What is the difference between the terms "disease course" and "illness trajectory"? KEY TERMS, CONCEPTS, AND THEORIES The terms "illness" and "disease" are frequently employed interchangeably; however, there is a distinction, particularly in relation to the life experiences of families of patients with chronic illness.
Four illness trajectories have been recommended to conceptualize how function declines as diseases advance to death. These illness trajectories allow patients, family members, healthcare providers, and healthcare planners to prepare for next steps and to make more informed and critical decisions about care.
This Fast Fact will review the medical evidence of these trajectories as well as their utility as a patient teaching tool. General Evidence: A large observational study, described distinct illness trajectories at the end of life for frailty/dementia, cancer, and organ failure (1).
Time is the fundamental predictor variable in health trajectory research because health indicators are plotted and modeled as a function of time. Although apparently straightforward, the nature, conceptualization, and measurement of time is elusive and challenging (McGrath & Tschan, 2004).
Theorizing about intra-individual change (Singer & Willett, 2003) in health or illness over time requires: (a) conceptualization of a health-illness dimension of interest and selection of a change-sensitive indicator of it; (b) conceptualization of time and selection of a timescale relevant to the indicator and to the context of the research que...
[trah-jek´tah-re] the movement of an object along a three-dimensional path, or of a projectile within an individual's body. 2. the course of a disease.
11. Strauss et al5 described a Chronic Illness Trajectory Framework where the pattern of illness is characterised by a cycle of 'decline-reprieve-decline-reprieve-decline to death', which renders expectations uncertain and arrangements and plans unpredictable.
Phases in the Chronic Illness TrajectoryPhaseDefinitionPretrajectoryBefore symptom presentationTrajectory onsetInitial symptom presentation and diagnosisStableSymptoms are under control and life activities continue within the limitations of the symptoms6 more rows•Jul 15, 2021
Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both. Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States.
MethodsDifferent trajectories for different diseases. ... Trajectory 1: short period of evident decline, typically cancer. ... Trajectory 2: long term limitations with intermittent serious episodes. ... Trajectory 3: prolonged dwindling.
As articulated by the Institute of Medicine, and augmented by researcher and palliative physician Joanne Lynn in the early 2000s, there are four commonly recognized trajectories: Sudden Death, Terminal Disease, Major Organ Failure, and Frailty (Lynn, 2004).
Trajectory onset phase- occurs with the first onset of signs and symptoms and includes the diagnostic period. The acute phase- follows the crisis phase and refers to the period when the patient's symptoms can be controlled by a prescribed regimen. Stable phase - this phase starts once symptoms are controlled.
The Trajectory Theory of Chronic Illness Management is a middle-range nursing theory that has been proposed by Corbin and Strauss (1991a). Analysis and evaluation of this theory was performed using Fawcett and Downs's (1992) guidelines.
Depression is also a chronic illness. It causes persistent feelings of sadness, apathy, or hopelessness, and prevents someone from finding pleasure in activities they once enjoyed. Depression can also cause physical symptoms, such as fatigue, appetite changes, and sleeping too much or not enough.
High blood pressure (hypertension) affects 58% of seniors. ... High cholesterol affects 47% of seniors. ... Arthritis affects 31% of seniors. ... Coronary heart disease affects 29% of seniors. ... Diabetes affects 27% of seniors. ... Chronic kidney disease (CKD) affects 18% of seniors. ... Heart failure affects 14% of seniors.More items...
A person with chronic diseases like, hypertension or diabetes can potentially control their disease with a proper diet and exercise. A person diagnosed with a terminal illness like metastatic breast cancer can exercise and diet, but it will not change the fact that they will eventually succumb to their disease.
Four illness trajectories have been recommended to conceptualize how function declines as diseases advance to death. These illness trajectories allow patients, family members, healthcare providers, and healthcare planners to prepare for next steps and to make more informed and critical decisions about care.
Kavitha J. Ramchandran, Jamie H. von Roenn, in Evidence-Based Practice in Palliative Medicine, 2013
Palliative care providers should consider that a family must deal with crises and losses at multiple points along the illness trajectory and try to understand their history with the disease.
Thomas Carroll, ... Robert Gramling, in Evidence-Based Practice in Palliative Medicine, 2013
Ditte Roth Hulgaard, ... Charlotte Ulrikka Rask, in Reference Module in Neuroscience and Biobehavioral Psychology, 2020
Eric Prommer MD, FAAHPM, HMDC, ... Ambereen K. Mehta MD, in Pain Care Essentials and Innovations, 2021
The hospital-based pediatric palliative care program had been introduced to the child and family at an early stage for help with symptom control and for anticipatory guidance. The roles and involvement of the pediatric palliative care team evolved as needed at different points in the child's illness trajectory.
Therefore, it is vital that illness trajectories be reevaluated as the condition evolves. In particular, certain patterns such as an abrupt functional decline or frequent hospitalizations may indicate the need to readdress goals of care.
Organ failure: A more erratic trajectory with punctuated periods of decline likely correlating with acute exacerbations (1). Each exacerbation may result in death but is often survived with gradual deterioration in health and functional status. Timing of death is less certain than in cancer.
Multiple studies have supported this trajectory however, the timing of steep decline ranges between 1 to 5 months before death depending on the study (1,5-7). Cancer patients may also experience more predictable patterns ...
Timing of death is less certain than in cancer. Perhaps as a result, patients with congestive heart failure (CHF) and chronic obstructive pulmonary disorder are more likely to die in the hospital and less likely to receive hospice services nor understand the likely progression of their illness (9-12).
Health care providers should always exercise their own independent clinical judgment and consult other relevant and up-to-date experts and resources. Some Fast Facts cite the use of a product in a dosage, for an indication, or in a manner other than that recommended in the product labeling.
Four illness trajectories have been recommended to conceptualize how function declines as diseases advance to death. These illness trajectories allow patients, family members, healthcare providers, and healthcare planners to prepare for next steps and to make more informed and critical decisions about care.
Kavitha J. Ramchandran, Jamie H. von Roenn, in Evidence-Based Practice in Palliative Medicine, 2013
Palliative care providers should consider that a family must deal with crises and losses at multiple points along the illness trajectory and try to understand their history with the disease.
Thomas Carroll, ... Robert Gramling, in Evidence-Based Practice in Palliative Medicine, 2013
Ditte Roth Hulgaard, ... Charlotte Ulrikka Rask, in Reference Module in Neuroscience and Biobehavioral Psychology, 2020
The hospital-based pediatric palliative care program had been introduced to the child and family at an early stage for help with symptom control and for anticipatory guidance. The roles and involvement of the pediatric palliative care team evolved as needed at different points in the child's illness trajectory.
ACP plays an important role in the care of all patients with advanced illness, but becomes even more important in patients who may have multiple advanced illnesses.
1. Social & Behavioral Aspects of Illness: Acute and Chronic Illness C. Denise Clemmons, MS Guest Lecturer
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