Module Four: Introduction to Chronic Illness

This module introduces chronic illness. The impact of chronic illness on patients, families, and the health care system will be explored.

Module objectives

1) Summarize the impact of chronic illness on patients and families.

2) Differentiate illness from disease.

3) Explore the impact of chronic illness in the health care system.

4) Appraise own assumptions regarding chronic illness and those who live with chronic illness.

Key Points

· Chronic illness often becomes the person’s identity. It can include a broad array of social, economic, and behavioral facets for both the individual and family.

· ‘Disease’ refers to the pathology of a condition. ‘Illness’ is the human experience of disease. This includes how the situation is perceived and lived with (Larsen, 2019).

· Chronic disease consumes about 90% of health care dollars in the United States (CDC, 2022)

· Much of the increase in chronic disease is due to the aging population, but socioeconomic and technological factors also play a part (Larsen, 2019)

· Nurses must be aware of their assumptions regarding those individuals who are living with preventable illness.

· Even when medical care cannot ‘cure’ chronic illness, nursing care has a vital role in making a difference for individuals and families.

· Patients and caregivers often see the illness situation from different perspectives.

· Healthcare providers tend to follow a medical model – which is oriented to acute care (Larsen, 2019).

· There is a huge difference between caring for an individual in an acute, short term situation as opposed to caring for an individual with a chronic condition over an extended timeframe (Larsen, 2019).

· Social determinants of health have a significant impact on prevention, illness experience, the quality of care received, and outcomes (Larsen, 2019)

· The biggest driver of health status is individual behavior (Larsen, 2019)

· The Triple Aim objectives includes: improved care experiences, better population health outcomes, and lower costs – all applicable to chronic illness situations (CDC).

· Mindful presence and listening are powerful strategies a nurse can utilize when caring for individuals and families living with chronic illness.

· Nurses often think patient education is the key to everything. Often emotional support is more valuable than education, depending on the timing (Larsen, 2019).

· Nurses can work to prevent initial disease as well as prevent complications of the condition.

Key points references:

Centers for Disease Control and Prevention. (n.d).
Health and economic cost of chronic diseases.

Larsen, P.D. (2019). Chronicity. In P.D. Larson (Ed.), 
Chronic illness: Impact and intervention (pp. 3 – 18). Jones & Bartlett Learning. (you do
not need to find this resource – it is where I got some of the information for the key points)

Required Resources:

Perusethe following websites: these sites will guide you to multiple links –
choose what interests you and will support your synthesis and application

Agency for Healthcare Research and quality. (n.d.) Topic: Chronic conditions. Retrieved July 16, 2022, from


Centers for Disease Control and Prevention. (n.d.). About chronic diseases. Retrieved July 16, 2022, from

Centers for Disease Control and Prevention. (n.d.).
Health and economic cost of chronic diseases.

Retrieved July 16, 2022, from

Institute for Healthcare Improvement (n.d.). Chronic care management. Retrieved July 16, 2022, from

Required readings:

American Nurses Association (2015)
. Code of ethics for nurses: With interpretive statements. Silver Spring, MD: ANA. (portions as applicable)


Ashford, R. D., Curtis, B., & Brown, A. M. (2018). Substance use, recovery, and linguistics: The impact of word choice on explicit and implicit bias. Drug & Alcohol Dependence, 189, 131–138.


Centers for Disease Control and Prevention. (n.d.).
Health and economic cost of chronic diseases.

DeBarr, K., & Pettit, M. (2016). Weight Matters: Health Educators’ Knowledge of Obesity and Attitudes Toward People Who Are Obese. American Journal of Health Education, 47(6), 365–



Institute for Healtcare Improvement. (n.d.)
IHI and the triple aim initiative and the triple aim.

Note: This will take you to the Institute for Healthcare Improvement website. Please take some time to explore this site, paying particular attention to the Triple Aim. You will have to create a free account (if you don’t already have one).

Luck-Sikorski, C., Schomerus, G., Jochum, T., & Riedel-Heller, S. G. (2018). Layered stigma? Co occurring depression and obesity in the public eye. Journal of Psychosomatic Research, 106, 29–



Singh, K., Russell-Mayhew, S., von Ranson, K., & McLaren, L. (2019). Is there more to the equation?

