Final Exam Flashcards
List 5 factors that may influence an individuals ability to recognize symptoms
- Individual Differences/personality (ex. neurotic)
- Cultural differences (ex. non-expressive)
- Situational factors (ex. medical student disease)
- Stress
- Mood
List 4 factors that many influence an individuals interpretation of their symptoms
- Prior experience (history or prevalence)
- Socio-economic factors
- Expectations
- Seriousness of symptoms
What are the 5 components of an illness representation/schema?
- Identity/label
- Duration
- Consequences
- Causes
- Cure
- The more components you know the better
Contrast acute, chronic, and cyclic illness
Acute is sudden and of short duration
Chronic is long duration
Cyclic has alternating periods of activity
The most common age group to visit a doctor is in your 30’s. True or False
False.
Infants/children use it a lot and adults typically use it the least and then as they become elderly they begin to use it again
Women are more likely to visit a doctor then men. True or False
True.
Better self-reporting skills and also during pregnancy
Minorities are more likely to visit a doctor. True or False
True. But they are less likely to see specialists
Contrast worried well individuals and somaticizers
Worried well individuals have heightened self-care so they exaggerate their symptoms when they occurs
Somatiziers express physical symptoms after emotional insults
When considering illness, what do secondary gains refer to?
Downstream benefits that arise from having an illness:
- Time off/rest
- Removal from responsibility
- Medical vs. psychological symptoms
What time periods is delay behaviour composed of?
Delay behaviour is when a patient lives with one or more potentially serious symptoms without proper care
- Appraisal delay - unsure if symptoms are serious
- Illness delay - symptoms begin to imply an illness
- Behaviour delay - The time b/w illness recognition and treatment
- Medical delay - Time b/w appointment and treatment
What factors increase the probability of delay behaviour?
Age - middle age people delay
Lack of Access - lack of regular physician
Views - Dislike for medical care
History - Are symptoms frequent? Have you had it before?
What factors decrease the probability of delay behaviour?
- Symptoms are highly visible
- There is a high degree of pain
- You have noticed a large degree of change
- Symptoms are incapacitating
What is the difference between treatment delay and provider delay?
Treatment delay occurs after a primary visit. It may occur due to curiosity being satisfied after visit or fear/alarm of diagnosis
Provider delay occurs when treatment is halted due to abnormal patient population or lack of assistance from doctor
What does the term patient consumerism refer to?
People want to be more involved in their treatment and active in the decision making
People care about the delivery of their care and often patients spend a lot of time researching their symptoms
What is CAM and why do patients use it? Who is the most common demographic to use CAM?
Complementary and alternative medicine (CAM) includes: massage therapy, chiropractic care, acupuncture, homeopathy
People use CAM because they don’t have acess to primary physicians, are unhappy with primary care, appointments last long and are vicious
Patients are typically highly educated women with multiple chronic issues
What barriers do people experience to accessing good health care?
Poor communication - physician doesn’t listen
Jargon - physician doesn’t explain in lay terms
Baby talk - physician makes it too simple
Elderpeak - treats elders like infants
Nonperson treatment - Patient is depersonalized
Stereotypes - racism, sexism, cultural stereotypes
How is creative non-adherence different from non-adherence?
Non-adherence is when a patient doesn’t follow prescribed treatment. But creative non-adherence is when they modify/supplement their prescribed treatment
What factors may contribute to non-adherence?
- Poor communication
- Negative satisfaction
- Complex treatment regimen
- Type of treatment (people are typically much more adherent to medical treatment vs. social treatment)
How does a placebo effect work?
- It has indirect physiological responses which can reduce anxiety and lower stress response
It may cause release of endogenous opioids
What factors can increase the placebo effect?
- Patient-Physician relationship/interaction
- Personal characteristics
- The appearance and administration of placebo
What are the two types of pain?
