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
