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ESA 3 - HPHD > Coping > Flashcards

Coping Flashcards

1
Q

Who theorised the transactional model of stress?

A

Lazarus and Folkman, 1984

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2
Q

What happens in the transactional model of stress?

A

Potential stressor Primary appraisal Secondary appraisal Stress

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3
Q

What factors can cause stress in chronic illness?

A

Diagnosis Physical impact Treatment Hospitalisation Adjustment Chronic nature of illness Socioeconomic illness

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4
Q

What will a person have on diagnosis of a chronic illness?

A

Lots of worries and questions

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5
Q

What is the importance of the worries and questions a person will have on diagnosis of a chronic illness?

A

A strong predictor of future anxiety is the number of unanswered concerns

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6
Q

What may the emotional responses to diagnosis be?

A

Shock Anxiety Depression Denial Fear

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7
Q

What may the physical impact of a chronic disease be?

A

Pain Limited mobility Other symptoms

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8
Q

How may the treatment for a chronic illness cause stress?

A

Anxiety Discomfort Impact on body image Burdensome nature of self management

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9
Q

Give an example of where a chronic disease may have an impact on body image

A

Breast cancer

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10
Q

Why may self management of a chronic disease cause stress?

A

Life changes Having to take medication

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11
Q

Why may hospitalisation cause stress?

A

Loss of autonomy, privacy, or status Possible removal from usual support network

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12
Q

Whatadjustments may need to be made when a person has a chronic illness?

A

Biographical disruption Change in identity

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13
Q

What is meant by biographical disruption

A

Disruption to life trajectory

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14
Q

What is the result of the disruption to life trajectory in chronic illness?

A

Change in goals Have to rethink future

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15
Q

What change in identity might occur in chronic illness?

A

‘Sick role’

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16
Q

Why may the chronic nature of illness cause stress?

A

The change may be indefinite, and so it is hard to make plans

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17
Q

What is the socioeconomic impact of chronic illness?

A

May cause financial problems if work is affected Social problems Relationship problems

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18
Q

What is the result of the loss of income if a chronic illness means work is affected?

A

May struggle with mortgage, childcare etc

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19
Q

What social problems may a chronic illness cause?

A

Housing Childcare

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20
Q

Who may chronic illness cause relationship problems between?

A

Family Friends Colleagues

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21
Q

What must be considered when thinking about stress in chronically ill patients?

A

There is a different combination of issues for different patients, but all share the need for adjustment

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22
Q

What does stress depend on?

A

Perception

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23
Q

How may perception of chronic illness affect stress?

A

If they think the illness is very bad If they think they can’t cope

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24
Q

What are the categories of life events causing stress?

A

Family Personal Workplace Financial

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25
Q

What family events can cause stress?

A

Bereavement Divorce Marriage Family health Pregnancy Family unemployment

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26
Q

What personal events can cause stress?

A

Imprisonment Personal achievement Change in school/residence Sexual difficulties Change in habits Holidays

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27
Q

What workplace events can cause stress?

A

Dismissal Retirement Job change Change in responsibilities/conditions

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28
Q

What financial events can cause stress?

A

Change in financial state Mortgage

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29
Q

What are the types of coping styles?

A

Emotional focused coping Problem focused coping

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30
Q

What does emotional focused coping aim to do?

A

Change the emotion/appraisal

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31
Q

What are the approaches in emotional focused coping?

A

Behavioural approaches Cognitive approches

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32
Q

What is meant by a behavioural approach to coping?

A

Do something

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33
Q

Give three examples of behavioural approaches to emotional focused coping

A

Talking to friends Alcohol Finding a distraction

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34
Q

What is meant by a congitive approach to coping?

A

Change how you think about a situation

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35
Q

Give two examples of cognitive approaches in emotional focused coping

A

Denial Focus on positive aspect of problem

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36
Q

What does problem focused coping aim to do?

A

Change the problem or your resources, therefore alleviating emotional reaction

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37
Q

What may be done in problem focused coping?

A

Reduce demands of stressful situation Expand resources to deal with it

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38
Q

How may the demands of a stressful situation be reduced in problem focused coping?

A

Find out how to cope with feelings

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39
Q

What are the outcomes of problem focused and behavioural focused coping

A

All may help,but some will be less adaptive long term

40
Q

What is the best type of coping?

A

‘Active coping’

41
Q

What is active coping associated with?

A

Better adjustment

42
Q

What is the problem with active coping?

A

Chronically ill patients tend to report more ‘passive’ coping strategies Depressed individuals struggle with active coping

43
Q

When considering coping and stress in clinical practice, what is it important to consider when giving information?

A

A persons coping style

44
Q

How can coping be aided?

A

Increase/mobilise social support Increase personal control over condition Prepare patients for stressful events

45
Q

Why is it important to provide patients with social support?

A

Some patients may have impoverished social network Patient may be reluctant to display problem Patient may not have/lost social network

46
Q

How can a physician increase/mobilise social support?

A

Suggest formal/informal sources of support

47
Q

What formal/informal sources of support can be provided for the patient?

A

Social services Community resources Hospital visitors/chaplain Other religious and charitable organisations Patient groups

48
Q

How can control over condition be increased?

A

Pain management CBT and other psychological therapies Self management programs Involve patients in care-planning Facilitate cognitive control Resources to aid emotional management

49
Q

Give an example of a self management program used in a chronic disease

A

DAFNE (Dose adjustment for normal eating) self management course for type I diabetes

50
Q

What is the purpose of preparing patients for stressful events

A

Reduce ambiguity and uncertainty

51
Q

What stressful events may a patient be prepared for to reduce stress?

