems and Issues	78	(9)
Undertreatment by Professionals	79	(4)
Effects of Unrelieved Pain	83	(1)
Life-Cycle Differences	84	(2)
Effects of Culture on Pain	86	(1)
Interventions for Dealing with Chronic Pain	87	(17)
Problem-Solving Process	87	(2)
Pharmacological Management of Pain	89	(3)
Noninvasive Methods of Pain Control	92	(11)
Pain Management Programs	103	(1)
Outcomes	104	(1)
Nursing Diagnosis	104	(1)
Study Questions	105	(1)
References	105	(11)
Bibliography	116	(3)
Social Isolation	119	(28)
Diana Luskin Biordi
Introduction	119	(4)
When Is Isolation a Problem?	119	(1)
Distinctions of Social Isolation	120	(1)
Description and Characteristics of Social Isolation	120	(2)
Social Isolation as a Nursing Diagnosis	122	(1)
Problems and Issues of Social Isolation	123	(7)
The Isolation Process	123	(1)
Social Isolation and Stigma	123	(1)
Social Isolation and Social Roles	124	(1)
Social Isolation and Cultural Components	125	(1)
Social Components of Social Isolation	126	(1)
Demographics and Social Isolation	126	(2)
Illness Factors and Social Isolation	128	(1)
Health Care Perspectives	129	(1)
Interventions: Counteracting Social Isolation	130	(9)
Assessment of Social Isolation	131	(2)
Management of Self: Identity Development	133	(1)
Integrating Culture into Health Care	134	(1)
Respite	135	(1)
Support Groups and Other Mutual Aid	136	(1)
Spiritual Well-Being	136	(1)
Rebuilding Family Networks	136	(2)
Communication Technologies	138	(1)
Touch	138	(1)
Behavior Modification	138	(1)
Summary and Conclusions	139	(1)
Outcomes	139	(1)
Nursing Diagnosis	140	(1)
Study Questions	140	(1)
References	141	(4)
Bibliography	145	(2)
Altered Mobility and Fatigue	147	(34)
Sandra Bergquist
Geri B. Neuberger
Altered Mobility	147	(1)
Introduction	147	(1)
Problems and Issues with Altered Mobility	147	(8)
Causes of Altered Mobility	147	(2)
Impact of Age-Related Disorders	149	(2)
Effects of Immobility	151	(2)
Patterns of Mobility Alteration	153	(2)
Interventions for the Client with Altered Mobility	155	(7)
Physical Activity	155	(4)
Adequate Nutrition	159	(1)
Pain Control	160	(1)
Aids for Sensory Impairment	160	(1)
Psychosocial Interventions	161	(1)
Management of Equipment	161	(1)
Cultural Considerations	161	(1)
Reducing Environmental Barriers	162	(1)
Outcomes	162	(1)
Fatigue	163	(1)
Introduction	163	(2)
Significance of Fatigue	164	(1)
Defining Fatigue	164	(1)
Problems and Issues with Fatigue	165	(3)
Measurement of Fatigue	165	(1)
Fatigue in Chronic Disease	166	(1)
Fatigue and Other Symptoms	166	(1)
Cultural Influences	167	(1)
Interventions	168	(2)
Assessment of Fatigue	168	(1)
Support Groups	168	(1)
Managing Fatigue	168	(2)
Outcomes	170	(1)
Summary and Conclusions	170	(1)
Nursing Diagnosis	170	(2)
Study Questions	172	(1)
References	172	(9)
PART II Impact on the Client and Family
Quality of Life	181	(22)
Victoria Schirm
Introduction	181	(3)
Defining Quality of Life	182	(1)
Frameworks	183	(1)
Problems and Issues of Quality of Life in Chronic Illness	184	(6)
Health and Function Issues	184	(2)
Psychological and Spiritual Issues	186	(1)
Social and Economic Issues	187	(2)
Family Issues	189	(1)
Interventions for Improving Quality of Life	190	(5)
Interventions for Health and Function	190	(2)
Psychosocial and Spiritual Interventions	192	(2)
