Week 10-14 Flashcards
What are the Internal and External factors influencing effective communication?
Internal- sender and receiver
External- the context: physical and psychological environment
Describe: Rapport
the connection between person/s and the health professional.
- rapport develops trust
Define: SOLER
S- sit squarely O- open posture L- lean towards the client E- eye contact R- relax
Define: Effective communication
involves the sharing of information for one source to another
Define: Clinical pain
pain that requires some form of medical treatment
Define: Pain
pain therefore consists of sensory, emotional and cognitive experiences associated with actual or perceived tissue damage or irritation
Name the 7 types of Pain
Acute pain Acute recurrent pain Pre-chronic pain Chronic pain Hyperalgesia Congenital analgesia Pain without injury
Define: Acute pain
sharp stinging pain that is short lived and usually related to tissue damage
Define: Acute recurrent pain
episodes of discomfort interspersed with periods that are pain free
Define: Pre-chronic pain
acute pain that persists beyond the time of normal healing (3months)
Define: Chronic pain
may be continuous or intermittent, moderate or severe
Define: Hyperalgesia
a condition where a person becomes more sensitive to pain over time
Define: Congenital Analgesia
Inability to feel pain
Define: Pain without injury
discomfort that arises without obvious tissue damage
Nerve cell endings that initiate the sensation of pain are called?
Nociceptors
Name the components in the physiology of pain
- nociceptors
- Fast nerve A fibres
- Slow nerve C fibres
Explain: Physiology of Chronic pain
begins in the slow nerve fibres in the spinal cord, and projects onto the thalamus
Explain: Physiology of Acute pain
originates in the fast pain fibres, and projects to the somato sensory cortex
Which hemisphere is the Motor Cortex?
right hemisphere
Who developed the Gate Control Theory of Pain, and when?
Melzack and Wall
1965
(In Brief)
Describe: Gate Control Theory of Pain
in addition to the existence of a central control mechanism, there is also a descending neural pathways by which the brain shuts the gate blocking pain sigals.
- Anxiety and fear amplify pain
- Distraction dampens pain
(Pain)
Name the Psychosocial factors
Age
Gender
Culture
Explain the 2 ways of Measuring Pain
Pain Perception Threshold (IPPT)- is the point at which a stimulus is reported to be painful
Severe Pain Threshold (SPT)- is the point at which pain becomes unbearable
Name the treatments for Pain
- Pharmacological treatments (analgesics)
- Opiod analgesics
- non-opiod analgesics
- Surgery
- Counterirritation
- CBT
- Exercise
- Imagery
- EMDR
- Magnetic treatments
- Rest
- Meditation and Yoga
When was Palliative Care formalised as a standalone speciality in Australia?
1999
(Death and Dying)
What 5 aspects does Kubler-Ross’s Theory involve?
Denial Anger Bargaining Depression Acceptance
Name the 3 phases in the Grief Process
Avoidance
Confrontation
Restoration
Name 3 ways to hasten death
Euthanasia
Physician assisted suicide
Terminal sedation
Define: Health Behaviour
behaviours engaged in by currently health individuals to prevent illness and disease development
Define: Illness Behaviour
behaviours engaged in by currently ill individuals to identify their illness and assess strategies to alleviate the illness
Name the 2 other components of Illness Behaviour
- defines symptoms as an illness state
- serves a problem-solving function
Define: Sick Role
sick role behaviour refers to people’s responses to being diagnosed with a particular disease or health condition
What are the Rights of the Sick Role?
- Exemption from participation in social duties such as work
- Exemption from attribution of responsibility for acquiring illness
What are the Responsibilities of the Sick Role?
- An obligation to try and get well
- To seek out and co-operate with competent medical help.
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Attentional Focus
is a person’s characteristic style of monitoring bodily symptoms , emotions and well being.
People with strong internal focus are more likely to detect symptoms, tend to have illnesses that are less severe and perceive recovery rates as slower than people with external focus
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Sensitisers or Monitors
are people who cope with health problems and with other aversive events by closely scanning their bodies and environment for information
- e.g. Wanting more health information. Not necessarily accurate in their monitoring
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Repressors or Blunters
are people who cope with health problems by ignoring or distancing themselves from the stressful information
- e.g. Avoiding a screen test.
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Outlook on life
People who have a positive outlook report fewer symptoms (Seligman )
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Schemas or illness representation
influence how people react to symptoms.
Illness Schemas- The label, perceived causes, timeline, consequences and controllability.
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Psychological factors
People who are anxious and those who score less on tests of emotional stability (previously known as neuroticism ) tend to report more physical symptoms (Hypochondriasis Scale on M.M.P.I)
Define: Co-morbidity
the simultaneous occurrence of two or more physical and/or psychological disorders or symptoms
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Mood States
can influence an individual’s perception of illness.
- Affect may operate by influencing the individual’s level of attention to the visceral cues and the release of pain related hormones.
