Adaptation in chronic illness: an eclectic model for nurses

Abstract

The growing prevalence of chronic illness is due, in large part, to the control and/or eradication of infectious diseases as well as, in North America, the increasingly aged population and overall lengthening life span. Although the trajectory of chronic illness is in a generally downward direction, the rate of progression may vary as plateaux an remissions occur. As these changes occur, the individual and his family move through a process of continual adjustment. This paper presents a conceptual model of the process of adaptation in chronic illness. The primary concept in the model is appraisal (Lazarus, 1966) and the thought that continuous appraisal/reappraisal of the individual's progress toward the goal of adaptation is required by the individual, his family, and the nurse. The focus of the model is the chronically ill individual and his family. The goal is movement toward adaptation to the illness and its ramifications. The process is caring, which facilitates movement towards the goal. The model and its interpretation are outlined in the paper. Finally, some strategies for nurses, and others, are suggested as ways in which the concepts may be applied and implemented in practice.

Analysis of the stressful effects of hospitalisation and source isolation on coping and psychological constructs

“…Research has validated that these psychological constructs are reliable indicators of coping. 27,28,35,49,52–54 However, their application to the measurement of coping amongst patients in isolation is novel.…”

“…Support for the results of the first aim is provided by Craig and Edward. 54 They suggest that anxiety can be lessened by effective coping, while ineffective coping results in higher levels of anxiety. As noted, anxiety is widely regarded as a valid indicator of a person ’ s coping ability.…”

The concept of hope revisited for nursing

“…The development of nursing knowledge and interventions involve understandmg human responses and needs The human response of hope was identified as a concept m need of further danficahon The purpose of this paper was to review definitions and contextual usage of the word 'hope' from the hterature and answer the conceptual question 'What is hopef Literature from theology, philosophy, psychology and nursing was reviewed for contextual usage of the word 'hope' In the hterature, hope was viewed as part of human development, a process, a theory and a source of meaning in life In addition, antecendents, attributes and outcomes of hope were identified from the literature that contnbuted to a clearer understanding of the concept HOPE AND HUMAN EXISTENCE Withm the old proverb 'where there's life, there's hope' is the thought that hope belongs mseparably with human existence (O'CoUms 1969) Over the past several years, attempts have been made m different disaplmes to understand hope withm the life of an mdividuai Hope has been assoaated with mearung and value m life (Crumbaugh & Niahohc 1964, Frankl 1959, Travelbee 1971, and has been considered to be an essential component m human development (Enckson 1964, Green 1977, McGee 1984 Several writers have suggested that hope is a prerequisite for effective coping and deasion-makmg (Craig & Edwards 1983, Lazurus 1966, McGee 1984, Stotland 1969 In health care…”

“…In health care, hope has been mcorporated into the concept of carmg (Mayeroff 1971, Watson 1979 Hope has been impbcated as a factor m maintammg and regainmg health (Dufault & Martocchi 1985, Green et al 1982, Vaillot 1970, Watson 1979 and accepting illness-related limitations or dymg (Hmds 1988, Owen 1989, Wnght & Shontz 1968 The level of hope seems to be a factor m the eflfectiveiwss of psychiatnc mterventions (Beck & Weissman 1974 Enckson et al 1975, Menninger 1959, Perley et al 1971 and adaptation to chronic illness (Craig & Edwards 1983, Mandenno & Bzdek 1986, Miller 1983, O'Malley & Menke 1988, Wnght & Shontz 1968 Hope has also been studied as a vanable m the occurrence of, and recovery from cancer (Hickey 1986, Hmds & Martin 1988, Mishel et al 1984, Nowotny 1989, Owen 1989, Schmale & Iker 1966, Stoner & Keampfer 1985 As a result of these studies, knowledge about hope and its therapeutic value is begmnmg to emerge However, a clear understandmg of the word hope is not always evident Walker & Avant (1988) have suggested the process of concept analysis to danfy the mearungs of words and/or concepts Through the process of concept analysis, definitions, charactenstics and attnbutes of a concept can be identified to assist with further research…”

Time-Related Centile Ranges for Quality of Life Outcomes in Renal Transplantation

“…Support groups provide a similar function and have been shown to relieve some of the anxiety associated with chronic illness when individuals find that their feelings and experiences are not unique to themselves but are shared by others and are a product of their situation (Mechanic, 1977). Seeking information, whether it is from health care providers or others who have had the same or similar experiences, aides in coping with and in adaptation to chronic disease (Craig & Edwards, 1983).…”