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Behavioral Science > Communication: Younger Patients > Flashcards

Communication: Younger Patients Flashcards

1
Q

Piaget’s 4 different stages of cognitive development

A

Sensorimotor
Preoperational
Concrete operational
Formal operational

Before each of these stages, children don’t have the ability of understanding certain things irrespective of their intelligence.

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2
Q

Sensorimotor 0-2 years

A

Characteristics:
Experience of the world through movements and sensations

Developmental changes:
Object permanence
Infants are separate beings from the world around them
They realize actions can cause things to happen around them, causality
Learning occurs through assimilation and accommodation

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3
Q

Preoperational (2-7 years)

A

Characteristics:
Symbolic thinking (words/objects)
Egocentrism

Developmental changes:
Thinking still very concrete although it improves with language
Children struggle to see things from others perspectives

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4
Q

Concrete-operational 7-11 years

A

Characteristics:
Logical thinking about concrete events

Developmental changes:
Concept of conservation
Thinking becomes logical and organized, concrete inductive reasoning (specific info to a general principle)

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5
Q

Formal operational 12 years and up

A

Characteristics:
Abstract thinking and reasoning concerning hypothetical problems

Developmental changes:
Abstract thought
Teens begin to think more about moral, philosophical, ethical, social, and political issues that require theoretical and abstract reasoning
Begin to use seductive logic, or reasoning from a general principle to specific info

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6
Q

Attachment theory

John bowl by 1969

A

Most important principle is that an infant needs to develop a relationship wit at least one primary caregiver for social and emotional development to occur normally

Explains how much the parents relationship with the child influences child development

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7
Q

Separation anxiety

A

Occurs at around 7-12 months where child starts feeling distressed when the mother is absent

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8
Q

Pre-operational 2-7 years

A

Children have limited logic, and beliefs about illness are vague and often superstitious. The child associates illness with one specific and often unrelated cause

Children link causes of illness to some behavioral factors and may display fear quilt and anxiety

Children tend to focus on one symptom
Implication: the child may not report all the symptoms they are experiencing and the actual cause may be ignored

Children over generalize the conditions that’s are infectious—broken arm from brother and measles from over a telephone
Implication: child may fail to recognize an actual role of condition so they will not report it

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9
Q

Concrete operational stage

7-12 years

A

Child may recognize that disease may have a range of symptoms so their ability to report their bodily sensations and possible causative agents improves

Child understand that disease is caused by germs and transmitted through certain means

Later part of the stage, children also start to recognize the short term health risks of their own behavior… cig smoke is bad for lungs and too many sweets are bad for teeth
Implication: child is more likely to follow health advice as they understand the impact of their actions on their own health

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10
Q

Formal operational stage

12 years onwards

A

Exposure to education increases understanding about body structure

More capable of understanding scientific explanations of the cause and effects of their own illnesses
Understand the purpose of the treatment-even if it’s uncomfortable feeling

Implication: children are able to follow logical arguments so they are more able to discuss alternative treatments

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11
Q

Myths associated with childhood pain:

A

Children do not feel pain
Children do not remember pain
Analgesics can do more harm than good addressing and treating pain takes too much time
Pain build last character

THE EXPERIENCE OF PAIN IN THE CHILD CAN BE INFLUENCED BY THE UNDERSTANDING AND COMMUNICATION INCLUDING NONVERBAL CUES PROVIDED BY SIGNIFICANT OTHERS (anxiety and fear in mother)

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12
Q

Adolescence

A

Transitional developmental period between childhood and adulthood

This stage can have more biological,psychological and social changes than any other stage except infancy

Key time for developmental or positive health behaviors along with the emergence of health risk behaviors

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13
Q

Primary prevention

A

Interventions are designed to alter health risk behaviors before these begin

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14
Q

Factors influencing parents decisions to choose chiropractic care for their children

