Managing chronic health conditions

Introduction The World Health Organization (WHO) (2014) has reported that chronic conditions , or non-communicable diseases, currently cause a greater number of deaths than all other causes of death combined. Additionally, it estimates that deaths related to chronic conditions will rise from some 38 million deaths in 2012 to 52 million deaths by 2030 (WHO, 2014). The majority of these deaths (82%) are due to the four major chronic diseases: cardiovascular disease (CVD), chronic respiratory disease, diabetes and cancer (WHO, 2014). However, other chronic conditions, including injuries that result in persistent disability and mental health disorders, also contribute to increased morbidity and mortality. The significant increase in preventable chronic conditions and the management of these are major health care concerns of the industralised world. Regardless of the specific diagnosis, many chronic conditions have been shown to be amenable to a number of broad approaches to care (Flinders University, 2009). Interventions focus on early identification of risk; modification of lifestyle risk factor behaviours such as smoking, nutrition and physical activity; optimising evidence-based care and facilitating self-management (Flinders University, 2009). Addressing these factors contributes to reducing the burden of the development and progression of chronic conditions. While this may appear simple, the issues surrounding lifestyle risk are complex and, therefore, intervention strategies need to be multifaceted. Primary health care nurses, as part of the multidisciplinary health team, have been demonstrated to have a significant role in both health promotion and chronic disease management (Halcomb et al., 2007). However, to achieve these gains nurses need to be equipped with the skills and knowledge to intervene effectively. This chapter will present some of the key considerations and strategies that nurses need to understand to assist in both reducing lifestyle risk factors and managing chronic conditions. What is a chronic condition? A chronic condition is any disability or disease which an individual experiences over an extended period of time, usually for longer than six months (Department of Health and Ageing, 2009; Flinders University, 2009). The term ‘chronic condition’ is used rather than ‘chronic disease’ as it is inclusive of the broader range of diseases, injuries and disabilities which have ongoing health effects upon individuals (Flinders University, 2009). Such conditions may occur at any point across the lifespan; however, they are more prevalent with advancing age (Australian Health Ministers Conference, 2005).