Chapter 8 Flashcards
(110 cards)
1
Q
How does the WHO describe chronic diseases?
A
> describes chronic diseases as being of “long duration and generally slow progression”
2
Q
What are some common conditions that are generally subsumed under the umbrella of chronic disease
A
- CVD
- Cancer
- COPD (including asthma)
- Type 1 and type 2 diabetes.
- Arthritis.
- HIV
- AIDS
- MS
- IBD Crohn’s disease and ulcerative colitis).
3
Q
Chronic pain can be the result of what?
A
> the result of a wide variety of different health conditions and injuries
4
Q
1) More than half of people over 20 years of age, in both Canada and the United States, report having how many chronic conditions?
2) How many deaths in these countries are associated with chronic conditions?
A
1) at least one chronic health condition
2) approximately 88 to 89 per cent of all deaths are due to chronic diseases such as cancer and cardiovascular disease
5
Q
The incidence of chronic health problems generally increases with what factor? Is it changing?
A
> increases with age
there are changing trends and demographic dispar-ities - i.e. some only rise in children (IBD)
6
Q
1) Between 1999 and 2010, the number of children under five years of age diagnosed with IBD went up by what percentage each year?
2) What has caused it?
A
1) 7.2 per cent per year
2) Cause is still unknown, but environmental and genetic contributors, are to probably to blame
7
Q
Indigenous populations are disproportionately affected by chronic conditions- specifically what condition and by how much more times likely are they?
A
> Indigenous peoples are 1.5 to 2 times more likely to develop heart disease than the general Canadian population
8
Q
Disparities in prevalence of chronic disease, access to treatment, and treatment outcomes exist among which groups?
A
> minorities
people of lower educational attainment
individuals living in rural and remote areas
individuals living in poverty
9
Q
High rates of chronic health concerns place an enormous strain on health-care systems.
1) How much does it cost Canada per year?
2) What percentage of this is a direct health care cost?
3) What is the percentage of the US?
A
1) $200 billion per year
2) approximately 67 per cent of all direct health-care costs are attributed to chronic conditions
3) 86 per cent of all 2010 health-care spending went towards individuals with one or more chronic medical concerns
10
Q
The most devastating consequence of many chronic diseases is what?
A
> Loss of life
11
Q
Chronic illnesses represent what type of cause of mortality in North America? Why?
A
> Chronic illnesses represent one of the leading causes of mortality in North America
Heart disease and cancers account for the highest number of deaths in both the United States and Canada
12
Q
Health psychologists develop interventions targeting what?
A
> the psychosocial consequences of the possibility of loss of life
a loved one has passed away as a result of chronic disease
intervene to help people with a variety of other consequences of chronic illness
13
Q
Fatigue, which can impede patients’ ability to complete daily activities, is reported across a range of chronic conditions, including:
A
> cancer, HIV, cardiovascular disease, asthma, and arthritis, to name a few
14
Q
Can fatigue be a core symptom of a chronic health condition? If so, what condition has this core symptom?
A
> It can be a core symptom of the health condition, as is the case in fibromyalgia
15
Q
In addition to being an obvious consequence in pain-related diagnoses, such as arthritis and fibromyalgia, pain is commonly reported among a wide variety of patients including those with what conditions?
HIV, IBD, D, C, MS
A
> those with HIV
IBD
diabetes
cancer
and multiple sclerosis
16
Q
Persistent pain often leads to what?
A
> increased emotional and psychological distress
17
Q
Individuals with chronic health conditions including heart disease, cancer, high blood pressure, chronic pain, breathing problems, and gastrointestinal problems report what compared to those without a chronic condition?
Related to sleep…
A
> more frequent insomnia
18
Q
many chronic health conditions can lead to what type of physical impairments?
A
> can lead to functional impairments and physical disabilities
19
Q
Adjusting to loss of ability and physical function can be challenging, particularly as it impinges on what?
