Psychological Factors and Asthma Control

Question 1

What policy should we be aware off reagrding the psycholoigcal factors in the control of asthma?

Answer 1

• asthma and one or more psychosocial factors = risk of death
• difficult asthma is commonly assoictaed with coexistent psycholoigcal morbidity
• assessment of psychosocial morbidity should be perfirmed as part of a difficult asthma assessment

Question 2

Why are psychological factors important?

Answer 2

• impact of disease process - difficulties with adherence to treatmenr or taking in information
• respiratory illness has singificant psychological impact
• reduced QOL compared to healthy controls
• Psycholoigcal therapy can help us understand health behaviours

Question 3

What does evidence show the causes of psychological factors of asthma to to be assoicated with?

Answer 3

• asthma rekated deaths
• near fatal asthma
• brittle asthma
• non-compliance
• A&E visits
• depression, anxiety, panic and denial

Question 4

What are the main emotions assoicated with asthma?

Answer 4

• Depression
• Panic
• Denial
• Congitive factors
  
  • reduced confidence
  • beleifs around vulnerability

Question 5

Is there a high prevalence of anxiety in asthma ?

Answer 5

YES

• up to 33% of children/adolescents
• 6.5-24% of adults

Question 6

What are the main experiences felt when the SNS is stimulated?

Answer 6

• thoughts racing
• changes to vision
• heart beats faster
• breathing becomes quicker and shallower
• adrenal glands release adrenaline
• bladder urgenecy
• palms become sweaty
• hands get cold
• muscles tense

The body can distibguish between actual danger and the thought of danger

Question 7

What are the main symptoms of anxiety?

Answer 7

• Psychological cues
  
  • thoughts that something bad is going to happen
  • fear of losing control
  • sense of dead, impending doom
  • loss of confidence
• Behavioural cues
  
  • fidgeting
  • hesitating
  • avoidance
  • shaking
• Cognitive cues
  
  • difficulties concentrating
  • memory problems

Question 8

What is breathlessness a symptoms of?

Answer 8

respiratory disease and panic attacks

Question 9

What is denial used as ?

Answer 9

A coping strategy

not good in the long term

Question 10

What is impairment?

Answer 10

any loss or abnormality of psychological, ohysiological or anatomical structure or function

Question 11

What is a disability?

Answer 11

any restirction or lack of ability to perform an activity (resulting from impairment) relative to priort status

Question 12

What does internal focus refer to?

Answer 12

about the individual

Question 13

Draw a diagram indicating the holistic view of QOL

Answer 13

Question 14

What is disability an umbrella term for?

Answer 14

impairments, activity limitations and participation restrictions, referring to the negative aspects of the interaction between an individual and that individuals contextual factors

Question 15

What is the problem with the biomedical model of illness?

Answer 15

assumes there is a direct correlation between illness and the symptoms someone is experiencing

Question 16

Draw the biopsychosocial model of illness

Answer 16

Question 17

What does the common sense model of illness look at?

Answer 17

• looks at how a person makes sense of their condition
• illness represenations and how these go on to affect mood, motivation and behaviour

Question 18

What are the 5 main aspects of the common sense model of illness?

Answer 18

1. Identity: name, signs and symptoms
2. Cause: internal or external
3. Consequences: physical, social, economic, emotional
4. Time-line: acute, recurrent, chronic
5. Cure / Control

Question 19

Draw the common sense model of illness

Answer 19

Question 20

What are the benefits of finding causal attributions in ashtma?

Answer 20

• Knowing the cause of an illness or other traumatic incident can helps make the experience less anxiety provoking and the future more predictable.
• The process of finding a cause(s) for an asthma attack helps patients to make sense of their illness experience to guide their future actions to cope with the condition – their self-management.

Question 21

Summary of the affect of the psycological factors that impact asthma control

Answer 21

» Models of health behaviour can help us understand the relationship between psychological distress and impact on asthma and quality of life

» Psychological factors such as depression, anxiety, fear and panic can lead to worsening of asthma symptoms and sub-optimal self- management

» Self-management of asthma prevents exacerbations, improves care and is a cost effective investment for healthcare services