Chronic Illness (Essay Sample)

CHRONICITY
QUESTION 1
Chronicity is a complex term to define. Many authors have attempted to provide a distinct definition of chronicity but still none has come up with a clear succinct definition. The Australian Commission on Chronic Illness defines a chronic illness as an alteration of the body’s anatomy and physiology resulting into a permanent and residual disability that would require a long period of care, observation and a possible rehabilitation (Lubkin & Larsen 2013,p.3). A long-term disability is not necessarily about its nature and severity on the physical body of the patient but also its effects on the psychosocial well being of the patient (Suzanne 2014). The nature of the disease does not relate in any way to the perception of the patient about possible alteration of lifestyle, the level of disability and the socio-economic effects (Hickman, Rolley & Davidson 2010,p.64). In broad terms, chronicity can be defined in two ways. It is a disability resulting from the disease condition itself, or effects of therapeutic interventions on the individual. From a nursing perspective, the illness approach rather than the disease approach is important especially in chronic illness management. By definition, disease is the alteration of the body’s functioning while an illness is the effect of the disease on the individual, the family and the care providers. Illness entails how the disease is perceived, managed and responded to by all the stakeholders (Purdy 2013,p.17). Most of the chronic illnesses are associated with depression (Lubkin & Larsen 2013,p.4). A combination of the disease, the resultant depression and the resulting effects is a lethal combination the leads may to early graves (Lubkin & Larsen 2013,p.3). Nursing provides a holistic care approach that is centered on the disease and its potential non related effects such as depression. Whereas nursing cannot cure the disease it can make a difference in the patient throughout the illness experience in a positive manner thus reducing the rates of morbidity and mortality (Hickman, Rolley & Davidson 2010,p.64). Nursing care seeks to make a difference in the disease experience and not the disease process (Suzanne 2014).
References
Hickman, D., Rolley, J. & Davidson, P., 2010, 'Can principles of the Chronic Care Model be used to improve care of the older person in the acute care sector?', Collegian , pp.63-69.
Larsen, P. & Lubkin, M., 2009, 'Chronic Illness: Impact and Intervention. Sydney: Jones & Bartlett Learning, pp. 34-35.
Purdy, J. 2013, ‘Chronic Physical Illness: A Psychophysiological Approach for Chronic Physical Illness’, Yale Journal of Biology and Medicine , vol. 86, no.1, pp. 15–28.
Suzanne, R.2014, ‘Lecture 1: Introduction to the Subject: Defining chronic and complex illness: Impact on the patient’,UTS Lectures 2014, Lecture Notes, UTS, Sydney, viewed 12 September 2014,< https://online.uts.edu.au/bbcswebdav/pid-990029-dt-content-rid-5484720_1/xid-5484720_1>
Suzanne, R.2014, ‘Lecture 2: Depression a Significant Co-morbidity in Chronic Illness ’,UTS Lectures 2014, Lecture Notes, UTS, Sydney, viewed 12 September 2014,< https://online.uts.edu.au/bbcswebdav/pid-1014499-dt-content-rid-5484719_1/xid-5484719_1>
QUESTION 3
The National Primary Health Care Strategic Framework was approved and adopted by the Australian government in April, 2013. It was developed by the commonwealth, state and territories health departments and the approval was done by Health Ministers, through the Standing Counsel on Health. The framework was developed as a result of the increasing prevalence of the ageing population and concurrently an increased prevalence in chronic illnesses (National Primary Health Care Strategic Framework 2014,p.1). The framework aims at achieving equitable, safe, effective, sustainable and affordable health care services to all citizens of Australia. The framework’ objective is to improve the health care services to Australians paying particular emphasis on individuals with inequitable access to them. It seeks to keep all citizens of Australia healthy. It seeks to reduce the number of preventable illness and to reduce unnecessary hospital admissions and presentations. On its objective on complex and chronic illnesses, the framework aims at improving their management. The Australian government sought this framework for the sole reason that evidence points to the fact that health systems with stronger primary health care are more efficient, have fewer health inequalities, reduced number of hospitalizations, and a lower mortality rate. It was adopted after a wide national consultation (National Primary Health Care Strategic Framework 2014,p.1).
