Human Factors in Chronic Disease and Management

Question 1

What is the aim of Diabetes Attitudes, Wishes and Needs (DAWN)?

Answer 1

To improve outcomes of diabetes care by increasing the focus on the person behind the disease l, especially the psychosocial and behavioural barriers to effective diabetes management

Question 2

What is the relevance of psychological perspective in diabetes?

Answer 2

Diabetes is one of the most psychologically and behavioural demanding or chronic diseases = issues can exert considerable influence on glycaemic control

Question 3

What should health practitioners be alert for?

Answer 3

Disruptions to psychological wellness = usually requires screening

Question 4

How does distress impact diabetes?

Answer 4

Increased noradrenaline and cortisol which mobilise glucose and fatty acids
Stress impairs insulin release

Question 5

What is the link between diabetes and anxiety disorder?

Answer 5

Rates much higher in diabetics (20%) = worse when there are two or more chronic complications, may affect metabolic control indirectly by interfering with self care

Question 6

What is depression associated with?

Answer 6

Poor outcomes in chronic diseases

Question 7

How common is depression in diabetics?

Answer 7

Prevalence is nearly double and relapse is common = at least 1 in 5 and average of 4 episodes over 5 years

Question 8

What is depression associated with in diabetes?

Answer 8

Poor adherence, hyperglycaemia, CV disease and retinopathy

Linked with risky behaviours like food and alcohol binging and less attention to diabetic cues

Question 9

What is social connectedness?

Answer 9

Degree of social, family and community support

Question 10

Is social connectedness o good predictor of outcomes?

Answer 10

Yes = excellent predictor at 12 or 24 months, better than all the traditional risk factors combined

Question 11

What does diabetes research endorse in terms of social connectedness?

Answer 11

Encouragement of family supports and improving family climate in everyday management of diabetes to aid its control, especially in adults

Question 12

Who should adolescents be paired with in group interventions?

Answer 12

Peers (rather than family)

Question 13

How can life events and environmental factors impact management?

Answer 13

Can have practical and emotional effects = raise risk of anxiety, depression and distress

Question 14

What are attributes of people who cope better?

Answer 14

Tend to seek social support, can problem-solve, try to detach from stressful situations

Question 15

What kind of management does diabetes require?

Answer 15

Patient self management and collaborative patient professional management

Question 16

What are some examples of self management tasks that diabetics have to perform?

Answer 16

Diet, exercise, glucose monitoring, medication adherence, follow up appointment attendance, general disease awareness

Question 17

What are some of examples of mobile self management devices?

Answer 17

Lifescan OneTouch UltraMini glucometer, Apple iPhone or iPod touch, bluglu hardware adaptor and bant software application

Question 18

How does a bluglu adaptor work?

Answer 18

Allows wireless transfer of blood glucose readings via Bluetooth, avoiding the need for manual data entry

Question 19

What are the challenges of diabetes management in adolescents?

Answer 19

They make fewer changes to their daily diabetes regimen, despite their glucose profile suggesting a change is needed

Question 20

What are the design principles to overcome decision inertia in adolescents?

Answer 20

Help adolescents identify blood glucose trends
Promote cognitive processing related to identifying and correcting the trend
Integrate rewards and incentives into the system to sustain engagement

Question 21

How is peer support offered to adolescents?

Answer 21

Usually through private platform that allows users to communicate with their peers in a secure community area of the app

Question 22

Why are diabetic patients at a higher risk of mental health disorders?

Answer 22

Frequently under-recognised and undertreated = higher risk of long term complications

Question 23

What do children and young people with type 1 diabetes have a higher risk of?

Answer 23

Emotional and behavioural difficulties

Question 24

How is a Plan-Do-Study-Act (PDSA) cycle carried out?

Answer 24

Plan a small change to make in the clinical environment and carry out this small test of change
Review the effect of this test of change and I own to make another small change based on the results of the previous result

Question 25

What is illness cognition?

Answer 25

A patient’s own implicit common sense beliefs about their illness

Question 26

What is illness representation?

Answer 26

Organised conceptions of illness

Question 27

How are illness cognition and representation acquired?

Answer 27

Through personal experience, family and friends, contracts with health care system, mass media

Question 28

What do illness cognition and representation provide patients with?

Answer 28

A framework for understanding their illness, coping with their illness and telling them what to look out for if they become ill

Question 29

What is the self-regulatory model of illness cognitions?

Answer 29

Explains how illness cognitions affect coping strategies

Question 30

What is the aim of the self-regulatory model of illness cognitions?

Answer 30

For people to develop problem solving techniques when normal state is altered and to motivate them to re-establish state of normality and equilibrium

Question 31

What are the three process involved in the self-regulatory model of illness cognition?

Answer 31

Interpretation, coping and appraisal = interrelate in an on-going and dynamic manner

Question 32

What are the five dimensions of illness representation?

Answer 32

Identity, perceived cause of illness, timeline of disease, consequences, curability and controllability

Question 33

What is the self-regulatory model of illness cognition useful for understanding and predicting?

Answer 33

Emotional reactions to diabetic diagnosis and treatment, coping with diabetes, adherence with treatment and lifestyle changes, outcomes of diabetes