Coping with Illness and Disability

Question 1

what is the definition of stress?

Answer 1

a condition that results when the person/environment transactions lead the individual to perceive a discrepancy between the demands of the situation and the coping resources available.

Question 2

what are the main stress reduction strategies in the context for medical and surgical procedures?

Answer 2

• increase information/predictability
• dual process hypothesis
• increased perceived control
• identifying patient coping styles

Question 3

what kind of information is given to the patient to reduce stress?

Answer 3

 Procedural information
– information regarding the procedures.
 Sensory information
– information about the sensations that may be experienced.

Question 4

when is sensory information most useful?

Answer 4

before painful procedures

Question 5

what is the Dual-process hypothesis?

Answer 5

Proposes that procedural and sensory information works in different ways:

• Procedural information works by allowing patients to match ongoing events with expectations in a non-emotional manner.
• Sensory information works by “mapping” a non-threatening interpretation onto these expectations.

Question 6

what are the two styles of coping?

Answer 6

1) problem focussed

2) emotion focussed

Question 7

what is problem focussed coping?

Answer 7

efforts directed at changing the environment in some way or the changing the patient’s own actions or attitudes

seek information, change behaviour

Question 8

what is emotion focussed coping?

Answer 8

efforts designed to manage stress-related emotional or physical responses to maintain morale and allow one to function

meditation, emotional support.

Question 9

what are the 3 components of the Crisis Theory of Coping with Illness?

Answer 9

coping appraisal
adaptive tasks
coping skills

enable social and psychological equilibrium

Question 10

what are the factors affecting adjustment to illness i.e. coping appraisal?

Answer 10

• illness
• background, personality
• physical and social environment

Question 11

how does illness affect adjustment to illness?

Answer 11

unexpected, cause/outcome, disability, prior experience, stigma, disfigurement

Question 12

how does background affect adjustment to illness?

Answer 12

personality, age of onset, gender, occupation, pre-existing beliefs.

Question 13

how does physical and social environment affect adjustment to illness?

Answer 13

hospitalisation, accommodation, social support, societal attitudes

Question 14

how do highly agreeable patients behave?

Answer 14

follow self care instructions

have active coping strategies

Question 15

what is the illness representation model? what are the components?

Answer 15

• identity
• cause
• consequences
• time line
• curability and control

Question 16

identity (Illness representation model)

Answer 16

considered the label of the illness, or the symptoms the patient views as being part of the illness.

Question 17

cause (Illness representation model)

Answer 17

the patient’s views about what caused the problem (i.e. genetics, trauma, etc.).

Question 18

consequences (Illness representation model)

Answer 18

the effects the patient is experiencing from the illness and the view of the outcome.

Question 19

time-line (Illness representation model)

Answer 19

the patient’s view about how long the problem will last (i.e. chronic, acute, intermittent, etc.).

Question 20

cure/control (Illness representation model)

Answer 20

the patient’s expectations as they recover from or control the illness.

Question 21

what are the adaptive tasks (Crisis Theory) that a patient must undergo in illness?

Answer 21

• related to the illness or treatment: e.g. making good relationships with healthcare professionals
• related to general psychosocial functioning: preparing for an uncertain future

Question 22

what is the WHO model describing the onsequences of disease?

Answer 22

suggests causal links between them:

• impairment: problems with structure or organ
• handicap: disadvantageous in fulfilling a role in regards to a certain activity
• disability: functional limitation

Question 23

what are the causal links in the WHO model?

Answer 23

disability is very much linked with handicap while impairment does not link with handicap much

Question 24

what are the two types of responses to illness/disability?

Answer 24

• Adaptive responses: personal growth and adjustment to the illness.
• Maladaptive responses: poor adjustment (psychological problems, low functioning etc).

Question 25

what are the adaptive tasks related to illness or treatment?

Answer 25

o Coping with symptoms or disabilities.
o Adjusting to hospital environment and medical procedures.
o Developing/maintaining good relationships with healthcare professionals.

Question 26

what are the adaptive tasks related to general psychosocial functioning?

Answer 26

o Controlling negative feelings and maintaining good morale for the future.
o Maintaining a satisfactory self-image and a sense of competence.
o Preserving a good relationship with family and friends.

Question 27

what is the problem associated with emotion focused coping?

Answer 27

associated with poorer adjustment and greater level of depression

best way to cope it to be flexible

Question 28

how is it best to help children cope?

Answer 28

• specific information with a mix of sensory and procedural information
• older kids need >7 days before procedure; younger kids need it closer to the procedure
• coping interventions like videos normalising the procedure experience; distraction

use TELL SHOW DO

Question 29

what method is used to help children cope?

Answer 29

 Tell
– use simple language and a matter-of-fact style, tell the child what will happen in each procedure.
 Show
– procedure is demonstrated on an inanimate object or a member of staff.
 Do
– once the child understands, carry out the treatment. Use prompt distraction strategies.