Social and Economic Interventions	194	(1)
Family Interventions	195	(1)
Outcomes	195	(2)
Nursing Diagnosis	197	(1)
Study Questions	197	(1)
References	198	(5)
Compliance	203	(30)
Jill Berg
Lorraine S. Evangelista
Jacqueline M. Dunbar-Jacob
Introduction	203	(8)
Compliance and Chronic Illness	203	(1)
Definition of Terms	204	(1)
Components of Compliance	204	(1)
Models and Theories of Compliance	205	(5)
Prevalence of Noncompliance	210	(1)
Problems and Issues	211	(6)
Barriers to the Study of Compliance	211	(1)
Variables of Noncompliance	212	(5)
Ethical Issues in Compliance	217	(1)
Interventions to Attain Compliance	217	(7)
Assessment	218	(1)
Measuring Compliance Behaviors	219	(3)
Educational Strategies to Enhance Compliance	222	(1)
Behavioral Strategies to Enhance Compliance	222	(2)
Ethnocultural Interventions	224	(1)
Outcomes	224	(1)
Nursing Diagnosis	225	(1)
Study Questions	226	(1)
References	226	(7)
Family Caregivers	233	(28)
Shirley S. Travis
Kathy Piercy
Introduction	233	(4)
Current Family Caregiving	233	(1)
Preferences for Family Care	233	(1)
Characteristics of Family Caregivers	234	(1)
Types of Care Provided by Family Caregivers	235	(1)
Caregiving Histories and Maturation over Time	236	(1)
Positive Aspects of Caregiving	236	(1)
Future Caregiving	237	(1)
Problems and Issues	237	(6)
The Influence of Public Policy on Family Caregiving	239	(1)
Emotional Effects of Being a Caregiver	239	(2)
Family Relationships When Long-Term Caregiving Is Required	241	(1)
Elder Abuse and Neglect	241	(1)
Excessive Caregiving	242	(1)
Financial Impact of Caregiving	242	(1)
Interventions	243	(7)
The Interface of Informal and Formal Caregiving Networks	243	(1)
Family Caregivers as Members of Care Planning Teams	244	(1)
Life-Span Development and Developmentally Appropriate Care	244	(1)
Helping Families Learn to Cope	245	(1)
Spirituality and Caregiving	245	(3)
Programs, Services, and Resources for Family Caregivers	248	(1)
The Need for Culturally Sensitive Interventions	249	(1)
Outcomes	250	(2)
Care Recipient, Caregiver, and Caregiving System Outcomes	250	(1)
Societal Outcomes	251	(1)
Nursing Diagnosis	252	(1)
Study Questions	253	(1)
References	254	(5)
Bibliography	259	(2)
Body Image	261	(18)
Diana Luskin Biordi
Denise Boville
Donna S. King
Gregory Knapik
Andrea Warner
Kathy A. Zartman
Dawn M. Zwick
Introduction	261	(3)
Definitions of Body Image	261	(1)
Models of Body Image	262	(1)
Issues in Definitions and Models of Body Image	262	(2)
Impact on Illness and Wellness	264	(1)
Problems Secondary to Chronic Illness	264	(6)
External Changes	264	(1)
Functional Limitations	265	(1)
Meaning and Significance	266	(1)
Influence of Time	266	(1)
Social Influences	266	(1)
Cultural Influences	267	(1)
Other Factors Influencing Adjustment to Body Image	268	(2)
Impact of Poor Client Adjustment to Body Image	270	(1)
Interventions	270	(4)
Phases of Reimaging	270	(2)
Assessment	272	(1)
Specific Interventions	272	(2)
Outcomes	274	(1)
Nursing Diagnosis	275	(1)
Study Questions	275	(1)
References	275	(4)
Sexuality	279	(18)
Margaret Chamberlain Wilmoth
Introduction	279	(12)
Definitions	279	(1)
Standards of Practice	279	(1)
The Sexual Response Cycle and Sexual Physiology	280	(2)
Sexuality and Chronic Illness	282	(9)
