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At least 19 recordsLinked to original sources
PubMed1978

Impact of chronic illness on child and family: an overview based on five surveys with implications for management.

For the past eight years the Rochester Child Health Group has systematically investigated chronic illness in childhood with the goal of minimizing the psychosocial sequelae of chronic illness through more optimal management. This overview examines the impact of chronic illness on 404 children and their families in five separate studies: 1) 209 children in a follow-up of all children with chronic symptoms in a previous random sampling of children; 2) 42 children with juvenile arthritis; 3) 44 nephrotic children; 4) 54 asthmatic children; 5) 55 chronically ill children living in rural areas of Western New York. Information was obtained through parental interviews, school reports, and psychological testing of the child. The percentage of parents reporting impact of the child's illness on family differed according to study population. The percentage reporting areas of impact according to severity of the illness is as follows: worry, 75--97; financial, 46--60; fatigue of parent, 31--65; change in sleep arrangements, 17--31; change in furnishings, 15--40; less social life for parents, 12--35; restrictions on travel, 13--40; parental friction, 9--20; sibling neglect, 10--20; sibling resentment, 10--25; embarrassment, 12--20; interference from relatives, 5--17. Over half the parents felt their child's future education, job chances, and social life would be affected. One third reported activity limitations. Compared to a control group of children, a significantly greater percentage of parents of the chronically ill reported teacher concern about their child's effort and behavior, and showed concern about the child having too few friends. Two of the three studies in which psychological appraisals were obtained suggested that more of the ill children than controls showed indices of maladjustment. School information from two studies showed more of the ill children than controls underachieving and being referred to a school psychologist. Work by the Rochester Child Health Group has pointed up several ways in which providers of care can more optimally assist families in order to minimize these problems: 1) identifying families at risk at the onset to find which families may require special support; 2) Assuring that family and all care providers know who is orchestrating care, and that all areas of care are being provided; 3) Assuring that where necessary, an outreach person is meeting the needs of the family and child on an intensive, sustained, caring and creative basis.

Adolescent↗
PubMed1978

Medical students' orientation toward the chronically ill.

Medical students receive little training specifically directed toward care of chronically ill persons, and physicians, therefore, tend to have little knowledge of alternative long-term care arrangements. Moreover, the negative attitudes toward chronic patients which were observed by Becker in the 1950s still seem prevalent among medical students. Little interest is expressed by medical students in fields which focus on the chronically ill or aged. Restructuring of medical education is necessary in order to promote more concern among physicians with the needs of the chronically ill.

Attitude to Health↗
PubMed1978

Chronic illness in non-institutionalized persons. Part II. Who cares?

A survey was conducted to evaluate the care being received by non-institutionalized chronically ill persons in the Black, Coloured and White communities residing in the Municipality of Cape Town. Of the chronically ill persons identified, 170 (71%) of the Blacks, 188 (62%) of the Coloureds and 43 (86%) of the Whites were receiving care at the time of the survey, and the type, location and duration of this care are outlined. Only 26% of the chronically ill persons were considered to be receiving optimal care, and new recommendations for care were made for 201 (84%) of the Blacks, 203 (67%) of the Coloureds and 36 (72%) of the Whites. Of the patients for whom new recommendations were made, 37% were not currently receiving any care. The financial and occupational repercussions of chronic illness are considered, and methods of improving the comprehensive care of chronically ill persons are discussed.

Chronic Disease↗
PubMed1979

Dental management of the chronically ill child.

Recent advances in the medical management of chronically ill children are of interest to the general dental practitioner in those areas which relate to groups of child patients frequently treated in practice. There is now a greater understanding of the effects on the child with a chronic illness or handicap of multiple visits to hospital or medical consultants, and of hospitalization for extended periods with separation from parents and family. The bearing this has on our dental management of such children is considered, as also are the recent advances in the care of children with congenital cardiac defects, haematological disorders, and neurological disturbances.

Anemia↗
PubMed1978

Chronic illness in non-institutionalized persons. Part I. Prevalence and epidemiology.

A survey was conducted to investigate the prevalence and epidemiology of chronic illness in non-institutionalized persons residing in the Municipality of Cape Town. The Black, Coloured and White communities were independently surveyed and the standardized prevalence proportions of chronic illness were 24,7/1 000, 37,4/1 000 and 11,6/1 000 respectively. The epidemiological parameters investigated included age, sex, marital status, income, education occupation and the associated diseases, and the influence of these factors on the prevalence proportions are considered. Methodological problems of chronic illness surveys are discussed.

Accidents↗
PubMed1977

Attitudes toward the chronically ill and disabled: implications for the health care systems.

Health care services for the chronically ill are provided through a fragmented patchwork of activities by health care professionals. This article traces some of the origins of attitudes toward the chronically ill and identifies the problems created by disjointed patterns of care. A route for change that is humanistically based and uses a matrix model for care and management is suggested.

Attitude to Health↗
PubMed1976

Chronically ill children. A psychologically and emotionally deviant population?

The study evaluated the psychosocial functioning levels of a group of chronically ill (diabetic, asthmatic, cystic fibrotic, and hearing-impaired) children across a battery of standardized personality instruments. The assessments were performed to provide a rigorous test of the popular hypothesis that chronically ill children are especially vulnerable to psychopatholgy. In contrast to this sterotype, results across measures demonstrated the normalcy rather than the deviance of these children. Although exceptions were noted, the children's functional strengths and coping abilities noticeably outweighed their weaknesses.

Achievement↗
PubMed1978

Prescribing of psychoactive drugs for chronically ill elderly patients.

