Psychological effects of illness

Question 1

Define subjective disability

Answer 1

ill health with absence of objective disease

Question 2

Define subjective well-being

Answer 2

feel good but have severe objective disease

Question 3

What are PROMs?

Answer 3

patient-reported outcome measures

Question 4

What are the key domains of impact of health?

Answer 4

perceived health (symptoms)
physical functioning
occupational/role functioning
social functioning
emotional functioning
cognitive functioning

Question 5

Impacts of severe illness

Answer 5

disruption to daily living
treatment and hospitalisation
uncertainty and threat to future
lifestyle changes and forming/sustaining relationships

Question 6

Impact on family of chronic illness in childhood

Answer 6

changes in roles
loss of ‘perfect’ child
increased practical + emotional stress
depression
strain on parental relationships
financial issues

for siblings:
- needs overlooked
- take up support + caring roles
- miss quality time with sibling and parents
- anxiety
- jealousy
- increased empathy, increased maturity

Question 7

What is coping?

Answer 7

constantly changing cognitive and behavioural efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding resources

Question 8

What are 2 types of coping

Answer 8

emotion-focussed coping
problem-focussed coping

Question 9

Describe emotion-focussed coping

Answer 9

aimed at modifying response by regulating the emotional distress caused by the stressor or potential stressor

Question 10

Describe problem-focussed coping

Answer 10

these strategies attempt to alleviate or eliminate stressful situations through trying to take control
ie doing something constructive about events that are regarded as negative

Question 11

Name some specific coping strategies

Answer 11

problem solving (direct action, decision making, planning)

support seeking (social support, comfort/help seeking)

escape-avoidance (disengagement, denial, wishful thinking)

distraction (alternative activities)

cognitive restructuring (positive thinking, accommodation)

rumination (negative thinking, self blame, worry, catastrophising)

helplessness (inaction, passivity, giving up)

social withdrawal (self isolation, concealment, stoicism)

emotional regulation (emotional expression, relaxation)

information seeking (learning more, observation, monitoring)

negotiation (compromising, prioritising, deal making)

opposition (anger, blaming others, projection, reactance)

delegation (maladaptive help seeking, complaining, self pity)

Question 12

When is problem-focussed coping best?

Answer 12

in controllable situations

Question 13

When is emotion-focussed coping best?

Answer 13

in situations with little/no control

Question 14

Influences on coping

Answer 14

Illness-related factors (level of threat to life/functioning, treatment regimens, side effects)

background/personal factors (personality, timing in life, emotions, education)

physical/environmental factors (hospital/home environment, social support, finance, educational opportunities, resource availability)

Question 15

How does serious illness affect family in the first few days?

Answer 15

shock
disbelief
denial
fear
anger
guilt
hopelessness
helplessness
depression

Question 16

What are the stages of the Kubler-Ross grief cycle?

Answer 16

denial
anger
bargaining
depression
acceptance

Question 17

What are some challenges faced in serious illness?

Answer 17

Physical (tiredness, aches, lack of sleep)
Psychological/emotional
Social (financial, status, relationships, time usage)
Spiritual

Question 18

What roles do carers undertake?

Answer 18

ADLs (bathing, toileting, feeding, dressing)

Mediating (between professionals and patient, obtaining info, arranging outpatient appts, monitoring symptoms)

Nursing tasks (medication, injections, wound dressings, changing catheter/colostomy bags)

Question 19

What might carers be concerned about?

Answer 19

ability to provide care
stress
uncertainty
fear
conflict
altered role and lifestyle
own physical health
finances

Question 20

What problems might carers have?

Answer 20

extra demands on time/energy
changing roles/responsibilities
changing ability to work/professional responsibility
pressure to continue caring and have a life outside

Question 21

Describe The Family System

Answer 21

family system functions as a unit and every family member plays a critical role

a change in one member of the system causes a ripple effect of change throughout the family

Question 22

Describe an Open Family System

Answer 22

communicate freely
flexible boundaries
rules are up to date and promote growth

Question 23

Describe a Closed Family System

Answer 23

indirect/restricted communication
overly dependent on one another
inflexible rules

Question 24

What is involved in effective palliative care?

Answer 24

symptom control
psychological support
communication
information
practical support
end of life care
bereavement support

Question 25

List some signs of a struggling family (when a member has a serious illness)

Answer 25

frequent call outs to GP or district nurse
illness of carer
relationship breakdown within family
symptoms not responding to treatment
psychological distress in carers or patient
‘I can’t cope’