A
> impinges on one’s independence
lifestyle,
social roles,
previously enjoyed activities
also present a threat to emotional and psychological well-being
20
Q
Mental health concerns and chronic health problems commonly co-occur, which makes adjustment more difficult. This relationship is complex; what does that mean?
another inverse relationship:
A
> mental health prob-lems may interfere with recovery/rehabilitation from physical illness
physical illness can in-crease the risk of mental health problems
21
Q
Chronic medical conditions are cormorbid with mental health problems - at what rates compared to the general population?
A
> Across chronic medical conditions, comorbid mental health problems are commonly observed at rates higher than seen in the general population
22
Q
Chronic medical conditions can affect the ability to work - what factors are related to the inability to work?
P,PD, F, MHP, CI, GS
A
> these factors include pain, physical disability, fatigue, mental health problems, cognitive impairment, and gastrointestinal symptoms
23
Q
What effect can occur as a result of not working (Due to a chronic medical condition) ?
A
> significant effect on financial security and is associated with decreased quality of life
> family caregivers may also be impacted financially by loss of work that occurs because they need extra time to provide care or support to their ill family member
24
Q
Dyadic adjustment to chronic health problems involves multiple components, such as:
A
> coping with renegotiating roles within the relationship and dealing with the possibility of a long-term or life-threatening illness
25
How can a chronic medical condition affect a relationship?
> can place strain on the relationship.
> It is not unusual for both the healthy and the ill partner to experience psychological distress when one partner has a chronic illness
> people with a chronic health condition may experience decreased sexual desire, disability, or pain that im-pairs the couple’s sexual satisfaction and intimacy
26
There are numerous avenues through which health psychologists can intervene in chronic disease- what are some of the ways?
> these include prevention
> health-promotion work with at-risk populations prior to the onset of medical condition
> helping patients with adherence to recommended regimens
> help with adjustment to one’s new life situation.
27
Certain psychological and behavioural factors are known to increase one’s risk of developing a chronic health problem. These factors include:
> stress, lifestyle, and personality characteristics.
28
There are numerous examples linking chronic disease and stress - what was war an example of?
> Populations who experience natural disasters or war, for example, have been found to present with increased incidence of cardiovascu-lar disease
29
Individuals with persistently high levels of stress are more often seen for what condition?
> irritable bowel syndrome (IBS)
30
How does stress impact people with MS? Both negative and positive stress:
> Stressful events such as changes in routines and major negative life stressors have been shown to predict new or enlarging lesions in the brains of patients with MS (negative stress)
> positive stressors (i.e., stress that is linked to challenges/goals that provide a sense of meaning and purpose; see Chapter 3 for a more detailed discussion) are associated with reduced risk of developing new or enlarging brain lesions in MS patients
31
Perhaps paradoxically, during stressful periods people may engage in behaviours that further increase the risk of illness- what are some examples? What can we classify these behaviours as?
> behavioural changes that occur in response to stressors = risk factors for chronic medical conditions
> i.e. sleeping less to study
32
Certain lifestyle factors such as what are contributors to the development of chronic disease?
| TS,PI, PSH, UE, ECA
> tobacco smoking
> physical inactivity
> poor sleeping habits
> unhealthy eating
> excessive consumption of alcohol
33
he WHO has estimated that by improving diet, increasing activity, and eliminating smoking, what percentage of heart disease, stroke, and type 2 diabetes and cancer could be prevented?
> 80 per cent of heart disease, stroke, and type 2 diabetes cases,
> as well as 40 per cent of cancer cases, would be prevented.
34
Physical inactivity is the fourth leading risk factor for what?
> is the fourth leading risk factor for global mortality and has been identified by the WHO as a serious health issue
35
In both adults and children, physical activity can improve what? How about just adults?
**BOTH:
**- improves cholesterol levels,
- blood pressure,
- body composition,
- bone density,
- cardiorespiratory
- musculoskeletal fitness,
- + aspects of mental health.
