HPHD Flashcards
What are the biomedical and biopsychosocial models?
Biomedical - biological/physiological processes. Treat with physical intervention
BPS - includes social and psychological aspects
What is health psychology?
Contribution of psychology to the maintenance of health and the treatment of illness
What are stereotypes? Why do we have them, when do we rely on them and how can we get rid of them?
Generalisations about specific groups. Saves processing power. When were pressured/fatigued. Get to know the group and self reflect
What is the difference between stereotype, prejudice and discrimination? Use an example
Stereotypes is cognitive. Prejudice is evaluative. Discrimination is behavioural
Old people - pre judge that they will conform to their stereotype is prejudice. Acting on that is discrimination
Define health related behaviour
Anything that may promote good health or lead to illness
What are the 3 learning theories?
Classical conditioning - Pavlov
Operant conditioning - Skinner
Social learning theory - Bobo doll
Name the social cognition models
Health belief model
Theory of planned behaviour
What are the theoretical stages of change?
Contemplate Prepare Action Maintenance Relapse
What are the different levels of drinking behaviour?
Abstinence, low risk, hazardous, harmful, moderate dependence, severe dependence
What are the 5 principles of motivational interviewing?
Express empathy Avoid argument Roll with resistance Support self efficacy Develop discrepancy
What are the 8 steps of motivational interviewing?
Establish rapport, set agenda, assess readiness to change, sharpen focus, identify ambivalence, elicit self motivating statements, handle resistance and shift focus
Define compliance, adherence and concordance
Extent patient COMPLIES with medical advice
Extent patient COINCIDES with medical advice
The nature of interaction between doctor patient - Negotiation between patient and doctor over treatment
Why is concordance advantageous?
Leads to better adherence as the patient feels more involved and their beliefs, lifestyle and priorities are accounted for and addressed
What is the approximate rate of non compliance in chronic illnesses?
50%
What are some methods of measuring compliance? Give pros and cons
Urine/blood test/observation - accurate but expensive and invasive
Pill count - can lose pills
Reports - easy but biased
What factors might cause non compliance? Give an example of each
Illness - no symptoms Treatment - not easy/side effects Patient - lack of understanding or has beliefs Psychosocial - personality Healthcare - doesn't like the prescriber
Why might unintentional adherence occur? And intentional?
Lack of capacity/resources
Belief/attitude/expectation
What is an intervention and is it effective?
Address barriers/perceptions
Broadly effective but by small amounts. Isn’t patient centred
What is stress?
A short term change to mobilise for activity, mainly triggered by Catecholamines
What are the short term changes in the body due to stress?
Increase O2, fuel availability, mental and physical functioning
Conserve energy by reducing digestion/sex drive
Prepare for tissue damage
What is the effect of stress on the immune system in the short and long term?
Short term improves immune function
Long term reduces
What are the four negative effects stress has on health?
Mental health, immune system, physical (e.g. Cardiovascular) and unhealthy behaviours
What are the steps of appraisal?
Primary - is there a threat?
Secondary - can I cope with it?
Reappraisal - now I’ve tried it do I feel different
What is the function of attachment?
Maintain proximity to caregiver
What are the benefits of a secure attachment?
Social competence, peer relations
What are the three stages of child development?
Prefer human faces to inanimate
3 months - Distinguish strangers and non strangers and prefer non strangers
8 months - child will miss key people and be wary of strangers
What behavioural changes accompany separation?
Anxiety, aggression, clingy and bed wetting
What are the phases of separation?
Protest - distressed
Despair - helpless and withdrawn
Detachment - happier but remote upon carers return
How have hospitals improved for children?
Allow carer access, attachment objects, reassure, toys and homelike
What are the four stages of cognitive development?
Sensorimotor 0-2yrs - no abstract concepts, develop body schema and object permanence
Pre-operational 2-7yrs - egocentric, classify by 1 feature
Concrete operational 7-12yrs - logical but concrete, conservation, other perspectives
Formal operational 12+yrs - abstract and hypothetical
What should you do when dealing with children?
Simple info, no metaphors, act, play, give choices, rewards and compliments
What shouldn’t you do when dealing with kids?
Stand over, use force, false promises, get frustrated
Explain the diversity in likelihood to die
Women live longer
Older die more
Poorer die sooner
What are the types of death?
Gradual
Catastrophic
Premature
What is the usual initial reaction to death?
Shock, numb, disbelief, confusion
Explain the five stages of dying
Denial - not true Anger - why me Bargaining - I'll... If I can live to... Depression - what's the point Acceptance - it will be ok
What are some symptoms of bereavement/grief?
Short of breath, tired, crying, depression
Increased susceptibility to illness and mortality
What increases the risk of suffering from chronic grief or other complications?
Prior bereavement
Type of death - young person
Lack of support
Discourage expression/ending of grief
Define sexual dysfunction
Disturbance in sexual desire and in the psychophysiological changes that characterise the sexual response cycle
What is the sexual response cycle?
Desire
Arousal
Orgasm
What types of sexual dysfunction are there?
Loss of desire
Erectile dysfunction/sexual arousal disorder
Rapid ejaculation, inhibited orgasm/orgasmic dysfunction
Aversion or lack of enjoyment
Dysparenunia
Vaginismus
Explain the features of sexual dysfunction
Irrespective of orientations Can have 1+ problems Both partners Lifelong/acquired General/situational Physical/psychological
What points should be considered when discussing sexual dysfunction?
Empathy and reassure Embarrassment Stigma Confidential Terminology
Outline the structure of a clinical interview for sexual dysfunction
Detailed description of the problem Relationship with currents previous partners Medical, mental and family history Drug use Life events
Why might sexual dysfunction problems occur?
Failure - physical, psychological, life events, false beliefs, communication
Fear of failure - loss of confidence, pressure
How is sexual dysfunction treated?
Educate, modify beliefs, help communicate, directions, Viagra, desensitise, lube, oestrogen
What is the importance of breaking bad news well?
Maintain trust, reduce uncertainty, prevent unrealistic expectation, allow appropriate adjustments, promote open communication
What could happen if bad news is not broken well?
Damage doctor patient relationship
Emotional well being
Adjustment and coping
Explain SPIKES
Setting and listening - face to face, private, tissues, check who present
Perception - what have you been told about all this?
Invitation - what do they want to know?
Knowledge - warning shot, small chunks, check understand, no jargon
Empathy - how are you feeling, I can see this is upsetting
Strategy and summarise - next step
What is a persons sexual orientation, sexual identity and sexual behaviour?
Gender attracted to
Labels for them - lesbian, gay, bi
MSM, WSW
What is a transgender?
Someone who’s gender differs from their birth sex
What are the health problems for LGBT?
Generally poorer health - mental health, substance abuse, cancer, STIs due to abuse at school/work/family/neighbourhood
What should you do for a LGBT patient?
Validate patients identity
Confidential
Respect
Knowledgable
