L9: chronic & terminal illness, ch 13, 14 - complete

Question 1

what is the initial response to chronic illness? what type of coping do people engage in early on?

Answer 1

• shock, anxiety
• emotion-focused coping is engaged in more early on (i.e., denial)

Question 2

what 3 factors are involved in the coping process? what are the 3 influences to the coping process?

Answer 2

• coping process:

1. appraisal
2. adaptive tasks
3. coping skills

• factors:

1. illness-related factors
2. background, personal factors
3. physical/social environments

Question 3

what are the 2 adaptive tasks in coping, among ill people? what are the 3-4 components of each task?

Answer 3

• related to the illness or treatment
• cope with symptoms or disability caused by the health problem
• adjust to the hospital environment and medical procedures/regimens
• develop and maintain good relationships with their practioners
• related to general psychosocial functioning
• control negative feelings and retain a positive outlook
• maintain a satisfactory self-image and sense of competence
• preserve good relationships with family and friends
• prepare for an uncertain future

Question 4

what are 5 coping strategies found useful among cancer patients? why do some avoidance strategies prove beneficial?

Answer 4

• social support/direct problem solving (“talked it out with someone”)
• distancing (“I didn’t let it get to me”)
• positive focus (“I learned something from this experience”; similar to positive appraisal)
• cognitive escape/avoidance
• behavioural escape/avoidance

Question 5

what are 3 types of maladaptive coping strategies in ill individuals? why?

Answer 5

1. rumination
2. interpersonal withdrawal
3. avoidant coping

Question 6

how does denial manifest in cancer patients? what strategies do they use?

Answer 6

1. distractive strategies: reduce distress
2. passive escape mechanisms: decrease psychological well-being (e.g., trying not to think about it)

Question 7

what is the relationship between depression and chronic/terminal illness? why? how can this complicate medical evaluations and future prognoses?

Answer 7

• the longer one has a chronic/terminal illness, the greater their risk for depression and helplessness
• can complicate because of overlapping symptoms
• depression decreases cancer survivability

Question 8

what are 2 factors involved in cancer stigma? what is the most heavily stigmatized cancer? what are its effects?

Answer 8

• factors involved in cancer stigma
  1. extent to which an individual’s identity and sense of self are affected by the diagnosis
  2. perceived controllability and visibility of cancer
• most heavily stigmatized cancer: lung cancer
• effects: motivation to seek out treatment, see doctor, tell others, cancer screening

Question 9

what are 3 tasks that are made to adapt to chronic conditions?

Answer 9

1. mastery of demands directly related to ongoing management of the disease
2. minimizing physical limitations and disability
3. preserving as much positive functioning as possible

Question 10

what is quality of life and what is it based on?

Answer 10

• the degree of excellence that one evaluates to exist in their life
• based on physical, psychological, vocational, and social functioning
• emphasis is based on daily living

Question 11

how is quality of life evaluated? what is this referred to in research? why is this type of evaluation so useful?

Answer 11

• self-report likert-type scales
• subjective health
• high predictive validity in the rates of morbidity and mortality
• associated with prevalence, mortality, onset of all disease

Question 12

is subjective health consistent with objective health? why or why not?

Answer 12

• yup
• because the patient can put on a holistic lens, consider a wide breadth of factors, and evaluate their life as a whole
• it also includes emotional factors, which can result in better life behaviour

Question 13

why has the predictive validity of self-reported health increased over time?

Answer 13

• more access to health resources
• so they’re better at assessing their own stress

Question 14

give at least 4 reasons why caregiving is a chronic stressor (8 total)

Answer 14

• not having time to care for yourself
• engaging in unhealthy behaviours
  -disrupted or insufficient sleep
• poor stress management and preventation
• degrading social relationships and poor support
• increase in economic cost

Question 15

what are 3 health costs of caregiving? what are the health outcomes of caregivers? why?

Answer 15

• higher levels of depression and physical health problems in caregivers when compared with non-caregivers
• spouse caregivers who reported strain were at risk for premature mortality
• abnormal measures of endocrine and immune system function

Question 16

why is it important to study caregiving in this day and age?

Answer 16

• aging population resulting in more and more people needing caregiving
• less people available to provide caregiving
• family members will need to increase their efforts to keep up with care need

Question 17

after being diagnosed with a seriously life-threatening illness, what is the main issue of concern?

Answer 17

• mortality

Question 18

what is the life expectancy for a high-mortality disease? what does this result in?

Answer 18

• can be months away, can be years away
• the uncertainty becomes a source of stress

Question 19

why can optimism and hope cause detrimental health outcomes in terminal illness? what are 2 types of care that this leads to? Why is this an issue?

Answer 19

• aggressive care
• futile care: care that is provided even though there is pretty much no chance of having an impact
• problem because it can reduce quality of life/life expectancy

Question 20

how does self-blame affect coping and responses to health problems?

Answer 20

• those who blame themselves tend to cope poorly, showing higher levels of depression over time than patients with less self-blame
• over time, this rumination and catastrophizing may lead to poor outcomes

Question 21

how are the actions of family members important in participants adapting to illnesses?

Answer 21

• patients are more likely to adapt well to a chronic condition if their family members participate actively in their treatment regimens, encourage them to be self-sufficient, and respond to their needs in a caring and sensitive manner

Question 22

what are 6 coping strategies for chronic health problems? what are the effects of each strategy?