Interventions	291	(3)
Sexual Assessment	291	(1)
Including Sexuality into Practice	292	(2)
Summary and Conclusions	294	(1)
Nursing Diagnosis	294	(1)
References	294	(3)
Powerlessness	297	(14)
Lisa L. Onega
Pamala D. Larsen
Introduction	297	(2)
Historical Perspectives	297	(2)
Defining Powerlessness	299	(1)
Issues Related to Powerlessness	299	(3)
Physiological Factors	299	(1)
Management of the Medical Regimen	300	(1)
Loss	300	(1)
Lack of Knowledge	300	(1)
Health Care System	301	(1)
Societal Issues	301	(1)
Lack of Resources	302	(1)
Uncertainty	302	(1)
Interventions	302	(5)
Assessment	302	(1)
Client and Family Education	303	(1)
Diversional Experiences	304	(1)
Empowerment	304	(2)
Services	306	(1)
Recommendations for Further Conceptual and Data-Based Work	306	(1)
Summary and Conclusions	307	(1)
Nursing Diagnosis	307	(1)
Study Questions	308	(1)
References	308	(2)
Bibliography	310	(1)
PART III Impact of the Health Professional	311	(158)
Change Agent	313	(24)
Patricia A. Chin
Introduction	313	(2)
The Concept of Change	313	(1)
Assumptions	314	(1)
Planned and Unplanned Change	314	(1)
Issues Related to Change	315	(4)
Resistance to Change	315	(1)
Barriers to Change	315	(1)
Ethical Issues	316	(1)
``Slipping'' and Relapsing	317	(1)
Change During Times of Crisis	317	(1)
Cultural Issues	318	(1)
Interventions	319	(16)
Change Agent	319	(1)
Assessing and Planning for Change	320	(3)
Theoretical Frameworks	323	(12)
Maintenance of Change	335	(1)
Outcomes	335	(1)
Study Questions	335	(1)
References	335	(2)
Client and Family Education	337	(22)
Cheryl P. McCahon
Pamala D. Larsen
Introduction	337	(3)
The Teaching-Learning Process	337	(1)
The Role of Teaching in Nursing	337	(2)
Pedagogy and Andragogy	339	(1)
Phases of Learning	339	(1)
Barriers Influencing the Teaching-Learning Process	340	(6)
Developmental Issues	340	(2)
Gender	342	(1)
Culture	342	(1)
Motivation	343	(1)
Readiness to Learn	344	(1)
Communication	344	(1)
Societal Role Considerations	344	(1)
Physical and Functional Influences	345	(1)
Locus of Control	345	(1)
Compliance	345	(1)
Nurse Factors That Influence the Teaching-Learning Process	346	(1)
Interventions	346	(9)
The Teaching Role in Chronic Illness	347	(1)
Development of a Teaching Plan	348	(2)
Implementing the Teaching Plan	350	(2)
Evaluation of Learning	352	(1)
Other Strategies	353	(1)
Other Considerations	354	(1)
Outcomes	355	(1)
Nursing Diagnosis	355	(1)
Study Questions	355	(1)
References	356	(1)
Bibliography	357	(2)
Advocacy	359	(26)
Faye I. Hummel
Introduction	359	(8)
Evolution of Nursing Advocacy	359	(1)
Definition of Advocacy	360	(1)
Self-Care Nursing Theory	361	(1)
Philosophical Foundations of Advocacy in Nursing	361	(2)
The Need for Advocacy	363	(1)
The Advocate Role	364	(3)
Problems and Issues	367	(6)
Client Factors Affecting Advocacy	367	(2)
Nurse Factors Affecting Advocacy	369	(2)
Social Structural Factors Affecting Advocacy	371	(2)
Interventions	373	(5)
Advocacy Models	374	(4)
Summary and Conclusions	378	(1)
Nursing Diagnosis	378	(1)
Study Questions	379	(1)
References	379	(2)
Bibliography	381	(4)
Research in Chronic Illness	385	(22)
Barbara B. Germino
Introduction	385	(11)
Types of Research on Chronic Illness	385	(1)
Theoretical Support for Chronic Illness Research	386	(1)
