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MBBS - Year 1 > Psychology - Chronic Diseases > Flashcards

Psychology - Chronic Diseases Flashcards

1
Q

Different ways we think of health

A 
Not having symptoms 
Having physical or social reserves 
Having healthy lifestyles 
Being physically fit 
Psychological well-being 
Being able to function
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2
Q

Health behaviours

A

Behaviours that affect our health positively or negatively (behavioural pathogens vs. behavioural immunogens)

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3
Q

Diff approaches to med

A

Biomedical

Biopsychosocial

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4
Q

Biomedical approach

A

Assumes all disease can be explained using physiological processes and treatment is for the disease, not the person.

Separates body and mind and makes doctors fully responsible for health

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5
Q

Limitations of biomedical approach

A

Reductionist to reduce disease down to biomedical science
If physiological factors have no influence, how can we explain the placebo effect?
Ignores influence of social factors

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6
Q

Biopsychosocial approach

A

More holistic and makes the link between psychological, social factors and health more explicit
Illness is a result of several factors
Responsibility is on individual and society

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7
Q

Health behaviours vs illness behaviours

A

Health behaviours are usually preventative/proactive and aim to maintain health and illness behaviours are usually reactive and are in response to an illness

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8
Q

Theory of planned Behaviour

A

Describes the key factors that explain behaviour and predict behaviour change
Pt’s attitude, norms, perceived control or intention

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9
Q

Health belief Model

A 
Behaviour is a result of a set of core beliefs:
Susceptibility
Severity 
Cost 
Benefits 
Cues to action 
Health motivation 
Perceived control
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10
Q

Transthereotical/ stages of change model

A

Focuses on the process of behaviour change (rather than factors predicting it)
Steps don’t have to happen in order as behaviour is dynamic

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11
Q

Steps in transtheoretical model

A 
Pre-contemplation 
Contemplation 
Prepration
Action 
Maintenance
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12
Q

Pre-contemplation - stages of change model

A

Does not perceive they have a problem, has no intention of changing

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13
Q

Contemplation - stages of change model

A

Aware they have a problem, know they should make a change, not fully committed to idea (sitting on the fence).

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14
Q

Preparation - stages of change model

A

Intending to take action, may have begun to act

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15
Q

Action - stages of change model

A

Change has happened (over months) change occurs in behaviour, environment or experience

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16
Q

Maintenance - stages of change model

A

Working to prevent relapse, in maintenance stage if they remain free of problem for 6mths +

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17
Q

What else needs to be considered in addition to the stages of change model

A

Decisional balance
Self-efficacy
Processes of change

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18
Q

COM-B model

A

Any given health behaviour occurs as an interaction between 3 components

Can be used to understand why a person is carrying out a health risk behaviour but also to consider how we might intervene/ design interventions if we’re encouraging a health protective behaviour

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19
Q

COM - B model - capability

A

Psychological or physical ability to carry out the behaviour

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20
Q

COM - B model - motivation

A

Reflective or automatic mechanisms that activate or inhibit behaviour

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21
Q

COM - B model - opportunity

A

Physical or social environment that enables behaviour

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22
Q

How do we use psychological models in clinical practice

A

Explain and predict health related behaviours, and influence behaviour change

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23
Q

How do we apply psychological models

A

By asking questions in a consultation in order to try to identify elements from the specific models we have looked at

