Health Flashcards
what is a DALY
Disability Adjusted Life Year (DALY)
a common metric used
- Difference between a person’s life
expectancy and the number of years
that they can expect to live free of
health concerns/ disability.
what can influence the experience of stress
interpretation and appraisal of stressors
For example, perceiving a work deadline as a threat rather than a challenge can lead to increased stress levels.
Activities undertaken by people who experience symptoms but who have not yet received a diagnosis – ie determining their state of health and to discover suitable remedies.
Illness behaviour
Behaviour of people after a diagnosis – ie behaviour to get well – get surgery, chemo etc
sick role behaviour
what are some conditions shaping peoples responses to symptoms
personal factors (views of their own body, personality traits) Gender - males less likely , Age - older people contribute symptoms to aging. Socioeconomic factors, Stigma, characterization/interpretation of symptoms. Conceptualization of the disease (identity of disease, timeline, cause, controllability)
privileges of sick role behaviour - 3
1- right to make decisions on health issues 2. the right to be exempt from normal duties, 3 right to become dependant on others
responsibilites of sick role behaviour - 3
1 - duty to maintain health and get well 2 duty to preform routine healthcare management 3 duty to use health resources
factors representing effectiveness of media - 4
- awareness - instruction - persuasion - misrepresentation/factual inaccuracies
qualities that increase message effectiveness -4
credibility, engaging, personally relevant, understandble
what is a prospective study
LONGITUDINAL - following them forward -followed over time ie: measures variable 1 at a baseline , and then measure variable 2 outcomes later on to see if V1 predicts V2 For example, a group of individuals might be watched over an extended period of time to observe the progression of a particular disease. YEILD STRONGER RESULTS
what is a retrospective study?
Looking backwards - BEGINS WITH CASE STUDY-CONTROL STUDIES OF THOSE ALREADY SUFFERING WITH THE DISEASE inferring stuff about their past based on present state. measure V1 and 2 at same time to see if one infers another - involve looking at historical information. For example, researchers might start with an outcome, such as a disease, and then work their way backward to look at information about the individual’s life to determine risk factors that may have contributed to the onset of the illness.
what is a nocebo
negative side effects due to placebo
proportion of people that has a disease at a specific time is referred to as -
prevalence
freq. of new cases in a time period is refered to as
incidence
a persons chances of developing a disease or disorder independent of any risk that other people may have is referred to as
absolute risk
ratio of the incidence or prevelance of a disease in the unexposed group. Always 1.00.
relative risk -For example, male cigarette smokers
have a relative risk of about 23.3 for dying of lung cancer
This means that, compared with nonsmokers, men who smoke are more
than 23 times as likely to die
Conditions inferring a causal relationship -7
1- dose relationship must exist
2- removing condition reduces prevelance or incidence
3- cause and effect is physiologically possible
4-condition precede the disease
5- data reveals relationship
6- strength or relationship is high
7- studies are well designed
this model Posits that individuals move through 6 stages
transtheoretical
6 stages of transtheoretical model
- Precontemplation – no awareness/intent
- Contemplation – aware , not yet committed
- Preparation – planning behaviour change
- Action – implementation
- Maintenance – monitoring
- Termination – fail
which model -To predict an individuals intention to engage in a behaviour at a specific time and place -includes behavioural control beliefs and perceived power
theory of planned behaviour TPB includes behavioral control as an additional determinant of intentions and behavior.
this theory suggests that a person’s behavior is determined by their intention to perform the behavior and that this intention is, in turn, a function of their attitude toward the behavior and subjective norms
- Behavioural beliefs
- Evaluation of behaviour outcomes
- Normative beliefs
- Motivation to comply
The Theory of Reasoned Action (TRA) the only difference between this and TPB is
The theory of reasoned action (TRA) is a special case of the theory of planned behavior (TPB).