****
**ADULTS: **
- reduced risk of premature death,
- coronary heart disease,
- stroke,
- hypertension,
- various forms of cancer,
- type 2 diabetes, and
- osteoporosis
36
How did Canada compare to Slovenia when it came to children's rate of exercise? (What was Canada's percentage compared to theirs?)
> In Canada, only 9 per cent of youth aged 5 to 17 years met the physical activ-ity guidelines (60 minutes of physical activity per day)
> In Slovenia, 86 per cent of boys and 76 per cent of girls are getting the recommended 60 minutes of activity per day
37
Although the recommenda-tion is that adults engage in 150 minutes of moderate-to-vigorous physical activity per week, in increments of 10 minutes or more what per cent of Canadians 18 years of age and over are not meeting these physical activity guidelines?
> 77.8%
38
Poor sleep has been associated with a plethora of negative health outcomes. Describe the relationship between poor sleep and chronic medical conditions?
| It's an inverse relationship...
> Although having a health condition can impact quality of sleep, not getting enough sleep can also lead to chronic health problems.
> INVERSE RELATIONSHIP
39
What job is associated with poor sleep and also therefore classified as a risk factor for illness?
> night shifts or rotating night shifts
> This type of work schedule inevitably interferes with one’s regular sleeping pattern.
> The impact can be so severe that the World Health Organization has classified night work as a possible contributor to illness
40
Across populations, sleep loss is associated with:
> increased risk of having a heart attack
> increased mental distress and alcohol use
> and premature death
41
Increased consumption of fruits and vegetables has been found to lower of the risk of what and what is that reduced risk especially true for?
> found to lower risk of mortality, especially mortality from cardiovascular disease
42
Canada’s Food Guide recommends that adults (19 to 50 years of age) consume at least how many servings of fruit and vegetables? What is the case though?
> at least 7 to 10 servings of vegetables and fruits per day
> Added sugar and sodium is exceeding the weekly portions
> plus people are not eating the requited amount of servings for fruit, vegetables, and diary.
43
Sugar intake, trans fats, and saturated fats are associated with what while sodium is the culprit for what?
> with cardiovascular diseases and type 2 diabetes,
> while sodium may be a culprit in many cases of cardiovascular disease
44
What is the leading global cause of preventable death?
> smoking
45
What diseases is smoking associated with? By how many years does smoking decrease your life expectancy?
> including COPD,
> CVD
> and many forms of cancer
> Smoking can also reduce life expectancy by more than 10 years
46
Although the risks of smoking are numerous (see Chapter 6), quitting can significantly reduce these risks. How so?
> For instance, within one year of quitting, one’s risk of developing heart disease decreases by 50 per cent compared to smokers.
> Over time, the chances of developing heart disease (for those who have quit smoking) reduce and align more with those observed among non-smokers
47
While smoking is on the decline, what is happening with heavy drinking and binge drinking? What diseases are they associated with?
> they are on the rise.
> Alcohol consumption has been linked to a number of physical health conditions, including cancer, stroke, and hypertension
48
In the United States, 90 per cent of alcohol consumed by youth is classified as what type of drinking? What occurs in Canada?
> binge drinking
> In Canada, nearly 20 per cent of Canadians over the age of 12 report heavy drinking on a least one occasion per month over the course of the previous year.
49
Rates of heavy drinking are highest among adults aged what? At what age does it decrease?
> 20 to 34 years and decrease with age
50
Researchers have suggested that certain personality characteristics contribute to the risk of developing certain diseases. What are some examples?
> As an example, Type A personality—characteristic of people who are driven, hostile, impatient—has a long-standing history of being linked to cardiovascular diseases, such as heart attack and stroke
> High levels of neuroticism and low levels of conscientiousness have also been associated with the development of chronic disease
51
Overall, how does personality affect the development of chronic decisions?
> personality may influence lifestyle decisions and be-haviours, which in turn increase disease risk
52
Individuals who present with high levels of conscientiousness and low levels of neuroticism, on average, are at reduced risk of what?
