coping with illness and treatment Flashcards
what is health
a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
what is impairment
refers to a problem with a structure or organ of the body
what is disability
a functional limitation with regard to a particular activity
what is handicap
a disadvantage in filling a role in life relative to a peer group, as a result of impairment and disabilit
eg accessing sports centres or experiencing prejudice
what are the links between disability, handicap and impairment *
disability strongly correlates with handicap
low correlation between impairment and disability -suggesting other factors influence disability - these are the individual differences ie coping strategies, personality, social and environment
describe the crisis theory of coping with disability *
we need social and psychological equilibrium
serious illness presents a crisis - our normal ways of coping are not good enough
leads to a state of disorganisation, feelings of fear, guilt, sadness etc .
A crisis is self-limited because we cannot remain in an extreme state of disequilibrium.
there are 2 possible responses to the disequilibrium - adaptive and maladaptive
what are adaptive responses *
personal growth and adjustment to the illness
have a richer appreciation for life, reprioritise things
what are maladaptive responses *
poor adjustment - psychological problems, low functioning etc
what are the 3 factors that effect the way that we cope &
illness related factors
background and personal factors
physical and social environmental factors
describe illness related factors *
if it is unexpected - difficult to come to terms with
cause and outcome/prognosis - people blame self if it is related to healthstyle - lead to depression, if poor or unknown prognosis it is hard to deal with
disability caused
stigma
disfigurment
prior experience - family/someone in public eye
describe background/personal factors *
age of onset - teenages struggle more with dm than younger children because they have more responsibility
gender - women struggle more/perhaps are more ready to search for help
socioeconomic status and occupation - low status worse
pre-existing health beliefs
pre-existing personality - some helpful, some inaccurate
effect of extraversion on health *
lower rates of CHD
protective against resp diseases
more likely to seek help and have a better support network
effect of agreeableness on health *
hostility related to CHD
more aggreeable people adapt better to illness - perhaps because they have more social support and better quality friendships, and are more likely to follow self care instructions and have positive active coping strategies
if hostile get angry instead and are less engaged
effect of neuroticism on health *
higher use of alcohol and smoking, higher symptom reporting
anxiety and depression
describe the physical and social environment *
hospitalisation - stressful
accomodation and physical aids/adaptions may need to be made to home
societal attitudes - if symptoms less obvious others might have doubts so it can be harder to access help
social support and social role - men feel demasculinated by heart disease
small social network increases risk of cardiac death in pts with coronary artery disease
most socially isolated people scored higher on hostility, had lower incomes, and were more likely to be smokers - when these adjusted for social isolation was still a predictor of cardiac mortality - comparable to risks like smoking
describe coping appraisal *
belief about the illness and the coping strategy you need to employ
cognitive representation about how to cope
effects the coping skills they need to employ and so what adaptive tasks are needed
what is an illness representation *
A patients own implicit, common sense beliefs about their illness
what are the 5 illness representations *
• Identity: the label of the illness and symptoms
Cause: what may have caused the problem, such as genetics, circumstances, trauma, etc.
Consequences: expected effects from the illness and views about the outcome
Time-line: how long the problem will last and whether it is seen as acute, chronic or episodic
Cure/control: expectations about recovery or control of the illness
describe the illness perceptions questionnaire *
clinical tool - give pts the opportunity to speak so you can investigate their specific beliefs and correct any misconceptions
describe the picture of health study *
pts after MI were asked to draw pictures of heart
pts who draw damage to heart had recovered less at 3 months, condition would last longer and had less percieved control
extent of damage drawn = slower return to work
peak troponin-t levels were not related to 3 month outcomes or return to work
drawings of damage predict recovery better than medical variables
examples of maladaptive coping strategies
“Stress caused my heart attack, smoking helps me reduce my stress levels, so I’m going to continue smoking”
“Now I’ve had a heart attack, my life is as good as over, I’ll never be able to enjoy myself again”
- => low mood => reduce activity levels, avoid seeing friends => depression
describe adaptive tasks *
tasks related to illness/treatment
- coping with symptoms/disability
- adjusting to hospital environment/medical procedures
- developing and maintaining good relationships with healthcare professionals
tasks related to general psychosocial functioning
- controlling negative feelings and retaining a positive outlook - not done immediately, initially have negative feelings
- maintain a satisfactory self image and sense of competence - eg self admin meds
- preserve good relationships with family and friends - pt keep communication open
- prepare for an uncertain future
describe effects of an adaptive coping intervention *
intervention aimed at modifying illness cognitions - educated about condition and adress any incorrect beliefs, explored beliefs about recovery and make explicit recovery plans, action plan reviewed and concerns about medication and symptoms were adressed
pts with these interventions had more positive views of MI in terms of belief of consequences, time line, control, cure, and symptom distress
they returned to work quicker, had less angina symptoms and had higher attendance at rehab classes
what is coping *
‘Cognitive and behavioural efforts to master, reduce or tolerate external and internal demands and conflicts’
