Neurological Patients: Psychosocial Problems and change

Question 1

When treating neurological patients ____ change is your objective and patient _____ is a tool for that change

Answer 1

behavioral

education

Question 2

what are the levels of patient education?

Answer 2

information (general)
Instruction
Education
Guidance, coaching (specific)

Question 3

What are the phases of behavioral change?

Answer 3

Being receptive (having an open mind)
Understanding
Wanting (motivated)
being able to
doing (intention and implementation)
persevering (maintenance)

Question 4

What are typical personal factors/problems in neurological patients?

Answer 4

Neurological problems (paresis)
Neuropsychological/cognitive problems (caused by the CND)
Psychological problems (can be a reaction to the CND or caused by the CND)

Question 5

What is cognitive ability?

Answer 5

the ability to interpret information from daily life, ability to combine knowledge and new information

Question 6

What do neuropsychological problems concern?

Answer 6

Orientation
attention
information processing
memory
language
reading,writing,figures
reasoning
learning abilities

Question 7

some examples of neuropsychological problems include: aphasia, apraxia, agnosia, amnesia, visual neglect
Describe each one

Answer 7

Aphasia = communication impairment
apraxia = Inability to perform learned movement
agnosia= Inability to recognize people, objects, sounds
amnesia= memory loss
Visual neglect= partial loss of visual field

Question 8

What do psychological problems concern?

what are two examples of psychological problems in CND patients

Psychological problems are either caused by ______ changes and/or a ______ to the illness and have no detectable _____

Answer 8

thoughts, feelings, and behavior

1. Adjustment process (coping process)
2. Mood: depression, emotional instability, fatigue

neurological
reaction
reason

Question 9

What is the nine-cell model used for?

Answer 9

It is a why to distinguish neurological, neuropsychological, and psychological problems.

Question 10

What is memory? what is meant by encoding, storage, and retrieval?

Answer 10

memory is a system that encodes, stores, and retrieves information.

1. Encoding= modification of information
2. Storage= retention of encoded material
3. Retrieval= location and recovery of information from memory

Question 11

What are 3 stages of memory?

Answer 11

1. Sensory memory - from sensory input
By attention it becomes....
2. Short-term memory
When is encoded it becomes...
3. Long-term memory

Question 12

In which stage of memory is maintenance rehearsal important?

Answer 12

short-term

Question 13

What is needed to imprint something to long term-memory?

Answer 13

Attention
Interest
Emotional arousal
connection with previous experience
rehearsal

Question 14

What are the divisions of long-term memory?

Which division of long-term memory do physiotherapists influence most?

Answer 14

Procedural memory (how to do something)
Declarative memory (facts, data, events) which is subdivided into Episodic memory (personal experiences) and semantic memory (general factual information, the meaning of words)

Procedural

Question 15

What is procedural memory?

What is priming?

Answer 15

skills, classical/operational conditioning, and priming

When one stimulus influences a response to another stimulus without conscious guidance are attention. It is when you presort.

Question 16

What is anterograde amnesia?

What is retrograde amnesia?

Answer 16

anterograde= unable to store, retain new information
Retrograde= unable to access memories that happened in the past

Question 17

Which specific neuropsychological/cognitive problems do patients with stroke face?

Answer 17

orientation
memory loss
attention/concentration
visual neglect
aphasia/language 
information processing
apraxia

Question 18

Which specific psychological problems do patients with stroke face?

Answer 18

Depression
Anxiety (ongoing worries about illness, future, family)
Emotional instability: laughing or crying out of context
Indifference

Question 19

Which specific neuropsychological problems do patients with Parkinson disease face?

Answer 19

concentration
dementia
psychosis (hallucination)

Question 20

Which specific psychological problems do patients with Parkinson face?

Answer 20

Depression

Fatigue

Question 21

Which specific neuropsychological problems do patients with multiple sclerosis face?

Answer 21

Processing of new information
concentration
memory (amnesia)

Question 22

Which specific psychological problems do patients with multiple sclerosis face?

Answer 22

depression
fatigue
sleeping problems

Question 23

What is depression?
What is the prevalence of depression?
what is the difference between men and women

Answer 23

a mood disorder: abnormal depressive mood which is inappropriate to the situation
5% of population
twice as many women as men suffer from depression

Question 24

What is the prevalence of depression among CND patients?

Answer 24

40% of Parkinson patients suffer depression
40% of patients with CVA
and 50% of MS patients

Question 25

Depression can be a _____ to the illness or _____ by the illness

Answer 25

response

(co-)caused

Question 26

What are the 2 core signs of depression?

What are other signs of depression?

Answer 26

1. Depressive mood
2. Loss of interest/pleasure

weight loss/gain, sleeping too much or insomnia. fatigue. sense of guilt/worthlessness, concentration problems, difficulty making decisions. thoughts of suicide

Question 27

What are the 3 requirements of a depression diagnosis according to DSM-5?

Answer 27

1. Patient must have at least one of the core signs
2. At least 4 other signs
3. lasts more than 8 to 10 weeks

Question 28

What is Dysthymic disorder?
What is bipolar disorder?

Do these disorders occur significantly more in patients with CND ?

Answer 28

Dysthymic- A chronic form of depression which persists for at least 2 years. It is less acute than major depressive disorder but not necessarily less severe.

bipolar disorder- characterized by mood swings between euphoria and a state of extreme depression

no

Question 29

What does treatment of depression entail?

Answer 29

Medication= antidepressants
talking= cognitive behavioral therapy (RET)
Movement!