A

Personal referrals
Lack of knowledge
Dissatisfaction with conventional medicine

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15
Q

Andrew and Boyle view culture as consisting of four central characteristics

A
  1. Culture is learnt from birth through language acquisition and socialization
  2. Culture is shared by all members of the same cultural group
  3. Culture is an adaptation to specific activities related to environmental and technical factors and to the availability of natural resources
  4. Culture is a dynamic and ever-changing process
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16
Q

Socialization

A

Socialization refers to the way culture is transmitted and the individual is integrated into the groups organized way of life

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17
Q

De Santis

3 different culture categories that operate when you care for a patient

A

Physician culture
-medical jargon
Health setting culture
-rule specific to the organization you are working within
Patients culture
-health beliefs that differ from the ones you are following, which may influence how they perceive their current symptoms and the treatment prescribed

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18
Q

Jehovah’s witnesses

A

Founded by American Charles take Russell in the 1870s

Refusal of blood transfusion

Baptized Jehovah’s Witness often carry an advanced medical directive/release document instructing health care professional by to give blood transfusions under any circumstances and releasing hospital a for any damage caused by refusal of blood.

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19
Q

Rastafarianism

A

Evolved with teaching of Marcus Garvey who worked to promote interests of people of African descent and developed as an alternative to western colonial influence

Belief in natural healing process
Body is temple of god
Eat natural foods that are fresh and pure
Prohibition of pork,alcohol and predatory fish

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20
Q

Christianity

A

Estimated that 7 million practicing Christians in US and many more describe themselves as Christians

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21
Q

Traditional health related beliefs and practices among different ethnic groups fall into three groups

A

Harmless beliefs:foundation in traditional practice
Positive health outcomes:preventative activities
Harmful beliefs: health benefits and practices that result in physical harm or negative health continues

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22
Q

Personalistic systems based on three main causes of illness

A

Supernatural forces
Non humans- ghosts,ancestors or evil spirits
Human beings, witches or sorcerers

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23
Q

Naturalistic systems

A

When body is out of balance with natural environment

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24
Q

CBT

A

Cognitive behavioral therapy

Therapy that can help patients manage their problems by changing the symptoms why they think(cognitive) and what they do (behavioral)

MOST COMMON TO TREAT ANXIETY AND DEPRESSION

ALSO, 
OCD
Panic disorder
PTSD
BIPOLAR DISORDER
PSYCHOSIS
ANGER
LOW SELF ESTEEM 
EATING DISORDERS
SLEEP PROBLEMS
PROBLEMS RELATED TO ALCOHOL MISUSE

ALSO WITH LONG TERM HEALTH CONDITIONS-can’t cure physical symptoms but can help people better cope with their symptoms
IRRITABLE BOWL SYNDROME
CHRONIC FATIGUE
CHRONIC PAIN SYNDROME

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25
Q

GOALS OF CBT

A

Provide patients with clear and credible rationale for understanding their disorder and mechanisms for therapeutic change

Offer highly structured sessions

Be active and problem-focused

Encourage self/monitoring and the assessment of progress

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26
Q

CBT breaks down problems. The 5 parts are:

A

A situation-problem event or difficult situation

Thoughts

Emotions

Physical feelings

Actions/behavior

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27
Q

5 AREAS OF ASSESSMENT ARE:

A

A life situation, relationship or practical problems

Next 4 are together in a circle that can lead to any of them

Leads to altered thinking(unrealistic, extreme and unhelpful thoughts)

Altered physical feelings m/symptoms

Altered behavior (reduced activity, avoiding things or doing something unhelpful)

Altered emotional feelings

How you THINK has affected how you FELT and what you DID

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28
Q

Most basic form of thoughts

A
  • Automatic: no effort required! Not arising from reason
  • Distorted: don’t fit all the facts
  • Unhelpful : keep you anxious/depressed, making difficult to change
  • Plausible: face value accepted, unchallenged
  • Involuntary: Not chosen to have them and difficult to “switch off”
  • Global: tendency to generalize to other situations/scenarios
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29
Q

Arbitrary inference

A

“jumping to conclusions” not supported by evidence

cognitive distortion

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30
Q

Selective abstraction

A

“blowing it out of proportion” Judging the whole on the basis of a small negative.

