Coping with Illness and Treatment

Question 1

Describe the WHO model of consequences of disease and causal links

Answer 1

Impairment
Disability
Handicap

Question 2

What is impairment

Answer 2

refers to a problem with a structure or organ of the body

Question 3

What is disability

Answer 3

a functional limitation with regard to a particular activity

Question 4

What is handicap

Answer 4

refers to a disadvantage in filling a role in life relative to a peer group, as a result of impairment and disability

Question 5

What are the associations between impairment, disability and handicap

Answer 5

Disability strongly correlates with handicap.
But research shows a very low correlation between impairment and disability
Suggesting other factors in addition to impairment (structural problem), influencedisability (functional limitations)…

Question 6

What illness related factors affect how people cope

Answer 6

Unexpected
Cause & Outcome/Prognosis 
Disability
Stigma
Disfigurement
Prior experience

Question 7

What background/personal factors affect how people cope

Answer 7

Age of onset
Gender
SES & occupation
Pre-existing illness beliefs 
Pre-existing personality

Question 8

Describe the Crisis theory of coping

Answer 8

Serious illness presents ‘a crisis’ and our usual, habitual ways of coping are inadequate.
A state of disorganisation, feelings of fear, guilt, sadness etc .

Question 9

Compare adaptive and maladaptive responses

Answer 9

Adaptive responses personal growth and adjustment to the illness.

Maladaptive responses poor adjustment (psychological problems, low functioning etc).

Question 10

What are the health associations of the big five personality traits

Answer 10

Openness – no clear link to health
Conscientiousness - +2 years life expectancy
Extraversion – lower rates of CHD, protective respiratory disease
Agreeableness – Hostility associated w/ CHD
Neuroticism – higher use of alcohol and smoking; higher symptom reporting

Question 11

What are the physical and social environments that might affect coping

Answer 11

Hospitalisation
Accommodation and physical aids/adaptations
Societal attitudes
Social support & social role

Question 12

Define illness representations

Answer 12

A patients own implicit, common sense beliefs about their illness

Question 13

What are the features of illness representations

Answer 13

Identity
Cause
Consequences
Time line
Curability/controllability

Question 14

What are the two types of adaptive tasks

Answer 14

Tasks related to illness or treatment

Tasks related to general psychosocial functioning

Question 15

What may tasks related to illness or treatment be used in

Answer 15

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

Question 16

What may tasks related to general psychosocial functioning be used for

Answer 16

Controlling negative feelings and retaining a positive outlook
Maintaining a satisfactory self image and sense of competence
Preserving good relationships with family and friends
Preparing for an uncertain future

Question 17

Define coping

Answer 17

Cognitive and behavioural efforts to master, reduce or tolerate external and internal demands and conflicts (Strauss, 1988)

Question 18

Describe problem focussed coping

Answer 18

Efforts directed at changing the environment in some way or changing one’s own actions or attitudes.

Question 19

Describe emotional focussed coping

Answer 19

Efforts designed to manage the stress-related emotional responses in order to maintain one’s own morale and allow one to function.

Question 20

Give examples of techniques for problem focussed coping

Answer 20

Seeking relevant information about an illness
Learning specific illness related procedures e.g. pacing activities
Changing behaviour e.g. diet

Question 21

Give examples of techniques for emotion focussed coping

Answer 21

Seeking reassurance and emotional support
Learning relaxation strategies
Meditation

Question 22

Why may patient distress be a bad thing

Answer 22

Moral/ethical responsibility to minimize suffering if possible.
Distress during treatment related to longer term psychological morbidity.
Distress during treatment related to wide variety of treatment outcomes, eg, patients not complying.

Question 23

Compare procedural to sensory information

Answer 23

Procedural information – Information about the procedures to be undertaken

Sensory information – Information about the sensations that may be experienced.

Question 24

Give examples of how control in medical situations can be increased

Answer 24

A device for patient to signal their pain/discomfort during dental treatment can reduce distress
Patient can squeeze a buzzer during an MRI to halt the procedure
Control over treatment options for fertility procedures related to greater well-being

Question 25

What are the differences in timing of giving information to children of different ages

Answer 25

Older children (> 7yrs) benefit most from information presented about a week before a procedure, younger children closer to the procedure.

Question 26

What is the most effective coping strategy for younger children

Answer 26

Distraction

Question 27

What is the most effective coping strategy for children over 9

Answer 27

matching coping strategy to child’s preferred coping strategy is more effective.