Chronic Illness Archives - Page 2 of 2

Factors in Medical Recommendation Adherence: Part I

Posted on April 30, 2021April 30, 2021 by TriWellness in Uncategorized

Medical adherence, not to be confused with compliance, is an active involvement in the betterment of one’s health through actionable changes. Compliance, on the other hand, is a passive involvement in one’s wellness journey. Compliance also implies that the individual does not have much control as opposed to adherence, where the individual is in the driver’s seat of their own healthcare. Adherence can have a significant affect on an individual’s prognosis, however adherence may not be enacted. In a study conducted by the World Health Organization (WHO) in 2003, researchers found that in developed countries, 50% of individuals with chronic health conditions adhere to their providers recommendations and therapies for certain health conditions. This statistic is further compounded when faced with other factors and barriers to healthcare adherence discussed in this month’s blog post.

Understanding the recommendation

According to a study looking at English and Spanish- speakers, several individuals misunderstood the directions and recommendations from their physician. Factors contributing to this confusion was language, comprehension of the medical jargon (even if instructions were given in their native language), and age. Several other studies have shown that when given verbal instructions, patients struggle to recall the information at a later time, especially when the physician uses medical jargon. The resulting issues led patients to erroneously take their medication, which could potentially effect the therapeutic value of the medication. Furthermore, the lack of medicinal effect can lead to depression and feelings of hopelessness.

Our clinician’s recommendations:

It definitely can be intimidating when an authority figure is throwing information in what seems like a hefty pile. However, we may forget that we are the authorities of our bodies and we deserve to give ourselves a moment to check in with the information we are getting. I often recommend clients to request a follow-up document, whether their physician uses an Electronic Health Records (EHR) software or can give you a print out at the end of your visit. Sometimes, physicians may not use these methods, so I often recommend clients to take notes either with old school: pen and paper or using their notes application on their phone. Another component to ensuring optimal understanding, maybe requesting a provider who speaks your native language (if that option is available) so nothing is lost in translation, and asking your physician questions to make sure you understand (“If I understand you correctly,…” or “I just want to make sure I got this right,…” are some starters).

The rapport with the PHYSICIAN

It is no surprise that “bedside manners” effect adherence. Research has found that physicians who foster a therapeutic environment through effective communication and support led patients to be more actively involved in their treatment process. The more active patients are in their treatment, the more they are satisfied with their partnership with their provider, and the more cohesive partnership led to better adherence. Another study found that it is imperative that patients feel comfortable with their physician, to ensure that all the important information is shared with the provider. It is also important to have all the needed information for the physician to make an accurate recommendation.

Our clinicans recommendations:

When buying a car, we shop around until we find the car that meets our needs, because this is a decision that can potentially affect us in several areas of our lives (financially, commute, enjoyment, etc.). The same goes for finding the right provider. If you are able to meet with different providers in your area, it is ok to make sure they are a right fit for you. Your healthcare is a partnership, and you can decide if the provider’s style fits with your needs.

Interesting studies

Article from the WHO

https://pubmed.ncbi.nlm.nih.gov/7474271/

https://pubmed.ncbi.nlm.nih.gov/15096368/

https://pubmed.ncbi.nlm.nih.gov/11841530/

https://pubmed.ncbi.nlm.nih.gov/15893213/

Stayed tuned for Part II where we discuss culture and psychological factors to adherence and Part III where we explore how medical adherence affects chronic illness.

This month’s blog post was written by our Chronic Illness specialist, Aarti Felder.

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Chronic Illness Burnout

Posted on January 28, 2021January 29, 2021 by TriWellness in Uncategorized

Managing a chronic illness can be exhausting! There are so many components that need to be addressed in the management of a chronic condition from appointments, to procedures, to medication, to life in general, with the added stressors of today simultaneously all the while managing the physical sensations that the condition may cause. In my practice I like to use the following metaphor:

In video games we start out with a few hearts and as we go through the game and defeat a boss, we gain more hearts. Now, lets just say that each person starts the day with ten hearts. A person with chronic condition(s) may have had a bad night and didn't sleep well, that knocks out possibly one-two hearts. Then they may wake up in pain (minus one-two hearts), attempt to do their morning routine while experiencing pain (minus another one-two hearts), perhaps they have kids and have to help them get ready for school (minus two or more for each child). Now they have to head to a big boss battle, perhaps it's a big presentation at work, at this point, however, they may have half to no hearts left to go into this battle. How are they supposed battle that big boss?

This is how it can be for someone with a chronic condition, and of course they feel exhausted after their morning routine, needing a way to replenish their energy. However, life can be demanding and may require one to operate with little to no energy. It is completely understandable the difficulty one may endure in the attempt to comply with their medical team’s recommendations. With competing demands how does one manage their chronic condition and whatever life throws at them without experiencing burnout?

Acceptance and commitment Therapy

In my practice I utilize the Acceptance and Commitment Therapy (ACT) Hexaflex points to assist clients to find direction and travel towards a person that they value. Using the Values point of the Hexaflex, I encourage clients to identify their values to facilitate a direction between the competing demands.

