Impact on patient wellbeing

Question 1

What are ‘life events’?

Answer 1

“major happenings that can occur in a person’s life that require some degree of psychological readjustment”

Question 2

what are the main sources of life event stressors

Answer 2

the individual
family
society

Question 3

what impacts do these stressors have on a patient

Answer 3

physiological system - sympathetic NS
psychological aspects - cognitive function
Social aspect - behaviour, gender

Question 4

how are life stressors measured

Answer 4

– Self report
• interview
• questionnaires 
• rating scales
– Physiological
• galvanic skin response (electrical conductance of skin) 
• changes in BP, heart rate
• biochemical markers

Question 5

scales used to measure stressors

Answer 5

Social Re-adjustment Rating Scale (SRRS) = Developed to measure life events
• Scoring: adults indicate which life events have occurred to
them (past 12 mths)
• Values of all experienced life events added → total stress score

Question 6

Strengths of the Social Re-adjustment Rating Scale

Answer 6

• Wide range of events that most people find stressful
• Values assigned to the listed life events based on broad
sample of adults
• Easy, quick to complete
• Useful tool for assessment of stress and illness – e.g. retrospective approach (recall)
• Positive correlations between life events and illness

Question 7

Limitations to Social Re-adjustment Rating Scale

Answer 7

• Items vague/ ambiguous
– e.g. ‘personal injury or illness’ (53)
– e.g. ‘change in financial state’ (38)
• Failure to consider impact of event for individual – e.g. ‘retirement’ (45)
• Failure to distinguish between desirable and undesirable – e.g. ‘change in financial state’ (38)

Question 8

Other life events scales

Answer 8

• The Life Experiences Survey (LES)
– 57 events stated relatively precisely
• The PERI Life-Events Scale
– 102 items involving a gain, loss, ambiguous outcome
• The Unpleasant Events Scale (UES) – 320 events stated relatively precisely

Question 9

Other measures to assess stress?

Answer 9

• Physiological measures
– physiological arousal
– biochemical markers in blood/ urine
Limitations
– measure itself may induce stress
– influenced by other than stress variables
– expensive, labour intensive, time-consuming

Question 10

What are ‘daily hassles’?

Answer 10

• DAILY HASSLES can also cause stress (e.g. losing
one’s keys, daily commute)
• Hassles are minor stressors that occur regularly
• Accumulation of many minor stressors → suggested as important in influencing health
• Experiencing ˃ desirable events makes hassles ˃ bearable

Question 11

Assessment of daily hassles

Answer 11

• HASSLES SCALE
– Day-to-day unpleasant or potentially harmful events
• UPLIFTS SCALE
– Positive events that bring peace, satisfaction or joy

Question 12

Do hassles and uplift scores influence health?

Answer 12

HASSLES scores are associated with health status
– experiencing > hassles also leads to > symptoms for those already suffering from an illness
UPLIFT scores have little association with health status

Question 13

what are the two type s of stress

Answer 13

– Distress – harmful and damaging

– Eustress – beneficial or constructive