Psychological considerations in cardiac and respiratory disease

Question 1

Definition of impairment?

Answer 1

Loss or abnormality of psychological, physiological, or anatomical structure or function

Question 2

Definition of disability?

Answer 2

Restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being

Question 3

Definition of handicap?

Answer 3

Disadvantage for a given individual, resulting from an impairment or disability, that limits or prevents fulfilment of a role that is normal

Question 4

What is perseverative cognition?

Answer 4

The continued cognitive representation of stressful events, before or after their occurrence and even regardless of their occurrence
- Can take the form of worry, rumination, anger, mind wandering

Question 5

What is coping?

Answer 5

The process of trying to manage perceived discrepancy between demands placed on you and your resources to deal with them

Question 6

What are Bowlby’s stages of grief?

Answer 6

1. Numbness
2. Yearning/pining and anger
3. Disorganisation and despair
4. Reorganisation

Question 7

What is the Kuber-Ross grief response model?

Answer 7

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance

Question 8

What is cardiac neurosis AKA Da Costa’s syndrome?

Answer 8

A psychiatric disorder in which the patient experiences chest pain, breathlessness, rapid pulse, fatigue and palpitations but with no underlying cardiac pathology
- It is considered a form of anxiety disorder

Question 9

In which two situations does Da Costa’s syndrome develop?

Answer 9

1. In a relative/friend of an individual who has been recently diagnosed as suffering from a cardiac condition
2. In a period following an MI

Question 10

How can Da Costa’s syndrome be differentiated from angina?

Answer 10

History and ECG

- Angiography shows the coronary arteries to be normal

Question 11

Give some possible issues in rehabilitation

Answer 11

1. Clinical symptoms
2. On-going education
3. Misconceptions
4. Informal psychological assessment and support
5. Facilitate lifestyle changes
6. Promote return to normal activity

Question 12

What is the transtheoretical model of change?

Answer 12

1. Enter
2. Pre-contemplation
3. Contemplation
4. Determination
5. Action
6. Relapse
7. Maintenance

Question 13

Factors which influence rehabilitation

Answer 13

1. Age
2. Gender
3. Social deprivation
4. Co-existing physical illness and severity
5. Health and illness beliefs
6. Intelligence/education
7. FHx
8. Other people - family, workmates, neighbours
9. Culture - cultural restrictions on exercise/diet
10. The media

Question 14

How can we facilitate rehabilitation?

Answer 14

1. Education
2. Cognitive approaches: goal setting, cognitive techniques
3. Social support
4. Reinforcement: feedback, self-monitoring, patient autonomy
5. Client-practitioner relationship: communication, motivational interviewing