Onset Of Chronic Illness Research Articles

Health promotion for the elderly persons in Hong Kong.

By the year 2000, there will be one million elderly persons in Hong Kong. With the rise of an older population, the cost of health care is likely to increase. Studies conducted in Hong Kong have shown that over 30% of health care expenditure is spent on the elderly. Unless steps are taken to slow the onset of chronic illnesses in elderly people, health care expenditure will increase rapidly in the future. The present paper describes strategies that have been adopted for promoting a healthier elderly population in Hong Kong. The paper also reports the results of an evaluative study on the largest health promotion program for older people in Hong Kong. It seems to show that health promotion activities may have the potential to save lives, delay institutionalization, and improve life satisfaction.

Prevention of Relationship Problems: Retrospect and Prospect

Whilst nearly all couple relationships start out happy, half of all marriages end in divorce. Relationship education is a potentially effective strategy to reduce the prevalence of relationship problems and divorce. The substantial empirical research on the determinants of relationship satisfaction shows that there are key relationship skills, such as communication and conflict management skills, which impact on the course of relationship satisfaction and stability. Relationship education can teach couples these key relationship skills, and this may prevent relationship problems. However, relationship education is not targeted at those couples who need it most. Research needs to be focused on the effects of relationship education for couples at high risk for relationship problems. The reach of education programs to couples can be enhanced by developing flexible delivery education programs. Relationship education programs also need to promote coping with stressful events that often lead to relationship problems, such as the transition into step-families, the onset of chronic illness, and unemployment.

The Onset of Chronic Illness: Its Effect on the Patient-Spouse Relationship

The purpose of the present study was two-fold: (1) to examine changes that occur in the patient-spouse relationship when one couple member becomes chronically ill and (2) to link those changes to adjustment. Patients hospitalized for a first coronary event were interviewed along with spouses shortly before discharge and at 3 months and 12 months following discharge. As predicted, dialogue centering on the patient's illness, a shift in household responsibilities from patient to spouse, and changes in the support spouses provided to patients occurred. A shift in responsibilities from patient to spouse was adaptive for patients during the initial phase of adjustment but maladaptive during the later phase of adjustment; the shift was always maladaptive for spouses

Maintaining identity in elderly couples with chronic illness.

With the onset of chronic illness, it has been necessary for these couples to evaluate and redefine their separate as well as merged identities. As each of these individuals sought to realize a mature identity, role adjustments were required. Although not every member of the two illustrated couples had been able to accept the effects and concurrent responsibilities of chronic illness, the nurse practitioner was in a unique position to provide guidance. By reinforcing the importance of healthy identity states, these clients were able to merge temporarily and respond to their partner's basic needs, exchanging a sense of mutual satisfaction, and then to separate into distinct individual identity states. A major task of the older adult is to re-evaluate identity in light of the roles currently being played in life. Through this process, a workable philosophy of life and death should evolve. Most older people engage in a life review of accomplishments and failures, seeking to integrate the diverse elements to obtain an acceptable view of their life's worth (Kaluger, 1984). Couples experiencing chronic illness must reconsider the consequences of this illness state to adequately formulate healthy individual and merged identities. The role of the nurse practitioner is essential in providing guidance for adapting to the life changes confronting elderly couples with chronic illness while maintaining healthy individual and merged identities.

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.

Some changes in the sleeping and eating patterns of fifty patients with long-term illnesses

An interview guide was devised and administered to 25 homebound and 25 ambulatory patients with chronic illness in order to determine their nursing needs. A particular purpose of the interviews was identification of changes in the patients' eating and sleeping habits and problems arising therefrom that might be solved by better nursing care. Nearly all the 50 patients interviewed were found to have some change in sleeping and eating habits since the onset of chronic illness. There was a larger proportion of disturbing changes in sleeping patterns. Some patients had actually improved their eating habits as a result of diet instruction in connection with their treatment. Various ways that nursing care may be improved as a result of identifying problems through the use of an interview guide are discussed. It is concluded that much can be done along these lines to contribute to the welfare and comfort of patients with chronic illness.