Chronic Illness

Question 1

Know how medical measures of quality of life are correlated

Answer 1

Medical measures are only weakly related to patients’ or relatives’ assessments of quality of life

Question 2

What does assessment of quality of life considers?

Answer 2

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

Question 3

How does depression differ from in anxiety and denial?

Answer 3

Depression may occur later in the adjustment process than does denial or severe anxiety

Question 4

Know about denial

Answer 4

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

Question 5

What’s the most frequently cited stressor for cancer patients

Answer 5

Fear and uncertainty of the future. Limitation of physical ability, appearance, lifestyle, and pain management

Question 6

What are the effects of body image ( alteration of body image )

Answer 6

• 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

Question 7

Successful adjustment to chronic illness is associated with what?

Answer 7

• 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

Question 8

Analyses of the effectiveness of coping strategies in managing the stress associated with chronic illness conclude that?

Answer 8

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

Question 9

When was patient’s rehabilitation most successful in long term, when the patients spouse attributes infarction to what?

Answer 9

• 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

Question 10

Study by Collins: how many cancer patients reported some beneficial change in their lives?

Answer 10

• 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

Question 11

Web Md

Answer 11

• 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

Question 12

What is one important contributing factor to mid-life crisis

Answer 12

• 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

Question 13

The death rate among middle age adults has declined largely because of a 60% in what?

Answer 13

Death rate in middle age group have decline, due in large part to a 60% drop in cancer

Question 14

As a patient prognosis worsen what happens to their interpersonal communication? (Interpersonal communication deteriorates why?)

Answer 14

• 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

Question 15

How does psychotherapy with the dying differ from traditional psychotherapy?

Answer 15

• 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

Question 16

Elisabeths Kubler- Ross stages of adjustment to dying

Answer 16

• 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.

Question 17

Researchers investigating gender differences in the receipt of social support found what?

Answer 17

Social support maybe protective toward women than men. That being married benefit men than woman in terms to life span

Question 18

The main cause of premature death in adulthood is sudden death due to what?

Answer 18

Sudden death due to heart attack or stroke

Question 19

After infancy the main cause of death in children under 15 is what?

Answer 19

Accidents , account for 40% of all deaths in this group

Question 20

Why are patients less likely to turn to alternative treatments? When they are satisfied with what?

Answer 20

When patient are well informed and feel cared by others

Question 21

According to the research in your text, a substantial percentage of terminally ill patient prefer what type of care?

Answer 21

Home care appear to be the care of choice for most terminally ill patients
 Due to hospital cost and many people cannot afford hospitalization

Question 22

What does competent home care for the terminally ill require?

Answer 22

They will have to have regular contact between medical personnel and family members. The family members is adequately trained

Question 23

When young children experience the impending death of a sibling, the best approach is what?

Answer 23

• 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

Question 24

What are the goals of medical staff who work with the dying?

Answer 24

• 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.

Question 25

What is the number one killer in the United States accounting for 20% of all death?

Answer 25

Coronary heart disease

Question 26

What is the combination of obesity centered around the waist, high level of triglycerides, low levels of HDL cholesterol, and difficulty metabolizing blood sugar are symptomatic of what?

Answer 26

Metabolic syndrome, which helps predict heart attacks

Question 27

What percentage of women dies from a first heart attack as compared to men? Know statistics for both?

Answer 27

Women have a 50% chance of dying from a first heart attack, compared to 30% men.

Question 28

What cynical hostility is, what is it characterized by?

Answer 28

Characterized by suspiciousness, resentment, frequent anger, antagonism, and distrust of others.

Question 29

What remains an under-diagnosed and untreated contributor to CHD morbidity and mortality

Answer 29

Depression

Question 30

When does cardiac invalidism occur

Answer 30

It occurs as a consequence of myocardial infarction. Patients and their spouses see the patient’s abilities as lower than they actually are

Question 31

Where is sudden death from heart attack most likely to occur?

Answer 31

Approximately 70% of sudden deaths from heart attacks occur when in the home rather than the workplace

Question 32

What is the correlation between someone’s beliefs about the level of blood pressure and the actual blood pressure? High, low, moderate?

Answer 32

Low

Question 33

The predictors of depression in stroke patients include?

Answer 33

• Depression is a serious problem for stroke patients, and it depends on the site of the stroke and severity.
 Psychosocial factors predicts the degree of depression
 Depression depends on the relationship the stroke patient has with caregiver overprotective caregiver is linked to poor relation and if the caregiver view the situation negatively then both people will be depress
 If patient experience poor perception of the future and perceive little meaning in life it can lead to depression

Question 34

What is alexi-thymia?

Answer 34

After a stroke, right-brain-damaged patients often have alexithymia, which involves difficulty in identifying and describing feelings

Question 35

Herbert and Cohen did a study in 1993, their reviews of literature found support that the immune functioning is impaired by what?

Answer 35

Depression alteration to the immune system

Question 36

Long-term provision of care to friends or family members with long-term illness has been linked with a range of health related problem, this can be attributed to caregiver what?

Answer 36

Severe and long term stressors

Question 37

What may mute the adverse effects of stress on the immune system?

Answer 37

Relaxation

Question 38

What is the most common mode of transmission of HIV AIDS world-wide?

Answer 38

70%-75% of heterosexual

Question 39

According to the Center of Disease Control and Prevention, the number of AIDS cases is growing fastest in which population?

Answer 39

The number of AIDS cases is growing faster among women, especially minority women, than any other group

Question 40

Condom use among adolescents?

Answer 40

Adolescents DO NOT use condom because it is uncomfortable to insist on it in the passion of the moment

Question 41

What does research investigating the relationship between psychosocial factors and cancer find?

Answer 41

Research examined the role of psychosocial factors in the course of cancer, specifically, whether the cancer progresses rapidly or slowly.
 Avoidance or the inability to confront the disease and its implications (consequences) has been associated with more rapid course of the disease.
 Research found a positive association between depression and cancer. And found the risk for smoking-related cancers among smokers who were depressed. And an increase for non-smoking associated cancers.
 They found a relationship between cancer and use of denial or repressive coping strategies.

Question 42

In one study of a cognitive behavioral treatment for Rheumatoid Arthritis as something increase and something decrease.

Answer 42

Cognitive behavioral interventions in the treatment RA has been used
 The study: RA patient were randomized into a cognitive-behavioral treatment that taught skills in managing stress pain, and symptoms of the disease, or they received an arteries self-help book containing useful information about athirst self-management.
 Cognitive-behavioral treatment was designed to increase perception of self-efficacy with respect to the disease
 Experience reduced pain and joint inflammation and improved psychosocial factor

Question 43

Osteoarthritis

Answer 43

• Affects an estimate of 26.9 million Americans……women are more commonly affected than men
• This disorder develops when the smooth lining of a joint, known as, articular cartilage, begins to crack or wear away because of overuse, injury, or other causes.
• The disease tends to affect the weight-bearing joints: the hips, knees, and spine. As the cartilage deteriorates, the joint may become inflamed, stiff, and painful