Cognitive distortion

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31
Q

personalisation

A

inappropriately relating external events to oneself without an obvious basis for making such connections

cognitive distortion

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32
Q

Dichotomous thinking

A

“black or white” “all or nothing thinking” viewing situation in only two categories instead of on a continuum

cognitive distortion

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33
Q

Overgeneralization

A

a single incident or person serves as a basis for judging all instances in the same way

cognitive distortion

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34
Q

Magnification/minimization

A

Here the individual has a tendency to exaggerate the important of negative information or experiences, while trivializing or reducing the significance of positive information or experiences

cognitive distortion

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35
Q

Catastrophising

A

predict the future negatively without considering other, more likely outcomes

cognitive distortion

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36
Q

disqualification or discounting

A

When a compliment or favorable outcome is transmuted into something negative

cognitive distortion

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37
Q

mind reading

A

making assumptions about other people’s thoughts, feelings and behaviors without checking the evidence

cognitive distortion

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38
Q

labelling or global judgements

A

when a negative or judgmental label is applied to a single situation or person

“I am a failure and a loser”

cognitive distortion

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39
Q

emotional reasoning

A

when an individual takes a ‘feeling’ as evidence and proof of the thought. “I feel panicky, this means something bad is going to happen”

cognitive distortion

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40
Q

ABC model

A

A- Activating event
B- Beliefs
C- Consequences
Actions and emotions

Negative event leads to rational belief or irrational belief which then leads to a healthy negative emotion or unhealthy negative emotion

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41
Q

Daily thought record (DTR)

A

contains at least three columns

situation : objective description of what is happening

feelings: feeling word and intensity
thoughts: what is going through my mind

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42
Q

Pros of CBT

A

Helpful in cases where medication alone hasn’t worked

completed in a short period of time

highly structured

teaches useful and practical strat that can be used going forward.

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43
Q

Cons of CBT

A

Pt must commit to process

must attend regular sessions and do their “homework”

may not be suitable for those with more complex mental health needs or learning disabilities

Pt may experience initial periods of anxiety or feel emotionally uncomfortable

focuses on individual’s capacity to change themselves

only addresses current problems and focuses on specific issues. doesn’t address underlying causes

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44
Q

cognition

A

thoughts

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45
Q

affect

A

emotions or feelings

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46
Q

behavior

A

what people say and do

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47
Q

symptoms

A

what the patient feels

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48
Q

signs

A

what the doctor can see

49
Q

classification

A

the grouping together of events (symptoms and signs in the case of illness)

50
Q

disease

A

a name given by the medical profession to a particular grouping of symptoms and signs

51
Q

illness outline

A 
illness
symptom recognition
cultural influences
illness representation
sick role
52
Q

what is illness

A

a condition of pronounced dilation from the normal healthy state

subjective & psychological concept

53
Q

what is illness behavior

A

the state when the individual feels ill and behaves in a particular way

54
Q

Abnormal illness behavior

A

excessive use of OTC medication

  • frequent consultation with no good cause
  • person adopts the sick role in the absence of any obvious symptomatology
55
Q

hypochondriasis

A

chronic preoccupation with symptoms with no specific physical cause

56
Q

Lay referral system

A

informal network of lay people (non medical practitioners) who provide their own information and interpretation about the person’s symptoms

57
Q

illness representation

A

the course of action taken will be determined by the representation: illness representations interpret symptoms and give them meaning.

