Impact of Life events of patient well-being Flashcards
What are life events ?
Major happenings that can occur in a persons life that require some degree of psychological adjustment.
Why and how are life events significant ?
Major life events can pose an important impact on health status.
- challenge
- create stress/ be stressful
- consequences (link stress to illness)
What are life events linked to ?
Intricately linked to stress
What are the main sources of life event stressors ?
Individual
Family
Society
Daily Hassles
Describe individual sources of life event stressors
Illness
Conflict
Personal relationships
Lacking control
Explain conflict (causing stress)
Internal conflict
Increased anxiety
Increased depression
Headaches
Nausea
(EMMONS & KING, 1988)
State the 3 types of internal conflict
Approach-Approach
Approach-Avoidance
Avoidance-Avoidance
Describe family sources of life event stressors
Divorce
Marriage
Illness
Disability
Death
Addition to the Family
Explain disability (causing stress)
Caring for a person with a chronic illness
Financial Burdens
Depression
Anxiety
Sadness
(KIECOLT-GLASER et al. 1987)
Describe society sources of life event stressors
Job
Environment
Explain job (causing stress)
Deadlines
Workload
Responsibility
Relationships
Physical Environment
What do life events (stressors) impact ?
Have an impact on different systems
- Physiological system
- Psychological system
- Social aspect
Physiological system
What nervous system does this involve ?
Sympathetic nervous system
Fight or Flight response
General Adaptation Syndrome
Psychological aspect
Cognitive functioning
Emotion
Social aspect
Social behaviour
Gender
Socio-cultural differences
Methods of assessment of life events
Stress can be measured by :
- Self-report
- Physiological testing
Self-report method of assessing stress
Interview
Questionnaire
Rating scales
Physiological method of assessing stress
Galvanic skin response (electrical conductance of skin)
Changes in BP, Heart Rate
Biochemical Markers
SRRS
Social Re-adjustment Rating Scale
Function of SRRS
Developed to measure life events (stress).
Also the likelihood that a person will develop a stress-related illness.
[HOLMES & RAHE 1967]
Describe the SRRS
List of life events rated on a scale of 0-100
Scoring: adults indicate which life-events have occurred to them (past 12 months)
Values of all experienced life events are added –> total stress score
Death of spouse
(mean value on SRRS scale)
100
Personal injury or illness
(mean value on SRRS scale)
53
Change in health of a family member
(mean value on SRRS scale)
44
Change in financial state
(mean value on SRRS scale)
38
Low stress range
<149
Mild stress range
150-200
Moderate stress range
200-299
Major stress range
> 300
Strengths of the SRRS scale
(EXAM type Q)
Wide range of events that people find stressful
Values assigned to the listed life events based on broad sample of adults
Easy, quick to complete
What is the SRRS useful for ?
Useful tool for assessment of stress and illness
Positive correlation between life-events and illness
Limitations of the SRRS scale
(EXAM type Q)
Items vague / ambiguous
Failure to consider impact of event for each individual
Failure to distinguish between desirable and undesirable
Accuracy of memory of life-events
Casuality
Example of where items are vague/ambiguous in the SRRS
Personal injury / illness (53)
Change in financial status (38)
Example of failure to consider the impact of event for individual in the SRRS
Retirement (45)
Example of failure to distinguish between desirable and undesirable events in the SRRS
Change in financial state (38)
State some life-event scales
SRRS
LES
PERI
UES
LES
Life Experiences Survey
- 57 events stated relatively precisely
PERI
PERI life-events scale
- 102 items involving a gain, loss, ambiguous outcome
UES
The unpleasant events scale
- 302 events stated relatively precisely
Limitations of physiological measures to assess stress
Measure itself may induce stress
Influenced by variables other than stress
Expensive, Labour intensive, Time-consuming
Describe the correlation between life-events and illness
Illness and accident rates tend to increase following changes in adverse life events/stress.
Case study on life events and breast cancer
Kruk, J. 2012
SRRS scale used
Case study on life-events and immune function
Jiang, 2020
Case study on life events and asthma
Sandberg et al. 2000
What are ‘daily hassles’ ?
Minor stressors that occur regularly
How can hassles become bearable ?
Experiencing desirable events makes hassles more bearable.
Methods of assessment of daily hassles
- HASSLES SCALE
- UPLIFTS SCALE
Describe the hassles scale
Day to Day unpleasant or potentially harmful events
Describe the uplifts scale
Positive events that bring peace, satisfaction or joy
e.g. completing a task
State the ranges of stress according to the Hassles scale
Low <75
Average: 105
High >135
HASS/Col
Hassles Assessment Scale for Students in college
SARAFINO & EWING 1990
Describe the HASS/Col scale
0 - never
1 - rarely
2 - occasionally
3 - often
4 - very often
5 - extremely often
Give 3 examples of hassles from the HASS/Col scale
Annoying social behaviour of others
Athletic activities of self
Exams
(Dating)
Do hassles and uplift scores influence health ?
Hassles scores are associated with health status
Uplift scores have little association with health status
Function of the HASSLES score
Strong predictor of psychological and physical wellbeing
Experiencing hassles also leads to symptoms for those already suffering from an illness.
State the 2 types of stress
Distress
Eustress
SELYE 1985
Distress
Harmful
Damaging
Eustress
Beneficial
Constructive
Positive effects of stress
Certain levels of stress may be helpful (McGuigan 1999)
- optimal level of arousal
Degree of arousal/motivation enhances performance
- e.g. athletic, exam…
Minor stressor
Daily Hassles
