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Unit 3
Applying concepts from the nursing process
composed of the elements illustrated in Figure 10-3 and has the
following objectives:
•
Prevent and/or delay the onset of chronic illness for
individuals and population groups
•
Reduce the progression and complications of chronic
illness
•
Maximise the well-being and quality of life of individuals
living with chronic illness and their families and carers
•
Reduce avoidable hospital admissions and healthcare
procedures
•
Implement best practice in the prevention, detection and
management of chronic illness
•
Enhance the capacity of the healthcare workforce to meet
population demand for chronic illness prevention and
care into the future (NHPAC, 2006).
In 2009, the National Preventative Health Taskforce
released the National Preventative Health Strategy that
focuses on the preventative causes, smoking, alcohol over
consumption and obesity, which underpin many chronic
conditions.
Characteristics of chronic conditions
In all illnesses, but even more so with chronic conditions, the
illness cannot be separated from the person (Fig. 10-4). People
with chronic illness must contend with it daily. Characteristics
of chronic illness include the following:
•
Managing chronic illness involves more than treating
medical problems. Associated psychological and social
problems must also be addressed, because living for long
periods with illness symptoms and disability can threaten
identity, bring about role changes, alter body image and
disrupt lifestyles. These changes require continuous
adaptation and accommodation, depending on a person’s
age and situation in life. Each decline in functional
ability requires physical, emotional and social adaptation
for patients and their families (Lubkin & Larsen, 2013).
•
Keeping chronic conditions under control requires
persistent adherence to therapeutic regimens. Failure
to adhere to a treatment plan or to do so consistently
increases the risk of developing complications and
accelerating the illness process. However, the realities
of daily life, including the impact of culture, values
and socioeconomic factors, affect the degree to which
people adhere to a treatment regimen. For example,
approximately 40% to 60% of individuals do not adhere
to their prescribed medications and this risk increases as
the number of medications increases. Managing a chronic
Level 3
High complexity
Care coordination
Prevention activities
Level 2
High risk
Disease/care management
Level 1
70–80% chronic disease population
Self-management support
Figure 10-2
Levels of healthcare for people with
chronic disease.
(Redrawn from National Health Priority Action
Council. (2006). National Chronic Disease Strategy
(Fig. 1, p. 4). Canberra: Australian Department of
Health and Ageing. Viewed April 2013 at www.
health.gov.au/internet/main/publishing.nsf/
Content/7E7E9140A3D3A3BCCA257140007AB32B/$File/
stratal3.pdf. (Copyright Commonwealth of Australia,
reproduced by permission.))
Figure 10-3
Core elements of the continuum of chronic
disease prevention and care.
(Redrawn from National Health Priority Action Council. (2006). National
Chronic Disease Strategy (Fig. 2, p. 8). Canberra: Australian Department
of Health and Ageing. Viewed April 2013 at
/
main/publishing.nsf/Content/7E7E9140A3D3A3BCCA257140007AB32B/$File/
stratal3.pdf. (Copyright Commonwealth of Australia, reproduced by
permission.))
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Early detection
Assessment
End-of-life care
Ongoing
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Rehabilitation
Psychosocial
support
Care coordination
Self-management
support
Multidisciplinary
care planning
and review
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Person, carer
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Evidence-based
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