Symptoms on their own have no meaning and are merely bodily sensations

58
Q

Common sense model of illness representations:

A

5 components:

  1. identity: label or name given to condition
  2. cause:
  3. timeline:
  4. consequences
  5. curability/controllability
59
Q

Sick role

A

any activity or behavior undertaken for the purpose of getting well by those who consider themselves ill

SOCIAL ROLE

rights:
- exempt from ‘normal’ social roles
- not held responsible for their condition
- has right to be taken care of

duties/obligations:

  • expected to perceive being sick as undesirable
  • seek technically competent help from a suitably qualified professional

Advantages: exempt from daily activities, able to rest and taken care of, workers comp

disadvantages:
behaviors are scrutinized, other may view behaviors as illegitimate attempt to gain advantages

60
Q

criticism to sick role

A

model only fits acute illness, does not fit chronic, long term/ permanent illness as easily
sometimes individuals are held responsible for their illness (alcoholism)

61
Q

Pain definition from WHO

A

an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage

pain drawings
pain diary

62
Q

self awareness

A

having a clear perception of your personality, including strengths, weaknesses, thoughts, beliefs, motivation, and emotions.

63
Q

nature of self:

A

persona
ego
shadow
the essential self

64
Q

persona

A

‘the mask’

the public face each of us puts on in society to appear to be in control

65
Q

Ego

A

this is the center of the conscious mind

  • the part of us that gets the job of living done
  • protects us by keeping us within the norms of society
66
Q

shadow

A
  • the unconscious
  • part of us that wants to do all the things that the ego tells us we can’t do
  • “i wasn’t myself”
67
Q

the essential self

A
  • incorporates both conscious and unconscious elements
  • our uniqueness, our essence, our energy
  • it is the self that gives us true courage and allows us to feel a ‘oneness’ with other humans
  • self that has patience and understanding
  • feel empathy
  • prevents us attempting to have our personal needs met by patients
  • allows us to act without prejudice and negativity

-MOST USEFUL TOOL IN PATIENT CARE

68
Q

Self efficacy

A

the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations

69
Q

attributions of a person with a strong sense of self-efficacy

A

view challenging problems as task to be mastered

  • develop deeper interest in the activities in which they participate
  • form a stronger sense of commitment to their interests and activities
  • recover quickly from setbacks and disappointments
70
Q

personality

A

made up of the characteristic patterns of thoughts, feelings and behaviors that make a person unique and remains fairly consistent throughout life

consistency: an order and regularity to behaviors

psychological and physiological: influence by biological needs and processes

behaviors/actions: personality does not just influence how we act and respond in our environment; also makes us act in certain ways

multiple expressions: personality also expressed in our thoughts, feelings, close relationships and other social interactions

71
Q

type theories– Jung

A

extraverts

introverts

72
Q

type theories– Friedman

A

Type A: intense, hard driving personality, “stress junkies”

Type B: relaxed, less competitive and lower in CHD risk

73
Q

type theories– Denollet

A

Type D: linked with early death

74
Q

psychodynamic

theories of personality

A

conscious and unconscious mind: behavior is determined by unconscious motivations and needs that are placed outside conscious awareness

Id, Ego, Superegoand interaction with these three elements to form complex behavior

75
Q

Id, ego, and superego

A

Id: instincts–pleasure principle
Ego: reality (manages Id’s impulses)
superego: morality

76
Q

Humanistic

Theories of personality

A

emphasizes the potential for the individual growth and change

focus on free-will and ability to determine destiny

77
Q

trait approaches

Theories of personality

A

refer to characteristics we use in everyday language to label consistent and enduring aspects of personality

78
Q

Eysenck trait approaches

A

Personality is based on three key traits:

extraversion- introversion

neuroticism-stability

psychoticism

His model is hierarchical: each key trait is made up of a number of traits, which form habitual responses, which in turn consist of specific actions

79
Q

Extraversion-introversion

A

Eysenck: personality based on three key traits: one being

extravert people are highly sociable, outgoing and seek the company of others. Introverts are quiet and introspective.