Research on the Prevention of Chronic Illness	386	(3)
Research on the Management of Chronic Illness	389	(7)
Issues in Chronic Illness Research	396	(2)
Issues of Descriptive Research in Prevention of Chronic Illness	396	(1)
Issues in Intervention Research in the Prevention of Chronic Illness	396	(2)
Summary and Conclusions	398	(1)
Study Questions	398	(1)
References	399	(8)
Ethics in Chronic Illness	407	(24)
Judith A. Erlen
Introduction	407	(9)
Living with a Chronic Illness	407	(1)
Ethics	408	(1)
Ethical Practice in Nursing	408	(1)
Ethical Principles	409	(3)
Ethical Perspectives	412	(2)
Influencing Factors	414	(1)
Ethical Dilemmas	415	(1)
The Ethical Decision-Making Process	415	(1)
Ethical Challenges and Concerns	416	(6)
Lack of Control	416	(2)
Suffering	418	(2)
Accessing Services	420	(2)
Interventions for Creating an Ethical Climate	422	(4)
Increasing the Nurse's Understanding of Ethics	422	(2)
Advocacy	424	(1)
Communicate Effectively	425	(1)
Outcomes	426	(1)
Study Questions	426	(1)
References	427	(4)
Nurse Case Management	431	(38)
Judith Papenhausen
Connie Burgess
Introduction	431	(10)
Differentiating Managed Care and Case Management	432	(4)
Nursing Case Management Models	436	(5)
Nurse Case Management Interventions	441	(7)
Selecting Appropriate Case Management Strategies	442	(1)
Salient Factors Framework	442	(2)
Salient Factors: The Clinical Strategy	444	(4)
Application of the Salient Factors Framework and Strategies	448	(1)
Summary and Conclusions	448	(1)
Study Questions	448	(1)
References	449	(3)
Bibliography	452	(1)
The Advanced Practice Nurse in Chronic Illness
Sue E. Meiner
Introduction	453	(6)
Advanced Practice Nursing Education	453	(1)
Roles	454	(1)
Theory-Based Practice	455	(1)
American Nurses Association Standards of Practice for the APN	456	(1)
Regulation of Practice	457	(1)
Models of Practice for Advanced Practice Nurses	457	(1)
Additional Roles for Experienced Advanced Practice Nurses	457	(1)
A Practice Scenario with a Clinical Nurse Specialist	458	(1)
A Practice Scenario with a Nurse Practitioner	458	(1)
Problems and Issues of Advanced Practice Nursing	459	(3)
Difficulty in Attracting Students and Faculty	459	(1)
Resistance from Physician Organizations	459	(1)
Using Protocols or Guidelines in Practice	459	(1)
Admitting Privileges in Acute Care Facilities	460	(1)
Reimbursement Issues in Advanced Practice Nursing	460	(1)
Prescriptive Authority	461	(1)
Cultural Perspectives of Advanced Practice Nursing	462	(1)
Interventions	462	(2)
Gaining Acceptance by Other Disciplines	462	(1)
Opening an Advanced Practice Nursing Practice	462	(2)
Policy Development	464	(1)
Outcomes	464	(2)
Study Questions	466	(1)
References	466	(3)
PART IV Impact of the System	469	(116)
Financial Impact	471	(20)
Sonya R. Hardin
Introduction	471	(1)
Gauging Health Care Costs	472	(1)
Issues of Rising Health Care Costs	472	(12)
Paying for Health Care	472	(4)
Health Care Spending	476	(1)
Where Health Care Money Goes	477	(2)
Chronic Illness and Costs	479	(5)
Impact of Rising Costs	484	(1)
Solutions to Rising Health Care Costs	484	(5)
Managing Chronic Conditions	486	(1)
Options to Expand Federal Health Care	486	(1)
Expanding Medicare	486	(2)
The Future	488	(1)
Summary and Conclusions	489	(1)
Study Questions	489	(1)
