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PSYC 314 > Chapter 9: Chronic & Terminal Illness > Flashcards

Chapter 9: Chronic & Terminal Illness Flashcards

1
Q

Chronic Conditions - Stats

A
  • most of us likely to develop at least 1 chronic condition that may lead to our death
  • 2/3 of canada health spending is on chronic conditions
  • more common among lower income, women, seniors
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2
Q

Crisis Theory

A

factors that influence how ppl adjust/cope after first learning they have a chronic illness (illness-related factors, personal, physical/social)

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3
Q

Adaptive tasks in coping

A
  1. tasks related to the illness or treatment (adjusting to hospital environment, etc.)
  2. tasks related to general psychosocial functioning (control negative feelings, positive outlook, etc.)
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4
Q

Coping with Cancer - patient strategies

A
  • social support
  • distancing
  • cognitive escape
  • behavioural escape
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5
Q

maladaptive coping

A
  • rumination
    -interpersonal withdrawal
  • avoidant coping (denial)
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6
Q

Informal Caregiving

A

The provision of physical/emotional care to a family member or friend at home

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7
Q

caregiving as a chronic stressor

A

The stress of caregivers is generally higher than non-caregivers and for that reason caregiving is considered a chronic stressor

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8
Q

Factors in caregiving stress

A
  • not having te time to care for oneself
  • engaging in unhealthy behaviours due to lack of time
    disrupted or insufficient sleep
  • poor stress management and stress prevention
  • degrading social relationships and social support
    caregivers are also m ore likely to believe that stress is having a negative impact on their physical health
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9
Q

Economic burden of caregiving

A
  • extra expenses
  • postponed education
  • declined promotion
  • missed days of work
  • reduced hours of work
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10
Q

Health Costs of Caregiving

A

Higher levels of depression and physical health problems in caregivers when compared with non-caregivers
- abnormalities in measures of endocrine (cortisol) and immune system function
- spouse caregivers are at risk of premature death

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11
Q

Benefits of caregiving

A
  • majority of caregivers consider it a positive experience
  • providing the best care possible
  • staying connected or becoming closer
  • rewarding sense of accomplishment, giving back to someone who has cared for them
  • sense of meaning and purpose
  • passing on a tradition of care in family
  • learning new skills
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12
Q

Future of Caregiving

A

based on stats Canada:
- there will be approx 120% more older adults using home care support
- there will be approx 30% fewer close family members avail to provide unpaid care
- family members will need to increase their efforts by 40% to keep up with care needs

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13
Q

Managing Terminal Illness

A

mortality is the main issue of concern to patients in the first few months of being diagnosed with a seriously life-threatening illness

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14
Q

High mortality illness

A

a high mortality disease does not typically mean a person will die in a few weeks or months
- however, families must adapt to this uncertainty (a source of stress in terminal illness)

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14
Q

denial in terminal illness

A

Denial is common in terminal illness - in some cases can be extreme and persistent
- many patients also hope they will be cured or hope for a miraculous recovery

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15
Q

denial and acceptance

A

denial is more common early on and acceptance is more common closer to death

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15
Q

acceptance in terminal illness

A

acceptance is important for both patients and their loved ones

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15
Q

Initial Response to pain

A

Sense of control is lowered; secondary appraisal is common
- engage in more emotion-focused coping early on

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16
Q

Crisis theory

A

Describes factors that influence how ppl adjust/cope after first learning they have a chronic illness

17
Q

Adaptive Tasks in Coping

A
  1. Tasks related to the illness or treatment
    - coping with the symptoms or disability of illness
    - adjusting to hospital environment, procedures, treatments
    - developing good relationships with practitioner
  2. Tasks related to general psychosocial functioning
    - controlling negative feelings
    - having positive outlook
    - maintaining satisfactory self-image, sense of competence
    - preserving good relationships with family/friends
    - preparing for uncertain future
18
Q

Coping strategies cancer patients found most useful

A
  • social support
  • distancing
  • positive focus
  • cognitive escape/avoidance
  • behavioural escape/avoidance
19
Q

Maladaptive Coping

A
  • rumination
  • interpersonal withdrawal
  • avoidant coping
20
Q

Rumination

A

associated with exacerbation of symptoms

21
Q

interpersonal withdrawal

A

associated with loneliness and low relationship satisfaction

22
Q

avoidant coping

A

associated with increased psychological distress and can exacerbate the disease process - leads to poor adjustment to illness