Answer 22

1. denying/minimizing the seriousness of the situation (emotional coping)
2. seeking info (problem-focused coping)
3. learning to provide one’s own medical care (sense of control)
4. setting concrete limiting goals (meaning)
5. recruiting instrumental and emotional support from family, friends, and practitioners (relational coping)
6. gaining a manageable perspective (meaning)

Question 23

what are 3 ways that stress and anxiety plays into asthma?

Answer 23

• stress can produce/aggravate asthma attacks/episodes
• anxiety increases symptom perception
• catastrophizing/appraising something as an asthma attack increases anxiety and symptoms of respiratory illness

Question 24

how are 2 ways that having epilepsy affect one’s social life?

Answer 24

• the “strangeness” of an epileptic episode stigmatizes them
• is associated with cognitive and motor impairments that can limit eligibility for certain activities and jobs

Question 25

what is the main challenge after spinal cord injury?

Answer 25

- make the most of their remaining abilities - lead as full a life as possible

Question 26

what are 2 psychosocial factors that increase compliance?

Answer 26

1. self-efficacy 2. social support

Question 27

what are 4 psychosocial issues that decrease compliance, with reference to diabetes?

Answer 27

1. weight gain caused by insulin 2. incompatible dietary recommendations with certain ethnic groups 3. frustration due to glucose being off target, despite being "good" 4. lack of importance due to diabetes not being painful

Question 28

what is the cycle between emotions and arthritis symptomology? give examples

Answer 28

- symptoms cause stress - stress increases symptoms

Question 29

how does control help with dealing with arthritis?

Answer 29

- helps their emotional adjustment - those who believed they could control their daily symptoms reported less mood disturbance than those who did not - those who saw themselves as active partners in decisions about their medical care and treatment showed better adjustment

Question 30

how does a parent's perception of a health problem change once their child has the illness?

Answer 30

- parents perceive a problem as less severe once their child has the illness

Question 31

what are 6 adjustment problems in chronic illness

Answer 31

- physical - vocational (education/career) - self-concept - social (activities, changed relationships) - emotional (denial, anxiety, depression) - compliance

Question 32

what are behavioural methods to enhance adherence?

Answer 32

- tailoring the regimen to make it as compatible as possible with the person's habits

Question 33

what are self-management programs? what are their purpose? what is an important feature of its approach?

Answer 33

- *provides info and trains patients in behavioural and cognitive skills to enhance their ability to carry out their regimens* - create and adapt to the new behaviours or life roles the health condition requires - cope with their emotions - important feature: teaches problem-solving skills

Question 34

what are 2 ways that cognitive processes affect a person's management of chronic health problems?

Answer 34

- **problem-solving training** - help clients reduce anxiety and other negative emotions they experience when they don't know how to solve many of their everyday difficulties - teaches new strategies for thinking through medical problem situations that arise - **cognitive restructuring** - clients discuss incorrect thoughts and beliefs and learn ways to cope better by thinking more constructively/realistically

Question 35

how are interpersonal therapies designed to help?

Answer 35

- help people change the way they interact with and perceive their social environments - by gaining insights about their feelings and behaviour toward other people - especially useful in helping patients deal with their anxieties and changed self-concepts or relationships with family and friends

Question 36

what is family therapy?

Answer 36

- has family meet as a group - examine and change interaction patterns among family members

Question 37

what are 3 cognitive adjustments that people make in response to high-mortality illnesses over a long period of time? what does this result in?

Answer 37

1. positive reappraisals to their life sitautions 2. gain sense of control over their illnesses 3. restore their self-esteem - promotes adaption: the greater their degree of patients' positive reappraisals after cancer diagnosis, the better their perceived health and psychosocial functioning months later

Question 38

what are the 3 ways that form the link between negative emotions and heart disease?

Answer 38

1. less healthy lifestyle when they experience negative emotions 2. negative emotions have physiological effects that promote heart disasease 3. shared genetic factors might increase vulnerability to both heart disease and negative emotions

Question 39

what are the findings of positive emotions and cardiovascular health?name and describe 2 theories that help explain this link

Answer 39

- **broaden-and-build theory:** - positive emotions broaden the scope of attention, cognition, and action of a person over time - this helps the person see more options in stressful situations, consider more alternative, and have a greater variety of coping responses at their disposal - positive emotions help a person build up reserves of energy and social resources - **undoing hypothesis** - positive emotions serve their adaptive role In stress by "undoing" the negative impact of stress on cardiovascular heealth

Question 40

what are 4 ways that cancer patients can find better adaption to their disease and higher quality of life?

Answer 40

- involved in decisions about their treatment and follow-up - have relatively high levels of perceived control - use active problem-solving strategies rather than avoidance coping - found meaning

Question 41

what is the main factor in the success of the cognitive-behaiouvral stress management methods? what are the 2 ways that this program improves their adjustment?

Answer 41

- main factor: the patient's learning skills that allow them to relax at will - how the program improves their adjustment: 1. reduced prevalence of depression, increased their use of positive reprisal strategies 2. enhanced immune function

Question 42

what are the effects of mindfulness-based stress reduction methods?

Answer 42

- reduce emotional distress

Question 43

what are 4 factors that has been suggested to be the focus of pscychosocial interventions in cases of impending death

Answer 43

- valuing the present moment - creating a living legacy - enhancing control - finding meaning and purpose in one's life

Question 44

what are the effects of psychosocial interventions on long-term and short-term survival?

Answer 44

- short-term: benefits to survival - long-term: doesn't prolong cancer patients' survival