Term
| How long must an illness occur for it to be considered chronic? |
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Definition
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Term
| What are some characteristics of a chronic illness? |
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Definition
-Affects child’s daily activities
-Lifestyle change
-Requires hospitalizations/home health care/extensive medical care
-Continuous behavioral adaptation |
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Term
| What are some examples of a chronic illness? |
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Definition
-Asthma
-Congenital heart
-Seizure disorder
-Diabetes mellitus
-Genetic d/o: T21
-Cystic fibrosis
-Leukemia
-Arthritis
-Hemophilia
-Sickle cell anemia
-Renal failure
-AIDS
-Spina bifida |
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Term
| What percentage of americans do chronic illnesses affect? |
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Definition
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Term
| Most cases of chronic illness are mild, what are some examples of mild chronic illnesses? |
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Definition
| Allergies, acne, congenital deformity |
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Term
| What % of those with mild chronic illnesses survive to adulthood? |
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Definition
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Term
| What are some general signs/symptoms you might see in a person with a chronic illness? |
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Definition
-Loss of social/physical activities
-Extreme stress
-Physical differences |
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Term
| How can stress affect a child and how might they cope with it? |
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Definition
-Children are vulnerable to change
-Each child deals with stress differently
-May become introspective/withdrawn
-Older children: engage in substance abuse |
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Term
| What are some behavior issues you might see with younger children w/ chronic illnesses? |
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Definition
-Tantrums
-Sleep disorders
-Feel out of control of environment |
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Term
| What are some behavior issues you might see with older children w/ chronic illnesses? |
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Definition
-Sexual conduct
-Substance/alcohol abuse/cigarette use
-weapons |
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Term
| What happens to the rate of behavior disturbances for those with chronic illnesses? |
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Definition
| Chronic illness doubles the rate for behavior disturbances |
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Term
| What happens to the risk of behavioral outcomes as the severity/life threatening-ness of the disease increases? |
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Definition
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Term
| When is a patient with a chronic illness at the most risk for changing behavior? |
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Definition
| In the 1st year after the diagnosis |
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Term
| If a patient has an earlier onset of illness, what happens to the risk of behavioral problems? |
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Definition
| Lower risk in behavioral problems |
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Term
| What are some factors that affect behavior outcomes in children with chronic illnesses? |
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Definition
-Disease features
-Family dynamics
-Coping strategies |
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Term
| What is the most common behavioral outcome/change in a child with a chronic illness? |
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Definition
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Term
| What percentage of children with DM experience a behavioral outcome/change? |
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Definition
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Term
| What factors cause a lower incidence of behavioral changes/outcomes? |
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Definition
-family cohesion
-higher level of expressiveness
-lower family conflict |
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Term
| What are some characteristics of internalizing behaviors in children with chronic illnesses? |
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Definition
-Anxiety and depression
-Somatic complaints
-Social withdrawal
-Higher incidence vs. healthy children
-Subclinical: difficult to identify |
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Term
| What are some characteristics of externalizing behaviors in children with chronic illnesses? |
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Definition
-Aggression and non-compliance
-Not as common as internalizing
-Increase overall family stress |
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Term
| What are some characteristics of coping strategies for children? |
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Definition
-Must assess at visits
-Avoidance mechanisms: poorer outcomes
-25%: seek mental health services
-Depends on developmental stage |
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Term
| Coping strategies for dealing with chronic illnesses (first year of life, characteristics) |
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Definition
-Building trust/sense of security
-Do not understand illness
-Behavior: reflection of coping with pain, separation from parents
-Presence of parents essential
-I can be taken care of”
-“Other people can do things for me”
-“Life is better when I cry, mom comes and takes care of me”
-“When I am unhappy and crying, mom comes along and makes it better” |
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Term
| What is the order of stages in the oral cycle of bonding (1st year of life)? |
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Definition
| Need -> Rage (helplessness, hopelessness, anger) -> Relief (eye contact, smiles, touch, lactose) -> Trust -> Need |
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Term
| Coping strategies for dealing with chronic illnesses (second year of life, characteristics) |