Acute and Chronic
Acute is caused by soft tissue damage, accompanied by infection and inflammation
Chronic is a long-term illness that may have no apparent cause, can trigger other issues, and is difficult to assess
List 3 types of chronic pain
- Chronic benign (ex. lower back pain)
- Recurrent acute pain (ex. migraines)
- Chronic progressive (ex. arthritis)
What factors may influence and individuals pain symptoms?
- Cultural differences - some cultures are more likely to express their pain
- Gender - women are more sensitive
- Coping styles - Catastrophizing heightens pain and resilience and positive emotions lower it
What are common way to measure pain?
- Verbal/self-report: uses personal vocabulary or answers questionnaire
- subjective, descriptive words may be limited, scales may not go in depth enough - Pain behaviour: facial/audible expressions, distortions in posture/gait, negative affect, activity avoidance
What is nociception and how is it transmitted? What are the types of nerve fibres?
Nocieception is the system that carries signals of damage and pain to the brain
Nerve fibres transmit pain signals to the cell bodies in the dorsal root ganglia in the dorsal horn of the spinal cord. Which is then sent for processing in the brine
A-delta fibre is a small, myelinated fibre that transmits first and sharp pain (opens pain gate)
C-fibres are unmyelinated and transmit secondary dull or aching pain (opens pain gate)
A-beta fibres are large myelinated fibres that transmit info about vibration and position (closes pain gate)
What is the gate-control theory?
The gate control theory is a theory of pain that proposes that psychological factors contribute to pain
The neural pain can can open/close to module pain signals (A-delta and C-fibres open; A-beta close)
Also Argeș that physical, emotional, and cognitive factors can open and close the gate
What is the body-self neurmatrix?
The body-self neuromatrix is a theory of pain posits there is a network of neurons that extends throughout areas of the brain to create the felt representation of a unified physical self
Each pain experience causes a neurosignature which is what gives rise to pain rather than the sensory inputs
Thus, during phantom limb the inputs do not stop the networks from generating neurosignatures related to missing body parts
How does the body endogenously manage pain?
Produces endogenous opioids:
- Beta-endorphins: peptides that project to limbic system
- Proenkephalin: peptides found in the endocrine and CNS
- Prodynophins: peptides in the gut, pituitary, and brain
Acute stress (SIA) and physical activity reduces sensitivity to pain
What are pain management techniques?
Traditional techniques: pharmacological, surgical, and sensory techniques
Psychology techniques: biofeedback, relaxation, hypnosis, acupuncture, distraction
What does the neurotic triad refer to?
- Hypochondria
- Hysteria,
- Depression
- People who have chronic pain show elevated scores in the neurotic triad
What 4 factors may increase susceptibility to chronic illness?
- Genetics
- Environment
- Lifestyle
- Previous injury or prolonged strain
What demographic profiles are more likely to suffer from chronic illness?
- women
- elderly
- Low SES
- certain sub-populations (ex. aboriginals or italians)
What are the components to quality of life?
- physical functioning
- psychological status
- social functioning
- disease or treatment-relates symptomology
Poor QoL is related to the degree in which normal life activities have been compromised
What factors may contribute to ones evaluation of QoL?
- Characteristics of the illness: acute vs. symptoms free phase
- Acute changes in symptoms: flare-ups
- Age-related changes over time: elderly vs. 35yrs old
- Culture: May impact how people experience common illness
List 4 reasons why it is important to study QoL
- documentation/history
2 Identify trends between illness and QoL factors - Compare effectiveness/impact between treatments
- Inform decision and policy makers
What are the 3 emotional bases (phases) of chronic illness?
- Denial - may interfere with treatment
- Anxiety/fear - elevated self-vigilance may hamper treatment
- Depression - increases with severity, hard to treat and increases risk of suicide
What 4 ‘șelf’ factors contribute to your self-concept?
- Physical self: positive body image increase SE
- Achieving self: job/hobbies increase SE
- Social self: positive social interaction increase SE
- Private self: decreases as dependence on others increases
What copying style is associated with less psychological distress during chronic illness?
Active coping