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UTSW 2011 HB Chr Dis

UT Southwestern - Human Behavior - Chronic Disease

What is a chronic disease? One which requires ongoing treatment and management typically greater than one year and often is lifelong and not curable.
What are the stats on chronic disease? 1) 45% Americans have @ least 1 (will be >50% in 2030), 2) 75% health care spending, 3) premiums increased 87% over last decade ($6k/year = 5x more than non-chronic)
Why is chronic disease increasing in prevalence? 1) people live longer, 2) obesity (1/3 adults), 3) poor behaviors (booze/smoking), 4) poor diet (<1/4 eat veggies & fruit), 5) no physical activity
What is the 1 risk factor for chronic disease in a patient?
What would be most effective against chronic disease? 80% prevented x diet, no smoking, healthier eating
What is functional status? ability to maintain independence & respond to daily urgencies
How many people live in nursing homes? 5% 65 year olds, 6% 75-84 year olds, 22% >85 years old. family/friends usually give >80% needs.
What are the Activities of Daily Living (ADL)? Katz et al. 1963, a measure of functional status evaluating basic activities: Bathe, Dress, Toilet, Transfer from Bed, Continence, Feeding (lose in that order)
What is the Instrumental Activities of Daily Living? A measure of functional status evaluating complex functions of community: Telephone, Transportation, Shopping, Cooking, Housework, Laundry, Managing Meds, Managing $
What are the key components of ideal chronic care? 1) Informed and activated patients 2) Prepared, proactivae interdisciplinary teams 3) organized healthcare 4) Delivery system design 5) Community 6) Self-management 7) Decision support 8) Clinical information systems
What are potential members of the interdisciplinary health care team? Social Worker, Pharmacist, Physical/Occupational Therapist, Psychologist, Chaplain, Nurse, PA, Physician
How can you help a patient deal with chronic illness? 1) normalize emotions, 2) investigate previous stress coping mech's, 3) cultivate sense of control x teaching, 4) positive attitude, 5) locate support system, 5) Accept change in appearance
What are Prochaska & DiClemente's Stages of Change w/chronic illness? 1) Pre-contemplation, 2) Contemplation, 3) Preparation, 4) Action, 5) Maintenance/Relapse Prevention, 6) Relapse
What is the best way to deal with a Pre-contemplative patient? 1) Validate state, 2) Clarify decision is theirs, 3) Encourage contemplation of future change benefits
What is the best way to deal with a Contemplative patient? 1) Validate state, 2) Clarify decision is theirs, 3) LIST pros & cons of change
What is the best way to deal with a Preparing chronic illness patient? 1) Identify obstacles, 2) patient Informs others of change, 3) Review benefits, 4) Plan of action
What is the best way to deal with an Action chronic illness patient? 1) Social Support system, 2) Plans for obstacles, 3) Acknowledge planning success, 4) Acnowledge need for change, 5) Manage stress
What is the best way to deal with a Maintenance chronic illness patient? 1) Reward sustained behavior, 2) focus on Long-term benefits
What is the best way to deal with a Relapse chronic illness patient? 1) Evaluate changed behavior leading to relapse, 2) Identify triggers, 3) Reise action plan, 4) Review benefits of change, 5) Get back to action plan (don't dwell)
What are some reason for non-compliance? 1) denied chronicity, 2) ignorance, 3) illiteracy, 4) doesn't bother NOW, 5) can't afford, 6) no team treatment, 7) competing survival needs, 8) mental health, 9) lack of motivation, 10) cultural issues
Created by: micah52