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Definition
-Use stories/drawings to help understand illness
-Beginning explaining to child in simple words/ideas |
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Term
| Coping strategies for dealing with chronic illnesses (preschool age, characteristics) |
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Definition
-Developing independence
-Treatment: represents lack of control
-Often will test boundaries: to gain some sense of control
-Maintain firmness, but give options |
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Term
| Coping strategies for dealing with chronic illnesses (early school-age/5-8, characteristics) |
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Definition
-Magical thinking
-“ I caused illness with bad thoughts”
-Sense they are different
-Allow choice/sense of management of illness |
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Term
| Coping strategies for dealing with chronic illnesses (older school-age/preteen, characteristics) |
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Definition
-Understand illness and treatment
-Maintain regular schedules/friends and activities
-Honesty in treatment |
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Term
| Coping strategies for dealing with chronic illnesses (adolescents, characteristics) |
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Definition
-Own identity: separate from family
-Self image
-Denial of illness
-Help teens gain control of illness |
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Term
| What % of adolescents with chronic illess participate in risky behaviors? |
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Definition
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Term
| Are adolescents with chronic disease more likely to participate in risky behaviors? |
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Definition
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Term
| What are some characterisitics of risky behaviors in adolescents w/ chronic illness? |
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Definition
-More likely depressed
-More likely to smoke daily, current canabis users
-More likely to have performed violent or antisocial behaviors
-Problems gaining access to social peer groups
-Socialize more with risk-taking peers
-Greater need to be accepted
-Demonstrate their “normalcy”
-Higher rates of emotional distress
-Believe they have “shorter life span”
-Feel more reckless, “live life to fullest”
-Behaviors: lead to increased disease complications |
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Term
| Do adolescents with chronic illnesses infrequently receive preventative counseling? |
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Definition
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Term
| What are adolescents with chronic illnesses uncommonly screened for? |
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Definition
| substance abuse/sexuality issues |
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Term
| Why are adolescents with chronic illnesses infrequently counseled on prevention and substance abuse/sexuality issues? |
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Definition
| less likely to be alone with physician |
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Term
| Where does greater emphasis need to be placed on adolescents with chronic illnesses? |
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Definition
| on preventative counseling |
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Term
| adherence to treatment (under age 8) |
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Definition
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Term
| adherence to treatment (12-14 years) |
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Definition
| understand link between actions and effects on illness |
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Term
| Adherence to treatment depends upon what 3 factors? |
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Definition
-Complexity of regimen
-Stages of disease (asymptomatic: decreased adherence)
-Family dynamics |
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Term
| How does one deal with behaviors resulting from chronic illnesses? |
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Definition
-Build self-concept
-Share control/decision-making
-Provide empathy before consequences
-Share thinking/problem solving |
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Term
In children with chronic illness, at what time after diagnosis of illness, do behavioral issues most commonly emerge?
A) within one month of dx
B) within 6 months of dx
C) within one year of dx
D) between 1-2 months after dx |
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Definition
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Term
Concerning behavioral issues, which strategy is most apt to produce positive results?
A) allow some “bending” of rules, since they are dealing with health issues
B) re-enforce positive behavior with rewards
C) only point out negative behavior
D) allow child to have some decision-making in the process of treatment, feeling of control |
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Definition
| D) allow child to have some decision-making in the process of treatment, feeling of control |
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Term
What would be an essential portion of a health care visit for a adolescent patient with chronic illness?
A) discussion of family issues
B) evaluation for depression/anxiety about illness
C) inquiry about drug/alcohol/tobacco usage
D) inquiry about progress in school
E) their perception about weight issues |
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Definition
| C) inquiry about drug/alcohol/tobacco usage |
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Term
A two month old female with a congenital heart condition, has been hospitalized since birth. Parents have been present for the majority of the time at her bedside. What situation describes a normal development pattern for a newborn with a chronic condition?
-During blood draws, baby does not cry or notice the needle
-Avoids smiling/cooing at her caregivers
-Baby sleeps for only one hour at a time both day and night
-When patient cries, caregivers respond, causing baby to be soothed and comforted quickly. |
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Definition
| When patient cries, caregivers respond, causing baby to be soothed and comforted quickly. |
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