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Helping patients with chronic conditions overcome barriers to self-care

doi: 10.1097/01.NPR.0000412877.80955.e0
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INSTRUCTIONS Helping patients with chronic conditions overcome barriers to self-care


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Helping patients with chronic conditions overcome barriers to self-care

General Purpose: To provide the nurse practitioner with an overview of the impact of chronic disease and factors influencing self-care for chronic conditions. Learning Objectives: After reading this article and taking this test, the NP will be able to: 1. Discuss the impact of chronic disease on individuals and populations. 2. Identify requirements for and barriers to self-care among patients with chronic diseases.

  1. For the individual patient, optimal self-care
    1. reduces reliance on acute care facilities.
    2. can improve quality of life.
    3. makes more money available for the growing number of sick elderly.
    4. places responsibility for care on the patient.
  2. How often do long-term chronic conditions require attention?
    1. daily
    2. weekly
    3. monthly
    4. semi-annually
  3. High comorbidity with chronic conditions is illustrated by the 66% of patients with diabetes who also have
    1. hypertension.
    2. peripheral vascular disease.
    3. suffered at least one stroke.
    4. a history of myocardial infarction.
  4. One characteristic of leading chronic conditions worldwide is that they
    1. differ in nature according to social class and education.
    2. share common risk factors.
    3. are treated differently in different cultures.
    4. are caused mainly by environmental pollution.
  5. Educating patients about specific disease conditions
    1. will produce the changes needed for self-care.
    2. is much more difficult when patients cannot read.
    3. does not achieve sustained behavioral changes required for self-care.
    4. is a major factor in improved glycemic control by patients with diabetes.
  6. The Chronic Care Model identifies essential elements of an effective healthcare system for quality chronic care as all of the following except
    1. a self-motivated patient.
    2. the healthcare system.
    3. clinical information systems.
    4. the community.
  7. An important element required for self-care is
    1. education from the healthcare provider.
    2. the patient's accurate understanding of the disease.
    3. family support for the chronically ill patient.
    4. coping with illness and disability.
  8. Self-management support involves a paradigm shift
    1. to a patient-caregiver collaborative partnership.
    2. from caregiver assistance to self-directed behavior.
    3. from promoting self-care to demonstrating its effectiveness.
    4. to a narrower support network.
  9. The first step toward self-care of chronic disease involves
    1. developing the patient's sense of responsibility for his or her own care.
    2. teaching the patient about his or her chronic disease.
    3. identifying the barriers to self-care.
    4. ensuring adequate financial resources for self-care.
  10. The most studied psychological challenges affecting self-care for patients with diabetes, COPD, and heart disease is/are
    1. self-mastery versus emotional stress.
    2. the sense of abandonment in the absence of family support.
    3. the will to live despite the ravages caused by chronic disease.
    4. major depression and emotional stress.
  11. The most frequently reported barrier to self-care for patients with diabetes is
    1. adjusting insulin dosages to varying daily glucose levels.
    2. not understanding of a specific diet plan.
    3. learning how to inject different types of insulin.
    4. not knowing how to control glucose levels while traveling.
  12. Which group is usually more integrated into extended family networks for self-care assistance?
    1. women
    2. men
    3. teenagers
    4. children under the age of 10
  13. In the “change talk” mnemonic DARN CAT, D stands for
    1. denial of the need for change.
    2. decision to make required changes.
    3. desire to make a change.
    4. delay in acknowledging the need for change.
  14. Reflective listening is defined as
    1. attentive listening that encourages the patient to talk.
    2. waiting for an opportunity to offer suggestions for behavioral change.
    3. explanations of the burdens of chronic disease in the patient's own words.
    4. capturing and echoing back the patient's own experience in a few words.
  15. The explanatory model of assessing cultural beliefs emphasizes
    1. understanding different cultures to understand their experiences.
    2. using culturally sensitive explanations to ensure changes in the patient's behavior.
    3. eliciting the patient's cultural beliefs about his chronic disease.
    4. understanding that people of all cultures are natural self-regulators.
  16. The sense of self-efficacy in self-care may derive from any of the following except
    1. verbal persuasion from a significant other.
    2. a sense of self-actualization.
    3. mastery experiences.
    4. vicarious experiences.


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