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Semester 4 (NME) > BSS > Flashcards

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1
Q

Name three features of symptoms which are important for people’s perceptions of their seriousness

A
  1. The intensity or severity of the symptom
  2. The familiarity of the symptom
  3. The duration and frequency of the symptom
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2
Q

Name 5 social triggers to consultation

A 
Crisis- Family Death
Relationships- If can't sleep = angry 
Sanctioning- "You look ill"
Temporising- I'll go on Monday
Activities- Interferes with life
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3
Q

The Health Belief Model suggests someone’ beliefs around an illness are based on:

A 
Perceived severity-
Perceived susceptibility-
Perceived barriers/ costs-
Perceived benefits-
Cue's to action-
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4
Q

Negative emotion has what link to pain perception?

A

Negative emotion increases pain perception

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5
Q

Name a psychological factor which contributes to delayed wound healing?

A

Stress can delay wound healing

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6
Q

What is the difference between sensory info and procedural info?

A

Procedural info lowers anxiety by reducing fear of unknown

Sensory info lowers anxiety by reducing difference between expected and actual sensation

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7
Q

What is the purpose of cognitive interventions?

A

Aims to reform cognitions by training positive responses

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8
Q

What are the two types of modelling (copying a person)?

A

Mastery model- Remain calm and relaxed

Coping model- Learn to cope but still find stressful

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9
Q

What method can be used to help reduce pain in children?

A

DISTRACTION

Get kids to blow away the pain

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10
Q

Alf hasn’t been in contact with his friends for a while but continues to see on Facebook that they are going out without him. After asking his friends about it, they say it’s because of his frequent toilet trips and smell of urine. What type of stigma is this?

A

Enacted Stigma

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11
Q

Following his stroke, Stephen feels like his is never going to be able to swallow again properly. Which category of Leventhal’s illness cognitions is this an example of?

A

Timeline

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12
Q

James has a poor diet. He sees his GP who helps James develop ways to lose weight. As part of his consultation his GP assists James in identifying his own barriers and solutions, increasing his intent to change and self-efficacy. What style of interviewing is this?

A

Motivational interviewing

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13
Q

What does CAGE stand for?

A

Cut down (ever felt you should…)
Annoyed (by people commenting on your drinking)
Guilt - felt bad or guilty about your drinking?
E- Eye opener (used it to wake up)

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14
Q

To have capacity to consent to medical treatment you must be able to understand the information, retain the information, weigh the information and what is the last thing?

A

Communicate (the information/decision

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15
Q

Are NGT’s classed as treatment or basic care?

A

Medical treatment

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16
Q

Gross negligence can be penalised as what?

A

Manslaughter

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17
Q

If the patient has no capacity to declare their opinions what must you do?

A

Act in P’s best interest

Unless evidence to suggest they would not want treatment X- religion/ power of attorney/ advance directive

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18
Q

What is the difference between medical care and basic care?

A

Basic care MUST always be given

Treatment can be stopped

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19
Q

What are the moral/ legal differences between acts and omissions?

A

Morally same

Legally different

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20
Q

What is the fight or flight model of stress?

A

External threats elicit a mainly physiological response.

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21
Q

What is the general adaptation syndrome stress model?

A

Three phases (alarm, resistance, exhaustion)

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22
Q

What is a problem with the ‘fight or flight’ and ‘general adaptation’ models of stress?

A

Not much room for psychological components

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23
Q

What is the life events theory?

A

List of stressful events recently experienced is used to predict stress

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24
Q

What are some problems with the life events theory of stress?

