Introduction to Psychological Frameworks for Understanding Illness Related Behaviours Flashcards
Definition of illness related behaviour
Varying ways individuals respond to bodily interactions, how they monitor internal states, define and interpret symptoms, make attributions, take remedial actions and utilise sources of informal and formal care
Definitions of monitors
Info seeking behaviour in patients
Definitions of blunters
Info avoiding behaviour in patients
Definition of coping
Different cognitive and behavioural efforts used to deal with illness demands
What are the 5 aspects involved in illness behaviours
Adherence to treatment as discussed
Attendance to appointments
Managing symptoms and negative emotional responses
Navigating complex healthcare systems and staff
Sustaining function in the face of challenges
Describe the Common Sense Model in illness cognition and behaviour
Illness perceptions
- identity
- duration
- consequences
- cure/control
- cause
Affects coping behaviour to manage threat
Appraisal of illness label and coping behaviour
Emotional response
Coping behaviour to manage threat
Appraisal of emotional response and coping
Describe the relationship between identity beliefs and emotion focused coping
Describe the relationship between cure/control and problem focused coping and cognitive appraisals
Higher identity beliefs => more emotion focused coping
Higher cure/control => higher problem focused coping and cognitive appraisal
Describe the relationship between distress and long term conditions
- depression
- suicide
- anxiety
What do we need to be careful of when diagnosing depression/anxiety after LTC diagnoses
Depression = 2-3x more common in those with LTCs
-associated with actual/anticipated loss
LTC => increased suicide risk
Anxiety common in early stages and after major changes
Hard to differentiate between anxiety/depression and distress due to change
What are the 4 factors that distress can impact on
Risk factors
Physiological responses
Physical health
Prognosis
What patient variables can affect patient responses to illness
-5 variables
Personality
Age
Past experience
Psychological state at time of onset
Ethnicity
Describe how personality can affect illness responses
- info seeking styles
- outlook on life
Monitors=>info seekers
Blunters=>info avoiders
Pessimism=>feelings of helplessness
Optimism=>linked to active coping
What 4 illness variables can affect illness responses
Challenging characteristics of condition
Impact on lifestyle/limits on mobility/disfigurations
Treatment regime
Life threatening/uncertain outcomes
What social variables can affect illness responses
-what social variables can be beneficial to the patient
Increased social support => increased adjustment and adherence
- provision of emotional, practical, info support
- support of family and friends
- patient needs and carer supported are aligned
Partner beliefs about condition and treatment impacts on patient beliefs => impacts health outcomes
What psychological factors can affect illness responses
How can your cure/control beliefs and perceptions of the illness affect your response
Describe the link between illness perception and illness severity
Low mood => low adherence/motivation/fear avoidance
Perceptions about illness more important when determining functional recovery than illness severity
Increased cure/control beliefs => increased chance of adhering to treatment
Those who accurately understand their condition to be
- controllable
- symptomatic
- severe consequences are more likely to adhere
Describe the role of family and care gives in health outcomes
Whos beliefs can impact +vely/-vely on the patients recovery
Support and cooperationfrom SO + patient’s own coping => successful recovery and adaptation
Relative’s own beliefs on condition, treatment, lifestyle advice impacts on patient recovery
What illness related demands require coping
-4 main demands
Self management and adherence
Pain/incapacity/symptoms
Interacting with many HC staff
Navigating HC environment
What emotion/social demands require coping
-4 main demands
Preserve emotional balance
Self image, mastery and control
Sustaining current relationships
Preparing for an uncertain future
What are the 2 types of coping
Problem focused
Emotion focused
Describe problem focused coping
Active involvement
- learning new skills
- info seeking
Describe emotion focused coping
Dealing with anxiety, uncertainty, negativity with
- distraction
- emotional expression
Reframe illness positively
Utilise social support
Describe adaptive coping
- controllable illness stressor
- uncontrollable ilness stressor
Controllable
More problem focused
Info seeking consistent with good outcomes
Uncontrollable
More emotion focused
Both lead to
- decreased psychological distress
- increased psychological wellbeing
What happens if you give the wrong appraisal during adaptive coping
Increased distress
Decreased psychological wellbeing
What are the key principles of self management
What 5 factors does it involve
HCS will only facilitate the discussion
Involves
- knowledge
- practical skills and problem solving to overcome barriers
- goal setting and self monitoring
- patient beliefs
- appropriate coping skills
How would you use the CSM (physical coping arm) in self management
Target illness perceptions and address any misconceptions
Come up with a detailed action plan together
Leads to
- decreased consequence, distress and timeline beliefs
- increased perceived control and understanding
What happens if you only address the physical coping arm and ignore the emotional coping arm
If not addressed, may lead to
- emotional suppression
- intervention reinforces hypervigilance for symptoms
People with LTCs are 2-3x more likely to experience mental health problems
How would you use the CSM (emotional coping arm) in self management
Target emotional coping by
- decreased emotional arousal
- increased emotion expression
Reappraise cognitions (control and susceptibility)
Led to
- increased use of relaxation techniques and perceptions of control and susceptibility
- decreased anxiety
- increased wellbeing
