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PSYC4200 Pre-Professional Psychological Interviewing and Assessment > Week 1 - Health > Flashcards

Week 1 - Health Flashcards

1
Q

Percent of people living with mental illness that have a coexisting, mortality-related physical illness

A

80%

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2
Q

Life expectancy of people living with mental illness compared to the general population

A

20 years earlier

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3
Q

Comorbidity is the __ not the __

A

Comorbidity is the expectation, not the exception

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4
Q

Why do people living with mental illness have reduced life expectancy compared to general population?

A

Largely due to high prevalence of comorbid physical health conditions, which in turn are largely due to modifiable risk factors e.g., smoking, alcohol, nutrition, physical activity etc.

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5
Q

Review - discrepancy in death rates between people that accessed mental health treatments vs. general public (seems to be growing)

A
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6
Q

Ratio that highlights enormity of issue of death rates (cause of death) of people that accessed mental health treatments

A

1:9 ratio: for every person living with mental illness who died early due to suicide, 9 people will die early from heart disease, respiratory disease or cancer.

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7
Q

Population that is at 50% increased risk of heart condition or stroke

A

women + anxiety
note - over 15 years 1 in 3 women will develop this condition

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8
Q

Population that has a 400% increased risk of a gut or liver disorder

A

Men + substance abuse

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8
Q

Statistic of psychological distress in men with coexisting mental and physical health condition compared to those with solely a mental health condition

A

Psyc distress in men with comorbidity is twice that of those with just a mental health condition

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9
Q

Statistic for Aboriginal and Torres Strait Islander people to have both a mental health and one or more other long-term health conditions

A

1 in 4

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10
Q

3 reasons (other than mortality) why need to be thinking about physical health as well

A
  1. Poorer treatment outcomes (both physical and mental)
  2. More severe illness course
  3. Poorer quality of life
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11
Q

Co-occurring substance misuse and schizophrenia leading to increased psychotic symptoms and poorer treatment compliance is an example of

A

Poorer treatment outcomes

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12
Q

Higher burden of physical illness is associated with a more severe illness course in Bipolar is an example of

A

More severe illness course

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13
Q

Anxiety disorders and physical conditions including cardiac, respiratory diseases, diabetes are associated with

A

Poorer quality of life

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14
Q

People living with mental health conditions see physical health as

A

connected to their wellbeing
The presence of serious physical illness adversely affects quality of life and may impede recovery from mental illness

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15
Q

What is an important part of treating mental illness?

A

Effectively managing physical illness
Physical health includes body mobility and functioning, engaging in practical everyday activities, participating socially and living a contributing life

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16
Q

What is considered best practice for psychologists

A

In stages of getting physical health (screening, 5 A’s etc.) on agenda for mental health settings and professionals.

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17
Q

Review slide

A
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18
Q

Major barrier to getting physical health care for people with mental health conditions

A

Being dismissed or fear of being dismissed
culture change is needed - mental health diagnoses often overshadow physical health conditions. Symptoms are overlooked as being psychological

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19
Q

4 reasons why psychologists may not routinely screen

A
  1. Focusing on the issues the clients identify
  2. Outside the scope (think it’s something for a specialist to deal with)
  3. Stigma (i.e., substance abuse - fear of offending)
  4. Complicating the treatment plan
    Also lack of awareness for services that we could refer people to
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20
Q

Purpose and benefits of routine screening

A
  1. Nobody is missed - research has shown that relying on clinical judgement alone to identify isn’t very effective
  2. Inform clinical decisions - provide basic education/behaviour change treatment vs referral to specialists, understand interconnected factors within a presenting issue
  3. Prevent development of chronic disease, reduce harms at an individual and population level
  4. Predicting outcomes, testing theory, designing interventions
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21
Q

Greatest current barrier to increasing life expectancy of people with serious mental illness

A

Is an implementation gap

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22
Q

Why psychologists should be routinely screening for physical health conditions?

A

If you don’t know, you can’t help - psychological scientists:
- Have a unique set of skills including assessment and diagnostic skills (helps to facilitate multidisciplinary support - might just be a referral to specialist)
- Behaviour change knowledge
- Support clients to access healthcare

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23
Q

4 reasons why people who experience mental ill health are more likely to develop a physical illness

A
  1. Medication side-effects
  2. Lifestyle (but is influenced by the below)
  3. Socioeconomic
  4. System level - social stigma, lack of health service integration, lack of clarity who is responsible
24
Q

True/false - there is a standardised approach to health assessment

A

False

25
Q

What is the assessment approach to health assessment?

A

Combination of informal and standardised screening and measurements
Informal: Semi-structured interview - provides non-judgemental, empathetic, private and confidential environment e.g., can you tell me about your alcohol/drug use in the past month?

26
Q

What is part of initial assessment?

