13.1 (17.2): Coping in palliative medicine Flashcards
List 3 issues that coping helps to mitigate
physical discomfort*
anxiety*
depression*
anger
existential distress
wish to die*
What is the definition of coping?
THOUGHTS and BEHAVIORS that people use to manage the internal and external demands of a situation that are appraised as stressful.
What is the definition of stress?*
a particular relationship between a person and environment that is appraised by the person to be taxing, exceeding resources or endangering well being
What are THREE general types of coping?
◆ Problem-focused
- change the situation (planning & addressing the problem) causing distress
Ex: info seeking, behavioral engagement, fighting spirit!, problem solving, prioritizing
◆ Emotion-focused
- aims to attenuate neg emotions stemming from the problem
Ex: anger, depressive, guilt, denial, positive reappraisal
◆ Meaning-focused
- redefine the meaning of the stressful experience
Ex: benefit finding, reattributions, change global beliefs, generate new goals, recall prev found benefits
List 3-5 activities of life that create symbols of immortality that can be used to enhance coping
- Biological - children*
- theological belief of life after death*
- creativity - ie. mozart alive after death due to creations*
- feeling part of external universe (ie. through nature)
- Experimental transcendence where sense of time is lost - this symbol connects to higher power to escape earthly fate
A strong sense of coherence helps one respond to stress with a conviction that life will continue to be meaningful.
What are the three elements that make up coherence*
Comprehensibility - ability for people to understand what happens around them
Manageability - ability to manage situation alone or via social network
meaningfulness - ability to find meaning in given situation
What three personality factors result in people responding to stress as a challenge (rather than a threat)?
What personality factor is associated with increased existential distress in face of a stressor?
openness to experiences
extraversion
Conscientiousness
neuroticism
List 3 internal mechanisms for coping
Hope*
meAning
Reminiscence
Dignity
COurage*
REsilience*
fighting spirit
HARDCORE Fighting Spirit!
Dig - HoMe - CoRe - fighting spirit
List four factors that contribute to courage*
character
self esteem*
sense of purpose
culture
hope*
love*
faith*
Emotional support
past success
dignity
List three ways to increase hope
- positive interpersonal relationships
- living in the moment
- cognitive reframing of negative thoughts
- ritual exercises
FS: HOMMESS
Home
Other - exercise, music, art
Meaning
Mindful
Education
spiritual and support
List two health related issues that contribute to hopelessness.
List a major outcome of hopelessness
uncontrolled pain
Disability *
depression
poor symptom control*
suicidal ideation
desire for hastened death
List four external resources to enhance coping
supportive and complementary therapies
magic and alternative therapies*
psychopharmacology
psychotherapy
caregivers
volunteers*
palliative care*
religion*
List four components of meaning centred therapy
- responsibility to self (reappraising the meaning of the problem)*
- responsibility to others (survivors, family, legacy)*
- creativity
- transcendence
- ascertaining one’s values*
- understanding the role of goals*
What is the relationship between religion and coping
Un poco complicated:
◆ If religious coping is either of the below, outcome tend to be POSITIVE:
- self-directing approach in which people rely on their God-given resources in coping (stresses personal agency)
OR
- collaborative approach, maintaining the competence of the individual
◆ If approach is as below, outcomes tend to be NEGATIVE:
- differing approach where people passively defer the responsibility for problem-solving to God
- associated with lower levels of competence
FS:
Locus of control, agency of self
List four generally ineffective strategies for coping
anger
aggression
Illicit drug use
abuse of prescription medication
What is the definition of resiliency?
Capacity to recover quickly from difficulties; toughness
Name SIX factors that are associated with resilience*
◆ psychological factors
- efficacy
- mastery
- self-esteem
- self-empowerment
- internal locus of control
- determination
- optimism
- hardiness
- hope
- acceptance of illness
◆ coping strats
- problem-focused
- emotion-focused
◆ strong social supports
Name FIVE factors positively influenced by the presence of resilience*
◆ illness perception
◆ pain perception
◆ health related QoL
◆ self-care
◆ adherence to tx
◆ exercise adherence
◆ physical outcomes
What is the contextual cognitive model of coping? I’m sorry…
1) individual + environment form a dynamic unit that influences the course of events
2) coping is a process over time and in different contexts
3) coping process involves:
- “primary appraisal”: judge whether the individual faces a loss/threat/challenge
- “secondary appraisal”: judge the controllability of the event
Name the FIVE stages of proactive coping
1) resource accumulation
2) recognition of potential stressors
3) initial appraisal
4) preliminary coping efforts
5) elicit and use feedback re: initial efforts
FS: ASAP-feedback
Accumulate
Stressors
Appraisal
Preliminary efforts
Feedback