References	490	(1)
Politics and Policy	491	(22)
Betty Smith-Campbell
Introduction	491	(1)
Policy Defined	492	(1)
Problems and Issues	492	(11)
U.S. Health Care: A System in Trouble	493	(4)
The Balanced Budget Act	497	(1)
Lack of Affordable, Accessible, and Quality Health Care	497	(4)
Quality-of-Life Issues	501	(2)
Interventions: Politics, a Caring Action	503	(5)
Stages of Influencing Policy	503	(1)
The Three Cs of Political Influence	504	(4)
Summary and Conclusions	508	(1)
Study Questions	508	(1)
References	509	(2)
Internet Resources	511	(2)
Home Health Care	513	(20)
Deborah Card
Wanda Huffstetler
Introduction	513	(7)
Historical Perspectives	514	(3)
Model of Home Health Care	517	(1)
Applying Nursing Theory to Home Health Care	517	(1)
The Language of Home Health Care	518	(1)
The Home Health Care Team	519	(1)
Problems and Issues of Home Health Care	520	(6)
Limited Reimbursement	521	(1)
Potential for Client Abandonment	522	(1)
Prospective Payment System: Moving toward Capitation	522	(2)
Increased Documentation	524	(1)
Skewed Outcome Data	524	(1)
Compliance Pitfalls	525	(1)
Insufficient Staffing of Home Health Agencies	525	(1)
Conflict with Hospice Nursing	525	(1)
Use of Family Caregivers	526	(1)
Interventions	526	(4)
Diversifying Home Care Services	526	(1)
Changing the Model of Care Delivery	527	(1)
Counterbalancing the Staffing Shortage	527	(1)
Changes in Nursing Education	527	(1)
Bridging the Gap between Home Health and Hospice Nursing	528	(1)
Avoiding Legal and Compliance Pitfalls	528	(1)
Computerization	528	(1)
Legislation	529	(1)
Supporting Family Caregivers	529	(1)
Summary and Conclusions	530	(1)
Study Questions	530	(1)
References	531	(1)
Bibliography	532	(1)
Long-Term Care	533	(22)
Susan J. Barnes
Introduction	533	(5)
Historical Perspectives	534	(1)
The Continuum of Care	535	(2)
Long-Term Care Recipients as a Vulnerable Population	537	(1)
Problems and Issues of Long-Term Care	538	(5)
Provision of Care	538	(2)
Ethical Issues in Long-Term Care	540	(3)
Adjustment to Long-Term Care	543	(1)
Interventions	543	(9)
Theoretical Framework for Practice	543	(1)
Admission and Assessment in the Long-Term Care Setting	543	(2)
Autonomy	545	(1)
Advocacy: The Role of the Ombudsman	546	(1)
Adjustment	547	(1)
Nursing Care	547	(4)
Research in Long-Term Care	551	(1)
Outcomes	552	(1)
Study Questions	552	(1)
References	552	(3)
Rehabilitation	555	(30)
Robin E. Remsburg
Barbara Carson
Introduction	555	(10)
Definitions	556	(1)
The Enabling-Disabling Process	557	(1)
Other Classification Systems	558	(2)
Excess Disability	560	(1)
Historical Perspective	560	(1)
Public Policy and Rehabilitation	561	(4)
Rehabilitation Issues and Challenges	565	(6)
Rising Costs and Care	565	(1)
Caregiver Burden	566	(1)
Inequities among Disabled Americans	567	(1)
Image of Disability	568	(1)
Changing Composition of the Disabled Population	569	(1)
Ethical Issues	570	(1)
Inadequate Documentation of Rehabilitation Outcomes	570	(1)
Interventions	571	(8)
The Rehabilitation Process	571	(2)
Rehabilitation Nursing	573	(1)
Rehabilitation Settings	574	(3)
Rehabilitation Specialties	577	(1)
Assuring Quality in Rehabilitation Facilities	578	(1)
Outcomes	579	(1)
Study Questions	580	(1)
References	580	(5)
Appendix A: Resources	585	(10)
Index	595