This model posits that health behavior is determined by an individual’s perception of their susceptibility to a health problem, the severity of the problem, the benefits of taking action, and the barriers to taking action.
Health belief model
This theory posits that people are more likely to engage in a health behavior if they have a sense of autonomy, competence, and relatedness in relation to that behavior.
self- determination theory
This theory emphasizes the role of cognitive and behavioral factors in shaping health behavior. It posits that health behavior is determined by three factors: personal factors (such as attitudes and beliefs), environmental factors (such as social norms and access to resources), and behavior itself (such as past experiences and self-regulation).
social-cognitive theory
This model posits that health and illness are influenced by a complex interplay of biological, psychological, and social factors. According to this model, health is not solely determined by biological factors, but also by psychological and social factors such as stress, coping mechanisms, and social support.
Biopsychosocial model
what is the definition of stress
any circumstance that threatens (or is perceived to threaten) one’s well being and that thereby taxes one’s coping ability.
Folkman and Lazarus (1984) found that there is a cumulative nature to stress
* i.e., minor stresses (like moving house, changing jobs) can add up to be as stressful as a major traumatic event (death of loved one or divorce).
* Feeling stress depends on individual cognitive processes
* going on a date is exciting for some, terrifying for others.
* People’s appraisals of events are very subjective and influence the effect of the event.
- Stress as a stimulus
- Stress as a result of cognitive appraisal 3.Stress as a response (physiological, emotional, behavioural)
Stress is a result of an interaction between an individual’s characteristics and appraisals, the external or internal event (stressor) environment, and the internal or external resources a person has available to them
this model contended that a person’s capacity to cope and adjust to challenges and problems is a consequence of transactions (or interactions) that occur between a person and their environment.
The Transactional Model of Stress and Coping, proposed by Lazarus and Folkman (1984
give examples of an emotional response to stress, a physiological response, and a behavioural response
Emotiional response –annoyance, greif, anxiety, anger, fear dejection
Physiological response – autonomic arousal, hormonal fluctuations, neurochemical changes etc
Behavioural response – coping efforts such as lashing out, blaming oneself, seeking help, solving problems and releasing emotions
Event factors that may trigger stress
Events that are:
- Imminent
- Occur unexpectedly
- Unpredictable
- Ambiguous
- Potentially risky
- Undesirable
- Associated with low perceived control
- High life change
name this stress: quickly dissipating reaction to an immediate threat involving the fight-flight-freeze-fawn response and is not considered a threat to health.
Acute - short term* For example – a sudden fright
name this stress -response to a stressor that varies in duration, and which may make us more physiologically resistant to stress.
intermittant * For example – being at university
name this stress: common to modern life, and which may pose a health risk. *
Chronic - long term For example – financial worries, ill-health, occupational demands, parenthood
what are the 3 stages of general adaption syndrome (GAS)
- Alarm stage: recognize a threat and mobilizes resources 2. Resistance stage: stress is prolonged and physiological arousal stabilizes but is still above baseline, as one copes with the stressor. 3. Exhaustion stage: body’s resources are depleted
in which stage of the GAS do you get a burst of energy that helps you think more critically and help effectively tackle the stressful situation at hand.
Alarm stage
positive psychology holds that the effects of stress are not entirely negative. can promote and improve what?
Stress can promote personal growth or self-improvement, and improve coping
optimism is the expectation of what?
the expectation of good things will happen, and bad things will not happen, contrasted to pessimism.
* Related to psychological wellbeing, physical well-being, and more adaptive coping.
______ involves an increased internal locus of control and high self-efficacy is strongly related to fostering better health habits, which are protective during times of increased stress. (One of the ffm)
conscientiousness
what is this coping style -thoughts or actions whose goal is to relieve the emotional impact of stress. * These do not actually alter the threatening or damaging conditions but make the person feel better.
Emotione focused
efforts to improve the troubled person-environment relationship by changing the cause of the stress. * By seeking information about what to do, by holding back from impulsive and premature actions, and by confronting the event (including person or persons) responsible for one’s difficulty.
