BSS: Psychological impacts of injury Flashcards
What is the immediate impact of traumatic injury?
- Psychological shock
* Strong emotional response to sudden/unexpected event, ANS activates physiological responses - Distress
* Related to cause of event rather than severity of injury, levels of distress early post- injury strong predictor of subsequent distress - Anger
* May be directed at emergency team - Inappropriate calmness/denial
* Can reflect dissociation from event
What are some immediate managements to injury?
- Investigation
- Physical treatment/analgesia
- Explanation & reassurance
- Information to & support of relatives
- Referral to ICU as appropriate
- Advice about activities/return to work
- Information about sources of support
Cognitive responses to injury.
-Cognitive appraisal
- Cognitive appraisal – evaluation of threat & coping resources
- Attributions – construct reasons for events
- Self-image – thoughts about appearance
- Self-belief– thoughts about who we are & our worth
- Sense of loss : ability work , confidence , functionality to work
- Desire for compensation?
Emotional responses to injury.
- Numbness
- Anger
- Shock
- Depression
> Individual pathway rather than universal stages
> Negative emotions linked to increased report of symptoms, pain & distress
Behavioural responses to injury.
- Aggression, agitation
- Adherence to rehabilitation
> Under-adherence (depression)
> Over-adherence (anger) - Malingering? - Patient still might suffer quite difficult psychological symptoms despite being physically better
-Use of social support : to moderate behaviour
- What is the model of psychological response? What is its purpose?
- What does the way the individual appraises their injury dictate?
- What is a feature of appraisals to injuries and their consequences?
- > Recovery outcomes are dependant on personal and situational factors through their influence on our cognitions, emotions and behaviours
- Their psychological; reactions or emotional responses to injury
- Not static and can change as injury progresses and setbacks are experienced
Give some personal factors that may affect recovery outcomes.
- Injury & previous experiences
- Personality (confident, resilient)
- Demographics (Age , SES)
Give some situational factors that may affect recovery outcomes.
- Personal
* Social support
* Economic situation
* Employment - Healthcare related
* Medical provision - availability is there long waiting times?
* MDT support
* Rehabilitation environment - companionship > people with similar experiences
* Accessibility & availability of rehab
Recovery outcomes.
Why is Psychosocial recovery as important as physical recovery?
- Loss of confidence
- Even if physical injury’s heal, individual may still feel unwell, depressed, and not the same as before injury
What is the self regulatory model/ purpose?
What are its 3 stages?
-Recovery outcomes are dependant on how individuals :
* Interpreting the threat
* Coping with threat
* Appraising the coping
Describe stage 1 of self regulatory model.
- Interpretation
Perception of injury :
-nature of the injury, the person & their situation
> Cognitive representations :
* Identity (What is it?)
* Cause (What caused it?)
* Control (What can be done)
* Time line (How long will it last?)
* Consequences (How will it affect me?)
> Emotional response:
* Denial
* Anger
* Depression
Describe stage 2 of self regulatory model.
- Coping
Is coping static?
Coping with thoughts & emotions:
* Approach style – e.g. learning about injury, attending rehabilitation
* Avoidant style – e.g. denial, wishful thinking, alcohol abuse
> No, coping can change depending on how they appraise the situation
Describe stage 3 of self regulatory model.
-Appraisal
- Individual assess success of coping strategies
> impacts on interpretation of threat & coping behaviour
»Individual regulates their own behaviour
What does healthy/maldaptive adaptation lead to?
What does the self regulatory model allow?
- Maturation OR deterioration
- Changes over time : explains how individuals adapt to injuries and its consequences
Pathological long term effects:
Psychological….
- Acute stress disorder (2 days – 4 weeks)
- Post-traumatic stress disorder (within 6 mths and lasts longer than 4 weeks)
- Intrusive memories, flashbacks, nightmares, chronic & hyper–arousal, numbness, memory disruption
- Depression
- Phobic anxiety
- Chronic pain/disability
- Unexplained symptoms
