Heart Disease, Hypertension, and Stroke课件.ppt

Heart Disease, Hypertension, and Stroke Psychological Issues in Advanced and Terminal Illness Average life expectancy in North America is 76 years. Leading causes of death in adults are chronic illness What are the leading causes of death across the life span? Mortality RatesLeading causes of death 1 year congenital abnormalities; sudden infant death syndrome (SIDS) Children 1 year old Accidents (40% of all deaths) Cancer (especially leukemia) Adolescence Unintentional injury Homicide AIDS Mortality RatesLeading causes of death Middle age Sudden death due to heart attack or stroke Cancer Elderly Heart disease Cancer Stroke Why do women live longer than men? Potential Reasons for Gender Differences in Mortality Females are more hardy Males engage in riskier behaviours (factor after birth and infancy) Men engage in riskier sports Males tend to hold high stress or higher risk jobs Men tend to have poorer health habits (e.g., drink more alcohol) Social support may be more protective in women Risk Factors Family history Marital status (adds 10 yrs in men; 4 yrs in women) Economic status Body weight Exercise Alcohol (add 2 years if drink 1-3 drinks/day) Risk Factors - continued Smoking Disposition (add 2 yrs if reasoned, practical) Education Environment (add 4 yrs if rural) Sleep (more than 9 hours subtract 5 years) Temperature (add 2 yrs if thermostat is 68) Health care – regular check ups add 3 yrs How do people adapt to chronic illness? Adapting Under Good Circumstances First concern upon hearing diagnosis is fears about mortality. Optimistic but tentative about plans May try to normalize activities Risk is they may over-extend May have feelings of helplessness Risk is to become overly dependent Three Themes of Adaptation Find meaning: why illness happened or rethink priorities Gain sense of control control symptoms and treatment Restore self-esteem Often by comparison with worse off others Adapting Under Bad Circumstances Relapse seen as a bad sign with poor