Session 8: Chronic and life-threatening health problems Flashcards
List 7 initial reactions to a chronic illness.
- Shock
- Behave in an automatic fashion
- Ask questions w/o immediate answers
- Daily activities and roles are disrupted
- Permanent behavioural & emotional adjustments must be made
- Changes their view of themselves
- Requires major coping efforts
What is the crisis theory?
Describes factors that influence people when they’re facing a crisis. The outcome of the crisis depends on the coping process.
Name the 3 contributing factors to the coping process.
- Illness-related factors
- Social and physical environmental factors
- Background and personal factors
Name the 3 processes of the coping process in sequential order.
- Cognitive appraisal (perceiving the meaning of the illness)
- Adaptive tasks
- Coping skills
What is the last step of the crisis theory.
Outcome of the crisis
Discuss illness-related factors and the 4 factors that influence it.
- Perceived threat
- some health problems present a greater threat
- increase in threat perceived is an increase in difficulty they’re likely to have coping - Disfigurement
- adjusting is hard, esp. if it’s the face
- individuals socially withdraw - Illnesses that draw attention
- difficulty coping w/ illnesses that have embarrassing bodily changes
- feel stigmatised and self-conscious - Treatement regimens
- painful treatment & serious side effects medication lead to additional health problems
- may have schedules that make it difficult to keep a job
Discuss background and personal factors and the 4 factors that influence it.
- Resilient personality
- hardy/resilient people cope better as they find purpose and see the good side in difficult situations - Beliefs about the causes, effects and treatment
- often wrong and make adjustment difficult
- people often blame themselves > depression - Timing of a health problem in a person’s life
- young children: focus on restrictions and possibly being separated from parents
- adolscents: need to be like affects coping
- adulthood:
* early: resentment about not getting married & entering a career
* middle: may have problem w/ not being able to finish tasks - Old age
- resentful about not enjoying the rewards of life long work
Discuss social and physical environmental factors and the 2 factors that influence it.
- Physical environmental factor
- hospital environment can be dull & depressing
- home environment: lack special tools that help achieve daily tasks
* these impair patient’s adjustment if they persist - Social environmental factor
- social support
- negative social network
What is cognitive appraisal?
The perceived meaning of the illness by the patient affects the coping process
What are the two adaptive tasks and what do each entail?
- Tasks related to the illness or treatment involve:
* coping w/ symptoms or disability
* adjustment to hospital environment
* develop and maintain good relationships w/ their practitioners - Tasks related to general psychosocial functioning
* control - feelings
* maintain a satisfactory self-image
* preserve good relationships w/ f&f
* prepare for uncertain future
Name 7 coping skills.
- Denying/minimalising seriousness of the situation
- Seeking information
- Learning to provide for one’s own medical care
- Setting concrete, limited goals
- Recruiting instrumental and emotional support
- Considering possible events & stressful circumstances
- Gaining a manageable perspective
Name the 6 adjustment problems in chronic illness.
- Vocational
- Emotional
* demoralisation syndrome: helplessness, hopelessness, fatigue and anhedonia in palliative care patients
* internalised rage: result is reactive depression - Social
- Self-concept
- Physical
- Compliance
List 7 psychosocial interventions for people w/ chronic conditions.
- Education about the illness
- Social support
- Behavioral methods
- Cognitive methods
- Relaxation and bio-feedback
- Self-management
- Interpersonal and family therapy
