Chronic Illness Flashcards
Know how medical measures of quality of life are correlated
Medical measures are only weakly related to patients’ or relatives’ assessments of quality of life
What does assessment of quality of life considers?
Physical functioning
Social functioning
Psychological status
Disease or treatment related to symptomatology
Researchers focus on how much the disease and its treatment interfere with daily activities like sleeping, eating, going to work, and activities.Quality of life assessment gauge the extent to which a patient normal life activities has been comprised by disease and treatment
How does depression differ from in anxiety and denial?
Depression may occur later in the adjustment process than does denial or severe anxiety
Know about denial
Denial is the defense mechanism by which people avoid the implication of an illness
- Patient act as if the illness is not severs, it will shortly go away, or as if it will have long term implication
- It can serve a protection function by keep patient from having to come to terms with the illness
- Denial can reduce the experience of unpleasant symptoms and side effect of treatment
What’s the most frequently cited stressor for cancer patients
Fear and uncertainty of the future. Limitation of physical ability, appearance, lifestyle, and pain management
What are the effects of body image ( alteration of body image )
• Is the perception and evaluation of one’s physical functioning and appearance
Negative aura
For acutely ill patient, changes in body image are short lived
For chronically ill patient, negative evaluation last longer
Body image is related to low self-esteem and an increased likelihood of depression and anxiety
Successful adjustment to chronic illness is associated with what?
• Rebuilding the social self is an important aspect of readjustment after chronic illness
Interaction with family and friends is a critical source for self-esteem
Good social resource -information, help, emotional support
Positive self-perception- because they contribute to a higher quality of life and influence longevity
Analyses of the effectiveness of coping strategies in managing the stress associated with chronic illness conclude that?
Avoid-ant coping is associated with creased psychological distress and a risk factor for adverse responses to illness. Active coping predict good adjustment to several disorder, lower distress, and high internal lucus control
When was patient’s rehabilitation most successful in long term, when the patients spouse attributes infarction to what?
• If the patient attribution were to external, uncontrollable factors or denied the heart attack even occurred, long term rehabilitation progresses better when the SPOUSE ATTRIBUTION WAS INCONGRUENT WITH THE PATIENT ATTRIBUTIONS
Study by Collins: how many cancer patients reported some beneficial change in their lives?
• More than 90% of cancer patients reported at least some beneficial changes in their lives as a result to cancer
Increase of appreciation
Putting efforts in relationships
Empathy and compassion
Web Md
• it is mentioned in the text that WebMD is one of the better known websites that are scrupulously careful about the information they post. They say that it is devoted to providing consumer and health information on the Internet
What is one important contributing factor to mid-life crisis
• Midlife crisis is the realization of death
They may be touch by a death of a parent, acquaintance, or friend
Their body is getting older
Loss of physical appearance ,sexual drive, or athlete ability
Work become meaningless
Adopt changes of midlife crisis like changing jobs, divorce and being remarried
The death rate among middle age adults has declined largely because of a 60% in what?
Death rate in middle age group have decline, due in large part to a 60% drop in cancer
As a patient prognosis worsen what happens to their interpersonal communication? (Interpersonal communication deteriorates why?)
• As the prognosis worsen and treatment becomes more drastic, communication may start to break down
Medical staff become evasive (indirect) when question about the patient
Death is a taboo topic
The people involve may believe the other person don’t want to talk about it
The participants have personal reasons for not wanting to discuss death ( patient don’t want to hear their answer to un asked questions because they know the answer and fear to confirm it )
Family feel guilty for not making them see the doctor before hand
Staff fear of approaching family with bad news
How does psychotherapy with the dying differ from traditional psychotherapy?
• The format is different and therapy is likely to be short term
Nature and time of visits must depends on the inclination and energy level of the patients rather than a fixed schedule appointment
If an issue arise and the patient don’t want to discuss it, their wish should be respected
Elisabeths Kubler- Ross stages of adjustment to dying
- Denial -the first stage is thought to be a person’s initial reaction on learning of the diagnosis of terminal illness. Patient may even deny that they have the illness, despite having been giving clear information. Denial, then, is the subconscious blocking out full realization of the reality and implications of disorder.
- Anger-second stage, why me? Considering all the other people who could have gotten the illness. The angry patient may show resentment toward anyone who is healthy, like hospital staff, family, and friends.
- Bargaining - third stage, the patient abandon anger in favor of a different strategy:Trading good behavior for health. Patient agrees to engage in good works or at least to abandon selfish ways in exchange for better health or more time.
- Depression - fourth stage, coming to terms with lack of control (anticipatory grief) Patient acknowledges that little can be done to stay the course of illness. Patient feels nauseated, breathless, and tired. They find it hard to eat, control elimination, to focus, and escape pain or discomfort.
- Acceptance - fifth stage, the patient may become too weak to be angry and too accustomed to the idea of dying to depressed.Patient use this time to make preparations, deciding how to divide up their remaining personal possessions and saying goodbye to old friends and family members.
Researchers investigating gender differences in the receipt of social support found what?
Social support maybe protective toward women than men. That being married benefit men than woman in terms to life span
The main cause of premature death in adulthood is sudden death due to what?
Sudden death due to heart attack or stroke
After infancy the main cause of death in children under 15 is what?
Accidents , account for 40% of all deaths in this group
Why are patients less likely to turn to alternative treatments? When they are satisfied with what?
When patient are well informed and feel cared by others
According to the research in your text, a substantial percentage of terminally ill patient prefer what type of care?
Home care appear to be the care of choice for most terminally ill patients
Due to hospital cost and many people cannot afford hospitalization
What does competent home care for the terminally ill require?
They will have to have regular contact between medical personnel and family members. The family members is adequately trained
When young children experience the impending death of a sibling, the best approach is what?
• In leading a child to cope with the death of a parent or a sibling, it is best not to wait until the death has actually occurred.
Rather, the child should be prepared for the death, perhaps by drawing on the death of a pet or a flower to aid understanding.
The child question about death should be answered as honestly as possible, without unwanted details
What are the goals of medical staff who work with the dying?
- Informed consent -patient should be told the nature of their condition and treatment to some extent. To be involved in their treatment.
- Safe conduct- they physician and other staff should act as helpful guides for the patients through this new and frighten stage of life
- Significant survival- the physician and other medical staff should help the use his or her remaining time as well as possible
- Anticipatory grief - the patient and their family member should be aided in working through their anticipatory sense of loss and depression
- Timely and appropriate death -the patient should be allowed to die when and how they want to be. The patient should be allowed to achieve death with dignity.
