Patients' Psychological Reactions to Chronic Illness: Are they Associated with Rehabilitation

1982 ◽  
Vol 13 (2) ◽  
pp. 38-44 ◽  
Author(s):  
Linda L. Viney ◽  
Mary T. Westbrook

The responses of 88 chronically ill patients to an open-ended question about their current experiences were content analysed to yield a set of measures assessing their psychological reactions to their illness. Uncertainty, anxiety, depression, anger expressed directly and indirectly, feelings of helplessness and competence, sociability and positive feelings were assessed by this means. Patients were interviewed during hospitalization and seven months later in the community. On both occasions they rated their handicaps in the areas of mobility, leisure activities, self-care and social relationships. These ratings were combined to provide four measures of rehabilitation. The findings indicate that psychological reactions to chronic illness predict rehabilitation. Improvement in mobility and relationships is perceived by patients who, during earlier hospitalization, experience anxiety and depression, express their anger directly rather than indirectly, and believe social supports to be available to them. They also experience few feelings of helplessness. The psychological reaction experienced concurrently wsith perceived improvement in all handicap Q-reas consisted of more good-feelings and less uncertainty and anxiety. Improvement in mobility and relationships was also associated with an intensification in the pattern of expression of anger described above and an increase in feelings of competence. Unexpectedly, increased depression was also characteristic of this last pattern of reaction to chronic illness.

1987 ◽  
Vol 17 (2) ◽  
pp. 169-181 ◽  
Author(s):  
Linda L. Viney ◽  
Mary Westbrook

In order to identify any pattern of psychological reactions to illness associated with later death, interview material from a sample of chronically ill people who died within months of being interviewed was compared with similar material from a sample of chronically ill people who did not die, as well as from a group of healthy people who did not die. The samples were matched for sex and age, and, where appropriate, for degree of disability and type of chronic illness. The comparisons were made by means of content analysis scales which were applied to a recorded segment of the interviews. A characteristic pattern of reactions among the chronically ill people who were later to die was established. This pattern included little uncertainty or directly expressed anger but much depression, guilt, and fear of bodily damage, together with many good feelings. In personal construct psychology terms, their construct systems were enabling them to anticipate what was happening to them more effectively than might have been expected.


2020 ◽  
Vol 27 (8) ◽  
pp. 1-13
Author(s):  
Charlotte Byrne ◽  
Andy Soundy

Background/Aims Physical activity is regarded as an essential component of self-management for people with chronic illness. Storytelling is an approach that successfully uses a group environment to influence change in physical activity intentions and behaviours. The aim of this study was to develop an understanding of what a storytelling intervention entails, its main effects and how this leads to the promotion of physical activity in chronically ill patients. Methods An integrative review was undertaken in three stages: search, appraisal and synthesis. Studies were included if they represented participants with a chronic illness, used a storytelling approach for the intervention and had physical activity as a component of the intervention. Results A total of 14 articles were identified that included a total of 818 participants (191 male, 348 female, 279 unknown). No articles were identified as flawed and all were included in the synthesis. Four themes were identified: ideal processes within interventions; psychosocial factors that influenced storytelling; perceived outcomes relating to storytelling; and perceived benefits of physical activity. Conclusions This review develops a deeper understanding of the required processes, associated factors and outcomes of storytelling interventions for people with chronic illness. It provides evidence of how storytelling can be used to promote physical activity. Further research into storytelling interventions is required.


2021 ◽  
pp. RTNP-D-20-00183
Author(s):  
Jasmin Meichlinger ◽  
Andrea Kobleder ◽  
Hanna Mayer

Background and PurposeThe Reconceptualized Uncertainty in Illness Theory (RUIT) includes the concept of “probabilistic thinking” intending to explain the positive reappraisal of uncertainty in chronic illness. However, the description of the concept is vague, thereby limiting the understanding of the theory. Thus, the aim was to develop a theoretical definition of probabilistic thinking in order to increase the explanatory value of RUIT.MethodsWe conducted a principle-based concept analysis by means of a conceptually driven literature search. Methods consisted of database, dictionary, lexicon, and free web searching as well as citation tracking. We analyzed the concept in terms of (a) epistemology, (b) pragmatics, (c) logic, and (d) linguistics.ResultsThe final data set included 27 publications, 14 of them from nursing. (a) Probabilistic thinking is a coping strategy to handle uncertainty. It involves a focus on either possibilities (in nursing) or probabilities (in other disciplines). (b) There is a lack of operationalization in nursing, though three measurements focusing the handling of probabilities are offered in psychology. (c) Nursing authors interpreting probabilistic thinking as accepted uncertainty lacked logical appropriateness, since probability negotiates uncertainty. (d) Probabilistic thinking is used synonymously with positive thinking and probabilistic reasoning.Implications for PracticeNurses working with chronically ill patients should consider the findings for the application of RUIT. They should recognize whether uncertainty is perceived as a danger and encourage probabilistic thinking. Efforts are necessary to achieve a common language between nursing and other disciplines in order to avoid misunderstandings in clinical practice and research.


