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1
Q

Health care is the responsibility of which branch of the government?

A

Provincial

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2
Q

What is the lowest and highest per-person health care cost in Canada?

A

Lowest: Quebec ($3,359)
Highest: Nunavut ($17,493)

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3
Q

Why is it important to have a family physician?

A

Because people see them regularly so it provides a chance for early detection

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4
Q

Percentage of family doctors who report patients can get same or next day appointments in Canada

A

22%

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5
Q

What percentage of patients wait more than 2 months to see a specialist?

A

29%

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6
Q

What are the satisfaction rates of health care?

A

85.7% are very to somewhat satisfied

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7
Q

Do physicians think they get enough time with patients?

A

55% don’t feel they do

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8
Q

What percentage of physicians think they can provide quality care to their patients?

A

Less than half

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9
Q

How many people are admitted to the hospital every year?

A

2.8 million

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10
Q

How are most people admitted to the hospital?

A

Through the emergency department

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11
Q

Why would a person be seen in a hospital but not be admitted?

A
  • Emergencies that can be solved quickly

- Day procedures

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12
Q

How many visits to the emergency room are there every year?

A

15 million

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13
Q

90% of people in emerg are seen in what time frame?

A

within 7.6 hours

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14
Q

What proportion of people seen in emerg get admitted?

A

1/10

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15
Q

30% of emergency room visits are made for__% of people

A

10%

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16
Q

What aspects of a hospital stay must people adjust to?

A
  • Lack of privacy
  • strict schedule
  • restricted activities
  • dependent on others
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17
Q

Often times people are seen by a team of people with frequent changes, what does this result in?

A

Depersonalization,

Patients feel a loss of autonomy and control

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18
Q

What will guide a person’s sick behaviour?

A

Both their own and the doctor’s expectations

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19
Q

Characteristics of an ideal patient according to the medical staff:

A

Cooperative, uncomplaining and stoical

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20
Q

What do doctors consider a bad patient?

A

Uncooperative, complaining, overemotional and dependent

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21
Q

Two types of “problem patients”

A
  1. Seriously ill patients with severe complications or poor prognosis who require a lot of attention
  2. People who are mot seriously ill but take more time than is warranted by their illness
    > Usually get sedated or discharged early
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22
Q

When is anxiety the highest in a hospital?

A

At admission and prior to surgeries

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23
Q

Coping with hospitalization

A

Problem vs Emotion Focused

Blaming self and/or others

Helplessness or loss of control

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24
Q

Things that help patients cope in a hospital ?

A
  • Provide information
  • Psychological counselling
  • Increased control
  • Room with a roommate recovering from a similar thing
  • Humour
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25
Q

How to help patients prepare for surgical procedures

A

Enhance their sense of control and address expectations

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26
Q

Does information make attention-focused people more or less stressed?

A

Less

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27
Q

Does information make avoidance-focused people more or less stressed?

A

More

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28
Q

Discharge Planning

A

A process by which post-hospital care is organized and risks are assessed.

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29
Q

How long are wait times for a hospital bed?

A

1 in 10 people wait more than 30 hours

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30
Q

How many people contract infections from hospitals and how many people die from them?

A

As many as 1 in 9 get infections

8000-12000 die from the infection every year

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31
Q

Factors that enhance satisfaction with hospital experience:

A
  • Respect through communication (avoid jargon, providing info)
  • Maintenance of dignity
  • Day-to-day control
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32
Q

What roles to psychologists play in hospitals?

A
  • Assess adjustment
  • help patients and families cope
  • assist in rehabilitation
  • research on making hospitals more effective and safer
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33
Q

What is pain

A

Unpleasant sensory or emotional experience with actual or potential tissue damage

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34
Q

What is the function of pain?

