Human Factors in Chronic Disease and Management Flashcards
What is the aim of Diabetes Attitudes, Wishes and Needs (DAWN)?
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
What is the relevance of psychological perspective in diabetes?
Diabetes is one of the most psychologically and behavioural demanding or chronic diseases = issues can exert considerable influence on glycaemic control
What should health practitioners be alert for?
Disruptions to psychological wellness = usually requires screening
How does distress impact diabetes?
Increased noradrenaline and cortisol which mobilise glucose and fatty acids
Stress impairs insulin release
What is the link between diabetes and anxiety disorder?
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
What is depression associated with?
Poor outcomes in chronic diseases
How common is depression in diabetics?
Prevalence is nearly double and relapse is common = at least 1 in 5 and average of 4 episodes over 5 years
What is depression associated with in diabetes?
Poor adherence, hyperglycaemia, CV disease and retinopathy
Linked with risky behaviours like food and alcohol binging and less attention to diabetic cues
What is social connectedness?
Degree of social, family and community support
Is social connectedness o good predictor of outcomes?
Yes = excellent predictor at 12 or 24 months, better than all the traditional risk factors combined
What does diabetes research endorse in terms of social connectedness?
Encouragement of family supports and improving family climate in everyday management of diabetes to aid its control, especially in adults
Who should adolescents be paired with in group interventions?
Peers (rather than family)
How can life events and environmental factors impact management?
Can have practical and emotional effects = raise risk of anxiety, depression and distress
What are attributes of people who cope better?
Tend to seek social support, can problem-solve, try to detach from stressful situations
What kind of management does diabetes require?
Patient self management and collaborative patient professional management
What are some examples of self management tasks that diabetics have to perform?
Diet, exercise, glucose monitoring, medication adherence, follow up appointment attendance, general disease awareness
What are some of examples of mobile self management devices?
Lifescan OneTouch UltraMini glucometer, Apple iPhone or iPod touch, bluglu hardware adaptor and bant software application
How does a bluglu adaptor work?
Allows wireless transfer of blood glucose readings via Bluetooth, avoiding the need for manual data entry
What are the challenges of diabetes management in adolescents?
They make fewer changes to their daily diabetes regimen, despite their glucose profile suggesting a change is needed
What are the design principles to overcome decision inertia in adolescents?
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
How is peer support offered to adolescents?
Usually through private platform that allows users to communicate with their peers in a secure community area of the app
Why are diabetic patients at a higher risk of mental health disorders?
Frequently under-recognised and undertreated = higher risk of long term complications
What do children and young people with type 1 diabetes have a higher risk of?
Emotional and behavioural difficulties
How is a Plan-Do-Study-Act (PDSA) cycle carried out?
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
What is illness cognition?
A patient’s own implicit common sense beliefs about their illness
What is illness representation?
Organised conceptions of illness
How are illness cognition and representation acquired?
Through personal experience, family and friends, contracts with health care system, mass media
What do illness cognition and representation provide patients with?
A framework for understanding their illness, coping with their illness and telling them what to look out for if they become ill
What is the self-regulatory model of illness cognitions?
Explains how illness cognitions affect coping strategies
What is the aim of the self-regulatory model of illness cognitions?
For people to develop problem solving techniques when normal state is altered and to motivate them to re-establish state of normality and equilibrium
What are the three process involved in the self-regulatory model of illness cognition?
Interpretation, coping and appraisal = interrelate in an on-going and dynamic manner
What are the five dimensions of illness representation?
Identity, perceived cause of illness, timeline of disease, consequences, curability and controllability
What is the self-regulatory model of illness cognition useful for understanding and predicting?
Emotional reactions to diabetic diagnosis and treatment, coping with diabetes, adherence with treatment and lifestyle changes, outcomes of diabetes