80
Q

Neuroticism-stability

A

Eysenck: personality based on three key traits: one being

people high on neuroticism tend to be anxious, moody, or vulnerable, whereas people low on neuroticism tend to be stable, calm and even -tempered

81
Q

Psychoticism

A

Eysenck: personality based on three key traits: one being

those high on this dimension are said to be egocentric, aggressive, cold, lacking in empathy, impulsive, and inconsiderate

82
Q

The Big Five (OCEAN)

personality traits
Goldberg

A
  1. Openness to experience: receptivity to new ideas and experiences
  2. Conscientiousness : organization and achievement
  3. Extraversion: person’s tendency to be sociable, outgoing, assertive and active
  4. Agreeableness: extent to which people are trusting, generous, and concerned for others
  5. Neuroticism: tendency to be sensitive and to experience negative emotions such as fear, anxiety, sadness and anger
83
Q
  1. cognitive-behavioral approaches

theories of personality

A

refers to how people think, behave, and how thought and behavior interact

84
Q
  1. biological and genetic approaches

theories of personality

A

suggest that genetics are responsible for personality. classic nature v. nurture; biological theories of personality side with nature.

Eysenck linked aspects of personality to biological processes

85
Q

Eysenck arousal theory

A

extraverts:
- below optimal level of arousal
- seek out social interactions for stimulation

introverts:

  • above optimal level
  • avoid excessive stimulation
86
Q

stereotypes

A

cognitive component

expectations and beliefs. Involve generalization about typical characteristics of members of a group

a thought that can be adopted about specific types of individuals or certain ways of doing things

based on:

  1. past information
  2. generalization
87
Q

prejudice

A

affective/emotional response

attitude towards the members of a group based solely on their membership in that group

88
Q

Discrimination

A

behavioral component of prejudicial reactions

actual actions towards the objects or prejudice

89
Q

examples of stereotyping

A 
Ageism 
Racial
Sexism
Religion
Profession
Media
90
Q

cognitive function

stereotypes

A

helps us make sense of the world, a form of categorization which simplifies and systematizes information

shortcuts to make sense of social contexts

91
Q

Social function

stereotypes

A

social categorization: used to explain social events

self categorization: emphasize a person’s group membership via depersonalization

92
Q

IAT

A

Implicit Association Test

allegedly measures and reveals subconscious racial bias

black and white faces and positive and negative words

93
Q

Difference between prejudice and discrimination

A

A prejudiced person may not act on their attitude. One can be prejudiced towards a certain group but not discriminate against them

Prejudice includes all 3 components of an attitude (affective, behavioral and cognitive) where discrimination just involves behavior

94
Q

what are the 4 main explanations of prejudice and discrimination

A
  1. Authoritarian personality
  2. Realistic Conflict Theory- Robbers Cave
  3. Stereotyping
  4. Social Identity Theory
95
Q

Robber’s Cave study…

A

Conducted by sheriff and colleagues in a boy’s summer camp at Robbers Cave State Park in Oklahoma

22 12 yr old boys with similar backgrounds (white middle-class, Protestant, two parents) divided into 2 groups that went camping in the same place, not knowing of each other’s existence

  1. observation of in-group formation: attachment to their groups
  2. competition stage: observed hostility between the two groups and led to physical attacks on each others ‘icons’
  3. conflict reduction (integration phase): two day cooling off period
96
Q

realistic group conflict theory

A

conflict between groups arise from competition for limited resources

study shows that conflict between groups can trigger prejudice attitudes and discriminatory behavior

97
Q

social identity theory

A

Taifel– found that mere categorization is enough to elicit some degree of bias

states that the in-group will discriminate against the out-group to enhance their self-image

98
Q

social identity

A

a person’s sense of who they are based on their group membership

99
Q

modern racism

A

consists of outright denial that there is discrimination against minorities

100
Q

reverse discrimination

A

treating members of a target group more favorably than members of other groups leading to negative effects

101
Q

authoritarianism

A
  • high submissiveness to established authority figures or institutions in one’s society
  • aggression against groups that authorities perceive as targets
  • high adherence to traditions and norms endorsed by society and established authorities and belief that others should conform to these norms
102
Q

social dominance orientation

A
  • general preference for relations between social groups to be hierarchical
  • extent to which one desires that their group dominate and be superior to other groups
103
Q

stereotype suppression

A

trying to push away any stereotypic thoughts that come to mind when you are in the presence of a patient belonging to a negatively stereotyped social group. DONT DO IT

104
Q

contact hypothesis (Allport 1954)

A

techniques to reduce prejudice

direct contact between members of different social groups leads to reduction or prejudice under appropriate conditions

105
Q

motivation definition

A

defined as the causes of an organism’s behavior or the reason that a person carries out some activities

reasons for people’s actions, desires, and needs

106
Q

2 types of motive

A

primary: satisfaction of basic biological needs such as food, oxygen, and water that must be met for survival

need not to be learned, basic and foremost motives that drive any individual

secondary: based on learned needs, drives and goals.

