Asthma, a pulmonary condition, is a chronic respiratory disorder typified by persistent underlying inflammation of tissues, airway obstruction, congestion, hyperresponsive airways, and the narrowing of smooth airway muscle. Asthma is one of the most common chronic medical conditions in children and is the leading cause of school absenteeism. This chapter describes childhood asthma, including its causes and triggers. It elucidates the extant research supporting treatment of the disorder and provides step-by-step empirically based interventions to ameliorate asthmatic symptomatology in children. The psychological underpinnings of asthma have been investigated in the field of psycho-neuroimmunology (PNI), which examines the interplay of the central nervous system, neuroendocrine, and immune system with psychological variables and their relation to physical health. Researchers have shown that relaxation and guided imagery (RGI), written emotional expression, yoga, and mindfulness therapy improve pulmonary lung functioning, decrease rates of absenteeism, and improve overall quality of life.
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- Go to chapter: A Randomised Clinical Trial of the Effectiveness of Home-Based Health Care With Telemonitoring in Patients With Copd
A Randomised Clinical Trial of the Effectiveness of Home-Based Health Care With Telemonitoring in Patients With Copd
This chapter reviews the effect of telemonitoring in addition to usual care (TUC) compared to usual care (UC) alone in patients with chronic obstructive pulmonary disease (COPD). A total of 110 patients with moderate to severe COPD were recruited from a specialist respiratory service in Northern Ireland. Patients had at least two of: emergency department admissions, hospital admissions, or emergency general practitioner contacts in the 12 months before the study. Patients were randomized to receive 6 months of home TUC, or 6 months of UC. The primary outcome measure was disease-specific quality of life, as measured by the St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C). The total cost to the health service of the intervention over the 6-month study period was £2039, giving an estimated incremental cost-effectiveness ratio (ICER) of £203,900. In selected patients with COPD, telemonitoring was effective in improving health-related quality of life and anxiety.
The primary purpose of Module 3 of the MAC program is the understanding and exploration of values as a central orienting concept. In the context of understanding the important role of values in enhanced performance and quality of life, the functional and dysfunctional role of emotions is also considered. This chapter suggests to clients that their personal values will be the anchor point for all behavioral decisions that need to be made in the course of enhancing performance and achieving goals. The concepts of mindful awareness, mindful attention, and cognitive fusion and cognitive defusion become integrated with the concept of values-directed versus emotion-directed behavior. The Relevant Mindful Activity Exercise is intended to connect the mindfulness concept to a relevant performance situation in the client’s life. The question of personal values is particularly salient when confronted by the variety of emotions and internal rules that client confronts on a daily basis.
Incontinence is a personal challenge that imposes heavy consequences on individual quality of life and a high financial burden on national healthcare costs. Both women and men suffer with incontinence, but more women than men experience it, with a female-to-male ratio of 2.6. Smaller numbers of both sexes suffer from fecal incontinence. This chapter deals with urinary incontinence (UI) in women, but similar factors influence policy affecting UI in men and fecal incontinence. Estimates of the cost of UI include the direct costs of diagnosis, treatment such as medication or surgery, and routine care such as absorbent pads. Stress, urge, and mixed incontinence are the most common types of UI in women. Strong research support has accumulated in favor of choosing conservative approaches as the first-line treatment for all three types of incontinence common in women. These practices include pelvic floor muscle training, bladder training, and the Knack Maneuver.
Children with neurofibromatosis type 1 (NF-1) and Tourette syndrome (TS) may present with undiagnosed symptoms to the pediatric primary care office. This chapter provides an in-depth discussion of the childhood presentations for NF-1 and TS with a focus on the cognitive, emotional, social, psychological, and developmental and behavioral health. Treatment strategies, including medical and behavioral therapy, are presented for children with these disorders to intercept behavioral health problems as early as possible with the goal of achieving behavioral health that enables the child to grow and interact within the family, school, and other community activities with a positive self-esteem and self-image. The key to intercepting behavioral health problems in children with NF-1 or TS is early identification and treatment of the conditions, recognition of potential problems, and implementation of evidence-based interventions. These actions can reduce symptoms and distress of the condition and help to improve their quality of life.
When the perpetrator is the client’s own body, the Illness and Somatic Disorders Protocol can be used. It is important to note that this protocol addresses both psychological and physical factors related to somatic complaints. For many, addressing the psychological dimensions will cause partial or complete remission of the physical symptoms. When primarily organic processes are involved, the psychological issues may be exacerbating the physical conditions. While physical symptoms may not remit, the clinical emphasis is on improving the person’s quality of life. Eye Movement Desensitization and Reprocessing (EMDR) has also been used in the hospital to assist clients who are suffering from intractable pain to let go of the guilt they feel about wanting to die and be released from the pain. There are many ways to bolster the immune system in order to facilitate the healing process, however, death may be inevitable for some clients.
The dietitian plays a crucial role in the delivery of the care to the patient for treatment of obesity. As an integral part of the health care team, the dietitian is responsible for helping to maintain good health and quality of life for the patients. The Academy of Nutrition and Dietetics Nutrition Care Process includes nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation. Body weight and changes in body weight nutrition screening should begin with measurement of height and weight along with calculation of body mass index (BMI). Nutrition screening should also include an assessment of dietary intake. Information on food intake can be obtained by a number of methods, including: 24-hour food recall, food frequency questionnaire, food record, and diet history. Nutritional adequacy established from dietary history and food intake records coupled with anthropometric and biochemical measures provides baseline data.
This chapter describes the basic features of person-centered care. A variety of factors contributes to person-centered care, including consistent assignment of staff, effective communication, empowerment of residents, and promotion of a meaningful life for residents. Being cared for by the same staff on a regular basis fosters residents’ ability to receive person-centered care. The ability to choose when and how care will occur and the type of activities that they wish to engage in fosters an active role for residents in their care, respects them as adults, and enhances quality of life. Helping residents achieve the highest possible level of physical, mental, and psychosocial function and well-being are crucial elements of person-centered care. Promoting physical activity not only carries many benefits for physical health, but also enhances residents’ confidence and independence, which influences quality of life.
This chapter provides a summary of the use of CARES tool through the exploration of Steven’s active dying process. It is hoped that the CARES tool increases health care providers’ awareness of the extensive and unique needs of the dying and the family. The skills required are not complex or high tech. The curative focus of health care must be tempered with an acceptance of the need for compassionate, empathic, evidence-based end-of-life care. Comfort and quality of life must have a respected place in health care culture. Death should only be viewed as a failure by health care providers if the patient and family are allowed to suffer. The extensive knowledge available on care of the dying can prevent suffering during the dying process, but this knowledge has yet to be made a standard of care.