Impact of Illness on QOL, Patients & Family

Question 1

What is the difference between quality of life and health-related quality of life?

Answer 1

QOL: An individual’s evaluation of their overall life experience at a given time

Health-related QOL: Evaluations of life experiences & how they are affected by disease, accidents or treatments

Question 2

What is QOL affected by?

Answer 2

• Physical/mental health
• Level of independence
• Quality of social relationships
• Social integration
• Personal, religious, spiritual beliefs

Question 3

What are the 6 domains that the 25 different facets of QOL are grouped into?

Answer 3

• Physical health
• Psychological
• Level of independence
• Social relationships
• Relation to environment
• Spirituality, religion, personal beliefs

Question 4

What factors can influence a person’s QOL?

Answer 4

• Demographics
• The condition
• Neurological damage
• Treatment
• Psychosocial factors

Question 5

What are some of the findings regarding QOL of young people?

Answer 5

• Children are less affected by health states than socioeconomic factors
• Depends on life circumstances/expectations e.g. stroke in younger working person compared to older retired person

Question 6

What are some of the findings regarding QOL of older people?

Answer 6

• Important life domains are good physical functioning, relationships, health/social activity
• More fearful of losing independence

Question 7

What factors of QOL can culture influence?

Answer 7

• Responses to pain
• Attitudes towards/use of traditional/Western medicine
• Concepts of dependency
• Norms of communication

Question 8

What are the 3 psychosocial influences on QOL?

Answer 8

• Emotional responses
• Coping differences
• Social support

Question 9

What are the 3 reasons why QOL assessment is useful in clinical practice?

Answer 9

• Measure to inform
• Measure to evaluate alternatives
• Measure to promote communication

Question 10

What are the pros and cons of generic vs. disease-specific measures of QOL?

Answer 10

• Generic: Allow for comparisons but don’t address unique illness/QOL issues
• Disease-specific: added value, but don’t allow cross-illness comparisons

Question 11

What are the pros and cons of individualised QOL measures?

Answer 11

• Abandon the dimension of generic/disease-specific instruments
• Allow respondents to choose dimensions/concerns of value to them
• Time consuming, exclude use in certain populations

Question 12

What are the 4 phases people with illness may have to deal with?

Answer 12

• Uncertainty
• Disruption
• Striving for recovery
• Restoration of wellbeing

Question 13

What are the 3 stages of response to cancer?

Answer 13

1) Initial response: Disbelief, denial, shock
2) Dysphoria: Gradually coming to terms, stress, insomnia, anxiety, depression
3) Adaptation: Adapting positively, developing long-term coping strategies

Question 14

How can depression & anxiety affect illness?

Answer 14

• Impedes engagement in treatment
• Anxiety associated with poor control of blood glucose levels in diabetics
• Can influence resuming to pre-illness functioning
• Hinders behavioural change

Question 15

What are the key benefits of maintaining positive emotions during illness?

Answer 15

• Promotion of psychological resilience & more effective problem-solving
• Dispelling of negative emotions
• Triggering an upward spiral of positive feelings

Question 16

What are some of the illness-specific issues raised by coping with illness?

Answer 16

• Symptoms
• Possibility of pain
• Uncertain future
• Changes in self-image and self-esteem
• Maintaining control over health/life
• Maintaining control over illness
• Changes in relationships

Question 17

When can the experience of an illness be described as a crisis?

Answer 17

When individuals face potential changes in identity, location, role and aspects of social support

Question 18

What are the 3 processes that result from the crisis of illness?

Answer 18

• Cognitive appraisals
• Adaptive tasks
• Coping skills

Question 19

What are the 3 types of coping strategies?

Answer 19

• Appraisal-focused: denial, positive reappraisal, mental preparation
• Problem-focused: information/support seeking, taking action, setting goals
• Emotion-focused: mood regulation, emotional discharge

Question 20

In relation to family systems, what are the 3 stages observed within a continuum of adaptation?

Answer 20

• Resistance: Family members deny/avoid reality
• Restructuring: Family members begin to accept & reorganise lives
• Consolidation: Newly adopted roles may become permanent

Question 21

What 3 dimensions of family systems functioning are relevant to the continuum of adaptation?

Answer 21

• Cohesion
• Adaptability
• Communication

Question 22

What are the 3 coping strategies used by parents coping with a child having cystic fibrosis?

Answer 22

• Maintaining/focusing on family life & relationships
• Maintaining wellbeing/social relationships
• Having relationships with medical staff/other parents

Question 23

What are the benefits of supportive relationships?

Answer 23

• Increase adherence to treatment/self-care
• Better emotional adjustment/coping
• Better physiological functioning
• Reduced mortality

Question 24

What are some of the consequences of caring?

Answer 24

• Emotional impact
• Physical effects
• Immunological effects
• Positive aspects

Question 25

What are some of the influences on caring outcomes?

Answer 25

• Feature of the illness
• Carer characteristics/responses
• Relationship between carer & patient
• Relationship quality
• Dyadic perceptions, shared/discrepant beliefs