Problem focused coping
describe the marginalisation of certain groups in healthcare (why do researches specifically exclude groups)
Researchers specifically exclude certain groups – simplifies analyses * Often difficult to recruit members of certain subgroups into research * Members of certain subgroups may be unwilling to participate in research
what are Barriers accessing and utilising health care system and facilities
cultural differences language barriers non-English speaking migrants most affected perceived racism misunderstandings of the health facilities
describe the primary level of prevention with example
guide individuals to develop good habits – ie wearing sunscreen, raising awareness of drug use
describe the secondary level of prevention with example
targeting of individuals who have early stages of emerging signs of disease, SCREENING
describe the tertiary level of prevention with example
individuals who have already been diagnosed with disease of have an injury – emphasis on minimization and treatment – prevent reoccurrence
what is the target population of prevention
normal, population risk - healthy people showing no symptoms of diease, no past or family history
what is the at risk group
– healthy people showing no symptons of disease BUT family history, exsistance of other factors
what are the qualities that increase message effectiveness (Characteristics of Persuasive Messages)
Credibility – this is the extent to which the message content is believed to be accurate and valid. This can be conveyed by the trustworthiness and competence of the source and the provision of convincing evidence. Sometimes individuals perceived as experts (e.g., researchers) are used to convey messages that require scientific accuracy and believability.
Engaging style and ideas – using stylistic features that are superficially attractive and entertaining, and content that is interesting, mentally stimulating or emotionally rousing.
Personally relevant – the communication is most effective if it is personally salient or relevant for the target audience. There is little point making an ad that features a teenager that is targeted at people over the age of 70.
Understandable – the message is most effective if it is simple, explicit, sufficiently detailed, comprehensive and comprehensible.
remind yourself of the three basic communication processes health awareness campaigns typically use to move the target audience towards the desired response:
Awareness messages inform people what to do, specify who should do it and provide cues about when and where it should be done.
Instruction messages present how to do it information.
The campaign also needs to present messages with Persuasive reasons why the audience should adopt the particular action or behaviour.
Essentially, what these messages are trying to do is to change or create a certain attitude towards the behaviour, with the hope that attitude adoption will lead to behavioural change.
define a chronic illness
long term - greater than 3 mths,
treatment is not curative -
often lifelong
lifestyle changes req.
functioning affected
Adjustment in the context of illness -
An organism returns to ‘equilibrium’ after facing a disruption
Make changes to fit with new environment
* A range of domains to ‘measure’ adjustment;
* Quality of life * Emotional wellbeing * Life satisfaction * Self-esteem * Role functioning (work and social)
Highly complex * Many processes and influences * Adjustment is probably a non-linear process * Illnesses are highly varied, e.g. epilepsy vs. amputation * Models don’t explain enough variance in adjustment outcomes
what does Moo and schaefers crisis theory explain
Individual’s ability to adapt influenced by three factors
Moos and Schaefer’s Crisis Theory offers a framework to understand and anticipate the factors that may affect coping and adaptation, by considering a chronic illness as a life crisis.
Firstly, :
moo and schafer split the coping process into three sequential parts which are
- Cognitive appraisal appraisal of the seriousness of the illness
- Adaptive tasks dealing with pain and procedures – maintaining an emotional balance – preserving self image – sustaining relationships – preparing for an uncertain future
- The use of coping skills understanding the illness – confronting related problems – managing emotions
Moo and schafer argue that how well someone will be able to cope with a chronic illness, and successfully navigate these cognitive and practical tasks, is then impacted by three sets of factors:
- Nature of the person (demographic and personal characteristics) ie. High achieveing athlete
- Aspects of the illness (course, outcome) ie. Suppen spinal injury
- Context (physical and social environment) ie. Supportive network societial beliefs about image
Crisis theory( Moos and Schaefer)
Individual’s ability to adapt influenced by three factors
Strengths: * Clinically useful – psychologists can assess ‘adaptation’ in all seven areas Issues: * No clearly measurable outcomes – how to measure ‘adaptive tasks’ * No clear empirical basis – how were these categories decided upon? * As a result, has not been empirically applied to the chronic illness literature
what does Lazarus and folkmans TRANSACTIONAL
Stress and coping model posit?
