Chronic Illness: Nursing Care, Self-Management, and Outcomes

This report delves into the multifaceted aspects of chronic illnesses, emphasizing the critical roles of nursing care and patient self-management. It begins by defining chronic illness and differentiating it from acute conditions, highlighting its prevalence and impact on global mortality, especially in low-income families. The report underscores the importance of viewing chronic illness as an illness rather than solely a disease, emphasizing the patient's experience of symptoms and suffering. It explores how specialized nursing interventions, including evidence-based practices, can improve patient outcomes and reduce hospital visits. The report also examines the significance of addressing depression and anxiety, common comorbidities in patients with chronic conditions, and highlights effective treatments. Furthermore, it discusses the challenges and benefits of self-management strategies, stressing the need for patient involvement and education. It also covers the chronic care model and its elements and provides examples of self-management programs and techniques. The report concludes by emphasizing the importance of tailored treatment plans and effective self-management strategies for better patient outcomes, supported by various research references.

Running head: CHRONIC ILLNESS
CHRONIC ILLNESS
Name of the Student
Name of the university
Author’s note

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Chronic illness
Question 1
Answer: - A disease lasting for a long time is normally considered as a chronic illness. A person
with the chronic illness needs to undergo a continuous treatment for this. Chronicity may be
defined as the impairment of the normal condition of the body which includes non pathologic,
alteration, residual disability. The difference between an acute condition and a chronic disease is
that an acute disease develops suddenly, its effects are adverse and more drastic and an acute
disease normally stops within a relatively short time. Chronic diseases on the other hand
continues for a long period of time, its symptoms and effects are not so drastic, but if it is left
untreated for a longer time , it can be really fatal (Harris & Zwar 2007).
It has been reported that chronic diseases are the leading causes of the deaths in the
world. It has also been reported that about 20% of the deaths occur in the high income families
and most of the deaths are found in the low income families as they cannot afford a continuous
treatment (Harris & Zwar 2007). There is a wide variety of diseases that are considered chronic,
which needs a diverse care of treatment for the individual. In order to treat a chronic illness, it
should be considered as an illness rather than a disease.
There is a minor difference between the disease and the term illness. Disease means the
pathophysiology of a particular condition, which involves the alteration in the structure and the
function (Hickman, Rolley & Davidson 2010). Illness on the other hand is the impact of the
condition on a particular patient. Illness refers to the experience of the symptoms, sufferings by
the patients. It is necessary to understand the etiology and the pathophysiology of clinical
condition, but it is important to assess the illness that the patient is experiencing in order to
provide a proper care. It is to be noted that nursing cannot cure chronic diseases but it can

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definitely improve the quality of care in the patient. Nurses with specialized skills, training can
improve the primary care in the patient. It has been found that nurses adopting evidence based
practices in treating the chronic diseases have faced better outcomes regarding the treatment
regimen. Assessing the illness by specialized nurses have been found to reduce the number of
hospital visits and improve the patient outcomes related to diseases like diabetes, heart diseases.
Recent researches have provided with the information that patients who have had nurse led care
were much more satisfied with the treatment in comparison to those who have not got proper
nursing interventions. And it is important for a nurse to focus on the signs and symptoms of the
disease rather than focusing on the pathophysiology (Chang & Johnson 2014). It is important for
the nurses to chalk lout specific plans for each patients as per their health requirement, which is
only possible if they assess the symptoms for the individual patients. A chronic disease can have
varied effects, which can vary from one individual to the other. So, a regimen of treatment that is
suitable for one patient might not be suitable for the other (Goodman et al.2013).
Depression and anxiety are common in patients in the primary care settings. Depression
is quite common in patients having disorders like cancer, acute coronary diseases, stroke,
diabetes and some other chronic illnesses. Anxiety and depression always provides poor quality
of life, functional impairment, cognitive impairment and often high rates of mortality
(Cummings, Caporino & Kendall 2014). In order to mange depressions in the patient, it is
important to provide integrative and comprehensive modes of treatments. Recent researches have
found that effective interventions like pharmacologic, psychotherapies, and care management
can reduce the morbidity (Ski et al. 2012). Knowledge of the barriers that causes depression in
patients and effective educational and organizational strategies can lessen the barriers to the
depression treatments.

