BSS: Coping with chronic illness Flashcards

1
Q

What is the WHO detention of chronic disease?

A
  • A disease that has a long duration and is the result of a combination of genetic, physiological, environmental and behavioural factors
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2
Q

What makes chronic disease treatment different to acute disease care?

A
  • Chronic disease treatment is focused more on management of symptoms rather than a cure for the disease.
    > Improvements in treatment mean people may live with a condition for many years
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3
Q

Describe the model that links stress and ill health?

A
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4
Q

What are some of the main stressors for chronic illnesses?

A
  • symptoms
  • medical consultation processes
  • investigations
  • diagnosis
  • treatment
  • interference in daily life
  • any adjustments that have to be made to an individuals life
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5
Q

Define coping.

A
  • Cognitive & behavioural efforts to manage external &/or internal demands that are appraised as taxing or exceeding the resources of the person
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6
Q

What are the two main situations when coping strategies will be needed?

A
  • everyday life, daily stresses and hassles (seem small compared to major events)
  • major life events
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7
Q

What is the self regulatory model?
What does it explain?

A
  • Explains adjustment at diagnosis &throughout course of disease
  • Health behaviours are dueto representations of disease that are constructed based on knowledge & past experience
  • Beliefs differ across &within different diseases based on perceived severity/threat
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8
Q

How would we use the self regulatory model to apply to real life situations?

A
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9
Q

What are the 2 ways in which coping methods can be classified?

A

– Problem-focused v. Emotion-focused

– Approach v. Avoidance

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10
Q

Describe Problem focussed and Emotion focussed.

What have studies indicated?

A
  • Problem-focused: Doing something practical to tackle the problem e.g. taking medication, seeking medical advice, seeking information
  • Emotion-focused: Doing something to manage your emotions
    e.g. venting negative feelings, seeking social support, positive reappraisal, avoidance

> Matching the stressor and the strategy is important
– Controllable → problem-focussed
– Not controllable → emotion-focussed

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11
Q

Describe Approach and Avoidance coping.

A
  • Toward or away from the stressor/related emotions?
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12
Q

What are some pros and cons of information seeking and avoidance?

A

Information seeking :
ü Can reduce uncertainty and increase sense of control
ü Can promote adherence
× Too much information can increase anxiety (blunters)
× Different patients will want/benefit from different amounts and types of information

Denial :
ü Can be beneficial in short term, by minimising anxiety and distress
× Prolonged denial impacts on adherence
× Prevents patients ‘coming to terms’ with their disease

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13
Q

What are the 5 stages of grief? How does this link to coping?

A

> not fixed!
– Denial
– Anger
– Bargaining
– Depression
– Acceptance
* The stage a person is at could influence their ways of coping at that time

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14
Q

Outline 3 individual differences and how they would respond generally to a diagnosis.

A
  • optimistic - positive thinking style
  • hardy personality - sees change as a challenge, demonstrate commitment and control - see change as normal aspect of life, not a threat. They can remain healthy even under stress
  • negative affect - linked to increased symptom perception
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15
Q
  1. Outline the illness related adjustments that would need to be made with a chronic disease
  2. Outline the adjustments that would need to be made in terms of general tasks of those with a chronic disease?
A
  1. – Living with symptoms & pain
    – Learning about treatments & management – Relationships with health care professionals
  2. – Managing social & emotional consequences
    – Preserving self-image, competence & mastery
    – Preparing for an uncertain future
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16
Q

What are the 3 cognitive processes proposed that aid adjustment to chronic disease?

A
  1. search for meaning - understand why it has happened and its impact, regain order and purpose
  2. regain mastery - gain control over event and life (or beliefs) e.g. that they can control of their symptoms or that the healthcare professionals will take good control
  3. enhance self esteem - comparison with people perceived as less fortunate
17
Q
  1. What does ‘response shift’ mean in regards to adjusting to chronic disease?
  2. What does ‘reality matching’ mean in regards to adjusting to chronic disease?
A

1.
– Change in perspective & priorities in life
– Realign goals to fit with new situation

  1. Maladaptive outcomes can occur when appraisals don’t match reality. Frustration and disappointment arise when uncontrollable events are deemed controllable.
    - more favourable outcomes occur when appraisals match reality
18
Q

What does adjustment to chronic illness involve?

A

> Process to help achieve a positive view of the self & the world in the face of the new problem
Likely to take some time – will involve assessing new information, developing adaptive views, re-evaluating priorities

Brings about change in:
– Role/Identity
– Functioning/ Isolation
– Social support
– Future (biographical disruption)

19
Q

What factors can complicate adjusting to chronic disease?

A
  • limited previous experience of chronic illness/ little awareness
  • decisions need to be made quickly about treatment etc, things happen fast paced so cant think about what is best option
  • unpredictability and uncertainty about prognosis and diagnosis
  • additional external stressors unrelated to disease that are overall increasing stress levels
20
Q

Define self management.

A
  • Anything that promotes the active involvement of a patient in managing their condition
21
Q

Why is self management difficult for some patients?

A
  1. Lifestyle changes are more difficult to make than changes that are illness-specific
  2. Patients may not see immediate benefits
  3. Must become part of patient’s normal daily life
  4. Will require adjustment
22
Q

What factors can make self management easier?

A
  1. Self-efficacy - belief they can do it
  2. Environmental factors
    – Supportive healthcare providers
    – Social support
    – Safe physical environment (e.g. housing, air quality)
23
Q

Outline some effects (pro and cons) of social support on adjusting to life with a chronic disease.

A

PROS
- encourages health promoting behaviour
- improves psychological wellbeing
- can reduce stress directly or by changing the patients perspective e.g. increased optimism, taking coping suggestions on board
- Most effective when the social support matches what the patient feels they need and want from it

CONS
- Social relationships do not guarantee social support > can be source of stress and compromise patient wellbeing