health psych - pain, breaking bad news, death + dying Flashcards
acute VS chronic pain
> 3 months ongoing tissue damage prolonged medication rest is not useful can arise from medical condition / unknown cause
control theory of pain
pain experienced in the brain through complex pathways between BRAIN + DAMAGE / disease source via NERVE fibres
messages pass through 2 neural relays / GATES in the SPINE (afferent + efferent?)
extent that gates open / close - affects number of pain messages that are received (pain stimulus)
when do gates open / close
gates open / close by PHYSIOLOGICAL events e.g. physical stimuli, tissue damage, nerve messages
and / or PSYCHOLOGICAL factors e.g. thoughts, beliefs, interpretations, fear, anxiety
factors that open gates
injury over / under active sensitivity of NS stress + tension focusing on pain-expectation negative beliefs minimal involvement in life
factors that close gates
medication counter stimulation exercise relaxation distraction positive emotions positive beliefs - control active life
psychological factors + pain
e.g. depression + anxiety may EXACERBATE, perception of pain influenced by expectations, beliefs + attributions about pain, stress
if bad new is not delivered well, evidence shows this can have an impact on what?
doctor-patient relationship
EMOtional well-being of patients e.g. distress + depression
ADJUSTment to + ability to cope with illness, for patients + their relatives
SPIKES
setting + listening skills
patient’s perception: what they already know
invitation: form pt to give info - how much to give
knowledge: give warning shot, small chunks, avoid jargon
Empathy: how are you feeling? listen to concerns
Summarise + strategy: check understanding, agree on next step, closure
Kübler-Ross 5 stages of grief
- denial: not true, can’t be happening to them
- anger: why them
- bargaining: go to church every week
- depression: why try to do anything? can’t fight any longer
- acceptance: make funeral arrangements
denail
can be means of coping with overwhelming information + emotions in early stage of getting the news
check patient understands + how much information they want to know
respect desire to not know
offer written information to patients to look at with family
check + review over time - ‘when ready’
bereavement: the grieving process
need to work through grief, disbelief + shock, developing awareness, resolution
common elements: anger, blame, depression
bereavement: risk factors for poor outcomes
prior bereavements, mental health
type of loss - young person, nature of death, caring status
lack of social support, stress from other crises
expression of grief discouraged
ending of grief discouraged - allow them time
things that help people come to terms with bereavement
importance of time to say goodbye, rituals in mourning, social support
