Chronic Illness

Illness refers to the personal experience of living with a biomedical disease that requires medical attention. Illness can be either acute, meaning the disease has a rapid onset and short duration, like influenza or gastroenteritis; or chronic, meaning the disease usually doesn’t resolve on its own, such as hypertension, diabetes mellitus, or asthma.

Chronic illness can result in decreased physical functioning, productivity, and overall quality of life. Now, there are three levels of disease prevention: primary, secondary, and tertiary.

Primary prevention looks at specific measures that can prevent a certain disease before it develops; and it includes health promotion efforts like encouraging healthy eating and exercise to prevent obesity, as well as protective measures like immunizations to prevent influenza, pneumonia, or COVID-19.

Next, secondary prevention is aimed at preventing disability or death by screening patients to detect disease early, such as mammograms to test for breast cancer or colonoscopies to detect colon cancer; and it includes providing prompt treatment if a disease is detected.

Then, tertiary prevention works to limit the impact of disease once a condition has already developed, such as cardiac rehabilitation for patients with heart disease or physical therapy for patients with spinal cord injuries.

So, when caring for your patient with chronic disease, begin by assessing their current health status by performing a physical assessment, noting any indications of disease progression.

Then, ask them if they’re having any difficulty performing activities of daily living, or ADLs; such as bathing, toileting, and eating; as well as instrumental activities of daily living, or IADLs, such as preparing food, taking medications, and keeping their living space clean.

Next, talk to them about their day-to-day activities as they manage their disease, including any specific lifestyle modifications and how well they can detect and manage symptoms or fluctuations in their health.

For example, for patients with type 2 diabetes mellitus, ask them about how they’re managing meal planning, exercise, blood glucose monitoring, and medication management, as well as how well they recognize and respond to symptoms of hypo- or hyperglycemia.

Also, be sure your patient has the resources they need to manage their chronic disease, such as adaptive equipment, testing supplies, medications, and transportation to appointments.

You’ll also want to check for any other factors that could interfere with your patient’s self-management, such as sensory deficits, cognitive impairment, level of health literacy, or financial constraints.

Remember to also assess their coping mechanisms related to life changes brought on by their diagnosis. Determine if there are any psychological factors, like stress or depression, that impact their ability to engage in self-management activities; and ask about how much support they have from family and friends.

After you’ve completed your assessment, evaluate the outcomes of the treatment plan, and collaborate with the health care team to provide additional resources or modify the disease management plan, as needed.

Now, when teaching your patient about their chronic disease, be sure to review the information they need so they can make informed decisions about managing their disease at home.

Use the information from your assessment to tailor your teaching to meet their individual needs and personal preferences, as needed.

For example, when reviewing their prescribed diet plan, include their preferred food choices whenever possible and consider how they could adapt to any meal preparation constraints they may have.

Finally, ensure they have understood your teaching by asking them to put the information in their own words, and allow plenty of time to answer their questions.

Alright, as a quick recap.... Illness refers to the personal experience of living with a biomedical disease, which can be either acute or chronic.

Chronic diseases can result in decreased physical functioning, productivity, and overall quality of life. Prevention of chronic disease can be primary, secondary, or tertiary.

Nursing considerations for a patient with a chronic disease include assessing their current health status and ability to self-manage their disease, evaluating the outcomes of the treatment plan, providing self-management education.