Learning Objectives
By the end of this section, you will be able to:
- Define chronic disease
- Discuss the impact of chronic disease and illness on patients
- Discuss demographic factors that influence chronic disease and chronic illness
Chronic diseases and illnesses are disorders that have a slower onset and are long-lasting. In comparison, acute disease refers to an illness that develops quickly and lasts a relatively short time, typically days or weeks (National Council on Aging, 2024). Chronic disorders affect more than half of the US population and are the leading causes of death and disability in the United States (Centers for Disease Control and Prevention [CDC], 2022a). They cost the US health care system nearly $3.7 trillion annually, accounting for 90% of the nation’s total health care costs (CDC, 2023b).
The significance of chronic diseases and illnesses on the health of the population, coupled with associated economic costs, has shifted the focus of health care and research to disease prevention and health promotion (Healthy People 2030, n.d.). This shift has prompted the US government and health institutions to prioritize population health and implementation of strategies to prevent and mitigate the effects of chronic illness and disease.
Chronic Disease
We define chronic disease is defined as a medical or health problem that lasts at least 1 year and requires ongoing medical attention or limits activities of daily living (ADLs) (CDC, 2022c). This definition encompasses the pathophysiological causes of the health problem and the disorder itself but does not address the subjective feelings and experiences of the patient who is living with the illness. Examples of chronic diseases include
- Alzheimer disease
- arthritis
- cancer
- cardiovascular disease (CVD)
- chronic kidney disease
- chronic lung disorders (e.g., asthma, chronic obstructive pulmonary disease [COPD])
- diabetes mellitus
- heart failure
- hyperlipidemia
- hypertension
- HIV
- mental health disorders (e.g., anxiety, depression)
- osteoporosis
- stroke
Chronic Illness
Many people use chronic disease and chronic illness interchangeably, but it is useful to distinguish between the terms. Although the definition of chronic disease refers to the disorder itself, chronic illness is defined as the human experience of living with a chronic disease (Martin, 2007). This definition encompasses the emotions, values, and beliefs of the individual experiencing the chronic condition and the impact the disorder has on their quality of life and ADLs.
The feelings and experiences associated with living with chronic illness vary significantly from person to person and can change frequently depending on factors such as age, the presence (or lack) of social support, and other social and demographic characteristics. As a nurse, it is important to understand that not all patients experiencing chronic illness will successfully cope with their condition in the same way. Nurses must be able to communicate effectively and implement treatment and support strategies that are reflective of the patient’s beliefs and values as they relate to their chronic conditions.
Demographic Factors Affecting Chronic Disease and Illness
Age, gender, and culture are three demographic factors that can have a significant impact on chronic disease and illness. For example, a child or adolescent experiencing a chronic disease is likely to have a completely different outlook on life than an older adult, due to differences in their respective lived experiences. Another example is the increased prevalence of certain chronic diseases seen in one gender compared with the other. Specifically, osteoporosis, depression, and arthritis are all more commonly seen in females than in males (Temkin et al., 2023). Additionally, an individual’s culture, including factors such as religion or spiritual beliefs, may influence how they approach and cope with chronic illness. Regardless of the factors in any given case, it is imperative that the nurse provide patient-centered care that considers the specific preferences and needs of the patient.
Cultural Context
Culture and Perspectives on Chronic Disease
Culture provides an important source of values and comfort for patients, families, and communities, and it often influences how they view chronic diseases. Some cultures may view chronic disease as a punishment or a test of faith. In others, chronic disease may be attributed to environmental factors. Cultural beliefs also often influence the types of treatments sought for chronic disease. Traditional healing practices, such as herbal medicine or spiritual rituals, may be preferred over Western medical interventions in some cultures. For example, Asian Americans are more likely to use complementary and alternative medicine compared to other races (Felicilda-Reynaldo et al., 2020). It is important for the nurse to remain open-minded and nonjudgmental about the patient’s cultural beliefs and preferences with regard to chronic disease.