The prescribing of psychoactive drugs for 1431 chronically ill elderly patients being assessed for long-term institutional or community care was surveyed. Psychoactive drugs had been prescribed for about one quarter of the patients; benzodiazepines were the most frequently prescribed group. Judging from the extensive prescribing of flurazepam and chloral hydrate, commonly used hypnotics, the main reason psychoactive drugs were prescribed was to provide night-time sedation. Antidepressants and drugs promoted as useful in improving cognitive function were infrequently prescribed. Commendable prescribing practices included the infrequent use of "cerebral vasodilators" and barbiturates. Questionable prescribing practices included the infrequent use of tricyclic antidepressants in severely depressed patients and the use of tranquilizers in patients described by their attending physician as markedly or extremely withdrawn.

Age Factors↗
PubMed1977

Sexuality in chronic illness.

Three parameters are involoved in sexual functioning-psychological, organic performance, and organic enjoyment spheres. In evaluating an individual with chronic illness who has sexual complaints one must obtain a normative data base with the general history of the present illness, pertinent past history, a complete sexual history, a psychosocial history with special concern of present factors leading one to pertinent physical findings, and laboratory data (see Table 2). Frequently, it is helpful to interview the sexual partner. Finally, the subjective and objective data must be assessed and a plan with psychiatric or organic treatment, or both, must be made. Often it only can be with prolonged follow-up that we can adequately delineate the exact etiology of the sexual disorder in an individual with chronic medical illness. Even if treatment is difficult, the physician's continued support and interest can mitigate problems in this important aspect of life.

Aging↗
PubMed1979

Onset of chronic illness in children and adolescents: psychotherapeutic and consultative intervention.

Patients with disparate chronic illnesses exhibit specific and similar reactions during the onset of disease. This paper suggests the importance of psychological intervention during the initial stages of disease, and makes recommendations for psychotherapeutic and consultative management of the patient. Consideration is given to the effects of such intervention on both patient and psychotherapist.

Adaptation, Psychological↗
PubMed1979

Measures and methods in evaluating patient education programs for chronic illness.

Patient education provides a vehicle for increasing the self-management of chronic illness and promoting modifications of life styles, which are considered important strategies for prevention. Evaluating the impact of such programs is complex and poses a number of methodologic and technical problems. Outcome measures of patient education programs are defined and reviewed in terms of the existing evaluation literature and our own studies utilizing diabetes as a prototype condition. Important dimensions of adaptation are outlined and indices to measure it discussed in an effort to examine aspects of educational programs directed at facilitating coping and maintaining quality of life. Factors which influence outcome variables are identified and include: patient factors (e.g., age, ethnic, socioeconomic, cultural, personality, and emotional), disease factors (e.g., severity of illness, age of onset, length of illness, mode of therapy), system factors (e.g., patient's location in the health care system, relation of teaching program to other health care providers). The effects of these factors are described including their implications for research design.

Age Factors↗
PubMed1978

A learning theory model of chronic illness behavior: theory, treatment, and research.

Over 300 patients have been treated on an inpatient psychosomatic service employing a learning model of chronic illness behavior. This model stresses social reinforcement and avoidance of occupational and social activities in the development of a syndrome characterized by somatic complaints and care-eliciting interpersonal behaviors. Preliminary studies showed that patients reinforced others for care-giving responses but showed improved tolerance of experimental pain and lower rates of drug use when care-taking responses were minimized and self-control encouraged. Treatment was designed to involve the patient in his own care, including behavior modification techniques to reduce symptomatology, social skills training, and family therapy. One-year follow-up shows that most patients achieve self-set goals, with generalization of beneficial treatment effects. Patients who return to an intact family show continuing decreases in somatic complaints and increases in achievement orientation. Treatment failures are characterized by lack of an intact family and return to the medical care system.

Adolescent↗
PubMed1979

Comprehensive care of the chronically ill cancer patient: an inter-agency model.

The article identifies continuity of care between hospital and community as the key element of comprehensive health care for the chronically ill cancer patient. It describes the collaborative effort of the Michigan Cancer Foundation and the Metropolitan Detroit Cancer Control Program to provide this continuity. The structure, process, and outcome of the inter-agency model is presented and illustrated through case example. The authors believe that this model is applicable to treatment of persons with other chronic diseases which require frequent hospitalization.

Adaptation, Psychological↗
PubMed1977

Responses of elderly and chronically ill subjects to bivalent influenza A/New Jersey/8/76 (Hsw1N1)-A/Victoria/3/75 (H3N2) vaccines.

Antibody responses and side effects to bivalent influenza A virus vaccines from three different manufacturers, containing 200 or 400 chick cell-agglutinating (CCA) units each of A/New Jersey/8/76 (Hsw1N1) and A/Victoria/3/75 (H3N2) antigens, were evaluated in 234 ambulatory elderly and chronically ill volunteers in a placebo-controlled, doubld-blind study. Systemic reactions did not occur significantly more often among recipients of vaccine than among volunteers who received placebo. Local reactions to vaccines were observed but were mild, transient, and well tolerated. Occurrence of preexisting antibody to each antigen was common. Titers of antibody to A/New Jersey/8/76 (Hsw1N1) antigen of greater than or equal to 1:40 occurred after immunization in 94%-100% of volunteers receiving vaccines and in 66% of the placebo recipients. Titers of antibody to A/Victoria/3/75 (H3N2) antigen of greater than or equal to 1:40 occurred in 53%-85% of vaccine recipients compared with 34% of those in the placebo group. Thus, bivalent split-product and whole-virus influenza I vaccines containing 200/200 or 400/400 CCA units of the two antigens appeared to be nearly equivalent in incidence and severity of side effects and antibody responses in recipients.

Adult↗