Diabetes Denial

  • 348 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
348
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
17
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Management of chronic diseases
    • Nature
    • Incurable
    • Mostly silent
    • Persisting pain if at all
    • No correlation between complaints and lab data.
    • Uncertain progress
    • Lifestyle related
    • Treatment
    • Important
    • Variable effects
    • Patients need self discipline
    • Costs are mental, professional, social and financial
    • Patients
    • Need to control it even though incurable
    • Juggle between treatment and life
    • As vigilance lessens problems increase
    • Has to be trained to handle acute crisis.
    • Doctors
    • Prescribe but not control fully
    • Need to share knowledge and foster attitudes
    • Intervene in emergency
    • Detect complications early
    • Should work in a team
  • 2. Two types of responses to initial shock of chronic illness*
    • Integration Process
    • Disbelief
    • Revolt (accusation)
    • Depression (sadness for health lost)
    • Confronting reality
    • Consenting (coping) with serenity
    *Lacroix A., Therapeutic Education 2003
    • Distancing Process
    • Anguish (medical team could cause it)
    • Denial of emotions (sense of shame/ suffer in silence)
    • Passive resignation
    • Meloncholia (may need psychiatric help)
  • 3. Doctor’s role of patient’s health belief model
    • Patient should be convinced that he is ill.
    • He must believe there could be serious consequences because of this illness
    • He must believe treatment will be beneficial
    • He must believe that the benefits will be more than psycho-social and financial side effects of the treatment.
    • These can be discovered only by “semi directive interviews” which convince the patient that interest being shown in him is not merely biological.
    • This shifts the locus of control to the patient.
  • 4. Empathy is the key to success
    • Empathy is not sympathy
    • Empathy is adult to adult
    • Empathy demands sincerity
    • Empathy demands dedication
    • Empathy creates trust and loyalty
  • 5. Th. Arrivaali (the knowlegeble)
    • Believes prevention is better than cure
    • Likes to be independent
    • Positive about life despite diabetes. Follows diet and leads a disciplined life
    • Well-informed: collects printed articles on diabetes & attends seminars
    • Motivated enough to exercise regularly, believes in timely medication, does not add sugar to food
    • Practices self monitoring and self injection, visits doctor less often, family involvement is very high, calm and collected during hypos - knows what to do.
    • Knows the severity of the ailment
    Age: 55-60 years Diagnosed since at least 8 -9 yrs.
    • Gender:
    • Mostly males/some females in south
    • Also seen in diabetic couples
    • Region:
    • Mainly South India
  • 6. Th. Bhayanthavar (the Scared) Recently diagnosed
    • Gender:
    • Equal proportion
    • of males & females
    Age: 40-45 years Region: Northern & Western India but a rare case in the south
    • Constantly curses his fate ‘Why me??’
    • Apathy in gaining knowledge about diabetes
    • Dependence on others …lack of faith in self
    • Looks upon diabetes as a demon controlling his life
    • Resents the rigid lifestyle. Claims that he feels dead from within.
    • Visits the doctor every 7 - 15 days and hoping to achieve better sugar control thereby
    • Cannot overcome the craving for sugar and sweets, family involvement in managing diabetes in low
    • Dependence on others for taking insulin injections
  • 7. Th. Parkalaam (the casual) Living with the disease for long
    • Gender:
    • higher proportion amongst housewives than males
    Age: 40 +years Region: Northern & Western India but a rare case in the south
    • Relaxed attitude towards self care, health and diabetes…no drive to seek knowledge
    • Feels defeated. Dislikes rigid and disciplined lifestyle
    • Considers self as least important member of the family. Family too attaches low importance to her health.
    • Believes, “God gives so he will manage it…”
    • Ignores diabetes until complications set in
    • No exercise, poor compliance to dosage schedule and no diet control
    • Visits doctor only for emergencies
  • 8. Th. Kurukku vazhi (the myopic)
    • Gender:
    • Equal proportion amongst Males and Females
    Age: 5 0 - 60 years Region: Spread across regions, fewer in south Diagnosed since at least 8 -9 yrs.
    • Convenience very important, looks for excuses to postpone treatment
    • Low awareness and lacks interest to increase it. Looks for ways to end the treatment. Keeps asking how long treatment will go on
    • Wants maximum results with minimum effort. Thinks only of short term
    • Convinces the doctor to postpone insulin treatment, continues on orals even when they have failed
    • Does not find even 10 minutes for regular exercise, cites paucity of time as main reason
    • Maintains good diet control. Avoids oil and sugar completely.
  • 9. Th. Yavum Arivom ( I Know it all) Recently diagnosed
    • Gender:
    • Mainly Males
    Age: 40 - 45 years Region: Not very region specific, but none found in South
    • Low awareness, but claims knowledge
    • Experiments with different medications without the doctor’s consent
    • Gets information from diabetic friends & relatives rather than professionals
    • Takes risk. Will try all the possible remedies including unproven and herbal
    • Avoids visiting the doctor to labs; feels it is a waste of money
  • 10. Patient segments Positive attitude to treatment Scared Negative attitude to treatment Knowledgeable Low levels of awareness Myopic I Know it all Casual High levels of awareness