A

Preperation for surgery or hospital visits

52
Q

How are patients prepared for surgery or hospital visits?

A

Effective communication as to what they are likely to experience

53
Q

What are the advantages of preparing patients for stressful events?

A

Reduces anxiety Reduces self-reported pain Reduces length of stay after surgery Improves patient adjustment/recovery

54
Q

Give an example of how patients can be prepared for stressful events

A

Pairing pre-op patients with post-op patients

55
Q

What is pairing pre-op patients with post-op patients assoicated with?

A

Reduced pre-op anxiety and earlier discharge

56
Q

Give an example of why it may be important to be responsive to individual preferences

A

Some patients may not want all details

57
Q

What must be done in the case of helping children cope?

A

Important to allow access, e.g. visits prior to admission Use social media

58
Q

What are the outcomes of successful coping?

A

Tolerating or adjusting to negative events or realities Reducing threats and enhancing prospects of recovery Maintaining a positive self image Maintaining emotional equilibrium Continuing satisfying relationships with others

59
Q

What is diagnosis of chronic or life-threatening illness often assoicated with?

A

Depression and anxiety

60
Q

How does the prevalence of depression differ in those with a chronic illness compared to those without?

A

It is 2-3 times more likely in people with a chronic illness

61
Q

What chronic illnesses are associated with an increased risk of depression?

A

Cancer Heart disease Diabetes Musculoskeletal/respiration/neurological disorder

62
Q

What % of the population is thought to have a chronic illness?

A

20%

63
Q

Who is anxiety more common in?

A

People with heart disease, stroke, and cancer

64
Q

What is anxiety?

A

An unpleasant emotional state that is a response to a threat

65
Q

What threats may anxiety be a response to?

A

Threats to identity or well-being Threatening events

66
Q

What medical events may cause anxiety?

A

Surgery Treatment Test results Uncertainty with prognosis

67
Q

What are people anxious of with regards to prognosis?

A

Discomfort Disability Death

68
Q

What feelings may anxiety include?

A

Panic Dread

69
Q

What stages of illness is anxiety likely to occur at?

A

Diagnosis Awaiting test results Discharge from hospital Illness progression Making lifestyle changes

70
Q

When does anxiety become a problem?

A

When it is out of proportion to the threat

71
Q

What may problematic anxiety cause?

A

Feelings of dread and fear Panic attack Physical symptoms

72
Q

What physical symptoms may anxiety lead to?

A

Sweating Nausea

73
Q

What is sustained anxiety associated with?

A

Unhelpful thinking patterns Physiological effects

74
Q

What unhelpful thinking patterns is sustained anxiety associated with?

A

Increased vigilance to threat Interpret ambiguous information as threatening Increased recall of threatning memories

75
Q

What can increased vigilance for threats lead to?

A

Hypersensitivity to symptom changes

76
Q

Give three anxiety disorders

A

Phobia Panic attacks PTSD

77
Q

What is depression a response to?

A

Loss, failure, or helplessness

78
Q

What events may cause depression?

A

Loss of physical/health capacity Loss of identity/social status Reaction to symptoms, or negative experiences of illness Physiological changes Medication side effects

79
Q

What is depression?

A

A emotional state characterised by; Persistent low mood Sadness Loss of interest Despair Feelings of worthlessness

80
Q

How long does depression last?

A

Tends to be long term

81
Q

How common is depression?

A

Very

82
Q

What groups are at higher risk of depression?

A

People with illnesses that are more severe, painful, or disabling In the context of negative life events When lacking resources to cope

83
Q

What can co-morbid depression do?

A

Exacerbate the pain and distress associated with physical health problems Adversely affect illness outcomes

84
Q

What states the negative effect of depression on illness outcomes?

A

NICE 2010

85
Q

How does depression worsen illness outcomes?

A

Via direct mechanisms Via indirect mechanisms

86
Q

What is a direct mechanism by which depression leads to worse illness outcomes?

A

Decreases adherance to treatment

87
Q

What is an indirect mechanism by which depression causes worse illness outcomes?

A

Associated with factors such as smoking, alcohol etc

88
Q

Why may psychological problems not be recognised?

A

Symptoms may be inadvertently missed by person or professional Patients may not disclose symptoms HCPs may avoid asking

89
Q

Why may symptoms be inadvertently missed by person or professional?

A

Attributed to illness or treatment Experienced outside the consultation

90
Q

What is meant by the symptoms being experienced outside the consultation?

A

May not occur when in contact withHCP

91
Q

Give an example of a symptom of depression that may be attributed to the illness or treatment

A

Tiredness

92
Q

Why may a patient not disclose their psychological symptoms?

A

Perception of inevitability Desire to avoid stigma, feeling judged, or a burden, or seen as failing to cope

93
Q

What is meant by a perception of inevitability?

A

The patient thinking’anyone would feel depressed in my situation’

94
Q

Why may HCPs avoid asking about psychological problems?

A

Perception that it is out of their role/expertise Feel they haven’t been adequately trained Capacity/time constraints Reluctance to label people

95
Q

What is it important to be aware of, regarding psychological problems?

A

The possibility of psychological problems Ways of helping

96
Q

How can the possibility of psychological problems be explored with a patient?

A

Listen/ask/provide opportunity to raise problems

97
Q

How can a physician help someone with psychologial problems?

A

NICE guidance Referrals Suggestions for mobilising support and engaging in self help

ESA 3 - HPHD (15 decks)

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