Patient Perspective

Question 1

How can body image be influenced by:

1. physical perspective
2. environmental/social aspects
3. discourses

Answer 1

1. embodiment - only tend to become aware of our bodies when things go wrong
2. what is considered desirable
   changes over time/social context
3. use of language
   dominant discourses

Question 2

What are the three elements of “The civilised body”

Answer 2

1. hide natural functions
2. control emotions
3. separate space between bodies

Question 3

1. define body image

2. define self esteem

Answer 3

1. the picture we have in our minds of the size, shape and form of our bodies
2. relates to how much you like oneself, and how you recognise or appreciate your indvidual character, qualities, skills and acomplishments

Question 4

How is body language gendered for:

a) men
b) women

Answer 4

a) language of power; related to function and action

b) language of control; body is an object; social currency

Question 5

1. What is biographical disruption

2. how can it occur following diagnosis

Answer 5

1. the destabilisation and questioning of identity and biography
2. can call into question the past, future, sense of “i” and where I am going.

Question 6

Why can a diagnosis of breast cancer be challenging for men?

Answer 6

challenges sense of masculinity, and can be distressing/stigmatising to live with a disease associated with women

Question 7

Name 4 problems with “leaky bodies”

Answer 7

1. more likely to remain in hospital
2. patients become withdrawn and more disengaged from others
3. visibility of illness and aversion of others
4. concern about leakage onto clothes

Question 8

Name sources from which people develop their views of vaccines (4)

Answer 8

1. publicly accessible media
2. conspiracy theories
3. celebrity endorsements
4. blogs/forums

Question 9

Describe responses to common objections of vaccination:

1. the diseases is not serious
2. the disease is uncommon
3. the vaccine is ineffective
4. the vaccine is unsafe
5. other methods are preferable to immunisation

Answer 9

1. diseases such as measles kill healthy children
2. diseases such as measles, diptheria and polio are common in unimmunised populations and are easily spread worldwide
3. all vaccines undergo vigerous trials to show they are effectove
4. all vaccines are assessed for safety and monitoring continues. Adverse events are rare
5. there is no evidence that homeopathic vaccines confer any protection

Question 10

1. What needs to be considered when introducing vaccines
2. How may avoidance of a vaccine affect:
   a) the individual
   b) the community

Answer 10

1. the safety of the vaccine, and how it is introduced/used in practice

2a) protection by herd immunity may be the safest option as it avoids the risk of the vaccine
2b) avoidance of vaccination leads to reduced coverage and diminished herd immunity.

Question 11

Name the 4 phases of grief

Answer 11

1. numbness
2. yearning/pining and anger
3. disorganisation and dispair
4. reorganisation

Question 12

Name symptoms of grief

Answer 12

• depression, sadness, helplessness, numbness
• somatic sensations - sensitivity to noise, stomach, muscle weakness, breathlessness
• sleep and appetite disturbance
• concentration impairment

Question 13

Describe the 4 tasks of mourning

Answer 13

1. accept the reality of the loss
2. work through the pain of grief
3. adjust to an environent in which the deceased is missing
4. emotionally relocate the deceased and move on with life

Question 14

describe factors affecting greif severity

Answer 14

• closeness of relationship
• expectedness/manner of death
• age and developmental stage of griever
• individual resilience
• attachment and dependency
• religious belief
• social support

Question 15

Why is it important to consider spirituality?

Answer 15

1. evidence of the effects of spirituality on health

2. leakage of values of the clinician

Question 16

How can religious belief impact on bereavement? (5)

Answer 16

1. belief in afterlife - continuing existence of loved one
2. continued attachment - prayer as means of communication
3. defence against fear of personal extinction
4. funeral rituals aid and progress grief process
5. funeral rituals recruit social support

Question 17

Name 5 examples of complimentary therapies

Answer 17

1. chiropractic
2. osteopathy
3. acupuncture
4. herbal medicine
5. homeopathy

Question 18

Which CAMs are staturory regulated?

Answer 18

chiropractic

osteopathy

Question 19

1. What is chiropractic medicine?

2. What is osteopathy?

Answer 19

1. use of hands to relieve problems with bones, muscles and joints, in a process called manipulation
2. a way of detecting, treating and preventing health problems by moving, stretching and massaging a person’s muscles and joints

Question 20

1. How much of CAM is funded by the NHS

2. What percentage of people want CAM on the NHS?

Answer 20

1. 13%

2. 75%

Question 21

Name 4 contextual factors that can influence effectiveness of CAM

Answer 21

1. patient-physician relationship
2. treatment features - patient centred care, therapeutic touch
3. health care setting features
4. patient expectations

Question 22

Describe how a social crisis may lead to the presentation of dementia

Answer 22

e.g. death of a spouse may lead to a person being unable to function, revealing cognitive dysfunction and impairment

Question 23

1. How may a patient respond to diagnosis of dementia?
2. How may carers respond to diagnosis of dementia?
3. Why may a person not want a diagnosis of dementia?

Answer 23

1. denial (with or without insight)
   grief reaction
   acceptance/positive coping strategies
2. confirmation of something they long suspected
   fear
   anger
   grief
3. big fear
   concerns over impact on daily life

Question 24

Describe 5 benefits of a diagnosis of dementia

Answer 24

1. know what it is you are dealing with
2. access to treatments
3. access to support services
4. infrormation and education
5. access and manage risks

Question 25

1. What are the effects of dementia on a spouse/partner?
2. What are the effects of dementia on a parent/child relationship?
3. How can dementia impact on relationships?
4. How can dementia impact on the health of carers?

Answer 25

1. relationship becomes skewed.
   altered outside relationships
2. role reversal
   effects on other dependents
3. effects of physical care
   poor sleep
   constant vigilance
   loss of support of affected family member
4. patient does not behave in any recognisable way as themselves
   patient may not recognise carer
   loss of dignitiy
   anticipatory grief