6b: Coping with illness and disability

Question 1

What is the Transactional definition of stress? Apply to medical procedures

Answer 1

Stress = condition that results when the person/environment transactions lead the individual to perceive that they are unable to meet the demands with their coping resources

Medical example:
Threat (e.g. surgery) = “It’s going to hurt so much. Will I be able to recover?”

Resources = “There’s nothing I can do. I can’t cope with this”

Question 2

How can you make experience (e.g. surgery) less stressful

Answer 2

Prepare with information
Better information = faster recovery

Procedural info = info about the procedures to be undertaken

Sensory info = feelings + sensations

Question 3

What is the Dual Process hypothesis?

Answer 3

Proposes that procedural and sensory information are both helpful because they work in different ways.

Procedural info = info about the procedures to be undertaken.
Allows patients to match ongoing events with their expectations in a non-emotional manner.

Sensory info = Info about the sensations that may be experienced.
Works by “mapping” a non-threatening interpretation on to these expectations.

Question 4

What is problem/emotion focused coping?

Answer 4

Problem focused coping = Efforts directed at changing the environment in some way or changing one’s own actions or attitudes.
EXAMPLES:
- Seeking relevant information about an illness
- Changing behaviour eg diet

Emotion focused coping = Efforts designed to manage the stress-related emotional responses in order to maintain one’s own morale and allow one to function.
EXAMPLES:
- Seeking emotional support
- Learning relaxation strategies
- Meditation
- Distraction

Question 5

Give strategies used to help children cope with treatment

Answer 5

Distraction - MOST EFFECTIVE
Modelling intervention
Preparatory information (procedural AND sensory)

Approach:

1. Tell - using simple language
2. Show - demonstrate using inanimate object or staff
3. Do - procedure does not begin until child understands what will be done

Question 6

Auerbach dental extract study

Answer 6

• 40 patients undergoing dental extraction surgery were either given general or detailed information in a pre-operative preparation.
• Both groups assessed for desire for information and involvement
• Distress during procedure measured

RESULTS:

GENERAL info group: High distress in people who wanted detailed info

DETAILED info group: High distress in people who had low desire for information. People with high desire for info had low distress.

Question 7

Langer and Rodin Nursing home study

Answer 7

Floor 1: Greater control (can move around furniture, water their own plants, choice of movies)

Floor 2: Less control (given timetable of activities, nurses water plants for them, no choice of movies)

Floor 1 residents showed GREATER engagement in activities and better general wellbeing + survival rate

Shows that perception of control is important in health

GREATER PERCEPTION OF CONTROL = REDUCED DISTRESS. Examples:

• Giving patient a device to signal pain during a procedure
• Self-admin of entonox (analgesic) during labour