A
  • Information (if something wrong)
  • Warn of potential serious injury
  • Promote learning to avoid the same situation later
  • Limit physical activity and promote rest
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35
Q

A-delta peripheral nerve fibers

A

Small, myelinated fibers that produce a feeling of sharp pain
>Terminate in sensory cortex

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36
Q

C Fibers in peripheral nervous system

A

Unmyelinated, produce a diffuse, dull, aching pain

>terminate in brainstem and forebrain

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37
Q

Referred pain

A

Pain that originates in internal organs, but it is perceived as coming from other parts of the body

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38
Q

Organic Pain

A

Comes from the body, tissue damage

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39
Q

Psychogenic pain

A

No visible tissue damage

> Experienced like organic pain

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40
Q

Gate control theory of pain

A

Pain is not just the result of a linear process from sensory stimulation to brain receptions & the experience of pain

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41
Q

Modulation of pain in the spinal cord

A

Small A-delta & C Fiber activation –> opens gate –> pain

Large A-beta fiber activation –> closes gate –> inhibits pain

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42
Q

Pain modulation descending from the brain

A

Central Control Trigger = activates cognitive processes that can open or close gate

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43
Q

Emotional triggers that open the pain gate

A

Anxiety
Tension
Depression

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44
Q

Emotional triggers that close the pain gate

A

Positive emotions

Relaxation

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45
Q

Cognitive factors that open the pain gate

A

Attention

Boredom

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46
Q

Cognitive factors that close the pain gate

A

Distraction

Involvement

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47
Q

Physical factors that open the gate

A

Level of injury

Activity level

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48
Q

Physical factors that close the gate

A

Medication

Counter stimulation

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49
Q

Acute pain

A

Temporary, lasts less than 6 months

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50
Q

Recurrent acute pain

A

Intermittent pain for longer than 6 months

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51
Q

Chronic pain

A

Lasts more than 6 months and gets worse over time

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52
Q

What cells in the brain are responsible for pain distortion

A

Glial cells

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53
Q

Criticism for pain questionnaires

A

It requires a high level of language and many people cannot tell the difference between the different descriptions

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54
Q

What is highest and lowest on the McGill pain index?

A

Highest: Causalgia
Lowest: sprain

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55
Q

What are the common pain behaviours

A
  • Facial and audible expressions of distress
  • Distortions of posture and gait
  • Negative affect
  • Avoidance of activity
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56
Q

How is pain induced in the lab

A

Cold pressor test (sticking hand in ice water)

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57
Q

The ____ attached to pain influences its experience

A

Meaning

> feeling pain for a good cause makes it feel less severe

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58
Q

Learning and pain

A

Learn to associate cues with pain such that cues can produce distress and may heighten pain perception

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59
Q

What are the secondary gains of pain?

A

Get more attention from others
Get treated well
Disability pay

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60
Q

Social support is associated with more or less pain?

A

Less

61
Q

How can support make pain worse?

A

If it is given too much attention or if a person is helped too much then they feel a lack of control

62
Q

Pain-prone personality

A

Neuroticism, introversion and passive coping

63
Q

What is the most common factor in care seeking?

A

Pain

64
Q

How do different genders experience pain differently

A

Men and women have similar pain thresholds

  • differences in intensity
  • differences in frequency
65
Q

Socio-cultural differences in pain

A
  • Culture differences in dealing with pain

- SES diffs in frequency and intensity of pain

66
Q

What are ways to deal with pain?

A
  • Coping
  • Medication
  • Behavioural and relaxation techniques
  • Cognitive techniques
67
Q

How many people in hospitals are under medicated?

A

About half

68
Q

Who are at most risk for poor control of medication and why

A

Children

>Doctors are afraid to over do it

69
Q

What 2 ways are medications given?

A
  1. PRN “as needed”

2. On a schedule

70
Q

Behavioural and relaxation techniques in coping with pain

A

Rear reduction
Resuming daily activities
Biofeedback

71
Q

Cognitive techniques for dealing with pain

A

Distraction
Guided imagery
Redefinition of pain

72
Q

Has swearing been shown to reduce pain?

A

Yes

73
Q

What are the goals of a multidisciplinary approach to chronic pain management?

A
  • Reduce pain experience
  • Improve physical functioning
  • Decrease medication and use of other medical services
  • Enhance family life
74
Q

Lifestyle changes for dealing with illness

A

Diet, exercise, developing regular activities

75
Q

Strategies for coping with high mortality illnesses

A
  • Finding meaning in illness
  • Gaining a sense of control over illness
  • Restoring self-esteem
76
Q

____ perceived social support is relates to poorer adjustment

A

Low

77
Q

What is coronary heart disease

A

A general term that describes the narrowing of the artery that causes less blood to through through

78
Q

How can arteries narrow?

