Session 4 - Stress, coping, and pain Flashcards
What are the physiological responses triggered in stress?
Fight or flight response:
- Increased oxygen availability, breathing and increased haematocrit.
- Enhanced mental functioning
- Enhanced physical functioning
- Increased fuel availability.
Why is stress positive?
Good for acute stressors, exercise, dangerous situations
Why is stress negative
Frequent daily hassles results in chronic stress response,, which is damaging to the body
Define a stressor
Anything that causes stress to an organism
Give 2 tools to measure stress
1) The Holmes and Rahe stress scale
2) The Kanner Daily Hassles and Uplifts scale
Explain the transactional model of stress
situation is appraised, if no threat percieved stress does not occur.
If threat percieved, and subject can cope with threat then positive stress, if inability to cope negative stress PIC
Define a primary and secondary appraisal in the transactional model of stress
Primary appraisal – Is this event a treat? How bad could it be?
Secondary appraisal – Do I have the resources or skills to cope?
Define the two factors that influence the impact of stress
- Control of event – More control = less stress
- Social support – more support = less stress
How can stress negatively impact on health? Give 3 methods
- Negatively impacts cardiovascular system
- Chronic stress depresses immune function and inflammation (acute stress upregulates immune function)
- Stress can lead to unhealthy behaviours such as overeating or undereating, lack of exercise, smoking
- Leads to more rigid and extreme thinking, overgeneralisation, catastophising, and rumination
- Can teach a learned helplessness leading to anxiety and depression
Give 5 strategies to deal with stress
Cognitive strategies – e.g. cognitive restructuring, hypothesis testing
Behavioural strategies – skills training e.g. assertiveness, time management
Emotional strategies – counselling, emotional disclosure, social support
Physical strategies – Relaxation training, biofeedback, exercise
Non-cognitive strategies – drugs
How might a patient react to a chronic illness and its treatment?
- Diagnosis leads to fear, shock, anxiety, depression, denial etc.
- Physical impacts of illness e.g. pain, limited mobility
- Treatment may cause anxiety, discomfort, impact on body image etc.
- Hospitalisation causes loss of autonomy, privacy, possible removal from usual support network etc.
- Adjustments with illness
- Socioeconomic impact of illness
Define emotion focused coping and give 2 exampleas
EFC = Change the emotion
Behavioural approaches - e.g. alcohol, distractions
Cognitive approaches - e.g. denial, focus on +ve aspects of problem
Define problem focussed coping and give 2 examples
PFC = change the problem or your resources
1) Expend resources to deal with it
2) Reduce demands of stressful situation by learning how to cope
Describe 4 ways to aid patient’s in coping with problems
1) Increase social support
2) Increase personal control e.g. patient choices, pain management
3) Prepare patients for stressful events through effective communication
4) Stress management
Why are patients with chronic illnesses at increased risk of mental health problems?
Depression and anxiety due to threats to well being, feelings of helplessness, failure.
Give 3 barriers which may prevent identification of depression in patients
1) Stigma associated with mental health
2) Patient doesnt want to be additional burden to doctors
3) Depression may set in after patient goes home
Outline NICE guidelines in dealing with depression
- Recognition, assessment and management
- Mild to moderate depression – individual guided self help, structured group physical activity
- Moderate to severe depression – antidepressants and individual CBT (cognitive behavioural therapy)
Outline NICE guidelines in dealing with anxiety
Generalised anxiety disorder – individual self help, medication
If more severe – individual CBT,
What is the bio-medical model of pain? What is its limitation?
Physical damage = real pain
But some patients report pain when no damage present, phantom limb pain, and placebo effect
Distinguish between acute and chronic pain
Acute - Short term, attracts our attention
Chronic - Pain for >12 weeks, does not indicate tissue damage, rest not helpful
Outline the Gate theory of pain
Neural gates for pain messages are located in dorsal horn of spinal cord.
Extent to which the gate is open affects the number of pain messages that pass onto the brain
Give 3 examples of what opens this gate and what closes it
Opens - injury, stress, Negative emotions
Closes - medication, exercise, relaxation
What are the limitations of the gate theory?
- No physical structure identified
- Allows that physical and psychological processes interact but still sees them as separate
What are the aims of a pain management programme?
- Improve fitness, mobility and posture
- Develop ways to cope with stress and depression
- Improve communication skills about condition
What aspects make a Pain management programme effective?
- Being believed that the pain is real
- Being part of a group with shared experience of chronic pain
- Social comparison theory – people often judge others as worse off.
