Long-Term Conditions: A Guide for Nurses and Healthcare Professionals

Contributors xi

Introduction xv

Section 1 Living with a Long-Term Condition

1 Nutrition 3
Helen Ford

Introduction 3

Nutrition in context 3

What is nutrition? 7

Basics of nutrition 8

How much do we need to eat? 16

Assessing dietary intake 20

Assessing nutritional status 22

Nutrition problems in long-term conditions 23

Conclusion 45

References 45

Resources 48

Further reading 48

2 Chronic Pain: Living with Chronic Pain 49
Gay James

Introduction 49

Causes and pathology of pain 51

Types of chronic pain 53

Incidence of chronic non-malignant pain 56

Psychology and social considerations in chronic pain 58

The impact of pain 59

Chronic pain assessment 63

Interventions to manage chronic pain 70

Conclusion 88

References 89

Further reading 92

Organisations in the United Kingdom who may offer support 92

3 Depression and Long-term Conditions 93
Robert Tummey

Introduction 93

What is depression? 94

Recognition of depression as co-morbidity with long-term physical conditions 95

Prevalence of depression as co-morbidity with long-term physical conditions 99

Diagnosis of depression 101

Treatment for depression 104

Conclusion 114

References 115

Further reading 118

Section 2 Empowerment

4 Adaptation in Long-term Conditions: The Role of Stigma Particularly in Conditions that Affect Appearance 121
Andrew R Thompson

Introduction 121

LTC, Visible difference, disfigurement and body-image 122

Psychosocial, social and cultural impact of living with an LTC affecting appearance 123

Stigmatisation and LTCs 129

Psychosocial interventions 130

Conclusion 133

Acknowledgements 133

References 133

Resources 136

Further reading 136

5 Self-management in Long-term Conditions 138
Sue Randall and Andy Turner

Introduction 138

Context 138

Historical perspective 140

Self-care and self-management 141

Co-creating health initiative (CCH) 152

Underpinning theories 155

Conclusion 159

References 160

Resources 163

Further reading 163

6 Assistive Technology – A Means of Empowerment 164
Darren Awang and Gillian Ward

Introduction 164

Policy background 165

Defining key terms 167

Whole system demonstrators 179

Ethical issues 183

Workforce design, education and training 184

A technological future? 186

Conclusion 188

References 188

Resources 192

Further reading 192

7 Risk and Empowerment in Long-term Conditions 193
Annette Roebuck

Introduction 193

Risk in context – the bigger picture 194

Wider views of risk and empowerment 195

Empowerment 203

Conclusion 215

Acknowledgements 216

References 216

Further reading 218

Section 3 Care Management

8 Care Coordination for Effective Long-term Condition Management 221
Sue Randall

Introduction 221

Population contexts in England, Scotland, Wales and Northern Ireland in relation to LTCs 222

Care coordination 224

Frameworks of care delivery 233

Service delivery models 237

Other ways of working which influence care coordination 251

New ways of working 254

Conclusion 256

Acknowledgements 256

References 257

Resources 261

Further reading 262

9 Rehabilitation in Long-term Conditions 263
Bernie Davies and Jo Galloway

Introduction 263

Definitions and concepts of rehabilitation 263

The role of rehabilitation in the context of managing LTCs 265

Models and theories informing rehabilitation 268

Teams and teamwork in rehabilitation 275

The principles and process of rehabilitation for people with LTCs 280

Outcome measures and evaluation 286

Conclusion 290

References 290

Resources 293

Further reading 293

10 Palliative Care in Long-term Conditions: Pathways to Care 294
Claire Whittle and Jill Main

Introduction 294

What is palliative care? 294

What is end of life care? 297

Illness trajectories 297

Family and carers 299

Dying from LTCs 300

End of life symptoms and management of symptoms 304

Policies 305

Models of care 306

Spirituality 313

Conclusion 314

References 314

Resources 317

Further reading 317

Index 319