that a person’s capacity to cope and adjust to challenges and problems is a consequence of transactions (or interactions) that occur between a person and their environment.
what are the 3 phases of Lazarus and folkmans transactional model
Stress and coping model – importance of appraisal and coping
- Primary and secondary appraisal (is this a problem? How bad? Can I cope with this?)
- Coping strategies
- Reappraisal
strengths:
Overlap with other theories (e.g. cognitive behavioural models)
* Good evidence base and overlap with other theories * Appraisals are central to coping
* Coping efforts clearly affect adjustment
this model Combines aspects of previous models * Defines adjustment as an outcome and a
process
* Acknowledges illness as an ongoing
stressor
Moss-morris Unified theory
The model of adjusting to chronic conditions has been proposed as a working model to help standardize some of the thinking and research in this area. The model addresses some of the complexities in the area by defining the process of adaption in a multifaceted way. It also provides good treatment utility in that interventions can be mapped onto building or maintaining existing cognitive and behavioural methods, which facilitate adjustment, and reducing those that maintain a state of disequilibrium
Type of cancer is determined by:
-the organ it starts in
- the kind of cell from which it derives
-and the appearance of the cells
stages of cancer
I – Localised and curable
II (early) and III (late) – Usually localised but advanced and may involve lymph nodes
IV – inoperable or metastatic cancer
type of cancer treatment vaires according to
Site of the cancer
– Stage: Localised or metastatic
– Lymph node involvement
– Other prognostic factors (e.g., oestrogen receptivity of breast cancer cells)
Pain
Pain does not always = suffering
Symptom severity and disability are not correlated
Without pain behaviour there would be no adaptive value to pain
what are the 3 dimensions of pain?
- Sensory – discriminative
How intense the pain is, location quality of the pain, duration - Affective – motivational
Unpleasantness, fight or flight response - Cognitive – evaluative
Appraisals, interpretation of pain
describe acute pain
Short duration, elicited by injury and goes away when tissue heals
Biomedical approaches are most effective
describe chronic pain
Often brought about by injury and worsened by other factors
Interferes with functioning
Not explained by pathology
Biomedical approaches rarely very effective, though freq. sought after
Duration for chronic pain:
- Pain beyond healing time
- 3 or 6 months (largely arbitrary)
what model of pain is described as Linear transmission from periphery through the spinal cord and to the brain
“The experience of pain is related to the amount of tissue injury or damage”
Specificity model - - I touch pain and the message transfers to the brain, the more firing the more intense the pain
does not explain:
why injurys are sometimes only noticed later
phantom pain
why non-pharmacological methods can relieve pain
pain durance absence of tissue pathology
or chronic pain
this theory states that when a part of the body is damaged, nerve endings at the injured site transmit impulses to a specific part of the spinal cord. When nerve impulses reach the spinal cord, two things can happen: If the injury isn’t intense, the gate in the spinal cord remains closed, and the pain signal is not transmitted to the brain. But if the injury is too severe, the gate opens, and the pain signal is transmitted to the brain, leading to experiencing the pain.
Gate control theory
Gating mechanism in spinal cord in the substansia gelatinosa in the dorsal horns of the spinal cord– receives and modulates signal
Many brain areas involved – no fixed ‘pain center’
Both ascending and descending signals can modify pain
Clear relevance of biopsychosocial model
Pain can be modified by variety of psych and physical signals explains cognitive aspects of pain and allows for learning and experience to influence the exp./ of pain
this theory of pain proposes that pain is a multidimensional experience produced by characteristic “neurosignature” patterns of nerve impulses generated by a widely distributed neural network-the “body-self neuromatrix”-in the brain.
the neuromatrix theory
A large widespread network of neurons that consists of loops between the thalamus and cortex as well as betweent eh cortex and llimbic system.
