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Learning Center Experience
By Barb Gunderson, School of Nursing Faculty
Chronic disease is a
growing health concern. What is chronic disease? According to the Center for
Managing Chronic Disease, it is “a long-lasting condition that can be
controlled but not cured” (2011, para. 1). Our health care system and nursing
education seems to be more focused on acute care and interventions directed
towards cure, however.
Nurses may prefer working in areas where they can see
progress and see that they have made a difference. So there is a need to
prepare nurses in the care of patients with chronic illness.
Although chronic illnesses are very prevalent in
society today, this has not always been the case. What makes this an issue
today? It is because 133 million Americans—45% of the
population—have at least one chronic disease (Center to Fight Chronic Disease,
n.d.). Thus, a good number of the patients nurses care for today will have at least
one chronic condition. Those people with chronic diseases represent those who
frequently access the health care system. The numbers of persons with chronic
conditions is increasing significantly, and thus the costs associated with that
care is increasing as well. It is reported that 70% of health care dollars spent, 81% of hospital
admits, 91% of medications prescribed, and 76% of physician office visits
relate to chronic illness (Center to Fight Chronic Disease,
Why is this
happening? Chronic disease has traditionally been thought of “old age” disease.
In the not too distant past, people died of acute conditions such as pneumonia
and other infections, heart attacks, and emphysema soon after diagnosis. People
did not live long enough to have chronic problems. But because of increased
knowledge about disease, technology, medications, and an increased focus on
prevention, life expectancies have dramatically increased. And our societal
conditions today lead to the development of chronic conditions at an earlier
age. People now live many years after a diagnosis of a chronic disease such as
diabetes, cardiovascular disease, hypertension, chronic obstructive pulmonary
disease, and kidney disease. Interventions are now focused on managing the
condition, maintaining the quality of life, and minimizing limitations of the
disease (palliative care).
contributing factors in the rise of chronic disease are our environment and
lifestyles. Our bodies are exposed to so many chemicals and pollutants, and
toxins in our food, water, and air. In other cases, our diets are high in
saturated fats and sodium. Our lives are now filled with modern conveniences
that decrease the amount of physical activity we get. Sedentary lifestyles and
poor nutrition have contributed to a rise in obesity which leads to chronic
conditions such as hypertension, cardiovascular disease, and diabetes. The
effects of substances such as tobacco products and alcohol lead to chronic lung
and liver problems. All of these exposures increase the risk for the
development of a chronic disease. These chronic conditions have a very slow
progressive insidious onset and thus diagnosis may not be made until the
disease has progressed significantly.
puts a person at risk for a shortened life span. And another challenge is that usually a person
has more than one chronic diagnosis. Each chronic condition usually requires
one or more prescription medications. Managing multiple chronic conditions is
very complex. Multiple medications puts a person at risk for adverse drug
reactions, geriatric syndromes, and impaired ability to perform activities of
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