> chronic disease
53
those in-dividuals who are very conscientious and who present with low levels of neuroticism tend to be what?
> the most physically active
54
people with high levels of neuroticism and low levels of conscientiousness present higher levels of what? What diseases are linked to this factor?
> chronic inflammation
> Chronic inflammation is associated with the de-velopment of disease such as cancer, arthritis, and heart disease.
55
How does the WHO define adherence to long term therapy?
> as “the extent to which a person’s behaviour—taking medication, following a diet, and/or executing lifestyle changes, cor-respond with agreed recommendations from a health care provider”
56
What is non-adherence associated with?
> non-adherence increases morbidity and mortality
57
In developing countries, only what per cent of patients with chronic disease adhere to recommended treatment regimens (WHO, 2003).
> 50%
58
What is a common example of non-adherence?
> Non-adherence to medication is one of the most familiar forms of non-adherence and can involve not taking prescribed medications, taking them sporadically, or not taking the prescribed dosage.
59
In relation chronic medical conditions, what is asthma?
> It is the most common chronic health condition in children and one of the most common chronic conditions in adult
60
For the individual with asthma, non-adherence often means?
> often means poorer asthma out-comes, reduced lung functioning, increased hospital-ization rates, and decreased quality of life.
61
Adjustment can be described in terms of:
> “the presence or absence of diagnosed psychological dis-order, psychological symptoms, or negative mood”
62
Who is a leading health researcher in the area of adjustment and has made significant contri-butions in this area?
> Annette Stanton from the University of California, Los Angeles,
63
In her work of examining cross-cutting issues in adjustment to chronic illness, Stanton and her colleagues have come to certain conclusions regarding chronic disease and ad-justment processes. What are the two conclusions:
1) chronic disease affects multiple domains of functioning and consequently adjustment must occur across these multiple domains
2) do not view adjustment as a static process, but as one that
unfolds over time.
3) every individual will adjust differently
64
Adjustment to IBD is usually influenced by multiple patient factors including:
> disease acceptance, disease charac-teristics, emotional representation of illness, frequency of gastroenterologist visits, and coping
65
What mental health disorder is often comorbid with chronic medical conditions?
> Depression is a frequent psychological comorbidity of chronic health conditions;
> people with chronic health problems are more likely to have a comorbid depressive disorder
66
Across chronic health problems, there is evidence that having a comorbid mental health prob-lem leads to increased:
| + more progression of what and higher rates of what?
> increased symptom severity, more rapid illness progression, and higher rates of mor-tality
67
Personal and situational characteristics have been found to be predictive of adjustment to chronic illness. Examples of such characteristics include:
| G,P, SS, CBG, SES, PCR
> gender, personality, social support, cultural back-ground, socio-economic status, and personal coping resources.
68
Gender differences in adjustment have been noted, for example, in patients with what conditions? What gender is impacted the most?
| D, C, A, HD. M/F
> with diabetes, cancer, arthritis, and heart disease- with women experiencing greater difficulties
69
Gender differences in dis-ease severity can also occur- what are some examples?
Women with coronary heart disease have more comorbid health con-ditions (e.g., diabetes, hypertension, renal dysfunction) and higher rates of complications than do men with the same diagnosis
70
A number of factors may contribute to these gender gaps in disease adjustment and severity- what would account for heart disease?
> In heart disease, the discrepancy may be due, in part, to women being older at the onset of the disease
> In heterosexual couples, women provide more support then men
> Moreover, in heterosexual couples female partners report more distress, regardless of whether they are the partner with the illness or the caregiving partner
> higher distress among women, regardless of who has the illness, is somewhat aligned with rates of distress in the general population where women report more depressive symptoms as well as worse perceived health and more functional limitations than men
71
In addition to contributing to disease risk, several personality traits have been linked to disease adjustment - which trait has recieved more attention?
| POSITIVE!
> Optimism, in particular, has received notable attention
72
How does optimism affect disease adjustment? (How does it specifically help with what kind of approach?)