Weight bias and the costs of obesity. Canadian Journal of Public Health, 110(1), 17–20.


Optional reading:

Berg, M. B., Lin, L., Hollar, S. M., Walker, S. N., & Erickson, L. E. (2016). The Relationship between Weight-Based Prejudice and Attitudes towards Obesity-Reducing Public Policies. Analyses of Social Issues & Public Policy, 16(1), 125–142.


Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider.

Ann Fam Med. 2014 Nov-Dec;12(6):573-6.


Mate, K. (2022, February 4).On the Quintuple Aim: Why Expand Beyond the Triple Aim?










Sporinova, B., Manns, B., Tonelli, M., Hemmelgarn, B., MacMaster, F., Mitchell, N., Au, F., Ma, Z., Weaver, R., & Quinn, A. (2019). Association of Mental Health Disorders With Health Care Utilization and Costs Among Adults With Chronic Disease. JAMA Network Open, 2(8), e199910.



Graded Assignment:

Focused reflections: Focused reflections:
Please refer to the Focused Reflections folder for a more detail.
Note: Reflections must
demonstrate that the assigned content was appropriately reviewed, understood, and synthesized to earn full points. Integrate additional professional healthcare and nursing journal articles and references as appropriate (see page

nine in the syllabus) with your

own thoughts.

Module Four Focused Reflections

Please respond to the following questions adhering to the grading rubric.

1. What can you as an
individual nursedo with the resources you currently have to help meet the three objectives outlined in the Triple Aim? Think about practical application in your own type of employment setting, addressing each of the three objectives. Responses such as ‘we need more funding’ will not earn credit.

2. Explore the potential impact of health care professional bias regarding individuals who live with high risk for preventable illness (ex. individuals who are obese, inactive, smoke, utilize substances, etc.)? The articles included in your assigned readings are a good place to start.

3. Examine your own personal biases (we all have them) regarding individuals who do not practice healthy lifestyle behaviors. What impacts these biases? How could you manage biases? No evidence needed for this question




Not satisfactory


All questions / topics addressed in a clear, focused manner. All responses demonstrate careful thinking. (4 points)

Not all questions addressed OR responses not clear and focused (2 points)

Not all required questions addressed.

(0 points)

Demonstrates synthesis of assigned readings -Chapter 10

Submission demonstrates that the assigned content was appropriately reviewed, understood, and synthesized.

Reflections demonstrate synthesis of professional healthcare and nursing journal articles and references (see page

nine in the syllabus) with your

own thought

Minimal direct quotations. (10 points)

Demonstrates limited familiarity and synthesis of assigned content. (5 points)

Responses do not demonstrate synthesis of assigned readings

(0 points)

Evidence based

At least one professional citation/reference pair supports response
to each question (unless stated otherwise). Resources must be integrated, cited, and referenced per APA style. See criteria for professional references on p. 9 of syllabus. Rare APA style errors. (3 pts)

Provides evidence-based, professional reference using incorrect APA format.
Or provides nonscholarly references with correct APA format intext. (1.5 points)

Provides no scholarly reference to support position/ideas in posting
and /or uses no APA format

(0 points)

Writing quality

Punctuation, spelling, spacing, capitalization and writing mechanics errors are rare. Writing is clear, succinct, focused, organized, Easy to understand main ideas. (3 points)

Fewer than 6 total writing mechanics errors. Writing is focused and

organized. (1.5 points)

Six or more writing mechanics errors; run-on sentences. Writing lacks organization or focus. (0 points)

sign up for the chapter in Nursing Care at the End of Life, authored by Lowey, or a chapter in Palliative Care: Quality Care to End of Life by Matzo& Sherman that you would like to summarize/reflect on. The URL for these books are included in the syllabus in the required resources section.

I signed up for chapter 10 of the book: Nursing Care at the end of Life, Authored by Lowey

Chapter 10 title: Nurse – Patient – Family Communication (Lowey)

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