L9 Flashcards
Which social groups are chronic conditions most common in?
lower-income, Canadians, women, and seniors
What happens in the initial response to the diagnosis of a chronic disease?
patients are in a state of crisis or shock, anxiety, anger, and lower sense of control; engage in secondary appraisal and emotion-focused coping (e.g. denial)
Denial
inability to recognize, accept, or deal; plays a mixed role (i.e. only beneficial early on as it serves as a protective buffer)
Crisis theory
describes factors that influence how people adjust or cope after first learning about their chronic illness
3 kinds of factors that affect the coping process (crisis theory)
illness-related factors; background, personal factors; physical/social environments
What activities are involved in the coping process?
appraisal, adaptive tasks, and coping skills
2 types of adaptive tasks people with an illness must address
tasks related to the illness or treatment and tasks related to general psychosocial functioning
Examples of tasks related to the illness or treatment
coping with the symptoms or disability of illness; adjusting to the hospital environment, procedures, treatments; developing good relationships with practitioners
Examples of tasks related to general psychosocial functioning
controlling negative feelings and having a positive outlook; maintaining a satisfactory self-image and sense of competence; preserving good relationships; preparing for an uncertain future
5 coping strategies found most useful by cancer patients
social support/direct problem solving, distancing, positive focus, cognitive escape/avoidance, behavioral escape/avoidance
3 maladaptive coping strategies
rumination, interpersonal withdrawal, avoidant coping
What is rumination associated with?
exacerbation of symptoms
What is interpersonal withdrawal associated with?
loneliness and low relationship satisfaction
What is avoidant coping (e.g. denial) associated with?
increased psychological distress, exacerbation of the disease process, poor adjustment to illness
Kinds of denial shown by cancer patients
denial of diagnosis, impact/outcomes, and emotions
Distractive strategies
activities that take one’s mind off their diagnosis; found to reduce distress
Passive escape mechanisms
not confronting or thinking about the diagnosis; decreases psychological well-being
Characteristics of cancer patients who self-blame
higher levels of depression over time, more distress, and lower quality of life
Depression
feelings of sadness, despair, helplessness, hopelessness
Effect of depression on patients
may be delayed as patients try to understand implications of condition; physically debilitating and has a direct impact on symptoms; leads to poorer adjustment to illness
Social challenges cancer patients experience
difficulty seeing family/friends; feeling socially awkward or embarrassed about their condition
Social challenges others (e.g. caregivers) experience
avoiding the patient due to feelings of vulnerability; worrying they’ll say the wrong thing or break down emotionally
Main factors in the experience of cancer stigma
perceived controllability and visibility of the cancer, and whether it interferes
Adaption
the process of making changes in order to adjust constructively to life’s circumstances
Examples of adaptive tasks for successful adjustment to chronic illnesses
mastery of demands related to ongoing management of the disease; minimizing physical limitations and disability; preserving as much positive functioning as possible
Quality of life
the degree of excellence people appraise their lives to contain based on physical, psychological, vocational, and social functioning; an important indicator of recovery from/adjustment to chronic illness
Where activities are emphasized in QoL?
daily living (e.g. sleeping, eating, going to work)
What is an important aspect of evaluating QoL?
a person’s perceptions of their own health (i.e. self-reported/self-rated/subjective health)
5 psychosocial interventions for chronic illness
psychopharmacology, patient and family education, individual or family therapy, stress management/relaxation, support groups
Immediate psychosocial benefits of support groups
improved mood, reduced uncertainty, improved self-esteem, enhanced coping skills, improved quality of life
Informal caregiving
the provision of physical/emotional care to a family member or friend at home; a chronic stressor
Factors in caregiver stress
not having enough time to care for oneself; feeling overwhelmed; engaging in unhealthy behaviors due to lack of time; disrupted or insufficient sleep; poor stress management and prevention; degrading social relationships and poor support
Health costs of caregiving
higher levels of depression and physical health problems, abnormalities in measures of endocrine and immune system function, premature mortality for spouse caregivers who reported strain
Benefits of caregiving
providing the best care possible; staying connected or becoming closer; sense of accomplishment from giving back to someone who has cared for them; sense of meaning or purpose; passing on tradition of care in family; learning new skills
At which point of a terminal illness is denial and acceptance more common?
denial is more common early on and acceptance is more common closer to death
Clinical pain
any pain that receives or requires professional care, either acute or chronic
2 ways physicians reduce pain
chemically and surgically
2 methods for administering painkilling chemicals
epidural block and patient-controlled analgesia
5 advantages of group psychotherapy over individual therapy in treating pain
efficiency; reduced isolation; credible feedback; new reference group; different perspective for therapist
2 goals of operant approach to treating pain
reduce the patient’s reliance on medication and the disability that accompanies chronic pain conditions
In vivo exposure
patient engages in feared activities repeatedly to reduce pain fears, catastrophizing, and increase activity
3 types of active coping
distraction, imagery, redefinition
Distraction
nonpainful stimulus in the immediate environment to divert one’s attention from discomfort
3 aspects that affect distraction’s effectiveness
amount of attention required; how interesting a task is; task’s credibility to the person
Nonpain imagery
conjuring up a mental scene unrelated to the pain in order to alleviate it
Pain redefinition
substituting constructive or realistic thoughts about the pain for one’s that arouse feelings of threat or harm
Asthma triggers
personal factors, environmental conditions (e.g. allergens), physical activities
Factors of asthma
heredity, history of respiratory infection, exposure to cigarette smoke
What induces asthma symptoms?
stress (e.g. interpersonal conflict), anxiety, catastrophizing, low self-efficacy, suggestion (e.g. placebo of allergens)
Factors that worsen and improve adjustment to epilepsy
stigma; optimism, social support, sense of control
2 psychosocial factors related to compliance
social support and self-efficacy
Adjustment problems in chronic illness
physical, vocational, self-concept, social, emotional, compliance
3 links between heart disease and negative emotions
less healthful lifestyles; increased physiological reactivity; shared genetic factors that increase vulnerability
Cardiac invalidism
people with heart disease become increasingly dependent and helpless