A

Clogged with plaque and fat

79
Q

What is bad about arteries narrowing?

A

There is insufficient oxygen to the heart

May feel pain and lead to a heart attack or stroke

80
Q

2 groups of risk factors for coronary heart disease

A
  1. Non-modifiable risk factors
    - genetics, gender, age
  2. Modifiable risk factors
    - lifestyle and cognition
81
Q

What are 3 positive factors that lead to less mortality with CHD?

A

Exercise
Optimism
Being religious

82
Q

What is the leading killer of women in Canada?

A

Coronary heart disease

83
Q

Why is CHD not identified or treated well in women?

A

Because doctors use a model created for men

84
Q

3 treatment approaches to CHD

A
  1. Medical (surgery, pump implant, drugs)
  2. Rehabilitation
  3. Psychosocial interventions
85
Q

Clot dissolving medication only works if administered in the first ____ hours

A

3

86
Q

What factors do the best cardiac rehabilitation programs have?

A

Both education and counselling

87
Q

___ is most important for predicting short term behaviours, ____ is most effective for predicting long term change

A

Self-efficacy

Motivation

88
Q

Psychosocial consequences of recovering from CHD

A 
Work (most return within 1 year)
Family (support makes recovery go faster, over protection and past problems might make it worse)
General adjusting (can be anxious and depressed for 1-2 years)
89
Q

Neoplasm

A

Unrestricted cell growth

90
Q

Metastasize

A

Spreading of cancer

91
Q

5 types of cancer

A
  1. Carcinomas - skin or organ cells
  2. Melanoma - skin
  3. Lymphomas - lymph system
  4. Sarcomas - muscle, bone or connective tissue
  5. Leukemias - blood forming organs
92
Q

Cancer is the ____ cause of death world wide and number __ in canada

A

Leading

1

93
Q

What percentage of males and females get cancer in their life?

A

45% males

41% females

94
Q

What are the chances of dying from cancer

A

29% males die from it and 24% of females

95
Q

Physical effects of cancer

A
  • Interfere with normal cell functioning
  • creates pressure on tissue and nerves, blocks blood and liquid flow
  • Pain comes later
96
Q

How does cancer directly kill?

A

By spreading to vital organs and taking nutrients so organ dies

97
Q

How does cancer indirectly kill

A

By weakening the victim, impairing appetite and immune function

98
Q

2 Types of risk factors for cancer

A
  1. Non-modifiable (age, gender)

2. Modifiable (lifestyle)

99
Q

Warning signs of cancer acronym

A

CAUTION

100
Q

Detecting cancer

A

Physician and self administered tests

101
Q

Diagnostic Procedures

A
  • blood or urine tests for abnormal levels of hormones or enzymes
  • Imaging to look for tumours
  • Biopsy
102
Q

What does treatment of cancer depend on?

A

Size, site(s), and quality of living tissue

103
Q

Cancer treatment options

A

Surgery - if cancer is localized
Radiation - destroys cancer cells so they cannot divide
Chemotherapy

104
Q

Adherence to cancer treatment is not good for which population

A

Adolescents

105
Q

Side effects and problems of cancer treatment

A
  • health tissue can be damaged
  • physical side effects
  • Anxiety
  • treatment is demanding, requires a change in lifestyle
106
Q

Factors that influence adjustment from cancer

A

Physical condition

Site of cancer, age, gender

107
Q

Interventions to help people adjust with cancer

A

CBT
Exercise
Disclosure
Therapy

108
Q

What are characteristics of chronic illnesses?

A

Persist for a long time
Do not go away by themselves
Rarely cured completely

109
Q

Stages of coping with a chronic illness

A

Crisis –> Initial Reaction –> Coping Strategies –> Long-term adaptation

110
Q

When can emotion focused coping be beneficial

A

At the beginning of a chronic illness

111
Q

Is anxiety and depression normal in chronic illness?

