Exam 1 (Lecture 7 and 8) Flashcards
What are the 5 As model of intervention
Ask
Advise
Assess
Assist
Arrange
What are the 5 stages of change?
Precontemplation Stage
Contemplation Stage
Preparation Stage
Action Stage
Maintenance Stage (Relapse Prevention)
What stage of change?
“I know I need to, doc, but…”
contemplation stage
What stage of change?
Experiment with small changes as their determination to change increases
Preparation stage
The preparation stage averages ____ months
Action stage?
maintenance stage?
preparation stage :0-3 months
action stage: 3-6 months
maintenance stage: 6+ months
Name some causes of non-adherence
- Patient didnt agree to care plan
- cost
- unable to access treatment
- SE
- patient think they are “better and no longer need treatment
What is considered bad news to a patient?
Likely to alter drastically a patient’s view of his or her future
That results in a cognitive, behavioral, or emotional deficit in the person receiving the news that persists for some time after the news is received
That results in decreased hope for the patient and his or her family’s future quality of life
What is the “mum” effect?
reluctance to give bad news to patients/families
What is the SPIKES 6 step protocol?
S - Setup
P - Perception
I - Invitation
K - Knowledge
E - Empathize
S - Summarize and
Strategize
______ irreversible cessation of circulatory and respiratory functions, OR
Irreversible cessation of all functions of the entire brain, including the brainstem
death
____ process of losing vital functions
dying
What are some signs of impending death
decreased Hearing, vision, oral intake, urine output, consciousness
Bedbound and/or profound weakness
Emotional distance, decreased conversation
Cool/mottled extremities, “death rattle”
_____ reaction to the loss of a close relationship
bereavement
_____ the emotional response caused by the loss of a close relationship
grief
____ psychological process by which the bereaved person undoes his or her bonds to the deceased and settles his or her personal grief
mouring
What are the 5 stages of impending death?
1: Shock and denial
2: Anger
3: Bargaining
4: Depression
5: Acceptance
Not every pt makes to ____ stage
acceptance
____ including visual and auditory hallucinations of the deceased, “sense” of the deceased’s presence
one of the normal grief reactions
searching behaviors
______ sleeplessness, appetite disturbances, agitation, chest tightness, sighing, exhaustion
somatic complaints
normal grief reaction
_____ taking on qualities, mannerisms, or characteristics of the deceased person
identification phenomena
As part of the normal grief reaction, Investment in _____ that belonged to the deceased
“linkage objects”
How long does grief tend to last?
6 months to a year
uncomplicated bereavement: Almost 25% of bereaved individuals meet criteria for major depression at ____ and again at ____
2 months
7 months
What is the criteria for prolonged grief disorder
-Longer than 1 year
- Since the death, on most days, the patient has felt one or both:
Intense yearning or longing for the deceased
Preoccupation with thoughts of the deceased
-significant distress or impaired functioning
-The patient’s grief response (duration and intensity) exceeds social, cultural, or religious norms for the patient’s social context
-The symptoms are not due to another psychiatric disorder
What is the difference in mood disturbances between depression and grief?
Depression: typically pervasive and unremitting… fluctuations are relatively minor
Grief: fluctuations are common (even in intense grief, moments of lightheartedness and happy reminiscence are possible)
What is the difference in shame and guilt between depression and grief?
Depression: fundamental belief that one is wicked or worthless
Grief: usually involves not having done enough for the deceased before death
What is the difference in suicidal ideation between depression and grief?
Depression: threaten suicide more often
Grief: often claim life is unbearable, but do not truly wish to die