- Anxiety and depression can also lead to excessive focus on bodily symptoms
Name the 10 Factors that impact on Recognition and Interpretation of Symptoms
- Attentional focus
- Sensitisers and monitors
- Repressors and blunters
- Outlook on life
- Schemas or illness representation
- Psychological factors
- Mood states
- Socio-cultural factors
- Socio-economic status
- Gender and age
(Factors that Impact on Recognition and Interpretation of Symptoms)
Explain: how Socio-cultural factors impact on recognition and interpretation of symptoms
Prior experience and expectations e.g. Based on family history and how people interpret symptoms.
- Experience of illness may either make us more attuned to symptoms for make us overlook symptoms
- In some cultures certain illnesses are considered the result of sin
- Tendency to exaggerate expected symptoms while ignoring unexpected symptoms.
- Past experience can lead to increased accuracy in identifying health problems but may also lead us to overlook or misinterpret symptoms
- Symptoms that are more obvious are more likely to be considered serious
(Factors that Impact on Recognition and Interpretation of Symptoms)
Explain: how Socio-economic status impact on recognition and interpretation of symptoms
People from higher socio economic status:
a. Report fewer symptoms and better health than do people from lower S.E.S
b. When they get sick are more likely to seek health care
c. Are less likely to see themselves as developing a serious illness
d. Lower representation amongst hospital patients.
Factors that Impact on Recognition and Interpretation of Symptoms-
Explain: Gender and Age
Women are more likely to:
a. Report symptoms and use health services
b. Be exposed to illness
c. Be more sensitive to their internal body symptoms
- Children and older people are more likely to use health services. Older people tend to attribute age for minor problems and illness for major health problems
Define: Help Seeking Behaviour
Seeking treatment when symptoms arise can mean the difference between dying and catching a disease when it is still treatable
Why is there a delay in seeking treatment? (for illness)
- Appraisal delay – symptoms are not yet noticed
- Illness delay – sickness seems unlikely because of
previous experience - Behavioural delay – professional help seems unnecessary
- Scheduling delay – individual procrastinates in making an appointment
- Treatment delay – perceived benefits do not outweigh perceived costs.
Define: Non-Adherence
Practice of individuals not to comply or follow with treatment advice, regimes or strategies
Non-Adherence causes what statistics?
- 10-20% of patients to require additional medication
- 5-10% to require further doctor visits and
- 5-10% to require further days off work, hospitalisation (64% of admissions with heart failure due to noncompliance)
What are the reasons for Non-Adherence?
- Forgetting
- Side effects
- Alternate therapies are considered better
- Feeling better or worse
- Education impacts on compliance e.g. Birth control in developing countries
- Lifestyle e.g. Medication non compliance with the mentally ill
What are additional factors impacting on Non-Adherence?
- Gender, ethnicity and income are poor predictors of compliance and adherence
- Adherence to treatment regimes for heart disease, hypertension and diabetes increase as people get older
- Having support of family and friends, being in a good mood and having optimistic outlook promote adherence
Name some factors impacting on Doctor Patient Communication
- Doctor’s level of job satisfaction and number of patients seen per week.
- Doctor’s communication style and skills
- Patient satisfaction with doctor important variables
- Problems include jargon, closed questions, hurried interview,
- Lack of comprehensive checks and no written instructions
- Patronising relationships often seen where active/passive roles are assumed.
Explain: Treatment Regime Variables
Keep regimes as simple as possible
Tailor treatment to fit patient lifestyle
Give simple easy to understand instructions
Involve family members, friends and others in patient’s treatment
What % of patients die in intensive care in Australia every year
14%
What elements constitute a Good Death
- good symptom control (physically, psycho-emotionally and existentially)
- time to prepare for death
- holistic care incorporating family
- restoration of relationships
- patient autonomy and maintaining dignity
- one that is right for the person
- important to live life
- leaving a legacy
What are the functions of Pain?
- It provides constant feedback about the body, enabling us to make adjustments to how we sit or sleep
- Pain is often a warning sign that something is wrong and results in protective behaviour
- Pain also triggers help-seeking behaviour
- Pain also has psychological consequences and can generate fear and anxiety.
- From an evolutionary perspective therefore, pain is a sign that action is needed
Physiology of pain
What do Free Nerve Endings do?
they are found throughout the body and respond to temperature, pressure and painful stimuli
Physiology of pain
Pain is routed to the CNS by…
Fast nerve A fibres OR Slow nerve C fibres
Physiology of pain
Define: Fast nerve A fibres
Large Myelinated nerve fibres that transmit fast stinging pain
Physiology of pain
Define: Slow nerve C fibres
Small Unmylineated nerve fibres that carry dull, aching pain.
- The basis of the slow pain system that serves all tissues except the brain. Usually activated by chemical changes that occur in damaged
body tissues.
In detail, Explain: Gate Control Theory of Pain
- Based on the notion that there is a neural gate in the substantia gelatinosa of the spinal cord where A and C fibres synapse that regulates the experience of pain
- Activation of the small C fibres tends to open the gates. When the gate is open, signals arriving at the spinal cord stimulate sensory neurons called transmission cells, which in turn relay the signals
upward to reach the brain and trigger pain - When the gate is closed signals are blocked from reaching the brain. Activation of the large A fibres tends to close the gate.