A

Health risk screening

27
Q

Framework that APS suggested to be part of routine screening

A

5 A’s:
- Ask
- Assess
- Advise/agree
- Assist
- Arrange

28
Q

Which aspect of 5 A’s involves:
- Identifying patients with risk factors

A

Ask

29
Q

Which aspect of 5 A’s involves:
- Level of risk factor and it’s relevance to the individual in terms of health
- Readiness to change
- Health literacy

A

Assess

30
Q

Which aspect of 5 A’s involves:
- Provide written information
- Brief advice and motivational interviewing
- negotiate goals and targets (incl. a lifestyle prescription)

A

Advise/agree

31
Q

Which aspect of 5 A’s involves:
- Develop a risk factor management plan that may include lifestyle education tailored to the individual (e.g., based on severity of risk factors, comorbidities) and pharmacotherapies
- Support for self-monitoring

A

Assist

32
Q

Which aspect of 5 A’s involves:
- Referral to allied health services or community programs
- Phone information/counselling services
- Follow-up, prevention and management of relapse

A

Arrange

33
Q

Review slide - rate of daily smoking much higher for people with mentally ill health than general population (so will be something common in your clients)

A
34
Q

Regarding smoking, at a minimum you should

A

3 of 5 A’s:
- Ask all clients “Do you smoke (tobacco or anything else)?”
- Advise - seek permission to give advice about smoking and how it might be interacting with the present condition “Stopping smoking improves mental health and wellbeing”
- Assist - make an enthusiastic offer of help and provide self-help material, advice regarding pharmacotherapy and offer referral to Quitline or a stop smoking specialist

35
Q

Most widely used standardised screening measure for nicotine dependence

A

Fagerstrom Test for Nicotine dependence

36
Q

Australian alcohol guidelines are in place to reduce health risks from drinking alcohol. What are the guidelines?

A

Healthy adults drink no more than 10 standard drinks a week and no more than 4 standard drinks on any one day to reduce the risk of harm. The less you drink the lower your risk of harm

37
Q

Three screening tools for AOD with sound reliability and validity developed by the World Health Organisation

A
  1. The Alcohol Use Disorders Identification Test (Audit)
  2. The Drug use disorders identification test (Dudit)
  3. The Alcohol, smoking and substance involvement screening test (Assist)
38
Q

Screening tool used to identify people with harmful patterns of alcohol use

A

Audit

39
Q

Screening tool used to assess the severity of illicit drug use

A

Dudit

40
Q

Clinician administered screening test that includes questions about range and frequency of substance use, impact and severity

A

Assist

41
Q

Type of assessment that usually correlates well with self-report in the assessment of AOD

A

Biochemical assessment e.g., saliva, smokealysers, urine etc.

42
Q

Validated measures of nutrition are generally complex and time consuming. Historically how has nutrition been measured?

A

Food diaries - self-reported intake over 7 days

43
Q

Weaknesses of nutrition measures such as food diaries

A
  • High burden on participant
  • Accuracy declines with increasing days (biomarkers)
  • completion can change consumption
44
Q

Another type of nutrition measure (not food diaries)

A

Food frequency questionnaire - estimates of dietary intake over a given time period

45
Q

Example of food frequency questionnaire

A

Healthy eating quiz
Based on Australian recommended food score, which was a dietary assessment - good psychometric properties, well validated

46
Q

Clinical tools for measuring nutrition

A

My day on a plate etc. (Orygen provides these resources for clinicians in their toolkit)

47
Q

Physical activity levels of people with mental illnesses compared to total population

A

Much lower than general public - 1/3 of people accessing mental health services report doing no physical activity at all

48
Q

Australia’s physical activity and sedentary behaviour guidelines - can use these to go off when asking people about physical activity review slide

A
49
Q

Physical activity screening tool that is most commonly used and geared towards general public

A

IPAQ-SF: International Physical Activity Questionnaire

50
Q

Physical activity screening tool that is more geared towards mental health

A

SIMPAQ: Simple Physical Activity Questionnaire

51
Q

What are the considerations when assessing health factors
PAABPAC - People Are Annoying But People Also Care

A

Purpose - population or individual level intervention
Administration - face to face, online, phone, pencil and paper
Accuracy - prevalence only, effect size related to an intervention effect
Budget - cost of an objective measurement, cost of using tool
Participant burden - length of time, personal intrusion, privacy, shame
Assessor skills - generic or specialist
Cultural relevance, specific population

52
Q

Role of psychological assessment in illness
IPSCHA

A

Illness specific - asthma, cancer, non-chronic illness
Population specific - children, adolescents, younger adults, older adults
Stage specific - early diagnosis, late effects
Concern specific - functional, quality of life, general health, anxiety and depression etc
Help people cope with diagnosis, treatment or symptoms
Address problems that accompany illness e.g., anger, frustration, grief, pain, anxiety, depression, and social and functional impairment

53
Q

A multifactorial unpleasant emotional experience of a psychological, social or spiritual nature and interferes with the ability to cope effectively with the disease, its symptoms and treatment.

Extends along a continuum, ranging from common normal feelings of vulnerability, sadness and fears to problems that can become disabling e.g., depression, anxiety, panic, social isolation, and existential and spiritual crisis

A

Distress

54
Q

Why are there best practice guidelines that anyone involved in care of patient with cancer should routinely screen for psychological distress

A

Around 40% (2 in 5 people) show significant level of psychological distress

55
Q

Without routinely screening for psychological distress in cancer patients, how many people are correctly identified

A

1 in 10 people

56
Q

Why does it matter that psychological distress in cancer patients is identified?

A

If left untreated, poorer outcomes.
Higher physical symptoms, poorer social functioning, cognition, treatment adherence and survival

57
Q

Review slide

A

Main components of distress screening - evidence for these recommendations in best practice guidelines is based on idea that screening is a necessary first step

58
Q

6th vital sign in people with cancer

A

Emotional/psychological distress

PSYC4200 Pre-Professional Psychological Interviewing and Assessment (3 decks)

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