Psychological effects of illness Flashcards
Define subjective disability
ill health with absence of objective disease
Define subjective well-being
feel good but have severe objective disease
What are PROMs?
patient-reported outcome measures
What are the key domains of impact of health?
perceived health (symptoms)
physical functioning
occupational/role functioning
social functioning
emotional functioning
cognitive functioning
Impacts of severe illness
disruption to daily living
treatment and hospitalisation
uncertainty and threat to future
lifestyle changes and forming/sustaining relationships
Impact on family of chronic illness in childhood
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
What is coping?
constantly changing cognitive and behavioural efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding resources
What are 2 types of coping
emotion-focussed coping
problem-focussed coping
Describe emotion-focussed coping
aimed at modifying response by regulating the emotional distress caused by the stressor or potential stressor
Describe problem-focussed coping
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
Name some specific coping strategies
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)
When is problem-focussed coping best?
in controllable situations
When is emotion-focussed coping best?
in situations with little/no control
Influences on coping
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)
How does serious illness affect family in the first few days?
shock
disbelief
denial
fear
anger
guilt
hopelessness
helplessness
depression
What are the stages of the Kubler-Ross grief cycle?
denial
anger
bargaining
depression
acceptance
What are some challenges faced in serious illness?
Physical (tiredness, aches, lack of sleep)
Psychological/emotional
Social (financial, status, relationships, time usage)
Spiritual
What roles do carers undertake?
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)
What might carers be concerned about?
ability to provide care
stress
uncertainty
fear
conflict
altered role and lifestyle
own physical health
finances
What problems might carers have?
extra demands on time/energy
changing roles/responsibilities
changing ability to work/professional responsibility
pressure to continue caring and have a life outside
Describe The Family System
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
Describe an Open Family System
communicate freely
flexible boundaries
rules are up to date and promote growth
Describe a Closed Family System
indirect/restricted communication
overly dependent on one another
inflexible rules
What is involved in effective palliative care?
symptom control
psychological support
communication
information
practical support
end of life care
bereavement support
List some signs of a struggling family (when a member has a serious illness)
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’
