Psychological impact of illness Flashcards
immediate response to event, injury and implications
psychological shock
distress
anger
inappropriate calmness/denial
immediate management
physical treatment/analgesia
referral to ICU as appropriate
explanation of and reassurance about treatment
information to and support of relatives
advice about activities/retunr to work
information about sources of support
2 models: factors influencing responses
model os psychological response
self-regulatory model
model of psychological response basic
factors influencing response
recovery outcomes
self-regulatory model basic
interpreting the threat
coping with the threat
appraising the coping
model of psychological response, personal factors
injury and previous experiences
personality
demographics
model of psychological response, personal situational factors
social support, economic situation, employment
model of psychological response, healthcare related situational factors
healthcare related: medical provision, MDT support, rehabilitation environment, accessibility and availability of rehabilitation
model of psychological response, behavioural response
aggression, agitation
adherence to rehabilitation: under adherence and over adherence
use of social support
malingering
model of psychological response, emotional response
numbness
anger
shock
depression
what are negative emotions linked to
increased report of symptoms, pain and distress
stage 1 of self regulatory model
interpretation
stages of interpretation phase
perception of injury
cognitive representations
emotional response
perception of injury
social messages
attention
individual differences
emotions
cognitive representations
identity, what is it
cause, what caused it
control, what can be done
time line, how long will it last
consequences, how will it affect me
emotional response
denial
anger
depression
stage 2 of the self regulatory model
coping
coping
approach style- learning about injury, attending rehabilitation
avoidant style- denial, wishful thinking, alcohol abuse
stage 3 of the self regulatory model
appraisal
appraisal
individual appraises sources of coping strategies
appraisal impacts on interpretation of threat and coping behaviour
individual regulates their own behaviour
long term impact of injury
pathological longer term effects such as psychological
-acute stress disorder and post traumatic stress disorder
acute stress disorder
symptoms immediately after a traumatic stressor
possible disorientation,, narrowing of attention with inability to process external stimuli
may be followed by period of diminished responsiveness or psychomotor agitation and overactivity
may have amnesia for the episode
symptoms decrease after 24-48 hours
diagnosis of acute stress disorder
should only be diagnosed if symptoms persist longer than 3 days
post-traumatic stress disorder
exposure to an intense and frightening emotional experience leading to lasting changes in behaviour, mood and cognition
predisposing factors such as personality, previously unresolved traumas or a history of psychiatric illness may prolong the course
PTSD effect on memory
characterised by intrusive, distressing memories of the traumatic event
often associated with marked impairments in learning and memory for new material
PTSD prevalence
6.8% lifetime
precipitating traumas for men and women for PTSD
combat for men
rape and sexual assault for women
predictive variables for PTSD
trauma severity
dissociation during the trauma
perceived threat and premorbid vulnerability factors
symptoms of PTSD
repetitive re-experiencing of traumatic event
avoidance of stimuli associated with the stressor, amnesia for aspects of the trauma as well as emotional numbness and social withdrawal
increased arousal
psychological long term impacts of injury
depression
phobic anxiety
chronic pain/ disability
unexplained symptoms
social long term impacts of injury
family
relationship problems
depression among family members
inability to return to work/ normal activities
psychological management of longer-term effects
CBT
EMDR
exposure based treatments
victim support group
CBT
cognitive behavioural therapy
EMDR
eye movement desensitisation and reprocessing
imaginal exposure whilst therapy waves finger across visual field and patient tracking finger
it is controversial
exposure based treatment
systematic desensitisation
or real life graded exposure