Chronic medical conditions impose significant burdens on patients and their families, often requiring ongoing management and lifestyle adjustments. The document outlines the typical emotional responses to a chronic diagnosis, including shock, disorganized thinking, and avoidance strategies, as well as the coping mechanisms influenced by illness-related and personal factors. Ultimately, the adjustment process involves cognitive appraisal and developing coping skills tailored to the individual's situation.

1. CHAPTER FOUR
Chronic Medical Disease and
Behavior

2. Overview
• Chronic illnesses, such as asthma, AIDS,
cancer, coronary heart disease and multiple
sclerosis, are another important focus for
health psychologists.
• having a chronic condition entails frequent
impositions on the patients and their families.

3.  Chronically ill people may suffer periodic episodes of
feeling poorly and need to have regular medical
checkups
 Restrict their diets or other aspects of their life
styles or administer daily treatment,
 For instance. Many chronic conditions entail more
than just impositions they produce frequent pain or
lead to disability or even death.

4. • Management of chronic illness focuses on tertiary
prevention for chronic illness to retard its progression,
prevent disability, and rehabilitate the person, physically
and psychologically.

5. Initial Reactions to diagnosis of Chronic Condition
• By observing patients in rehabilitation and health settings,
Franklin Shontz (1975) has described a sequence of reactions
people tend to exhibit following the diagnosis of a serious
illness.
• This sequence of reactions is:
• 1. Shock—an emergency response, marked by three
characteristics:
– {a) being stunned or bewildered
– (b) Behaving in an automatic fashion, and
– (c) Feeling detached from the situation, that is, feeling like being an
observer rather than a participant in the events that occur.

6. 2. Encounter = a phase that is marked by disorganized
thinking and feelings of loss, grief, helplessness,
despair, and being overwhelmed by reality.
3. Retreat—a phase in which people tends to use
avoidance strategies, such as denying either the
existence of the health problem or its implications.
 But then reality begins to intrude: the symptoms remain
or get worse, additional diagnoses confirm the original one

7. Coping with the crisis of illness: The Crisis Theory
• Crisis theory describes factors that influence how people adjust
during a crisis, such as having an illness.
• According to Crisis theory the outcome of the crisis or the
adjustment the person makes depends on the coping process,
which depends on three contributing influences:
• I. Illness-Related Factors
– • Greater threat :Some health problems present a greater threat to the
person than others do they may be more disabling, disfiguring, painful,
or life-threatening
– • Disfigurement:
– Adjusting to being disfigured can be extremely difficult, particularly
when it involves the person’s face. Many individuals whose faces are
badly scarred withdraw from social encounters, sometimes completely.

8. Embarrassing problems:
• Patients also have difficulty coping with illness- related factors that
involve annoying or embarrassing changes in bodily functioning or that
draw attention to their conditions.
• Visible conditions
– (e.g., tics, seizures) and treatment equipment’s that are visible or
produce noisy.
• Painful treatments:
– Some treatments are painful or involve medications that produce
serious side effects
– Time commitment for treatment regimen
– Lifestyle changes
– Hardy and resilient personality

9. II. Background and personal factors:
• The ways individuals cope with chronic health problems also
depend on many other background and personal factors, such
as their age, gender, social class, philosophical or religious
commitments, emotional maturity and self-esteem.

10. 4.3. The Coping Process in patients of chronic illness
• Coping with Chronic Illness has process:
(1) cognitive appraisal; An individual initially appraises the seriousness and
significance of the illness
Factors such as knowledge, illness beliefs, previous experience and social
support may influence this appraisal process.
(2) adaptive tasks
• (3) coping skills