Hoofdstuk 9

Question 1

People are not very accurate in assessing their actual internal physical states, their perception of body sensations can be heavily influenced by cognitive, social and emotional factors

Answer 1

cognitive (placebo/nocebo = puur verwachtingen)
- medical student’s disease
- mass psychogenic illness

Question 2

Cognitive Representations/Common Sense Models

Answer 2

• from direct experience (of certain illnesses) and the things we read and hear, we develop ideas and expectations about illnesses (some are correct, some are not)
• these models can affect our health-related behavior and seem to involve 4 basic coponents of how people think about disease
  1) illness identity
  2) causes and underlying pathology (how you get it + what physiological events occur with it)
  3) timeline (prognosis ideas)
  4) consequence

Question 3

Fear can motivate toward health behavior

Answer 3

can also motivate maladaptive avoidance behavior

Question 4

Latrogenic Conditions

Answer 4

patients develop health problems as as result of medical treatment

Question 5

According to the Health Belief Model

Answer 5

symptoms can initiate a decision-making process about seeking medical care
- part of this process involves assessing the perceived threat suggested by the symptoms
1) cues to actions
2) perceived susceptibility
3) perceived seriousness

Health Belief Model also proposes that people assess whether the perceived benefits of getting treatment outweigh the perceived barriers for doing so

Question 6

Treatment Delay

Answer 6

tijd tussen 1e symptoom en dokters bezoek

1) appraisal delay (tijd voor herkenning symptoom)
2) illness delay (tijd voor herkenning ziekte)
3) utilization delay (besluiten + gaan dokter)

Question 7

CAM Complementary and Alternative Medicine

Question 8

Hypochondriasis

Answer 8

the tendency to worry excessively about health
- psychiatric disorder after 6 months and when causing significant emotional distress or functional impairments- grote link met neuroticism + self-consciousness + vulnerability to stress

Question 9

CFS Chronic Fatigue Syndrome (medical techology cannot confirm)

Answer 9

persistent severe fatigue for at least 6 months

Question 10

The reasons why patients do and do not adhere to medical advicee

Answer 10

include characteristics illness and regimen, the clients and practioners and the way these people interrelate or communicate

Question 11

Behavioral methods in enhancing motivation to adhere to treatment regimens

Answer 11

• tailoring treatment/regimen
• prompts & reminders
• self-monitoring
• behavioral contracting (goals/activities + reward)

Question 12

Chronic Care model to promote Primary Prevention

Answer 12

1) organization of care
2) clinical information systems
3) delivery-system-design
4) decision support
5) self-management support
6) community resources

Question 13

Nosomical Infection

Answer 13

an infection contracted while in the hospital setting (MRSA, which resists antibiotic treatment)

Question 14

3 psychosocial components of burnout

Answer 14

1) emotional exhaustion
2) depersonalization
3) perceived inadequacy of professional accomplishment

Question 15

Problem-focused coping (alter cause of stress)

Answer 15

Emotion-focused coping (regulate emotional response to situation)

Question 16

Cognitive proceses illness/injury

Answer 16

-blame
-assessment personal control

Question 17

psychologists use 2 approaches in assessing emotional adjustment

Answer 17

1) diagnostic interviews (based on APA’s Diagnostic and Statistical Manual of Mental Disorders)
2) questionnaires (single disorder/multiple, like the Minnesota Multiphasic Personality Inventory MMPI)

Question 18

Million Behavioral Medicine Diagnostic

Answer 18

• self-report test that was developed to assess specific psychosocial factors and decision-making issues that are known to be relevant for medical patients (165 items)
• coping style/negative habits/stress moderators

Question 19

Psychosocial Adjustment to illness Scale

Answer 19

• specifically for use with medical patients (46 items)
• assess 7 psychosocial characteristics of the clients life, associated with adjustment to medical illness

Question 20

Principal Coping mechanism people use during phase of terminal illness is

Answer 20

denial

Question 21

3 types of stress terminal patients experience

Answer 21

1) physical effects
2) their altered lifestyle (restrictions)
3) realization that the end is near

Question 22

Kübler-Ross’ 5 stages of dying

Answer 22

1) denial
2) anger
3) bargaining
4) depression
5) acceptance

Question 23

Crisis Theory

Answer 23

describes factors that influence how people adjust
- the outcome of the crisis (or the adjust ment the person makes) depends on the coping process which depends on 3 contributing influences:

1) ilnness-related factors
2) background and personal factors
3) physical and social-environmental factors

Question 24

Coping Process

Answer 24

cognitive appraisal of illness –> adaptive tasks –> coping skills

Question 25

Moos’ Adaptive Tasks

Answer 25

1) tasks related to the illness or treatment
2) tasks related to general psychosocial functioning:
- control negative feelings
- maintain satisfactory self-image/sense of competence
- preserve good relationships
- prepare for uncertain future

Question 26

Asthma

Answer 26

immune system is activated to react in an allergic manner, producing antibodies that cause the bronchial tubes and other body tissues to become obstructed as their smooth muscles become inflamed, develop spasms and produce mucus

Question 27

Regimen Asthma

Answer 27

• avoid triggers
• medication (bronchodilaters/anti-inflammatories)
• exercise

Question 28

Epilepsy

Answer 28

related to psychosocial processes
- increased by emotional arousal
- when frequent + severe: maladaptation

Question 29

Spinal Cord Severed in neck regio:

Answer 29

tetraplegia/quadriplegia
Lower spinal cord: paraplegia

Question 30

Hyperglycemia

Answer 30

too much glucose in the blood over a long period of time
- mark of diabetes mellitis
- normally controlled by insulin form the pancreas

Type 1
- insulin-dependent diabetes
- develops in childhood/adolescence
- autoimmune processes have destroyed cells of hte pancreas that normally produce insulin
- ketoacidosis = high level fatty acids

Type 2
- manage with diet + medication
- overweight

Chronic stress, negative emotions and other psychosocial vulnerabilities increase the risk of diabetes

Question 31

Diabetes

Answer 31

can lead to neuropathy (nerve disease): high blood glucose levels cause chemical reactions that can destroy the myelin sheath that insulates nerve vibers
(can also lead to atherosclerosis)

Question 32

Stress impairs blood sugar control

Answer 32

1) adrenal glands release epinephrine and cortisol into the bloodstream
- epi causes the pancreas to decrease insulin production, cortisol causes the liver to increase glucose production and body tissues to decrease their use of glucose
2) stress can affect blood glucose levels indirectly by reducing adherence to diabetes regimens