Health Promotion

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Family health promotion

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Families With Chronic
Illness

• Chronic illness not only affects the lives of infants,
children, adolescents, young adults, older adults,
elderly, and the old-old, but also the physical, emotional, intellectual, social, and spiritual functioning of
multiple family members. Wide variations exist in the
ways chronic illness affects physical and men- tal
health, employment, social life, and longevity. Chronic
illness for an individual can entail single or multiple
illnesses or conditions that last or are per- sistent over
time. For example, a person that is newly diagnosed
with type 2 diabetes may also have hypertension,
hyperlipidemia, and neuropathy that are often linked
with this diagnosis. The person could also have a
condition that is unrelated, such as arthritis, asthma, or
even Alzheimer disease as they age.

• Differences in the ways families accommodate a chronic
condition are influenced not only by the level of
disability and associated symptoms, but also by the
individual and family perception about the disability.
Care needs can also differ depending on whether the
symptoms are constant (e.g., those associated with
cerebral palsy), episodic (e.g., those associated with
migraine headaches), relapsing (e.g., those associated
with sickle cell anemia), worsening or progressive (e.g.,
those associated with multiple sclerosis or cer- tain
types of cancer), or degenerative (e.g., those linked
with Alzheimer disease and Rhett syndrome).

• Regardless of the type of chronic illness experi- enced,
family members are involved at several levels,
depending on the age of the individual, the condition
being cared for, previous family experiences, levels of
expertise, unique relationships, and behavioral patterns. Over time, family is the biggest resource for care
of individuals with chronic illnesses. Family members
are the most enduring care providers, and offer the
constancy and continuity of care needed. Professionals
come and go, offering medical manage- ment,
education, and counseling as needed, whereas family
members provide ongoing and persistent care across
time.

• Increased hospital and medical center care has shifted the
primary focus of care delivery from care of acute conditions to
care of acute complications of chronic diseases such as heart
attacks and strokes, and the delivery of episodic care related to
chronic illnesses. Although this trend has signifi- cantly reduced
infectious diseases, the incidence of new diagnoses and new
complications of chronic illnesses has continued to increase. This
is partly due to our aging society, but it is also linked to
treatment of illness conditions and complications as they occur
rather than focusing on prevention of the occurrence or delay in
the onset of the chronic conditions (e.g., heart disease,
Alzheimer disease), or the prevention of preventable
complications (e.g., kidney failure with diabetes). Many clinicians
agree that much of the chronic-disease burden is preventable
through management and modification of lifestyle behaviors
(Glasgow et al., 2001).

• An- other contributing factor to the increase in chronic
illnesses is the growing concern about low health
literacy, with many lacking access and understand- ing
of wellness and healthy lifestyle behaviors (e.g., healthy
nutrition, activity, stress management) that can prevent
or delay illness onset, influencing the ef- fectiveness of
health care for many families.

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