A

Doesn’t take into account individuals own rating of event
Retrospective analysis can affect
Some life events can interact with each other
Stressors can be short/ long term

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25
What is Lazarus' transactional model of stress?
Stress response initiated if individual regards a situation as stressful (So individuals' response more important than event)
26
What are the three 'stages' of Lazarus' transactional model of stress?
Primary appraisal- Appraises event Secondary appraisal- Evaluate own capacity to cope Re-appraisal- After attempt to cope
27
The individal no longer passively responds to the world but interacts with it. This comes from which model?
Lazarus' transactional model of stress?
28
What is stress reactivity?
Changes in physiology due to stress. Very variable between people
29
What is stress recovery?
Speed of hormone/ physiology returning to normal (varies lots)
30
What is allostatic load?
The progressive accumulation of stress. Over time the recovery is less and less complete
31
For agreement to treatment to be legally acceptable it must meet three conditions
Consent must be informed to an adequate standard  Patients must be competent to consent to treatment  Patients must not be coerced into accepting treatment against their wishes
32
What is the core statement in the theory of planned behavior?
Strongest predictor of behavior is intentions, affected by (1- Attitude towards behavior, 2- subjective norms, 3- perceived behavior control)
33
GMC guidance says what about treating when patients behavior is expected to be the cause?
You must not refuse or delay treatment because you believe that patients’ actions have contributed to their condition
34
What is the first disease concept of addiction?
The first disease concept regarded the substance as the problem and called for the treatment of excessive drinkers
35
What is the second disease concept of addiction?
This theory no longer saw the substance as the problem but pointed the finger at those individuals who became addicted. Within this perspective, the small minority of those who consumed alcohol to excess were seen as having a problem
36
What is motivational interviewing?
- Help people understand themselves better + links thoughts and feelings with behaviour - Gives People strategies to change lifestyle - Teach people how to manage themselves
37
What are the 5 main principles of motivational interviewing?
``` Avoid arguments Express empathy Support self-efficacy Roll with resistance Develop/ explore discrepancy ```
38
Name three models of decision making:
Paternalistic- clinician led Informational- patient led Shared
39
What is BresDex?
A decision aid to help in breast cancer decisions
40
A patient has alcohol-related problems. There is no physical dependency on alcohol. However, there is evidence of moderate levels of psychological and social harm caused by alcohol. The most appropriate place for a General Practitioner to refer the patient would be:
Alcohol Advice Centre
41
A Px says "I can't give up smoking. It's my only pleasure!" In response, the nurse says "I recognise your choice here and when you think you are ready then come and speak to me about how you might go about it". What, in MI techniques terms, is this an example of?
Rolling with Resistance
42
In terms of motivational interviewing, what is Rolling with Resistance?
Not confronting the client and avoiding providing resistance, especially in the early stages
43
In terms of motivational interviewing, what is developing discrepancy?
Show a mis-match between where the client is and where the client wants to be
44
High pre-operative anxiety is a predictor of what?
Poor post operative outcome
45
In terms of motivational interviewing, what is supporting self efficacy?
Focus on past success, highlighting skills and strengths to help the patient 'believe' they can do it
46
In terms of motivational interviewing, why is expressing empathy important?
Helps build trust with the client | Allows them to be more open
47
When a person dies (say from a rare disease) without having joined the organ donor register, is there any way their organs can be tested to help understanding of the disease post death?
No | In England, all donations, whether from living or dead donors, rely on altruism
48
What is the currently accepted view when deciding on resource allocation between patients with different ages?
Ageism is a term which implies that discrimination on the basis of age is similar to discrimination on the basis of gender
49
Prior to seeing the doctor, people often go through various stages such as seeking advice from associates, friends and family. This behaviour is referred to as:
The lay referral system
50
What is enacted stigma?
Discrimination based on stigma
51
What are the characteristics of problem focused coping?
Seeking information + support Taking problem solving actions Identifying rewards of actions
52
What are some of the characteristics of emotion focused coping?
``` Emotional discharge Resigned acceptance Affective regulation (emotional regulation of feelings) ```
53
What are some of the characteristics of appraisal-focused coping?
Logical analysis Cognitive avoidance Cognitive redefinition of problems
54
What is the definition of dependency?
Shows withdrawal if taken away
