Management of Chronic Diseases

Chronic diseases are diseases of long duration and generally slow progression. Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality in the world, representing 63% of all deaths. Out of the 36 million people who died from chronic disease in 2008, nine million were under 60 and ninety per cent of these premature deaths occurred in low- and middle-income countries.Because often characterized by common risk factors, many of these diseases are preventable. One of the major goals of all E.U. Member States is the consolidation of a more equitable access to effective treatment of chronic disease across the EU, something that could bring significant benefits to the health and economy in all European countries.

The diagnosis of a chronic disease is a fact that all people are afraid and anxious of occurring sometime in their lives. In some of them this fear is luckily to become a reality and so they have to face new challenges that undermine their basic defenses and the living conditions that were set till then in their daily lives.

Along with the diagnosis of the disease, the patient is confronted with an uncertain future and a sense of loss of control over vital aspects of his life. The sense of the unknown scares the patients. Certain questions are emerging about how to deal with the disease, and how to continue in everyday life and future. Denial, anger, social withdrawals are characteristics of the first reaction of the patients when they learn they have been diagnosed to a chronic disease. Initially, one may feel that his feelings are ‘frozen’, that does not feel ‘nothing’. Awareness is certainly painful when this initial ‘numbness’ begins to subside and the feelings come back strongly. At this stage the patient needs special psychological help to begin to adapt and reconstruct his personal relations and everyday life on a new basis. He enters the phase of renegotiation of losses. But what has actually been lost?

More specifically, we refer to losses concerning the functional level and the physical manifestations of the disease and thus the person’s ability to perform daily activities, take care of himself and so on. At the social level, the outcome often depends on the nature of the disease. Deadly diseases can trigger anxiety and lead the patient in the decision to avoid his direct friendly environment while chronic diseases generating social stigma may also lead to marginalization. The losses at the professional level also depend on the nature of the disease. Many patients with chronic diseases necessarily retire or they experience a significant reduce of their ability to work, which means that their professional identity is lost and something that usually produces a lack of self esteem and the guilt that they can no longer be useful.

Pain management during the course of the disease is also important on many levels. How is it to live with pain? Can sufferer find within himself the mental strength to cope with chronic pain; The nature of the disease dictates uncontrollable crises and periods of intense pain and powerlessness and loss of control. In what ways can someone be reconciled with this new situation?

What to do

Addressing the challenges posed by a chronic disease on psychological and emotional level requires a pragmatic and above all, positive approach. The adjustment to the new situation or the choice to be optimistic about the future may initially seem in vain, but it is possible. A recent study about patients with kidney problems who were subject to weekly dialysis, found that the predisposal and the will for life did not differ from the control group consisted of healthy participants.A psychologist can help a chronic disease patient to gain the emotional strength he needs to deal with the difficulties caused by a chronic condition. The psychologist in cooperation with the physician and other specialists that may follow the patient, can help him obtain the appropriate coping strategies, which not only enhance the treatment program he is under, but also contribute to the overall prosperity of his life despite any existing physical difficulties.

There are other possible proposals to address a chronic disease patient, including:

  • Keep your contacts. Build and maintain quality relationships with friends and relatives. Many health organizations support groups composed of individuals who face similar situations. These groups will not only help your wellbeing but will offer an extremely important opportunity for you to help others.
  • Take care of yourself. Do not let the uncertainty about your health condition hinder you from eating well, get plenty of rest, exercise and have fun.
  • Keep your everyday tasks, obligations and hobbies as much as you can. This will provide stability in an otherwise chaotic environment that the uncertainty of your illness may cause.


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