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
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 functional status?
ability to maintain independence & respond to daily urgencies
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
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 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)
What would be most effective against chronic disease?
80% prevented x diet, no smoking, healthier eating
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 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)
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
