18 - Illness and Coping Behaviours Flashcards

1
Q

How do ‘we’ make sense of the world?

A
  1. Searching: extract information using senses, e.g. see, hear, attend.
  2. Inferring: process information based on experience/ capacity, e.g. judge, store, recode, transform, retrieve and transmit
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2
Q

We create mental representations of health and illness. What does this representation guide?

A

Guides our actions to continue or treat.

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3
Q

What does it mean to be ‘healthy’ according to WHO 1947?

A

“A state of complete physical, mental and social well being”

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4
Q

What does it mean to be ill?

A
  1. Having symptoms - bodily signs or physical sensations (pain, tired, nausea / blood pressure, rash, etc).
  2. Sensations are novel and/or non-attributable (attention).
  3. Having symptoms… for some time (timeline).
  4. Not feeling normal (perception).
  5. Not being able to do what normally do (behaviour).
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5
Q

What is symptom perception?

A
  • Difference in physiological or emotional state labelled as unusual and/or harmful.
  • Sign of the onset of illness and/or progression.
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6
Q

What did Broadbent and Petrie find in their 2007 study about symptoms?

A

Extremely common, 2-3 symptoms a week, e.g. 38% headache

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7
Q

What did Campbell and Rowland find in their 1996 study about acting upon symptoms?

A

Usually not acted upon, <5% go to doctor with symptoms

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8
Q

What is symptom perception affected by?

A
  • Persistence: severity, worsening and/or more symptoms.
  • Attention: Focus/ Distraction/ Context, e.g. medical student-itis.
  • Societal mores: stereotypes (e.g. 28% of death in men cardiovascular disease; in women – 6% 16% 26% 36% 46%?); culture/ socialisation (e.g. acceptable to be ill/ not be ill)
  • Individuals differences: life stage, sex, personality styles
  • Mood: sad, anxious, relaxed, e.g. negative moods more symptoms.
  • Experience: illness experience, knowledge
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9
Q

What was Parsons study ‘The Sick Role’?

A

Society ‘gives’ people a sick role when it identifies and accepts them as ill

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10
Q

What are examples of societal expectations of ‘sick people’?

A

Exemption from normal social roles – must be legitimised by an authority (e.g. mum/ ASD/ GP)
Exemption from responsibility for illness (e.g. sick must be looked after/ not your fault)
Illness is undesirable (e.g. want to get well)
Seek appropriate help (e.g. see a doctor, stay in)
Time limited (e.g. acute/ length illness)

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11
Q

What are illness behaviours?

A

Illness behaviours are the actions a person undertakes when they feel ill to:

  • Relieve the experience
  • Seek more information (Kasl and Cobb. 1966; Mechanic, 1995).
  • Solve ‘the problem’ of illness and return to status-quo.
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12
Q

What was Leventhal’s illness model?

A

Self-regulation/illness representation theory – person’s mental model of their illness

Framework linking illness representations with coping, and actions

  • Person’s mental model of his/her illness.
  • Person’s mental model of someone else’s illness ‘inaccurate’.
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13
Q

What is stage 1 of Leventhal’s model - Cognitive Representation?

A

Cognitive Representation - Belief Scheme

  • Identity – beliefs about the illness label and symptoms
  • Cause – beliefs about causes illness
  • Timeline – beliefs about length illness (acute/ chronic)
  • Consequences – beliefs about illness impact on physical, social and psychological well-being
  • Control/ Cure – beliefs about the how well illness can be controlled or cured
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14
Q

What is stage 1 of Leventhal’s model - Emotional Representation?

A

Feelings/mood

Symptom/diagnosis: clam, relief, shock, fear, depression, anxiety, distress

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15
Q

What is stage 2 of Leventhal’s model - Coping?

A

Types of coping strategies people use to return to health status quo:
• Appraisal-focused – to make sense of illness (logical analysis, preparation)
• Problem-focused (approach) – to ‘fix’ illness (go to doctor, take remedy, plan goals or action).
• Emotion-focused (avoidance) – to ‘fix’ feelings (ignore, denial, anger, comfort).

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16
Q

What is stage 3 of Leventhal’s model - Appraisal?

A
  • Evaluate coping strategy with illness problem.
  • Worked / not worked.
  • Choose another strategy and/or reappraise symptoms
17
Q

What is the Period of Dysphoria?

A

< 2 weeks: short-term coping; change perceptions and behaviour.

18
Q

What are the dynamic adjustment to illness?

A
  1. Initial response and coping strategies, e.g. calm/ do nothing, denial/ over compensate (Period of Dysphoria)
  2. Revised response and coping strategies, e.g. anxiety/ seek help (adaptation, coping strategies)
19
Q

What did Geoff’s study find regarding ovarian cancer?

A

Found 90% of women with ovarian cancer experienced symptoms prior to diagnosis

  • 70% for 3 months
  • 15% for 1 year
20
Q

Why are people reluctant to go to the doctors?

A
  • Symptoms very typical of other things e.g. indigestion, nausea, wind, bloating, full feeling, inc waist size, pain in lower abdomen, change in bowel or bladder habits, lower back pain
  • Women thought it would be embarrassing to go to the doctor
21
Q

What is MEASURE?

A

Illness Perception Questionnaire (Moss-Morris et al, 2002)

22
Q

What was Horne’s beliefs about medicine?

A
  1. Specific – necessity: beliefs that this medication improves health status (e.g. efficacy)
  2. Specific – concerns: beliefs that this medication harmful (e.g. dependence, side-effects)
  3. General – harms: beliefs about harms of all medications (e.g. all some form of poison)
  4. General – overuse: beliefs professionals over-reliant on medication (e.g. over-prescription)
23
Q

What % of medication is not taken as prescribed?

A

Between 30-40%

24
Q

What are reasons for non-adherence to medication?

A

Information / instructions unclear
Memory
Beliefs and cognitions patients (active non-adherence)

25
Q

What was found about jab behaviour influences?

A

Jab behaviour predicted by beliefs about vaccine, not ‘flu’

26
Q

What did Petrie find in his 2011 study regarding asthma?

A

124 asthma patients, not adhering inhaler use, completed IPQ & BMQ.

Findings:

  • increased adherence by 10%
  • changed people’s understanding illness
  • changed peoples beliefs about necessity of inhaler.

Compared the effect of sending text messages reminding asthma patients to take their medicines compared to normal practice – improved adherence

27
Q

What does the Common Sense Model help to understand?

A

how beliefs, coping and behaviours linked to illness behaviour.

28
Q

What are beliefs about treatment associated with?

A

Adherence

29
Q

What was Horne’s theory about beliefs about medicines?

A

Doctors have a stronger belief about medicines than patients