> improves outcomes by coping.
> Optimism leads to more active and adaptive approaches to coping, such as positive reappraisal, acceptance, and problem-focused coping
73
Social support is also tied to adjustment and long-term outcomes in chronic disease. This was observed in a study examining readmission to hospital in 371 patients following myocardial infarction. What was found in their hospital re-admissions?
> Hospital re-admissions were significantly lower among patients who reported good levels of social support as compared to low or moderate levels of social support
74
Evidence suggests that social support could help what type of bodily functioning and accordingly what does that support?
> help boost immune functioning, which could help improve health and, con-sequently, adjustment
75
Sup-portive others provide opportunity for ill individuals to do what?
> participate in conversations and activities that allow them to better understand and cope with their diagnoses and symptoms
> Supportive others may also encourage adher-ence and positive health behaviours
76
Racial and ethnic disparities in chronic dis-ease prevalence and mortality are observed in what countries?
> Canada and in the United States
77
In Canada, Indigenous populations are more likely to experience what diseases? What diseases cause higher rates of mortality?
> are more likely to present with diabetes
> cardiovascular disease
> obesity
> and tuberculosis
> as well as higher rates of mortality from circulatory diseases and cancers
78
It is well documented that individuals of lower socio-economic status (SES) experience what kind of health outcomes?
> poorer ill-ness outcomes
79
he potential contributors to the association between SES and disease are numerous. People of lower SES are more likely to be exposed to what three things?
> chronic stressors
> food insec-urity
> environmental hazards
80
In the context of chronic ill-ness, coping efforts can lead to what outcomes?
> can lead to approach or avoidance of aspects of the chronic disease
81
Approach-oriented coping involves what?
> involves actively engaging in strategies, such as solving problems, gathering information, seeking support, and actively think-ing through one’s emotional experience
82
Avoidance-oriented strategies involve:
> behavioural (e.g., disengagement from treatment) or cognitive (e.g., denial) strategies to distance oneself from the reality of the illness
83
Generally speaking, people who use more approach-oriented coping adjust how to their disease, and avoidance-oriented coping is associated with what kind of adjustment?
> better to their disease
> poorer adjustment
84
In many clinical settings, health psycholo-gists play a large role in what?
> play a large role in disease prevention and health promotion.
85
What is health promotion?
> Health promotion is defined by the WHO as the process of enabling people to increase control over, and improve, their health
86
Health psychologists frequently work with populations that are known to be at what risk?
> are known to be at higher risk of developing chronic disease.
87
Health psychologists integrate a number of strategies, such as:
> psychoeducation, problem-solving training and interviewing techniques designed to enhance clients’ motivation to make healthier choices and improve the management of their health conditions
88
Broadly, what do health psychologists do?
> Psychologists may also be involved more broadly with populations to promote health in groups at high risk
> Works directly with patients and clients
> may be involved in policy making, media campaigns, and program development.
> engaged in research to help identify risk factors for chronic disease and strategies for the promotion of wellness across the lifespan
89
Social media are used for a number of purposes by health-care professionals, such as:
> to share the latest research, promote best practices in health care, communi-cate important health-related information to the public, and advocate for patient care.
90
Patients with chronic illness, on the other hand, are taking to social media to:
> are taking to social media to discuss their experiences with chronic disease management, diagnosis, and treatment; and as a place to build a community and garner support.
91
What social media platform is notable for chronic diseases?
> Twitter has been a particularly popular platform for health promotion and disease management.
> By tweeting about their research or clinical experiences, or retweeting relevant articles, psychologists and health-care providers are speaking out about important issues in the prevention and manage-ment of chronic disease.
92
What is the Healthcare Hashtag Project?
> the Healthcare Hashtag Project is a website that was developed as a place where all health care–related hashtags are compiled and their use tracked.
> The goal of the Healthcare Hashtag Project is to promote health-related conversations, advocacy, and community building by uniting tweeters through the use of hashtags
93
The #DontHateYourGuts, the #ThisIsDiabetes, and the #itdoesnthavetohurt campaigns are three campaigns directed at what?