1997 ◽  
Vol 80 (2) ◽  
pp. 643-658 ◽  
Author(s):  
Stuart W. Twemlow ◽  
Lolafaye Coyne ◽  
Samuel L. Bradshaw ◽  
Barbara H. Lerma

To what extent do personal constructs affect the relationship between doctor and patient when the ill patient does not readily recover with treatment? Questionnaires were returned anonymously by 609 patients with a self-reported diagnosis of chronic fatigue syndrome, who were considered chronically ill. Findings were compared with those of an earlier study of a population of 397 general medical patients. The chronically ill patients lost an average of 65 days of work per year due to illness compared to general medical patients who missed six or fewer days per year because they were ill. The chronically ill patients also reported a 66% higher frequency of iatrogenic illness, spent more money on health care, took more medication, saw more specialists, and were more litigious than the general medical population. Research suggested several patterns of relationships between doctors and patients, and attitudes to health and illness, which may alert doctors to patients' perceptions, beliefs, encoded constructs, and patterns of relating that affect responses to treatment. More attention by doctors to patients who are experiencing the stress of chronic illness is indicated.


2018 ◽  
Vol 21 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Francesco Burrai ◽  
Rossella Lupi ◽  
Marco Luppi ◽  
Valentina Micheluzzi ◽  
Gabriele Donati ◽  
...  

Background: Participation in music therapy is associated with improved psychological and physical indices among chronically ill patients. Listening to music during hemodialysis treatments positively affects patients’ hemodynamics, laboratory values, quality of life, and physical symptoms. The effect of live singing during hemodialysis treatments, however, has not previously been studied. Methods: A total of 24 participants with a diagnosis of end-stage kidney disease participated in the study. The vocalist was a musically trained dialysis nurse. Twelve of the patients listened to 15 min of live singing during 6 consecutive hemodialysis sessions, while the other 12 underwent standard hemodialysis. After a washout period of 2 days, the two groups were reversed. Results: Listening to live music was associated with improvements in systolic and diastolic blood pressure, better quality of sleep, fewer cramps, and reduced anxiety/depression, pain, and itching ( p < .05, all values). Conclusions: Listening to live music during hemodialysis is an effective and potentially low-cost therapy for the dialysis care team to employ during hemodialysis treatments.


Author(s):  
Nathan Emmerich ◽  
Pat McConville

The COVID-19 pandemic has occasioned a great deal of ethical reflection both in general and on the issue of reverse triage; a practice that effectively reallocates resources from one patient to another on the basis of the latter having a more favourable clinical prognosis. This paper addresses a specific concern that has arisen in relation to such proposals: the potential reallocation of ventilators relied upon by disabled or chronically ill patients. This issue is examined via three morally parallel scenarios. First, the standard reallocation of a ventilator in accordance with reverse triage protocols; second, the reallocation of a personal ventilator from a chronically ill patient ordinarily reliant on it; and, third, the reallocation of a personal ventilator owned by a financially privileged individual but who is not ordinarily reliant on it. This paper suggests that whilst property rights cannot resolve these scenarios in a satisfactory manner, it may be possible to do so if we draw on the resources of phenomenology. However, in contradistinction to a recent paper on this topic (Reynolds et al. 2021), we argue that ethical claims to ventilators are not well grounded by the overly demanding notion that they are embodied objects. We suggest that the alternative phenomenological notion of homelikeness provides for a more plausible resolution of the issue. The personal ventilators of individuals who commonly rely upon them become part of their ordinary, everyday or homelike being. They are a necessary part of the continuation or maintenance of their basic state of health or wellbeing and the reallocation of such objects is unethical. Keywords: Phenomenology, COVID-19, Pandemic, Triage, Reverse triage, Ventilation, Chronic illness, Allocation of resources


2006 ◽  
Vol 3 (2) ◽  
Author(s):  
Michele Petrinco ◽  
Silvia Snidero ◽  
Miriam Totis ◽  
Mario Casini ◽  
Anuška Ferligoj ◽  
...  

The main objective of this study was to quantify the characteristics of social networks in a sample of elderly ill patients. These patients who had chronic illness were receiving home based care, in an Italian district during 2001. Both patients and caregivers were interviewed. The analysis of the caregivers' questionnaire was conducted to avoid missing answers when gathered from the patients. This method also enabled a better understanding of the impact of social support on chronic illness pathologies. Further more, it allowed the investigation of the patients' network, the caregivers' point of view, the costs, the quality of care and the assessment of sociodemographical data of both. Results highlighted the particular situation of patients, characterized by high dependence from other persons especially for every day activities. Most of the caregivers were family members for the number of persons involved and for the time spent for the care. The network support maintenance and mobilization costs evaluation was faced suggesting three different strategies, according to three different ways of time-opportunity calculation, of the informal caregivers.


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