A

Normal at first but them is maladaptive in the long term

112
Q

Factors that contribute to illness being a crisis

A

Illness related factors (visibility, intrusion on life)
Background and personal factors (age, SES, religion)
Physical and Social Environment (hospital vs home, social support)

113
Q

Cognitive appraisal in the coping process of a chronic disease

A
  • Meaning or significance of illness

- Beliefs about nature, cause, controllability of illness

114
Q

Adaptive tasks in coping with chronic illness

A

Tasks related with illness or treatment

Tasks related to psychosocial functioning

115
Q

How can making beating an illness like a game helpful?

A

Gives person control

116
Q

What does AIDS stand for?

A

Acquired Immune Deficiency Syndrome

117
Q

What does the HIV virus attack in the body?

A

T-cells

118
Q

How long between HIV and AIDS?

A

The time varies

119
Q

Risk factors of HIV

A
  • sexual activity
  • sharing needles
  • birth by infected mother
120
Q

Groups most at risk for HIV in North America

A

IV drug users

Homosexual men

121
Q

Can HIV be managed?

A

Yes, people can use medication and lead a relatively normal life
> It will never turn into AIDS

122
Q

Stigma around AIDS

A

Associated with drug users and homosexuality

123
Q

What is the main thing that adaptation to HIV is affected by?

A

Access to medication to decrease symptoms

124
Q

How do psychological factors affect the course of AIDS?

A

Stress makes it worse

Hope, self compassion and optimism help adjustment

125
Q

What is the new initiative to abolish AIDS

A

Universal HIV testing

126
Q

How many people who have AIDS are unaware of it?

A

1 in 4

127
Q

What is the average lifespan in Canada

A
  1. 1 years
    men: 78.8
    women: 83.3
128
Q

Why is infant mortality rate relatively high in Canada for a developed country?

A

We have recently started making more of an effort to deliver premature babies

129
Q

What are the 2 most common sources of death for children between 1 and 15

A

Accidents

Cancer (especially leukemia)

130
Q

Most common causes of death age 15-24

A

Accident
Suicide
Cancer
Homicide

131
Q

When is fear of death highest and lowest?

A

Middle age highest

Old age lowest

132
Q

Why do women tend to live longer than men

A
  • Less risk taking
  • Hormonal differences
  • Men have more risky jobs
  • Women are more likely to seek help when they have a problem
133
Q

What misconceptions to children have about death?

A

0-5 dont understand, think death is like sleep
5-11 begin to grasp finality of death
Teenagers understand death, tend to blame themselves

134
Q

Terror Management Theory

A

The cultural world views that protect us from the idea of death

135
Q

What is the goal of palliative care?

A

Reducing pain and discomfort

136
Q

Kubler-Ross’s 5 stages of dying

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
137
Q

Are the stages of dying correct?

A

Has not been proven but they have provided a useful framework

138
Q

Benefits of stages of dying theory

A
  • Helped specify importance of counselling

- initiated death research

139
Q

Limitations of 5 stages of dying theory

A
  • Not everyone goes through all stages
  • no universal order
  • does not acknowledge anxiety
140
Q

Types of care for terminally ill patients

A

Life support
Palliative care
Hospital, nursing home, hospice

141
Q

Hospice care

A

Medical and social support for patient and families to provide a better quality of life and death

142
Q

8 C’s of hospice care

A 
Compassion 
Competence 
Confidence 
Conscience 
Commitment 
Courage 
Culture 
Communication
143
Q

Ways of ending life

A

Do not resuscitate order
Assisted suicide
Euthanasia

144
Q

Conditions for Euthanasia in Canada

A
  • Untreatable condition
  • Voluntary
  • Advance stage of disease
  • Suffering cannot be relieved
  • Over 18 and of sound mind
145
Q

What happens to the survivors

A

Grief - emotional reaction to loss of loved one
Bereavement - objective situation of having lost someone
Mourning - public display of grief

146
Q

Early models of coping with the loss of a loved one

A

Working through the grief, have to come to terms with it

147
Q

Does finding meaning in the loss of a loved one help?

A

Yes

But looking and not finding meaning makes it worse

148
Q

What affect does losing a loved one have on death

A

People are more likely to die after losing someone

149
Q

Different trajectories of Grief

A 
Resilience 
Recovery 
Chronic dysfunction 
Delayed grief or trauma
Chronic depression

Health Psychology (3 decks)

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