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We examine conditions that people live with for life and serious conditions that are life threatening

Most illness is acute that is episodic Chronic conditions are constant and can bring about psychological stress Psychological responses differ depending on the nature of the symptoms The perception one has of their condition can affect how well they cope with the condition

Cancer
People in Canada have about a 1 in 4 chance of getting cancer in their lives Cancer takes many forms and symptoms vary from type to type Oncology is the study of cancer Oncologists often specialize in only one type of cancer specific to one site in the body

Cancer
What all cancers share is the uncontrollable growth of abnormal cells Normal cell division and growth is controlled at the level of the DNA Sometimes the genes that control growth are damaged This allows the cell to grow uncontrollably

Cancer

When enough uncontrolled cells form a mass, this is a tumour

When tumour cells spread through other parts of the body they are metastasized
When diagnosed, many people go through

denial

This has been shown to have health benefits in the early stages of cancer

Suffering among cancer patients comes in physical, psychological and social forms

Physical problems
Fatigue and pain are the two most common

Most people tend to be in more pain than they need to be Patients tend not to take analgesics for fear of tolerance or addiction Patients forget and also believe that a certain amount of pain should be tolerated

Psychological distress
Fear and depression are the two most common psychological problems These can become chronic

There is usually fear that treated cancer may recur and that it may metastasize Depression tends to be proportional to the prognosis of the disease

Psychological distress

Depression results in:

Poor quality of life Longer hospital stays Lower medical adherence Higher mortality rate

Intrusive memories are common These are unwanted thoughts related to illness or death of friends family or even someone in a movie

Psychological distress
Emotion-focused coping is focusing on ways to reduce the emotional impact of the disease Problem-focused coping involves
Seeking of information about the disease

Closely following treatment recommendations


actively addressing the stressors associated with the

cancer

The problem-focused approach seems to be more effective at reducing depression and anxiety

Cancer treatment
Common treatments include:

Surgery radiation therapy Chemotherapy hormone therapy

Hormones are used to treat breast and prostate cancer


These forms are influenced by certain hormones

(testosterone, estrogens)

Surgery can remove tumours but cannot do anything

to cells that have metastasized

Radiation therapy can shrink tumours


Radiation and

Cancer treatment

surgery are designed to deal with specific sites of cancer


If cancer has metastasized then chemotherapy is

used
Harm to healthy cells may occur

Cancer treatment
Side effects include fatigue, nausea, hair loss, oral and gastrointestinal erosion Social support can influence the progression of the disease and recovery

Support groups can:


Encourage people to express emotions Build group cohesion increasing the sense of social

support Improve patient communication skills Offer relaxation training

Diabetes

This is the seventh leading cause of death in Canada

The incidence of this disease is increasing (17 per 100,000)


People tend to die of complications such as hear

disease

Diabetes is when the pancreas produces to little insulin

Insulin is needed for cells to get sugar from the blood

Diabetes
Type I is the production of little or no insulin Type II is the underproduction or ineffective

utilization of insulin
Type II is more common in people over the age of 45

especially if they are obese

Diabetes
Symptoms:
Type I frequent urination, unusual thirst, extreme

hunger, weight loss and fatigue


Type II similar to type I but also frequent

infections, cuts and bruises take a long time to heal

Type I sufferers have to take daily insulin Both types have to closely monitor their blood sugar and their dietary intake of sugar

Diabetes
Long-term consequences can include:
Amputation Cardiovascular disease Kidney failure Neurological problems Going blind Stroke

Depression and low blood sugar can feed off each other (bidirectionally)

Cardiovascular disease

526 per 100,000 died from these conditions in 1996 (mostly

heart attack and stroke) Men are more likely than women to die of heart disease

Cardiovascular disease
3 main conditions can be identified
Myocardial infarction irreversible

damage to heart muscle (heart attack) people survive their first but not the second
Coronary artery bypass graft healthy

arteries from other parts of the body are grafted to the coronary artery to bypass blocked arteries
Angioplasty this involves the

unblocking of blocked blood vessels. Balloons or tubes are inserted into constricted blood vessels to widen them

Cardiovascular disease
Anxiety about having another heart attack can lead people to a sedentary lifestyle This is usually accompanied by weight gain and reduced physical activity This makes people prone to another heart attack Depressed patients are four times as likely to die within 6 months of diagnosis

Cardiovascular disease
Depression also increases angina or chest pain

Rehabilitation includes monitoring of physical condition, education, diet and exercise Relaxation and anger management skills may also be taught Outbursts of anger and anxiety can trigger heart attacks

Atherectomy

HIV and AIDS


Symptoms of HIV (human immunodeficiency virus)

Fever swelling of lymph nodes Fatigue Diarrhea sleep sweating yeast infections

HIV breaks down the bodys immune system This makes it susceptible to other infections

HIV and AIDS


The only transmission modes are unprotected sex,

needles and mother to fetus


AIDS is particularly stressful since most people that

live with it are stigmatized


There are myths about how people can contract this

This social stigmatization can lead to extreme

depression similar to post-traumatic stress disorder

Other chronic conditions and quality of life


Major depression is seen in many arthritis and

Parkinson sufferers Depression can make Parkinsons Disease worse (motor function and motivation)

Other chronic conditions and quality of life


Quality of life refers to the extent to which symptoms

and treatment affect a persons physical, social, cognitive and emotional functioning
Treatments that may alleviate a medical cause of a

disease might have negative effects on other aspects of a patients life

Other chronic conditions and quality of life

1.

Two major things must be considered:


Tradeoffs between length of life and quality of life

2.

Patients must be integrally involved with decisions because only they know what is important to them

Death and Dying


A logical progression has been suggested to occur when

someone has been told they are dying


Denial this is a defence mechanism used when

traumatic information is received. People think that the physician is not being serious
Anger this is sometimes directed at the medical system

or family and friends for not being helpful enough

Death and Dying


Bargaining sometimes people try to buy more time

by offering themselves for research or make strong religious or spiritual commitments


Depression if people become depressed they tend to

give up, this often accelerates death


Acceptance at this point, people are likely to be at

peace. Death is viewed as a relief