23
Q

denial in cancer patients

A
  • denial of diagnosis
  • denial of impact
  • denial of emotions

Impact on physical and social functioning were inconsistent; the impact on psychological functioning depended on the form of denial

Distractive strategies were found reduce distress, whereas passive escape mechanisms turned out to decrease psychological well-being

24
Q

Depression in cancer patients

A

may be delayed as patients try to understand implications of condition
- physically debilitating
- direct impact on symptoms
- history of depression is associated with poorer adjustment to cancer and other chronic illnesses

25
Q

Can depression impact cancer survivability

A

increasing depression = decreasing months of survival!

26
Q

cancer stigma

A

cancer stigma depends on the extent to which a person’s identity and sense of self are affected by the diagnosis
- perceived controllability and visibility of cancer, and whether it interferes with daily functioning are also main factors in cancer stigma

27
Q

effects of cancer stigma

A

stigma is associated with more problematic outcomes (ex. depression)

  • cancer stigma is correlated with reduced cancer screening for cervical, breast, and colorectal cancer
28
Q

adaptation

A

making changes in order to adjust constructively to life’s circumstances

Successful adjustment to chronic conditions involves several major adaptive tasks that continue indefinitely

29
Q

Cancer survivor

A

Long-term cancer survivor have higher rates of emotional distress, especially those of lower SES and those who are single and disabled

Social relationships are impacted, especially for couples

most cancer patients display a remarkable amount of resilience

30
Q

Quality of Life

A

The degree of excellence people appraise their lives to contain

Based on physical, psychological, vocational, and social functioning; includes disease or treatment related symptoms

Emphasis is placed on daily living

an important indicator of recovery from

31
Q

Evaluating quality of life

A

the most important aspect of quality of life is a person’s perceptions of their own health (Self reported or subjective health)

32
Q

is subjective health consistent with objective health

A

Yes! Self reported health is associated with prevalance of all diseases, onset if all diseases, and labratory parameters of health

33
Q

Is subjective health predictive of mortality?

A

Self reported health significantly predicts mortality in longitudinal research often more than objective indices of physical health

34
Q

Is life satisfaction predictive of morbidity

A

YES - there is also a significant association between life satisfaction and onset of many chronic diseases

35
Q

Is life satisfaction predictive of mortality

A

YES - life satisfaction scores predict mortality (although less consistently than self-reported health)

36
Q

What psychological interventions are used to manage chronic illness and disease

A
  • Psychopharmacological
  • patient and family education
  • individual or family therapy
  • stress management/relaxation
  • support groups
37
Q

psychological benefits of
Cancer Support Groups

A

there is a significant survival benefit from support groups at one-year, but not 4 years
- improved mood
reduced uncertainty
-improved self-esteem
- enhanced coping skills
- improved quality of life

38
Q

Factors in caregiver stress

A
  • not having time to care for oneself; feeling overwhelmed
  • engaging in unhealthy behaviours due to lack of time
  • disrupted or insufficient sleep
  • poor stress management
  • degrading social relationships and poor support

caregivers are also more likely to believe that stress is having a negative impact on their physical health

39
Q

Health costs of caregiving

A

higher lvls of depression and physical health problems

abnormalities in measures of endocrine (cortisol) and immune system functioning

premature death

40
Q

benefits of caregiving

A

overwhelming majority of caregivers consider it to be a positive experience

  • providing the best care possible
  • staying connected or becoming closer
  • rewarding sense of accomplishment, giving back to someone who has cared for them
  • sense of meaning and purpose
  • passing on a tradition of care in family
  • learning new skills
41
Q

Future of caregiving

A
  • there will be approx 120% more older adults using home care
  • approx 30% fewer close family members who will be avail to provide unpaid care
  • family members will need to increase their efforts by 40% to keep up with care needs
42
Q

Denial in terminal illness

A

enial is common in terminal illness yet it can pose significant challenges for the person and their family

Many patients also hope they will be cured or hope for a miraculous recovery. This can lead patients to choose aggressive care, even if it is futile

43
Q

Denial/Acceptance

A

There is evidence that denial is more common early on and acceptance is more common closer to death

44
Q

Acceptance in Terminal Illness

A

Acceptance is important for Both patients and their loved ones. But acceptance means different things to different people

PSYC 314 (6 decks)

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