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Deborah Leader, RN

Insights into Helping Patients Better-Manage COPD & Other Chronic Illnesses

By November 28, 2012

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Meet Janet B. At 63 years old, she's been diagnosed with very severe COPD and pulmonary hypertension, a common comorbidity of COPD. She admits to sometimes forgetting to take her medications (including oxygen) and smoking 3 to 4 cigarettes every day. During a recent visit to her physician, she was told if she continued to smoke, she may as well not make another doctor's appointment because there was nothing more the doctor could do for her, she was going to die. Upon leaving her doctor's office, she lit up in her car as her caregiver drove her home. Rational? No, but when it comes to chronic illness, human behavior seldom is.

The above scenario is only one example of how threats to health and other behavioral barriers can interfere with optimal health in people with chronic illnesses like COPD.  A new study, presented in the Journal of General Internal Medicine examined why the ability to effectively manage chronic illnesses remains so elusive.

The study identified the following barriers to health:

  • fear of threats to health by health care providers.
  • unwillingness to think about health problems, in spite of known risks or when information is too confusing.
  • discounting risks because they're too far into the future to think about.
  • being unmotivated to act in a way that is beneficial to health.
  • lacking confidence in the ability to overcome a health problem.
  • being distracted by the pressures of everyday life, unable to focus on current health problems.

In an effort to improve health behavior and better-manage disease, strategies have been developed by behavioral economists and social psychologists to address each concern individually. Authors of the study encourage health care providers to evaluate these tools, and use them in their clinical practice. The following are several examples suggested by the authors:

  • Health care providers should label positive behaviors in ways that are consistent with a patient's life goals and priorities, and not focus on negative behaviors.
  • There should be greater focus on the more immediate dangers posed by chronic diseases.
  • Health goals should be broken down into "baby steps."
  • Specific plans should be implemented as to when, where, and how an action will be taken.

If you feel that your doctor would benefit from this information, print the following study results and take them with you to your next appointment. If you're not comfortable with presenting them to your doctor in person, send her a copy, anonymously, in the mail. Bridging the communication gap between you and your doctor, is one of the most important things you'll ever do. A collaborative effort between doctors and patients will help improve health behaviors and better-control disease.

Comments
December 2, 2012 at 11:17 am
(1) Patricia Lewis says:

I don’t know what “fear of threats to health by health care providers” means (in the list of barriers). Can you explain it? Thanks.

December 13, 2012 at 12:41 pm
(2) Deborah Leader says:

Patricia,

Say you have diabetes and the doctor tells you if you don’t get your blood sugar under control, you are going to eventually lose your eyesight and maybe even have your leg amputated. These types of threats have been identified as barriers to health, meaning they are less effective in the long run at persuading patients to follow their treatment plan.

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