Psychological frameworks for understanding illness related behaviour Flashcards
What are Illness related behaviour?
refers to the varying ways individuals respond to bodily indications, how they monitor internal states, define and interpret symptoms, make attributions, take remedial actions and utilize various sources of informal and formal care’.
Illness related behaviours are:
* Multifaceted
* Vary across and within conditions
What may Illness related behaviours include?
- Adherence to treatment (including when asymptomatic)
- Attendance for health care appointments
- Managing acute and chronic symptoms
- Navigating complex health care systems and professionals
- Sustaining function in the face of challenges
- Managing negative emotional responses
How are illness percieved by the patient?
Illness perceptions direct coping strategies which in turn impact on psychological response/adjustment to illness.
1. Identity
What is this? What symptoms are associated with this?
2. Cause
What made this happen?
3. Timeline
How long will this last? Is this something that comes and goes?
4. Consequences
What does this mean for me? And my family?
5. Cure and Control
What can I do?How well does the medicine work?
What is the patient responce to a health threat?
What happens after patients illness perceptions?
‘if then rules’
* IF my diabetes is caused by genetics, THEN there is no point in exercise.
* IF there are no treatments for cancer, THEN there is no point in seeing the Doctor.
* IF I know I have a chronic condition, THEN I will take my medicines even when asymptomatic
What is the impact of Distress in long term conditions?
- Depression = 2-3 more common in patients with LTCs compared with those without
- Depression (loss; actual and anticipated)
- Having a long-term condition associated with increased risk of suicide
- Anxiety
Is it a mental health problem?
Distress vs depression
How does distress impact health?
Dual Pathway Model: Two broad ways in which psychological processes may influence physical health
How can stress impact heart disease?
Factors influencing patients’ response to illness?
- Personality
- Information-seeking styles
Monitors – information seekers
Blunters – information avoiders - Negative affect/disposition - pessimistic style –feelings of helplessness
- Optimism good things will happen - associated with active coping.
- Age (different perceptions in children)
- Past experience
- Psychological state at time of onset
- Perceptions of illness are important but are certain condition characteristics that are challenging.
lifestyle change required/treatment regime
Life-threatening
Uncertainty of outcome
Requiring aggressive treatment (e.g., surgery)
Disfiguring - appearance issues can be particularly challenging and can lead to shame and social isolation.
Place limits on mobility etc.
What affects recovery post and Survival?
Attendance at cardiac rehab related to stronger belief that condition could be cured or controlled.
Treatment control perceptions significant association with mortality
Patients’ beliefs about their illness before surgery strongly influence recovery from cardiac surgery.
What is the role of family/care givers for patients with chronic condition?
- Successful recovery & adaptation to living with a chronic condition may depend as much on support from a patient’s partner as on patient’s own coping resources
- Studies show that how the relative views the condition, treatment and lifestyle advice impacts on patient recovery from MI
- Lifestyle change for patient often involves family members.
Why is coping needed?
Tasks or demands requiring coping
Illness related demands
* Self-management/treatment adherence
* pain, incapacity , symptoms
* dealing with a range of health care staff
* navigating hospital/health care environment
Emotional/social demands
* preserving emotional balance
* self-image and sense of mastery & control
* sustaining existing relationships
* preparing for uncertain future
What is Coping and What are the different types of coping?
Coping - General term to describe the different cognitive & behavioural efforts used by patients to deal with demands of illness.
PROBLEM-FOCUSED - dealing directly with demands by active involvement (e.g. by learning new skills; seeking info. etc.)
EMOTION-FOCUSED - dealing with anxiety, uncertainty & other negative emotions ( e.g. by distraction, avoidance, emotional expression etc. )
Re-frame illness in a positive light
Utilise social support
