I&P Flashcards
What is quality of life?
Includes lots of factors, physical health, psychological factors, independence etc.
Key factors of a persons quality of life rating
Mutli-dimensional, dynamic and subjective.
Flanagan quality of life scale can measure it.
Rokeach
Definite quality of life according to our terminal values and instrumental values (what we ill do to reach our terminal values)
Quality of life & Illness
Non-linear association of quality of life and severity of illness
EXCEPTION = PARKINSONS - this is a linear relationship
HRQoL
Effect of medical condition as assessed by a patient.
Can use PROMS to measure the effect of the disease
OR EQ-5D can measure quality of life
Also eGOR Objectives to measure quality of life!
Recalibration of Quality of Life
Dynamic - it changes over time
Response Shift - Changing internal standard, values re-evaluated to what we want to achieve
Rating scale - use a different measure i.e. we compare our health now to 10 years ago as opposed to other your age
Items assessed - at different stages of our life different aspects become more important!
Biomedical approach to disability
Impairment, causes disability leads to handicap! there is a causal pathway between these!
Cause within the individual
Social model of disability
Impairments dont cause disability, social barriers cause disability! (environmental and social e.g. prejudices, stereotypes, discrimination)
Interventions should be a social change not just medical intervention!
Cause within society
Equality Act 2010
Protects against - Discrimination (treated less favourably) and Victimisation (treated less favourable because they asserted their rights)
Expected utility theory (EUT)
Von Veumann and Morgenstern
Normative theory - desribes how we should make choices, links choices with values and probabilities of each option
Subjective EUT - describes the perception of the risk and how important that it to us
Maximum expected utility choice
Choice based on evaluating all options of EU, if we pick this it is a rational choice.
Assumptions for Rational decision making
follow rules, complete knowledge, accurate beliefs/representations, people know their values and they are stable
Decision Science - Bounded Rationality
By Simon - says people don’t have the processing power to calculate EUT
Simon - choose the satisfiscing choice
Tversky - elimination by aspects
Heuritisc (Chairmen) - use a rule of thumb
Information Processing Strategies
Heuristic vs. Systematic
Heuristic - uses rule of thumb, sub-conscious, little effort, satisfactory, more likely to be wrong
Systematic - analytical slow, more stable values, more likely to be happy with choice
Biases in decision making
Due to framing (direct) and perception (indirect)
Gamblers fallacy - the look at the context of the risk, rather than the risk itself!
Doctors errors and decision making!
Graber: Describes either no fault, system fault or cognitive!
We expect heuristic decisions from doctors
Croskerry’s dual model of diagnostic reasoning explains the behaviour of clinicians!
Public health programmes vs Public health interventions
Target policy/society in health progreammes where interventions are based on practice/individual!
7 Good lifestyles to cause longer life
Alameda Country Study - Belloc & Breslow
7-8 hours sleep, no more than 1-2 alcoholic drinks a day, not smoking, regular physical activity, no snacking, eating breakfast, moderate weight
DO 3 TO LIVE LONGER
Social Cognition Theories in Behaviour Change
Bandura - says behaviour is governed by:
Expectancies about behaviour and self-efficacy
Consequences and incentives of the behaviour
Social cognitions i.e. peoples representations of the social world!
Bandar also shows that children are more influence by real life experiences towards emotion, particularly under the age of 9.
Components of information to change behaviour
Information component
Motivational component
Skills component
Theory of planned behaviour
Beliefs, evaluations motivation, control and perceived power –> leads to attitude subjective norms and perceived behavioural control –> leads to behavioural intention
Ajzen & madden
Absoloute Poverty
Consistent across all countries. UN 7 indicators are:
Dirty water, lack of sanitation, lack of shelter, poor nutrition/insufficient calories, lack of essential medical and maternity care, no access to education, information deprivation
Relative poverty
Relation to a measure in the country a person lives
- has less than 60% of national median income
- deep poverty = less than 40% of national median income
Social class and Health
NS-SEC is a way to split occupation into social classification (Goldthorp)
Higher social class = longer life expectancy
Social gradient occurs between the classes
Lowest classes all have higher numbers of fatal accidents
Life expectancy rising for all but a slowest rate in the lowest social classes!
Explanations for social inequalities & health
1) Health selection - healthy rise up the social gradient and the ‘unhealthy sink’. Shown through discrimination (solve with equality act, social model of disability etc.)9
2) Individual and behavioural - people in lower SEC have more unhealthy ways
3) Materialist - uneven distribution of resources
4) Psychosocial - social inequalities cause psychosocial consequences
5) Life course - accumulation of disadvantages before birth affects health throughout life!
Whitehall studies of occupational social class
Shows evidence of the ‘social gradient’
Lower social status linked to poorer physical and mental health
Marmot Status Syndrome - psychological mechanisms assosciated with social status differentiation!
What does it mean to be ill?
It is more than not being well, variation in physiological and emotional state!
A person needs to recognise their symptoms before they act on illness - and people need to authenticate these symptoms before they act
Symptom perception is affected by:
Attention, societal mores (e.g. stereotypes that men get heart attacks), mood, experience
Sick Roll
Parsons - society gives people a sick roll when they have identified them as ill –> then has expectations as to how they should act
Kasl & Cobb - describes the activities that people take when they feel ill!
Common Sense Model of Illness
Stage 1 - Illness Representation (cognitive), identifying the cause, timeline, consequence
Sage 2 - Coping –> problem focused of emotion focused
Period of dysphonia (less than 2 weeks) is a short term coping mechanism!
Self - Regulation Model of illness
Leventhal - 3 stages
Stage 1 - illness representation
Stage 2 - coping behaviours
Stage 3 - appraisal of coping behaviours!
Components of emotion
Subjective expereince Internal bodily responses Thought/action tendencies Cognitive appraisal Facial expressions! Emotions are reactive and short lives, moods diffuse and persistent
Emotional States
Ekman & Friesen
Argue there are 6 primary emotions distinctive by facial expression, other emotions are just blends of these
Happiness, Sadness, Fear, Anger, Surprise, Disgust!
Cross cultural judgement of emotions shows high level of agreement! Mind deficits/autism cause problems with this!
Change in emotion with spinal cord injury level
Holman - shows the higher the level of the spinal injury the lesser the change in emotionality of the experience
Loser peripheral sensation for emotion hence reducing intention
Edman Physiologically differentiating Emotion
Anger - high heart rate, high temp
Fear/Sad - high heart rate, low temp
Happy, disgust, surprise - low heart rate
Theories of emotion
Pattern Theory (sange) - encounter –> physiological arousal –> experience emotion
Cognitive theory Schacter & Singer) - encounter –> physiological arousal –> cognitive appraisal of arousal –> experience the emotion!
Appraisal Theories –> Encounter + the appraisal –> experience of emotion!
Regulation of emotion
Brain systems and neurotransmitters!
Amygdala and emotion processing! - specialised and protective, used for rapid info processing!