55
What is the definition of addiction?
Need for normal function, drives normal behavior
56
What is the definition of substance abuse?
Outside social norms
57
What are the 4 stages of substance addiction?
Initiation Maintenance Cessation Releapse
58
What are the 4 stages of cessation in addiction?
Pre-contemplation Contemplation Action Maintenance
59
What is the concept of stress resistance?
Not all individuals respond to stressors in the same way | - Includes coping strategies, social support and personality traits
60
What is allostatic load?
Stress systems constantly fluctuate | As you respond and recover from stress (allostasis) over time recovery becomes less and less complete
61
What is a state of allostasis?
The recovering from a stressor | returning to homeostasis
62
What is instrumental support?
Physical help (buy shopping etc)
63
Which three groups of people are most likely to visit their GP?
Women Pre-school children Adults over 65
64
What is the difference between morbidity and mortality rates?
Mortality rate = No deaths/ no population (corrected for age and sex as more M die younger) Morbidity rate= No affected/ no population
65
What is the difference between objective and subjective measures of functioning?
Subjective: Individuals rate their own health Objective: Functional questions (eg ADL)
66
What are unidimensional, multidimensional and composite scales of health measurement?
Uni: Focusses on on health aspect (e.g. mood) Multi: Assess broad health (e.g. is your health good. bad) Composite: Combines both
67
What is the ways of coping (Lazarus and Folkman) questionnaire used to asses?
Coping processes
68
In the health belief model what is a lack of health motivation?
"Better things to do"- Seen as unimportant
69
Eldery people are less likely to present in a GP setting because....
They believe their health condition is part of the natural ageing process
70
The Health Belief Model suggests that the most useful predictor of a patient’s likely adherence to treatment is?
The patient’s beliefs about barriers and benefits of the | treatment
71
In the theory of planned behavior what is a subjective norm?
An individuals perception about a behavior, influenced by judgement of significant others (spouse, parent, friend)
72
In the theory of planned behavior what is attitude towards a behavior?
The degree to which performance of a behavior is positively or negatively valued
73
What has the disease model of addiction been criticised for?
Being inconsistent with evidence that some people can return to ‘normal’ drinking patterns - Keeps Px from developing self-control and stigmatizes them
74
What is the disease model of addiction?
Addiction is a disease with biological/ neurological/ genetic and environmental sources of origin. Changes in brains mesolimbic pathway
75
One limitation of the Health Belief Model is...?
It doesn't account for emotional factors such as fear or denial
76
“My local gym is really intimidating” is an example of what?
External behavior control factor
77
In which order to the stages of Levanthals self-regulatory model come?
Interpretation Coping Appraisal
78
What are the steps (in order) of the stages of change model?
``` Pre-contemplation Contemplation Preparation Action Maintenance ```
79
Based on the theory of planned behaviour, an individual’s motivation to comply with others creates their:
Subjective norm
80
According to the protection motivation theory, which 4 things contribute to an individual’s behavioural intentions?
Perceived severity Percieved vulnerability Perceived efficacy of behavior Perceived self-efficacy
81
A patient’s perceptions of the possible effects of an illness on their life describes what type of illness cognition?
Consequence
82
What is the most appropriate way to measure illness cognitions in a clinical environment?
Questionnaires
83
Shontz (1975) describes three stages people go through following a diagnosis, what are these three stages and what characterizes them?
1) Shock(bewilderment/ detachment) 2) Encounter reaction (loss/ grief/ despair) 3) Retreat (Denial of problems and their implications)
84
Crisis theory (Moos and Schaefer (1984)) states what?
People in crisis are particularly susceptible to external influences.
85
What are the 5 changes which affect people in crisis (Moos and Schaefer 1984)?
``` Identity Role - now passive and dependent Social support - isolation is common Location- hospitalization Future- uncertainty ```
86
According to Moos and Schaefer (1984), once confronted with the crisis of an illness, which three processes constitute the coping process?
Cognitive appraisal Adaptive tasks Coping skills
87
Name 3 predictors of compliance according to Ley (1981/89), what is not a predictor?
Understanding/ memory/ satisfaction NOT: Ease of use
88
To a social learning perspective, addictive behaviors are learned according to which processes?
Classical conditioning Operant conditioning Observational learning Cognitive processes
89
Which of the 4 stages of substance use is influenced by self-help?
Cessation
90
Which of these is a process of relapse? | (a) Subjective norms (b) Societal norms (c) No coping response (d) No cues to action (e) None of the above
c) No coping response

Semester 4 (NME) (24 decks)

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