107
Q

motivational factors

A

-people’s desires and preferences influence the judgements they make of the validity and utility of new information, through a process called motivated reasoning.

individuals who prefer to reach a particular conclusion use BIASED COGNITIVE PROCESSES

  • search for reasons to accept supportive information and discount disconfirming information
  • people with a chronic illness who tend to use ILLOGICAL THOUGHT PATTERNS tend not to follow medical advice
  • people who use DEFENSE MECHANISMS to cope with stressful information, are more likely that other individual to deny that they are at risk for AIDS
108
Q

unrealistic optimism

A

people often engage in risky or unhealthy behavior due to unrealistic optimism

definition: an inaccurate perception of risk and susceptibility

  • comparison with others ( i don’t smoke as much as my friend)
  • ignore their own risk-taking behaviors (i may drink yo excess some times, but it is not that important)
  • risk-reducing behavior (at least i don’t inject drugs)
109
Q

4 reasons underlying unrealistic optimism

A
  1. lack of personal experience with the problem
  2. the belief that the problem is preventable by the individual action
  3. belief that if the problem has not yet appeared, it will not
  4. belief that the problem is infrequent
110
Q

Why is unrealistic optimism relevant to practice as a chiropractor?

A
  • all health care professionals should try to encourage positive behaviors
  • by the same token, we want people to avoid health-damaging behavior
  • we need to know the best way of getting people to engage in such activity
111
Q

Health Belief Model (HBM)

A

a psychological health behavior change model

to explain and predict preventative health behaviors

to describe the behavioral response to treatment in patients with both acute and chronic illnesses

makes a series of predictions about behavior and suggests that they are a result of a set of 5 CORE BELIEFS

112
Q

5 core beliefs of HBM…

A
  1. susceptibility to illness
  2. severity of illness
  3. the COSTS involved in carrying out the behavior
  4. the benefits involved in carrying out the behavior
  5. cues to action which may be internal (physiological cues) or external (info from media, health care providers or friends and family)
    - example: reminder postcard from dentist
113
Q

HBM relevance to chiropractic?

implications for planning of interventions

A

if we can persuade people:

  • they are susceptible to some disease then we are more likely to convince them to engage in some form of preventative action
  • also developing that disease will have severe consequences
  • if they engage in preventative action, then they are less susceptible to disease
  • the costs of taking action will be outweighed by the potential benefits of taking the desired action
114
Q

Critique of HBM

A

-focus on conscious processing of info, but do we weigh up pros and cons of eating and apply
-emphasis on individual but what about society
-what about interrelationship between the different core beliefs?
-absence of a role for emotional factors
health beliefs are treated as static

115
Q

theory of reasoned action (TRA)

A

predicts behavioral intent, which it is assumed lead to behavior

behavioral intent is a product of

  • individuals attitude towards performing the behavior
  • subjective norms
116
Q

behavioral intention

A

product of :

  • individual’s attitude towards performing the behavior
  • subjective norms
117
Q

subjective norms

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two components: normative beliefs (beliefs held by us about how people who are important to us expect us to behave) and willingness to comply (with the subjective norms also plays a role in predicting the strength of intention)

118
Q

theory of planned behavior (TPB)

A

behavioral intentions are a consequence of a combination of several beliefs

  1. attitudes: towards a behavior
  2. subjective norms:perception of social norms and pressures to perform a behavior and evaluation of whether the individual is motivated to comply with this pressure
  3. perceived behavioral control: suggests that the individual can carry out the particular behavior considering both internal and external levels of control

Behavioral Science (1 decks)

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