On chronic illnesses, the National Chronic Disease Strategy provides the framework for the management and care or complex and chronic illnesses. It covers diseases such as cancer, asthma, diabetes, cardiovascular diseases, rheumatoid arthritis, osteoarthritis, and osteoporosis. In the year 2005, other diseases were added onto the list and they include mental health, obesity, dental heath and injury prevention and control (Suzanne 2014). It identified the risk factors for the development of chronic illnesses and settled on a strategy to prevent them. It also categorized care for chronic illness into three levels. The policy identified four key action areas that entail prevention across a continuum, early detection and early treatment, integration and continuity of care and prevention, and self management. Its particular objectives on chronic illness, it seeks to prevent and possibly delay the onset of chronic illness for an individual or a group of individuals. It aims at providing maximum care for individuals with chronic illnesses and offer support to their families. It seeks to reduce the number of hospital admissions while improving the quality of life for individuals with chronic diseases. It aims at providing best practice care in the prevention, detection and care of chronic diseases. Finally, it aims at enhancing the capacity of the health care team to meet the population demand of chronic disease management in preparation for future challenges (Suzanne 2014).
The Australian government initiatives are a welcome gesture. At least it lays down structures to deal with the increasing prevalence of chronic illness. However, there are challenges to the implementation of these initiatives. There is a concomitant increase in multi-morbidity in aged individuals with chronic illness. This creates a vicious cycle with more and more time spent on preventive measures (Aspin et al. 2010,p.386). The National Primary Health Care Strategic Framework capitalizes on this deficit and attempts to focus more on preventive strategies. That is good enough. The policy does not address co-morbidity. Most chronic illnesses have other co-morbid conditions related either directly or indirectly to the chronic condition. The policies focus on primary care of the main known chronic illnesses but fail to address the co-morbid conditions. The implementation of these policies requires heavy funding; however there has been a proposed Federal Budget Cut (Suzanne 2014). The challenge is: will they survive the cut? Or is there a need to review the policies? Implementation of the initiatives will require collaboration with other care agencies interested in the management of chronic diseases. Agencies such as New South Wales Chronic Care Network, ACI Networks would provide a more structured and collaborative approach that would see the effective implementation of the policies. In order to effect a widespread change, a national strategy aimed at primary care would suffice if they are more integrated, simpler to understand and are not burdensome administratively (Harris & Zwar 2007,p.104)
References
Aspin, C., Jowsey, T., Glasgow, N., Dugdale, P., Nolte, E., & O’Hallahan, J. 2010, ‘Health policy responses to rising rates of multi-morbid chronic illness in Australia and New Zealand’, Austarlian and New Zealand Journal of Public Health , vol. 34, pp.386-93.
Harris, M., & Zwar, N. 2007, ’Care of patients with chronic disease:. Medical Journal of Australia , vol. 187,pp. 104–107.
Standing Counsel on Health 2013, National Primary Health Care Strategic Framework, Australia, viewed 12 September2014,
Suzanne, R.2014, ‘Lecture 4: The impact of policy on chronic and complex care. Future directions for chronic illness management in the Australian context’,UTS Lectures 2014, Lecture Notes, UTS, Sydney, viewed 12 September 2014,
QUESTION 4
The prime contact between the patient and primary health care was the General Practitioner. However, there is a new emerging role for the practice nurses in Australia in the care of patients with chronic illness. There is a mutual agreement that care cannot be provided as it has always been done before. There is an increasing demand for health care services, an increased cost of health care, expanded service and a workforce shortage in Australia and other governments in the twenty first century. It would only be imperative that health systems offer strategic solutions to deal with the current challenges facing health service industry in the respective countries (Merrick et al.2012,p.133).This puts the Practice Nurses on the spotlight. The general practitioners are overworked and would need to be offloaded with the care demands. Primary care is the channel through which patients are guided through the health system and ensures an effective relationship between the patients and the clinicians. In Australia, the government is putting up strategies that will impact on the provision of primary care touch on the role of each healthcare provide...