Psychology - Chronic Illness Flashcards
Define chronic illness
- Lasts more than 3 MONTHS
- Progresses SLOW
- May include REMISSION and RELAPSE
- NO CURE
Initial reactions to diagnosis
-SHOCK: emotional distress, bewildered, feeling detached, disorganised thinking
- EMOTION focussed strategies: grief, fear, helplessness, overwhelmed, anxiety, depression
- Retreat and DENIAL: denying and avoiding to control emotional responses
Anxiety and Depression in the context of illness
Anxiety: Response to threat, exacerbated by feeling out of control, unpredictability.
Depression: 2-3 x more common in Chronic Disease. Difficult to diagnose due to similarities between symptoms.
Impacts, compliance, increased risk of dying, reduced recovery.
Crisis Theory and factors influencing adjustment
Diagnosis of Chronic illness seen as a LIFE CRISIS - the COPING process restores EQUILIBRIUM
ILLNESS factors: level of disability, embarrassment, pain, threat to life, lifestyle changes
PERSONAL factors: Age, stage of life, gender, socio-economic status, personal beliefs, previous illness experience, personality factors (high neuroticism, low conscientiousness = greater health risk.
PHYSICAL, SOCIAL AND ENVIROMENTAL : social support, hospital, home, loneliness, social environment
Coping strategies in chronic illness
Cognitive appraisal: examines the MEANING of the illness in their life (threat or challenge)
Adaptive tasks related to illness/treatment - coping with physical changes, self care routines, developing relationships with staff
Adaptive tasks related to general psychosocial functioning - preserve relationship and social network, preparing for an uncertain future, maintain sense of competence and self image.
Denial, avoiding, blaming, guilt and shame
Acceptance, adherence to treatment, self management and goal setting
Adherence behaviours
Unintentional non adherence - want to adhere but practical barriers such as capacity, resources, or unclear directions
Intentional non adherence - deliberate, due to perceptual barrier such as motivational beliefs and preferences e.g. do not trust medicine
Psychological interventions to support adjustment and coping
EDUCATIONAL, SOCIAL and BEHAVIOURAL approaches - reminders/alerts, support groups
RELAXATION measures - manage stress and anxiety
COGNITIVE methods, e.g. CBT to change maladaptive beliefs
INSIGHT and FAMILY THERAPY therapy
Define habits
Triggered in RESPONSE to contextual CUES such as washing hands after toilet
Habit loop
CUES - internal or external TRIGGERS (place, person, time)
ROUTINE - behaviour to REINFORCE or change
Reward - makes the routine worthwhile, positively reinforces the habit
Habit formation
Initiation phase- define new behaviour and plan
Learning - behaviour repeated to strengthen context
Stability - habit has strengthened and we miss it when its not performed