Impact of Illness on QOL, Patients & Family Flashcards
What is the difference between quality of life and health-related quality of life?
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
What is QOL affected by?
- Physical/mental health
- Level of independence
- Quality of social relationships
- Social integration
- Personal, religious, spiritual beliefs
What are the 6 domains that the 25 different facets of QOL are grouped into?
- Physical health
- Psychological
- Level of independence
- Social relationships
- Relation to environment
- Spirituality, religion, personal beliefs
What factors can influence a person’s QOL?
- Demographics
- The condition
- Neurological damage
- Treatment
- Psychosocial factors
What are some of the findings regarding QOL of young people?
- 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
What are some of the findings regarding QOL of older people?
- Important life domains are good physical functioning, relationships, health/social activity
- More fearful of losing independence
What factors of QOL can culture influence?
- Responses to pain
- Attitudes towards/use of traditional/Western medicine
- Concepts of dependency
- Norms of communication
What are the 3 psychosocial influences on QOL?
- Emotional responses
- Coping differences
- Social support
What are the 3 reasons why QOL assessment is useful in clinical practice?
- Measure to inform
- Measure to evaluate alternatives
- Measure to promote communication
What are the pros and cons of generic vs. disease-specific measures of QOL?
- Generic: Allow for comparisons but don’t address unique illness/QOL issues
- Disease-specific: added value, but don’t allow cross-illness comparisons
What are the pros and cons of individualised QOL measures?
- 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
What are the 4 phases people with illness may have to deal with?
- Uncertainty
- Disruption
- Striving for recovery
- Restoration of wellbeing
What are the 3 stages of response to cancer?
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
How can depression & anxiety affect illness?
- 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
What are the key benefits of maintaining positive emotions during illness?
- Promotion of psychological resilience & more effective problem-solving
- Dispelling of negative emotions
- Triggering an upward spiral of positive feelings
What are some of the illness-specific issues raised by coping with illness?
- 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
When can the experience of an illness be described as a crisis?
When individuals face potential changes in identity, location, role and aspects of social support
What are the 3 processes that result from the crisis of illness?
- Cognitive appraisals
- Adaptive tasks
- Coping skills
What are the 3 types of coping strategies?
- Appraisal-focused: denial, positive reappraisal, mental preparation
- Problem-focused: information/support seeking, taking action, setting goals
- Emotion-focused: mood regulation, emotional discharge
In relation to family systems, what are the 3 stages observed within a continuum of adaptation?
- Resistance: Family members deny/avoid reality
- Restructuring: Family members begin to accept & reorganise lives
- Consolidation: Newly adopted roles may become permanent
What 3 dimensions of family systems functioning are relevant to the continuum of adaptation?
- Cohesion
- Adaptability
- Communication
What are the 3 coping strategies used by parents coping with a child having cystic fibrosis?
- Maintaining/focusing on family life & relationships
- Maintaining wellbeing/social relationships
- Having relationships with medical staff/other parents
What are the benefits of supportive relationships?
- Increase adherence to treatment/self-care
- Better emotional adjustment/coping
- Better physiological functioning
- Reduced mortality
What are some of the consequences of caring?
- Emotional impact
- Physical effects
- Immunological effects
- Positive aspects
What are some of the influences on caring outcomes?
- Feature of the illness
- Carer characteristics/responses
- Relationship between carer & patient
- Relationship quality
- Dyadic perceptions, shared/discrepant beliefs
