PCCP 3 Flashcards
What is prejudice?
Evaluative and affective component of a stereotype. Often negative judgement and attitudes.
What is discrimination?
Behavioural component of a stereotype.
Acting upon a negatively prejudiced attitude.
What is a Stereotype?
Cognitive social schema of a type of person or group that discounts individual differences. Mechanism of saving processing power.
What is classical conditioning?
Pavlovs dogs
Theory of learned behaviour in which stimulus-response can become automatic over time.
How can classical conditioning be used to change health behaviour?
Aversive stimuli to prevent bad habits. Eg alcohol + medication to induce nausea
What is operant conditioning?
Theory of learning behaviour.
Negative reinforcement prevents behaviour and positive reinforcement increases behaviour.
How can operant conditioning be used to change health behaviour?
Money saved towards holiday by giving up smoking.
What is social learning theory?
Theory of learnt behaviour in which people learn by modelling themselves on the behaviour of others.
More likely to copy if
- Behaviour is rewarded
- We feel able to copy the behaviour
- Copying a high status person
How can social learning theory be used to change health behaviour?
Celebrities in public health campaigns.
What is the cognitive dissonance theory?
Theory of behaviour in which we aim to reduce the discomfort that occurs when our beliefs and behaviour/outside events are inconsistent by either changing beliefs or changing our behaviour.
How can cognitive dissonance theory be used to change health behaviour?
Provide uncomfortable information about smoking to create dissonance.
But….push people to rerationalise in the wrong direction
What is the health belief model of behaviour?
Model of behaviour in which decision to act is a cost benefit balance between between beliefs about threat to health and beliefs about health related behaviour.
Eg weigh up threat of sti (likelihood/severity etc) vs wearing a condom (pros and cons)
What is the Theory of planned behaviour ?
Theory of behaviour in which 1. Attitude 2. Subjective norm 3. Perceived control Affect an intention to act. May or may not translate into action
What is the intention behaviour gap? How can it be reduced?
Intention does not translate into behaviour.
Reduced by Implementation intentions- write down concrete plans.
What are the main stages of behaviour change?
Pre contemplation Contemplation Preparation Action Maintenance Relapse
What is the difference between compliance and adherence? Which is preferable?
Compliance - extent to which the patient does what the doctor orders them
Adherence - extent to which patient behaviour coincides with agreed medical advice.
Adherence is better because more patient centred.
Give 4 reasons it may be difficult to measure adherence.
Hard to define what counts as adherence
Hard to compare different conditions
Adherence can be masked by taking medication when they know they will be tested
Can’t know medication has been taken
How can we test adherence? What might be the problem with these methods?
Observation of consumption
Pill counters
Self report
But still can’t guarantee that the medication has been taken
Give 3 patient- related factors which might influence whether the patient adheres to treatment.
Understanding of the illness and how the treatment works.
Recall of treatment regime
Beliefs about treatment and illness
Give 2 illness - related factors which might influence whether the patient adheres to treatment.
Presence and severity of symptoms
Give 4 treatment- related factors which might influence whether the patient adheres to treatment.
Complexity
Duration
Side effect profile
Give 2 psychosocial- related factors which might influence whether the patient adheres to treatment.
Psychological health
Social support
Give 2 healthcare- related factors which might influence whether the patient adheres to treatment.
Continuity of care
Communication skills of prescriber - perception of manner and competence.
What kind of interventions can improve unintentional lack of adherence?
Memory aids
Blister packs
What kind of interventions can improve intentional lack of adherence?
Improving communication skills - becoming more patient centred
What is concordance?
Not related to medication taking behaviour.
More about the nature of the relationship between doctor and patient, allowing shared decision making.
But applying concordance principles will lead to greater adherence.
What are the main differences between the biomedical and biopsychosocial models?
Psychological and social factors also valued:
Can’t separate the mind from the body - psychological factors affect health
Deprivation and unemployment can affect health
Particularly relevant for chronic illness
Describe the physiology of acute stress
Fight flight or freeze
Up regulation of heart rate, resp rate, immune system
Down regulation of GI, reproductive
Describe the physiology of chronic stress
Increased metabolism
Down regulation of immune system
More prone to disease
What is the transactional model of stress?
We are constantly exposed to stressors.
We have resources that allow us to cope - social support, resilience, certainty
Weigh up balance (appraisal) between stress level and ability to cope - leads to perception of stress level.
What is primary and secondary appraisal of stress?
Part of transactional model.
Weighing up stress level by looking at:
Primary - how stressful is the event?
Secondary - what resources/ coping strategies do we have?
Give some physical disorders potentiated by health?
Peptic ulcers
Cardiovascular disease
Upregulate on of cortisol - decrease in immune system
What non physical pathways may stress impact on health?
Increase unhealthy behaviour - smoking alcohol etc
Mental health
Which stage of behaviour change is motivational interviewing designed for?
Pre contemplative
What is motivational interviewing?
Method which allows patients to come up with their own strategies and plans for behaviour change.
What are piagets 4 stages?
0-2 sensorimotor - development of object permanence
2-7 - preoperational - development of symbolic thought, still egocentric
7-12 - concrete operational - development of conservation, development of theory of mind
Give some examples of good practice in communicating well with children.
- Sit at same level as child
- Use their name and address them directly rather than just the adult
- Simple language
- Use props to explain difficult or abstract concepts
What are the consequences of attachment theory?
Damaging for a child to be separated from a parent for too long
Make effort to allow parent to stay in hospital
What are problem focussed and emotion focussed coping? Give an example of each.
Problem focussed:
Expand resources eg research, buy equipment
Emotion focussed:
Change feeling eg Talking to friends, alcohol, denial
How can you help a patient to cope?
Increase/mobilise social support
Increase sense of personal control
Reduce uncertainty
What factors might mean that anxiety or depression may be missed?
Non disclosure
Doctor avoiding asking
What level of drinking is considered to be dangerous?
Increasing risk - Greater than 3-4 per day (male) 2-3 (female)
High risk - greater than 8 per day (male) 6 per day (female)
What are the 5 stages of grief, described by Kubler Ross?
Denial Anger Bargaining Depression Acceptance
Describe the SPIKES model of breaking bad news.
S - setting (private, few interruptions, sit down)
P - perception (ask what they already know)
I - information (how much would they like to know)
K - knowledge (warning shot, small chunks, check understanding)
E - emotional support (ask concerns)
S - summarise
Give 3 intentional causes of non adherence
Beliefs about taking medication/diagnosis
Expectations about efficacy of treatment
Expectations about side effects
Give 3 unintentional causes of nonadherence.
Poor memory
Lack of transport to the pharmacy
Lack of understanding of need for treatment