Another contribution to burnout, could be a consequence of having thoughts of past that could lead to depression which can further take a few hearts. Or perhaps it is a consequence of thinking about the future, resulting in freezing anxiety, and therefore consuming another few hearts. However, in placing one’s awareness in the Present Moment, can be energy replenishing. I encourage clients to practice present moment awareness by turning their focus to their five senses and how it can relate a sense of calm:

Taste	What does the air taste like? Is it cool and refreshing or energizing?
Smell	What does the air smell like? Is there a sweet floral scent, or does it smell clean and fresh?
Sound	What do you hear? Is there birds that you can hear chirping or the wrestling leaves in the wind?
Sight	What do you see? Does the sun sparkle between the leaves wrestling in the wind?
Feel	What do you feel? Do you feel the warmth of the sun on your face or chill of the wind as blows across your face?

Questions that I asked myself to engage five of my senses in the present moment to achieve a sense a calm.

Resources

Dr Russ Harris – ACCEPTANCE & COMMITMENT THERAPY

ACT Made Simple

ACT Extra Bits

This is a portion of energy replenishing exercises to combat chronic illness burnout. To learn more strategies or to discuss other demanding life stressors, contact us and we can assist you on your journey to wellness.

This month’s blog post was written by Aarti Felder, our specialist on managing Chronic Illness and Mental Health. To learn more about her, please check out her bio.

Dealing with a Chronic Illness During a Pandemic

Posted on July 23, 2020 by TriWellness in Uncategorized

It’s difficult enough to cope with a chronic illness as well as coping with the stressors of a pandemic, however it can be even more challenging to manage both concurrently. During the pandemic we are faced with many unknowns: Who has the virus? Do I have the virus? When will this all be over? What’s next after this? These questions can cause anxiety, fear, confusion which can further exacerbate a chronic condition especially if the condition is particularly susceptible to the more severe symptoms of the virus. If this describes you, what can you do? As a Licensed Clinical Professional Counselor, I have found some of these strategies to be helpful in alleviating some distressing feelings and thoughts in my clients through the focus of mind, body, and spirit.

Mind

Thoughts, emotions, and the things we do are all interconnected and can impact our bodies. For example, if one has asthma and is experiencing tightness in their chest because they are fearful of catching the virus further intensifying their asthmatic symptoms and ultimately arriving to the decision to not engage in any activities, even in activities that are considered low risk. They can then feel frozen by their fear, leading to more feelings of anxiety and even depression in a vicious cycle.

In order to impact the cycle, one must examine their thoughts through different forms. Some of my clients find it helpful to journal their thoughts to allow a space to keep their thoughts rather than in their head. Others find it therapeutic to mediate and place themselves in a calm space to examine those thoughts.

Body

The body and mind are connected. As previously mentioned, in our mind we may have thoughts and emotions that affect our bodies. Whether it’s an individual with asthma who experiences anxiety in their chest and lungs or an individual with gastric issues experiencing that same anxiety in their gut, their emotions and thoughts impact their body.

This is another cycle that can be affected with physical activity. It can be difficult to get out of the house to go to the gym or maybe it’s impossible to socially distance yourself at the beach. However, clients have found the therapeutic impact of getting some fresh air by going for hikes in the forest where they can maintain social distance while also wearing a mask, if possible. Other clients found a sense of serenity in doing yoga on their balcony in their high rise.

https://youtu.be/09EO9IJgOiI

Here is a guided walking meditation by Headspace that can provide a sense of tranquility through engaging the mind through mindfulness, body through walking, and spirit through the connection with the Earth.

Spirit

Each person may define their spirituality differently and may find different ways to incorporate their spirituality through rituals, gatherings, or any other way. Spirituality often involves the connection with someone or something outside ourselves. Engaging spiritual activities can be difficult during the pandemic, especially if you have a condition that makes you vulnerable to the virus.

We live in the age of spectacular technology with devices that allow us to connect with people all around the world in many different forums right at our finger tips! Utilizing such devices to connect with loved ones or to a community of like-minded individuals can be an effective way to connect with other people and embolden the spirit.

If you are introvert, perhaps the idea of connecting with people is not as appealing. However, taking notice of your connection with the earth beneath your feet, the air you breathe, and the beauty all around you and the universe can give you a sense of serenity in your heart.

The cosmos is within us. We are made of star-stuff. We are a way for the universe to know itself.
Carl Sagan describes our connection with the universe.

You may also find other helpful strategies in our previous blog posts, check it out!

Some of the strategies that were discussed here can be difficult to engage without some guidance. These skills can be utilized as training activities in the gym where you are training to be your optimal self. If you find yourself needing assistance or interested in developing more skills, please reach out to us through the Contact Us page or give us a call.

This article was written by Aarti S. Felder, MA, LCPC, to learn more about her you can find her bio here.