Week 8

Question 1

Clinical model for classifying psychosocial interventions in chronic disease (Maes)

Answer 1

There are 3 different levels of classification in interventions:
1. Aim: what is the intervention directed at? This can be directed at the quality of life of at self-management.
2. Level: at what level do you intervene? This can be at the individual, group of environmental level.
3. Channel: direct vs. indirect intervention.

Question 2

Quality of life interventions (QOL- interventions)
(part of AIM)

Answer 2

Aimed at restoring or improving the quality of life of the patient and the patients environment. Helps the patient adapt better to the disease and accept the disease. Has a focus on stress, pain, psychical and social limitations.

Question 3

Physical training programs (QOL- intervention)

Answer 3

Usually part of larger multicomponent rehabilitation programs. Has beneficial effects on morbidity, mortality, quality of life, anxiety and depression. This lasts as long at the patient really engages in physical activity.

Question 4

Stress mangement programs (QOL-intervention)

Answer 4

Has positive effect on quality of life, disease progression and mortality. Intervention techniques include cognitive restructuring, relaxation, meditation, time management and skills training.

Question 5

Social support interventions (QOL-intervention)

Answer 5

Patients suffering from a chronic disease who have a better social network cope better. It has a positive impact on the quality of life, morbidity, mortality and disease management. Some patients need social support and others more practical support.

Question 6

Palliative care interventions (QOL-intervention)

Answer 6

Focus upon acceptance of the disease when cure-recovery is no longer possible. Can include psychotherapy for anxiety and depression, self-help groups and care for terminally ill.

Question 7

The Hook (cognitive restructuring and stress-management intervention)

Answer 7

Focusses exclusively on cognitive restructuring. The aim is to help patients gain control over their emotional reactivity to daily stressors by promoting a shift in basic beliefs and attitudes.
1. What is behaviour modification?
2. What is impatience?
3. What can we do about it?

Question 8

Relaxation

Answer 8

Can be used alone or in combination with other techniques to enhance stress management skills of patients. Is effective, but the effect decreases when people don’t maintain the exercise.

Question 9

Life skills training

Answer 9

Focus on acquiring the necessary social skills to communicate adequately about the disease. Includes:
- Communicating about limitations
- Asking for help
- Problem-solving

Question 10

Assertiveness training

Answer 10

Important for people who have developed social anxiety concerning their illness. They have to learn how to talk about the disease to others and not being ashamed of the disease. Has an impact on the quality of life and on disease management.

Question 11

Social support groups

Answer 11

Exchange information and offer each other support. Talk to others about the disease and its consequences. Especially important if the personal network of the patient is unable to provide this. Is effective on well-being and quality of life, but also on morbidity and mortality.

Question 12

Behavioural techniques used to increase self-management

Answer 12

• Self-monitoring
• Goal settin g
• Shaping the process of change (small steps)
• Self-reinforcement
• Stimulus control
• Behavioural contracting
• Modelling

Question 13

Self-management interventions

Answer 13

Make use of a combination of intervention techniques. Have stronger effects on outcomes (disease management) than only educational interventions (because they are limited to provision of information).

Question 14

Individual vs. group intervention

Answer 14

Psychologists are mostly educated within an intervention paradigm that supports the idea that effective interventions are intensive, direct forms of intervention targeted at the problem of individual patients. This implies ‘doing a lot for a very small number of patients’. But if psychologists are to make a significant contribution to the care of chronic patients, they should go for the numbers rather than for the most intensive and personally satisfying form of treatment. This causes a trend towards the development of interventions for groups of patients.

Question 15

Social engineering

Answer 15

Changing the physical and social environment of the patient so that the patient can function in a normal way for as long as possible.

Question 16

Indirect interventions (channel)

Answer 16

• Other healthcare professionals: can be in a better position to deliver the intervention.
• Trained lay person: the effectiveness depends on the training the lay people received and their supervision.
• Manuals / online: effective, but more effective when combined with a session with a healthcare provider.