Health Psychology Flashcards
1
Q
3 Types of Non-Adherence: Donovan & Blake (1992)
A
- RATIONAL: Deliberately non-adherent
- UNWITTING: Not your fault, a misunderstanding
- ERRATIC: Forgetful (not your fault) or you run out (your fault)
2
Q
Why do we rationally decide not to adhere? - Sarafino et al, 1994
A
- UNPLEASANT OR UNDESIRABLE SIDE EFFECTS
- BELIEVE TREATMENT IS NOT WORKING
- PRACTICAL BARRIERS (COST)
3
Q
Why do we rationally decide not to adhere?
A
- MULTIPLE PHYSICIANS (Vlasnik et al., 2005) - Decrease patients’ confidence in the prescribed treatment
- FEAR OF DEPENDENCE (Apter et al., 2003) - Fears of addictive behaviour and adverse side effects
- RELIGIOUS BELIEFS (Lim & Ngah, 1991) - Preference for natural remedies
- NO WAY, NOT THAT PHARAMCEUTICAL COMPANY - Not wanting pharmaceutical companies, believing they are profit driven, to benefit
4
Q
Factors Affecting Erratic (non-deliberate) Non Adherence
A
- MEMORY: Do patients recall what they have been told?
- Ley et al (1979) - Asked patients to recall a series of statements presented in two ways:
1. UNSTRUCTURED
2. STRUCTURED
= Recall was 25% better for structured information, and was also better for information presented at the beginning of the consultation (primacy effect) – Perhaps therefore, better to emphasise most important information at the start?
5
Q
Medical Non Adherence: Implications
A
- SOKOL ET AL (2005): Relationship between adherence & risk for hospitalisation in diabetes patients – More non-adherence related to greater overall cost
6
Q
Pain, why do we have it?
A
- It’s good for us…
1. Helps to regulate daily activities; it provides us low level feedback about bodily systems, and, by doing so, lets us know when to make adjustments (e.g., shift posture, turn over when sleeping)
2. It also, when it becomes too intense, leads us to seek treatment - Experience before serious injury (e.g., picking up something hot)
- Sets a limit on activities to avoid damage – lets us know when enough is enough
- Helps us, by way of reinforcement, avoid noxious stimuli in the future (e.g., hot)
7
Q
Can we define pain? In two ways, either by its duration or nature
A
- DURATION
∙ Acute (0-6 months):
✳︎ Examples such as stubbing toe or breaking bone
✳︎ Can be recurrent, e.g., migraines
∙ Chronic (more than 6 months):
✳︎ Can be either benign, as pain experienced to a similar intensity, like back pain, or can be progressive, as pain that worsens with time, like arthritic pain - NATURE - Nature can be subdivided into three categories: severity, pattern and type
∙ Severity: From mild discomfort - Excruciating
∙ Type: Stabbing, shooting, piercing, throbbing, dull, aching
∙ Pattern: Brief, continuous, sporadic, intermittent, kinetic
8
Q
Can we measure pain?
A
- Pain, as a subjective experience, is difficult to measure, and what is painful to one person might not be painful, or be less painful, to another, and reactions of different people to the same pain inducing agent will vary
- We can ask about the pain, using questionnaires and diaries, and can, as HCP, take into account pain behaviours, like facial grimaces, changes in posture and audible expressions. Some studies, to better understand how people respond to pain, and how individual differences, liker personality and mood, affect pain responses, have artificially induced pain in the lab, using pain induction methods like cold pressor, and measured responses
- McGill Pain Questionnaire
- Lab based pain induction technique - Cold Pressor
9
Q
Biological theories of pain
A
- Specificity theory
- Pattern theory
10
Q
Biological theories: limited?
A
- Specificity & Pattern theories = Pain is picked up by receptors in the skin that relay this information, via neurons and their chemical messengers, to the brain, which processes this pain related information, and responds.
- LIMITATIONS:
✳︎ PAIN, BUT NO RECEPTORS
✳︎ RECEPTORS, BUT NO PAIN
✳︎ PSYCHOLOGICAL FACTORS
11
Q
Pain but no receptors
A
- Phantom Limb Pain: Experiencing pain in the absence of pain receptors, i.e., pain as if from an absent limb
(similar for those with spinal cord injuries/paralysis = 70% experience phantom pain) - Explain? - Neural Plasticity?
✳︎ Alton Towers victim
12
Q
Receptors but no pain
A
- Congenital Analgesia (Congenital Universal Insensitivity to Pain - CUIP)
A rare genetic condition where, despite an intact pain pathway, people are born with inability to feel pain
✳︎ Mrs C
13
Q
Psychological Factors: Attention
A
- EPISODIC ANALGESIA:
- Pain perception fails to occur immediately post injury
- Prevalent in competitive sports men and women, and in the context of war, e.g.,
- Possibly due to:
1. Distraction/Attention (see
week 3)
2. Physiological (sympathetic)
arousal = diminished pain
sensitivity - James et al, (2002) = our response to and perception of pain is variable - 1) focus on pain: tolerate pain for short time, 2) distracted from pain: can tolerate pain longer (aka keep arm in freezing water longer)
14
Q
Psychological Factors: Meaning
A
- Beecher et al (1959): the meaning we give to the injury or pain, and the commensurable emotional response, positive or negative, can influence our pain perception and reporting
15
Q
Psychological Factors: Mood
A
- Pinerua et al (1999): Depression & Pain (Cold Pressor)
- those with depression were more likely to rate the experience as painful