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24
Q

Classification of pain

A

Nociceptive

Neuropathic

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25
Nociceptive pain
Pain arising from activation of nociceptors following tissue injury – A-delta and C-fibre terminals
26
Characteristics of nociceptive pain
Proportionate to injury | Enables healing w/ resolution of pain Physiological
27
Neuropathic pain
Pain arising from disease or damage to nervous system Innate immune cells secrete chemical mediators that reduce the inhibitory effect of GABA. Causes pain signals to fire without a stimulus
28
Characteristics of neuropathic pain
Frequently lost lasting Not proportional to tissue injury Pathological
29
Why are cognitions important
Decided about how we think of our pain
30
Types of cognitions
Unhelpful Catastrophizing Rumination Expectations
31
Unhelpful cognition
Anxiety provoking Over generalization, using words like ‘always’ or ‘never’ Jumping to conclusions (usually -ve) ‘Should’ thinking – ‘I should be able to do x and I can’t’
32
Catatrophizing cognitions
Extreme assumptions/ amplifying the -ve aspects Magnification Helplessness
33
Association with pain that is perceived as an externally located, difficult to control and fixed
Passive coping strategies and predicts psychological distress
34
Pt's w/ strong efficacy beliefs beliefs about pain
Pain is malleable | Associated with active coping mechanisms and lower levels of pain and distress
35
Associations w/ individuals who catastrophises pain
Increased pain and psychological dysfunction
36
What happens if a patient believes chronic pain is due to harm and damage
Avoid things that are painful --> reduction in physical mobility --> secondary problems incl postural changes, stiffness in joints. These patients are usually less compliant --> anxiety and -ve behavioural changes
37
Non-pharmalogical intervention of pain
``` Hypnosis Biofeedback PT Exercise Accupuncture ```
38
Pain Management Programmes (PMP)
Use combination of CBT, ACT and duration along with exercise to enable people to cope or manage pain better
39
Aims of PMP
Education about pain Techniques to address anxiety and depression to promote coping Effective medication use
40
Types of placebo
Pure placebo Impure placebo Placebo procedure
41
Pure placebo
Thought to contain no active ingredient, for example, a sugar pill
42
Impure placebo
Contains an active ingredient, but one that is not known to have any effect on the condition being treated, e.g. a vitamin C tablet being given for headache
43
Placebo procedure
A procedure, for instance, taking blood pressure, which is not known to produce any clinical change
44
What do placebos work through
Sociomatics
45
Contributory mechanisms of sociomatics
Social influence Role expectation Classical and operant conditioning Cognitive influence
46
When do we experience stress
When the demands of a situation exceed our resources to cope with it The greater the discrepancy between demands and resources, the greater the experience of stress
47
Ways in which stress can manifest
``` Anxiety Sleeplessness Crying Appetite problems Lower libido Isolation Decreased confidence ```
48
Stressors can be
``` Internal External Acute Chronic Major life events ```
49
Internal stressors
How we appraise (make sense of) a situation
50
External stressors
Events out of our control
51
Acute stressors
Sudden illness, exams, work demands
52
Chronic stressors
Long illness, relationships, work
53
Physiological responses in chronic stress
Responses remain active for longer and lead to the wear and tear of our body Can affect physical and mental health, contribute to the onset of illness, or delay recovery and response to treatment
54
Health problems linked w/ stress
High bp/ coronary heart disease Headaches/ migraines Muscular pain/ myopathy (adrenaline increases skeletal muscle tension) Digestion: ulcers, IBS (acids remain in GI system) Diabetes (production of increased glucose levels) Suppression of the immune system; infections Anxiety, depression (as a result of stress)
55
Diathesis-stress model
Views illness as the result of an interaction between pre-existing vulnerability (diathesis), and the external stress caused by life
56
What can the diathesis-stress model explain
Why some people are very resilient and are able to adapt while others develop illness or delayed recovery times.
57
Psychological approaches to stress management
Cognitive behavioural approaches | Mindfulness-based approaches
58
Allostatic load
Effects of long-term activation of the physiological stress response ACTH Adrenaline Norepinephrine and cortisol
59
ACTH in allostatic load
Pushes the brain to function mainly in the limbic region (cerebral cortex loses 2/3 of its functioning) Tunnel vision, reduction in rational thinking, forced down a fight or flight mindset
60
What does adrenaline cause in allostatic load
Increased skeletal muscle tension --> msk pain, stiffness, discomfort due to build up on lactic acid and ammonia Immunosuppressive action during periods of heightened psychophysiological arousal ---> repeated illness (cortisol and corticosterone)
61
Norepinephrine and cortisol in allostatic load
Slows and suppresses the digestive process, resulting in acids not being removed from the GI system Increases alertness, puts you on edge, can cause a state which presents like anxiety
62
Peripheral sensitisation
Prolonged exposure to the stimuli enhances the responsiveness of the nociceptors The activation threshold of nociceptors decreases, so pain signals are sent from less stimulation than is normally required
63
Central sensitisation
The increased signals coming from the nociceptors cause the dorsal horn neurons to increase in excitability
64
What does prolonged exposure to noxious agents cause
Somatosensory nervous system to become hypersensitive
65
Features of hypersensitivity
Increased pain signals, from stimuli that is not normally processed as being painful Exaggerated response to painful stimuli
66
Risk factors for chronic pain
``` Ageing Suffering from an injury Having surgery Being female Being overweight/obese ```
67
Social factors affecting health seeking behaviour
``` Income - prescription costs Education Access - geography Support from family Cultural Employment status ```
68
Psychological factors influencing health seeking behaviour
Fear of outcome Fear of inaction Memory Past experiences of medical intervention
69
Rights of the sick role
Not responsible for being ‘in the sick role’ | Exempt from carrying out some/ all of normal functions
70
Responsibilities of the sick role
Must try to get well and make the side role temporary | Mist achieve this by following medical treatment

MBBS - Year 1 (93 decks)

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