Psychology Flashcards
What is chronic illness?
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
- Illness lasting >3 months with slow progression
- Periods of remission and relapse
- Huge impact on QOL
- Tx often dont cure just control
Initial reaction to diagnosis
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
- Shock: emotional distress, feeling stunned, bewildered, behaving in an automatic fashion, feeling detached, disorganised thinking
- Emotion focused strategies: fear, grief, helplessness, overwhelmed, anxious, depressed
- Denial and retreat: attempt to avoid emotional responses
Adjustment Variability: Around 30% of individuals may struggle to adjust to their chronic illness, while most will eventually adjust psychologically (de Ridder et al., 2008).
Note that anxiety and depression are both more common in those with a chronic illness, and that depression
increases the risk of dying and decreases recovery in terms of ability to carry out ADLs. It also reduces the
motivation one has to access care and adhere to treatments.
Crisis Theory
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
Chronic illness is a life crisis upsetting normal psychological and social equilibrium.
Adjustment
* Psychological adjustment is influenced by factors such as disability, pain, embarrassment, life-threatening symptoms, and lifestyle changes.
These can be cateogised as:
* Personal Factors
* Illness factors
* Physical, social and environmental factors
Appraisal
* Transactional model of stress and coping
* Perceived threat vs perceived resources
* Influenced by perception of condition
Adaptive Tasks
* Effective coping depends on appraisal of meaning and significance of illness
* Adapting= physical and routine changes etc
* General Psychological= maintain emotional balance and self-image.
Coping Skills
* Denying- prevents overwhelm
* Avoid - moves blame to self or others, guilt and info seeking
* Acceptance Tx adhereance, self management and goal setting
Pros and Cons of the Crisis Theory
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
PRO
* Provides a structured approach to understanding and addressing personal crises.
* Facilitates timely interventions, potentially preventing long-term psychological issues.
* Helps individuals develop coping mechanisms and resilience
CONS
* May be too broad, making it challenging to apply in specific situations.
* Risk of overlooking individual experiences by focusing on systemic factors.
* Potential difficulty in implementing interventions due to the complexity of external influences
Unintential non adherence
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
- Unintentional non-adherence is due to practical barriers and insufficient capacity/resources to adhere …
- Capacity and resources: poor instructions by HCPs or a poor understanding of how the treatment helps
- Practical barriers: depression and substance abuse means people often find routines hard to follow, anxious patients may forget things, poor literacy levels, disability may prevent people opening packets, etc …
Intentional non-adherence
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
- Intentional non-adherence is less common and is purely down to perceptual barriers …
- Perceived overprescribing: patients may feel symptoms occur as a side effect of the new drugs
- Motivational beliefs/preferences: may represent inaccurate opinions on the disease or complete denial that they even have it
The Necessity-Concerns Framework
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
- Reflects a balance between personal beliefs about:
- The necessity of taking treatment/medication
- The concerns about taking the treatment/medication
7 Adaptive tasks
Describe the psychological aspects of chronic disease including factors which influence the initial response, psychological adaptation and self-management (session)
- Tasks related to the illness or treatment
- Cope with physical changes (symptoms, disability)
- Adjust to the hospital environment, procedures, new self-care routines
- Develop & maintain good relationships with healthcare providers
- Tasks related to general psychosocial functioning
- Maintain an emotional balance: Control negative feelings & retain a positive outlook
- Maintain a satisfactory self-image and a sense of competence
- Preserve good relationships with social network
- Prepare for an uncertain future
Personality factors that affect Crisis response
How do children and their parent cope with serious disease?
Describe some of the ways in which children and their parents/carers cope with serious disease (PBL 1 + 2)
- Emotional Expression may be through art, play, talking
- Fears, sadness or confusion
- Children tend to be resillient but
- Need familiar routines including school to create normalacy
- Support from peers similar to them
- Distraction and entertainment
- Reassurance Spiritual and religious support
- Parent support groups
- Information seeking to make informed decisions
- Advocate for their child, empower the,
- Self care and stress management
- Therapy and practical adjustments
Attachment and how parents promote
Briefly describe the concept of attachment and explain what a parent does to promote secure attachment (session)
- Responding to Needs: Being consistently responsive to the child’s physical and emotional needs
- Providing Comfort: soothing them when they’re upset, builds trust and security.
- Being Available: Being emotionally and physically present allows the child to feel safe exploring their environment, knowing they can return to the caregiver for support.
- Positive Interaction: Engaging in positive, warm interactions, such as eye contact, affection, and verbal communication, fosters emotional connection.
- Consistency and Predictability: Maintaining consistent routines and behaviors helps the child develop a sense of stability and predictability.
- Encouraging Exploration: Allowing the child to explore independently while providing a safe base to return to promotes confidence and self-assurance.
Why do people smoke?
Describe the reasons why individuals may start smoking (PBL 1)
- Peer Pressure
- Stress and Coping
- Curiosity or Experimentation
- Social or Cultural Norms
- Advertising and Media Influence:
What is dependence?