> directed at inflam-matory bowel disease, diabetes awareness, and children’s pain, respectively.
94
Self-management is a process in which:
> a process in which a person is actively engaged in understanding and imple-menting the day-to-day tasks involved in managing his or her chronic health problem
95
> Self-management programs aim to do what?
> empower people with chronic disease by increasing their sense of self-efficacy and agency in managing their illness.
96
Generally, the self-management process includes:
> learn-ing about the condition and health needs
> taking ownership of the health needs
> performing health-promotion activities.
> active treatment engagement
> modification of life-style factors to minimize the impact of the health condition.
> activating and/or making use of psychological, social, and community resources.
97
Describe the topics that are covered in the HIV self-management program:
(1) integration of medication regimes in day-to-day life for consistent use;
(2) tech-niques for dealing with frustration, fear, fatigue, pain, and isolation;
(3) exercise for maintaining and improving strength, flexibility, and endurance;
(4) communicating effectively with family, friends, and health professionals;
(5) nutrition;
(6) evaluating symptoms;
(7) advance directives;
(8) decision-making; and
(9) sex, intimacy, and disclosure
98
Self-management programs are led either by:
> peers or by health professionals, often using
manuals or online platforms.
99
self-management programs are effective for:
> improving certain health outcomes.
> improvements in treatment adherence
> mprovements in ability to cope with the illness
> decreases in symptom severity
> changes in lifestyle factors
> reduced health-care costs and service use
100
Psychological interventions for people with chronic disease may be implemented for a variety of reasons, such as:
> Psychological interventions may target stress or behavioural changes as a means of preventing chronic illness or disease progression.
> Psychological interventions can also help with adherence, coping and distress
101
CBT treatment protocols vary in the way they are organized and with respect to their specific emphasis, but generally involve :
> psychoeducation, relaxation training, self-monitoring, identifying and challenging unhelpful thoughts, implementation of behavioural strategies (e.g., pacing, gradual exposure), and relapse prevention.
102
CBT programs have been used to address both aspects of what?
> of the disease management (e.g., adher-ence)
> and psychological sequelae (e.g., coping, distress) or comorbidity (e.g., anxiety, depression).
103
In recent years, there has also been a rise in web-based delivery of CBT for chronic health conditions. Such programs can be particularly beneficial among medical populations where:
> where dis-ability may impede capacity to attend treatment or where a plethora of medical appointments makes it challenging to add more commitments
104
Mindfulness-based approaches, such as mindfulness-based stress reduction (MBSR), are rapidly gaining popularity as treatment options for people with:
> health problems
105
Mindfulness can be defined as:
> “paying attention, on purpose, in the present
moment, and non-judgmentally” and shares common elements with meditation
106
Describe mindfulness in its original state - who invented it and what did it look like?
> Jon Kabat-Zinn originally developed MBSR for patients with chronic pain and associated symptoms in the early 1990s.
> Since this time, MBSR has been applied across a variety of conditions and concerns.
> In its original form, MBSR is offered in 2-to 2.5-hour group sessions over 8 to 10 weeks. In these sessions, par-ticipants learn to increase their awareness, learn new breathing and mindfulness skills, and change the way in which they respond to distressing thoughts, sensations, and emotions.
107
Reviews of effects of MBSR on chronic disease have shown that MBSR can lead to:
> improvements in depression, anxiety, and psychological distress
108
Acceptance and commitment therapy (ACT) is based on the notion that:
> our attempts to con-trol distressing internal experiences are futile leading to increased distress and interference.
> non-judgemental acceptance of their experiences.
> The objective is to improve psychological flexibility and functioning, and to decrease interference of unpleasant ex-periences
109
ACT has been well-supported for the treatment of what disorders?
> depression and anxiety
> chronic pain
> Patients with diabetes who participated in an ACT intervention showed better coping and self-care abilities
110