Normally the neuromatrix processes incoming sensory info, but it can even act in the absence of sensory input producing phantom limb syndrome
a person who experiences a sudden onset of lower back pain after lifting a heavy object at work. The initial pain episode triggers fear and worry about the severity of the injury, leading to the belief that any movement or physical activity will worsen the pain or cause further damage.
Due to this fear of pain and injury, the individual begins avoiding activities that involve bending, lifting, or any type of physical exertion. They may even start avoiding work altogether or engaging in social and recreational activities that they associate with potential pain triggers.
what model of pain are they experiencing
fear- avoidance model
These changes contribute to increased pain sensitivity, reinforcing the belief that any movement will cause pain and further strengthening the fear-avoidance cycle.
it involves
initial injury
cognitive appraisal
fear of pain
avoidance
disuse/deconditioning
chronic pain development
this Model of Pain is a psychological framework that explains how individuals appraise and cope with pain-related STRESSors. This model proposes that individuals’ cognitive APPRAISAL of pain and their COPING strategies play a crucial role in shaping their pain experience and its impact on their well-being.
Stress-appraisal-coping model of pain
The model consists of three main components:
STRESSOR APPRAISAL
COPING STRATEGIES
PAIN OUTCOME
Pain catastrophizing refers to a cognitive and emotional response pattern in which individuals with chronic pain tend to magnify the significance of their pain and engage in exaggerated negative thinking and emotions related to their pain experience. It involves a tendency to focus on the worst possible outcomes and engage in an overwhelming sense of helplessness and hopelessness in relation to pain.
Addressing pain catastrophizing often involves cognitive-behavioral interventions that aim to modify maladaptive thoughts, challenge catastrophic beliefs, enhance self-efficacy for pain management, and promote the use of adaptive coping strategies. By reducing pain catastrophizing, individuals can experience improvements in pain management, emotional well-being, and overall quality of life.
what do afferent neurons do?
relay information from the sensory receptors to the brain
What do motor (efferent ) neurons do?
are for info coming from the brain down to signal movement etc\
what are interneurons
inside the spinal grey matter connect the afferent and motor neurons
Myelinated afferent neurons are called A FIBRES - there are 2 types, whats the biggest and which is faster
A-beta fibres are large and A-delta = small) large fibres are more than 100x faster (b comes first in the alphabet)
unmyelinated are called C FIBERS – most common –up to 60%
A-beta fibres fire with little stimulation, C fibres need more – accordingly these different fibres result in different pain sensations
which one produces fast pain that is sharp or pricking and the other often results in a slower developing sensation of burning or dull pain
for example stimulation of A-Delta fibres produce fast pain that is sharp or pricking whereas stimulation of C fibres often results in a slower developing sensation of burning or dull pain
For example, imagine accidentally touching a hot stove. The moment your skin comes into contact with the hot surface, the A-delta fibers in your skin are activated, sending a rapid pain signal to your brain. This fast pain is sharp and immediate, causing you to quickly withdraw your hand from the stove to avoid further injury.
On the other hand, slow pain, or chronic pain, is characterized by a slower-developing sensation of burning or dull pain. It is mediated by the activation of C fibers, which are unmyelinated nerve fibers responsible for transmitting slower pain signals to the brain. Stimulation of C fibers often leads to a delayed and longer-lasting perception of pain, which is typically described as a burning, aching, or throbbing sensation.
the sensory tracts and motor tracts are on which side of the spinal cord - posterior/anterior
Sensory tracks are on the back side of spinal cord(posterior) motor tracts are anterior (front)
my motors at the front and i feel sensations on the back