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Question 2.
Answer: - Self management of chronic diseases is always not suitable for the treatment. Self
management of chronic illnesses not only refers to the management of the symptoms, assessment
of the therapeutic uses, but also refers to the management of the psychosocial and the physical
management of the disease (Thirsk & Clark 2014). It involves the self management of the
treatment plans, social and role management. Nothing more can be better than a person
remaining active and involved in his own treatment. Self management is an effective component
of chronic illness treatment and better patient outcomes. Self management is beyond the
conventional knowledge based education in patients (Havas, Bonner & Douglas 2016). It
involves processes that would develop problem solving skills in the patients, that would help to
increase the self efficacy in patients. It helps the patients to deal with the real life situations. This
approach has also been able to encompass a change in the primary health care setting that is
patient focused (Ory et al. 2013). Family physicians can support this self management by
planning the patient physician interaction, and try to assess the situation from the patient’s point
of view (Havas, Bonner & Douglas 2016).Self management barriers should be removed to get a
better outcome. Resources on community self management and proper education to the patient
can bring about a successful self management program. Although it is always not possible for a
patient to self assess the conditions, but there are certain parameters that a patient can always
follow, like maintenance of the food habits. Self management has risks related to problematic
ideological and normative assumptions. Emerging evidences supports the fact that practice
strategies that are essential for the patient’s self management and improved outcome in the
patient (Disler, Gallagher & Davidson 2012).

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The rising prevalence of the chronic diseases is a matter of concern in all countries. The
chronic care model is widely adopted to improve the care related to the chronic illness. The
chronic care model refers to the important elements of the health care symptoms regarding the
chronic health care (Hickman, Rolley & Davidson 2010). The elements are the community, self
management, design of the delivery system, clinical information system and decision support
system. The evidence based practices under each element provide productive informations
between the patients who take active part in their own treatment regimen. Self management
techniques empower the patient to manage their illnesses in the following ways-
 It emphasizes on the patients role in the management of their own health
 Use of effective strategies for self management. That may include self assessment, action
planning, learning goals, problem solving and the follow up.
 Organizing community resources for providing self management support.
The chronic diseases self management programs that can be developed are-
 Techniques to reduce the frustrations, pain, isolation.
 Management of the therapeutic regimen.
 Nutrition information
 Communication improvement with the family.
These techniques ate effective in managing the outcome of some chronic illnesses like
diabetes, arthritis, asthma, and other cardiac difficulties (Schulman-green et al. 2012).
Thus it can be concluded that proper self management strategies provided to the patient
can give a better outcome in the treatment of the diseases.

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References
Chang, E. & Johnson, A. eds. 2014, Chronic illness and disability, Principles for nursing
practice, Elsevier Health Sciences, NSW.
Cummings, C.M., Caporino, N.E. & Kendall, P.C. 2014, Comorbidity of anxiety and depression
in children and adolescents: 20 years after, Psychological bulletin, United States of
America.
Disler, R.T., Gallagher, R.D. & Davidson, P.M. 2012, Factors influencing self-management in
chronic obstructive pulmonary disease: an integrative review, International Journal of
Nursing Studies, Australia.
Goodman, R.A., Posner, S.F., Huang, E.S., Parekh, A.K. & Koh, H.K. 2013, Peer Reviewed:
Defining and Measuring Chronic Conditions: Imperatives for Research, Policy, Program,
and Practice, Preventing chronic disease, United states of America.
Harris, M.F. & Zwar, N.A. 2007, Care of patients with chronic disease: the challenge for general
practice, Medical Journal of Australia, NSW.
Havas, K., Bonner, A. & Douglas, C. 2016, Self‐management support for people with chronic
kidney disease: Patient perspectives, Journal of renal care, Australia.
Hickman, L.D., Rolley, J.X. & Davidson, P.M. 2010, Can principles of the Chronic Care Model
be used to improve care of the older person in the acute care sector?, Collegian, Australia.
Lubkin, I.M. & Larsen, P.D. 2006, Chronic illness: Impact and interventions, Jones & Bartlett
Learning, United States of America.

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Ory, M.G., Ahn, S., Jiang, L., Smith, M.L., Ritter, P.L., Whitelaw, N. & Lorig, K. 2013,
Successes of a national study of the chronic disease self-management program: meeting
the triple aim of health care reform, Medical care, United States of America.
Schulman‐Green, D., Jaser, S., Martin, F., Alonzo, A., Grey, M., McCorkle, R., Redeker, N.S.,
Reynolds, N. & Whittemore, R.. 2012, Processes of self‐management in chronic
illness, Journal of Nursing Scholarship, United States of America.
Ski, C.F., Page, K., Thompson, D.R., Cummins, R.A., Salzberg, M. & Worrall‐Carter, L. 2012,
Clinical outcomes associated with screening and referral for depression in an acute
cardiac ward, Journal of clinical nursing, NSW.
Stellefson, M., Dipnarine, K. & Stopka, C. 2013, Peer reviewed: The chronic care model and
diabetes management in US primary care settings: A systematic review, Preventing
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Thirsk, L.M. & Clark, A.M. 2014, What is the ‘self’in chronic disease self-
management?, International Journal of Nursing Studies.
Warwick, M., Gallagher, R., Chenoweth, L. & Stein‐Parbury, J. 2010, Self‐management and
symptom monitoring among older adults with chronic obstructive pulmonary
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