1. p. 252-270

2. Not just the physical side of condition – how does condition influence person and person influence the process of condition? Psychological and social aspects influence patient’s management of disease as well as process of disease Patient with coronary heart disease

3. Patient often angry with person giving diagnosis Manner in which information given important Clearly state diagnosis and immediate treatment plan Detail can follow later when patient is calm

4. If diagnosis is a child’s, very stressful and emotional for parents More difficult to explain diagnosis to children. They often repeat information but don’t understand fully. Children should be included in consultations Parents help with giving information

5. Identity Time-line Consequences Control Cause Patient tries to make sense of symptoms, influence behaviour Beliefs about illness determines reaction to diagnosis

6. Doctor-patient / physio-patient relationship important Guide parents on how to include child in relationship Challenges -living with symptoms continious use of medications behavioural changes changes socially and in work emotional distress decisions about treatment Improve quality of life while managing challenges

7. Adherence Improving self-management Behavioural changes in childhood Managing healthy siblings

8. Social and peer relationships Employment Role changes

9. Stress and coping Anxiety Procedure-related distress Depression Cognitive functioning Transitional care

10. Denial Anger Bargaining Depression Acceptance

11. Physical Behavioural Cognitive Emotional

12. Pryor, J.A. and Prasad, S.A. 2009. Physiotherapy for respiratory and cardiac problems. Adult and paediatrics. Edinburgh: Churchill Livingstone Images courtesy of Google search engine