Describe tobacco dependence and withdrawal and outline the evidence base for smoking cessation strategies (session)
At least two of the following over 12 months of smoking:
* Extended or higher level of use than intended
* Tolerance for nicotine
* Unsuccessful efforts to quit or reduce
* Inordinate amount of time acquiring or using
* Withdrawal syndrome/cravings
* Failure to attend to responsibilities
* Prioritising smoking over social, occupational or recreational activities
* Use despite knowing harmful physical/social effects
* Use despite awareness of own physical or psychological problems attributed to smoking
* Smoking in hazardous situations
What is Withdrawal?
Describe tobacco dependence and withdrawal and outline the evidence base for smoking cessation strategies (session)
- Transient or permanent physical and psychological changes following temporary or long-term smoking cessation - mostly during first 3-4 weeks of abstinence.
- After smoking a cigarette, nicotine levels are high but within an hour of smoking nicotine levels markedly
reduce and withdrawal will be experienced. - Thus, dependent smokers often experience multiple episodes of
withdrawal discomfort throughout the day. - The stress relieving effect of smoking is an illusion as the stress that is relieved is merely a withdrawal symptom
Reward reinforcement
Describe tobacco dependence and withdrawal and outline the evidence base for smoking cessation strategies (session)
What is the COM-B Model?
Understand how habits develop and their impact on health behaviour (session)
- The COM-B model describes 3 sets of factors contributing to one’s ability to change a target behaviour (e.g. taking a medication regularly) …
Capability - Psychological factors include comprehension of disease and treatment, and cognitive function (memory)
- Physical factors include dexterity to take medication
Opportunity - Physical factors include access to medicine and costs of the medicine
- Social factors include support networks and cultural beliefs
Motivation - Factors here are automatic or reflective, and include the perception of the illness, beliefs about the treatment and self-efficacy
What is the transtheoretical Model?
Understand how habits develop and their impact on health behaviour (session)
- Precontemplation: no awareness that the behaviour is an issue and no intention to change it
- Contemplation: realisation of the issue but no plans to change immediately
- Preparation: planning to make the change
- Action: making the change
- Maintenance: continuing the action in the long term
- Maintenance in the long term OR relapse
What is Habit Loop?
Understand how habits develop and their impact on health behaviour (session)
Cue/Trigger: This could be internal (emotions, thoughts) or external (places, people, time of day).
Routine: The behavior performed in response to the cue.
Reward: The positive reinforcement that makes the behavior feel worthwhile, helping to maintain the habit.
How do habits form?
Understand how habits develop and their impact on health behaviour (session)
- Initiation: define the new behaviour and context in which it will be practiced
- Learning: repetition of the behaviour in the context to strengthen the association
- Stability: the habit has formed and persists over time
What is motivational interviewing?
Describe ways in which unhealthy habits can be identified and replaced by more adaptive health behaviour (session)
How to break old habits?
Describe ways in which unhealthy habits can be identified and replaced by more adaptive health behaviour (session)
Old habits are hard to change as enjoyable behaviours stimulate dopamine release and a feeling of euphoria.
Repeating the behaviours reinforces this feeling and the habit.
Replacing the habit with a new one will not erase the original behaviour. Ways around this include …
Disrupting the old habit (not buying cigarettes)
Replacing unhealthy habits with healthy ones (eat an apple instead of smoking)
Increasing social support (buddying)
Counselling support (helping to understand the habit)
Problem solving BCT
Describe ways in which unhealthy habits can be identified and replaced by more adaptive health behaviour (session)
How to disrupt unhealthy habits.
- Identify Unhealthy Habits: Recognize patterns in behavior that negatively affect health (e.g., smoking, overeating, sedentary lifestyle) by examining triggers and rewards that maintain these behaviors.
- Set Small, Manageable Goals: Break down larger health behavior changes (e.g., exercising regularly, eating healthier) into smaller, achievable steps.
- Disrupt the Unwanted Habit: Replace the unhealthy behavior by introducing new, healthier behaviors that provide similar rewards, like exercising instead of smoking or choosing healthier foods.
- Action Planning and Goal Setting: Use SMART goals (Specific, Measurable, Achievable, Realistic, Timely) to structure behavior change efforts.
- Increase Motivation: Use motivational interviewing techniques (e.g., open questions, affirmation, reflection) to increase the individual’s commitment to change.
- Self-Monitoring: Track behaviors (e.g., using a fitness tracker or food journal) to raise awareness and reinforce positive changes.
- Focus on Long-Term Rewards: Emphasize the long-term health benefits, like improved quality of life, reduced risk of illness, and greater physical and mental well-being.
Emotional support for MS
Describe emotional and social support for patients with MS and their carers (PBL 2 + forum)
- Peer support groups – Offer shared experiences, reduce isolation, and build community for both patients and carers.
- Counselling and psychological therapies – Help manage depression, anxiety, and emotional adjustment to a long-term condition.
- Carer support services – Provide respite care, emotional support, and practical advice for managing caregiver stress.
- Occupational and social engagement programs – Encourage participation in hobbies, volunteering, or adapted work to maintain identity and purpose.
- Charities and advocacy organisations (e.g., MS Society) – Provide information, helplines, emotional support, and connections to local resources.
