12. Coping with illness and disability Flashcards
What is health?
- State of complete physical, mental and social well-being
* Not merely an absence of disease or infirmity
What proportion of people have a chronic illness in developed countries?
1/3
What are the 3 main consequences of disease and their causal links, that the WHO classification describes?
- Impairment - refers to a problem with a structure or organ of the body
- Disability - functional limitation with regard to a particular activity
- Handicap - interaction of the individual with the environment; usually a disadvantage as a result of impairment and disability
Is there a correlation between disability + handicap, and impairment + disability, and what does this suggest?
- High correlation between disability + handicap
- Low correlation between impairment + disability
- Suggests that something in addition to impairment (structural problem) influences disability (functional limitations)
How high is the human capacity for overcoming serious health problems (resilience)?
Very very high (apart from a minority who suffer from severe psychological problems)
What 3 parts is the coping process made up of and what 3 factors influence this (in the crisis theory)?
Factors
• Illness related
• Background and personal
• Physical and social environmental
Coping
1) Coping appraisal
2) Adaptive tasks
3) Coping skills
What are the 2 responses to a crisis?
- Adaptive - leads to personal growth and adjustment to illness
- Maladaptive - leads to poor adjustment (psychological problems, low functioning etc.)
What illness related factors can influence the coping process?
- Unexpected - harder to come to terms with
- Cause and prognosis - guilt
- Disability - level of it
- Stigma
- Prior experience
What background and personal factors can influence the coping process?
• Age of onset
• Gender
• Socio-economic background
- lower background makes it harder
• Occupation - if it requires good health
• Pre-existing illness beliefs e.g. cancer = death sentence
• Personality
What big 5 personality traits have been linked to health outcomes?
- Openness - no clear link
- Conscientiousness - +2 years to life expectancy
- Extraversion - lower rates of CHD, protective respiratory disease
- Agreeableness - hostility associated with CHD
- Neuroticism - higher use of alcohol and smoking, but higher symptom reporting (hyper-vigilant)
How does life satisfaction change after becoming disabled, and what personality trait affects this?
• Significantly negative impact on life satisfaction
• May be small improvement years on
• Life satisfaction is significantly moderated by agreeableness
• Agreeable people:
- tend to have good social support and better quality of friendships
- more likely to follow self-care instructions
- positive and active coping strategies
What physical and social environmental factors influence the coping process?
- Hospitalisation - negative effect
- Accommodation and physical aids
- Societal attitudes
- Social support and social role
What is an illness belief?
A patient’s own implicit, common sense beliefs about their illness
What 5 things are asked in an illness perception questionnaire?
- Identity - symptoms?
- Cause - e.g. pollution
- Timeline - likely to be acute or chronic?
- Consequences - expected effects
- Curability/control - expectations about recovery or control
What did a study where MI patient’s drew their hearts show?
- Patients who drew damage to their heart perceived that their heart had recovered less after 3 months, that it would last longer and that they had less control
- Extent of damage drawn was correlated with a slower return to work
- Peak troponin-t was not related to 3-month outcomes or return to work
Study concluded that drawings of damage predict better recovery than medical variables
