Flashcards in Exam 3 Deck (46):
What are the most beneficial social supports?
• A person in whom you can confide, particularly on a daily basis
• Marriage, especially a satisfying marriage
• Family support
• Community support
How do physical pain and social pain relate?
They both use the same pain-related neurocircuitry that physical pain relies on.
What promotes resilience?
○ A sense of coherence about one's life
○ A sense of purpose of meaning in one's life
○ A sense of humor
○ Trust in others
○ A sense that life is worth living
○ Religious beliefs
What factors associated are associated with good provider-patient communication?
Make sure the patient understands and shares in decision making
Teach skills that can be learned easily and incorporated into routines easily
Warm nonverbal communication
What are stress carriers?
People in your environment who cause you special stress.
How does gender affect the likelihood of using health services?
Women use medical services more than men do.
What is patient depersonalization and what are its effects?
• Nonperson treatment - when you treat the illness and not the person
• Can confuse or alarm the nonparticipating but physically present patient
• Provides emotional protection for the provider
What types of symptoms are likely to result in an individual seeking treatment?
• Individual differences
• Attentional differences
• Situational factors
Which factors are correlated with higher adherence, and which are correlated with lower adherence?
○ The patient receives a clear, jargon-free explanation of the etiology, diagnosis, and treatment recommendations.
○ The patient has been asked to repeat the instructions
○ The instructions are written down
○ Unclear recommendations are singled out and clarified
○ Instructions are repeated more than once.
○ Patient's lifestyle is not conducive to the recommendations
○The goals are too big (not breaking down the goals into manageable bites)
What interventions are developed to help people cope successfully with stress?
• Mindfulness Meditation and Acceptance/Commitment Therapy
• Expressive writing
• Relaxation Training
• Coping Skills Training
• Stress Management
What are the key elements of commonsense models of illness?
• Identity: A label, for an illness. Usually its name.
• Causes: Factors that the person believes gave rise to the illness
• Consequences: Symptoms of the illness, treatments, and implications for quality of life
• Timeline: the length of time the illness is expected to last
• Control/cure: identifies whether the person believes the illness can be managed or cured through appropriate actions and treatments
• Coherence: How well these beliefs hang together in a cogent representation of the disorder
Psychological resources enable people to confront and cope with stressors. They also help them bounce back from bad experiences and adapt flexibly to the changing demands of stressful situations. This is called resilience.
What are the major ways to apply problem-focused coping
• People anticipate potential stressors and act in advance, either to prevent them or to reduce their impact.
• Ability to anticipate or detect potential stressors
• Coping skills for managing them
• Self-regulatory skills (ways that people control, direct, and correct their actions as they attempt to counter stressful events
• Ability to distance oneself from negative experiences
• Framing appraisals of stressors positively
Compare and contrast acute pain and chronic pain.
Acute pain: Usually results from an injury, lasts six months or longer and usually disappears when the tissue damage is repaired.
Chronic pain: Begins with acute pain but goes on for six months or more. Doesn't decrease with treatment and passage of time.
Psychological Control Definition
The belief that one can determine one's own behavior, influence one's environment, and bring about desired outcomes.
What is a social support?
Information from others that one is loved and cared for, esteemed and valued, and part of a network of communication and mutual obligations.
What are the advantages and disadvantages to using painkillers such as morphine?
Disadvantages: Addictive, patients may build up a tolerance
What are the factors that relate to a patient’s likelihood of adherence?
• Distracting problems at home, such as instability and conflict
Describe the avoidant coping style
• Avoider may cope well with a trip to the dentist but cope poorly with ongoing job stress
• Deals most effectively with short-term threats
• People who cope with avoidance may not make enough cognitive and emotional efforts to anticipate and manage long-term threats
What are the types of coping styles?
• These interventions use information, relaxation, and cognitive-behavioral techniques, such as learning to think differently about the unpleasant sensations of a procedure, to reduce anxiety, improve coping, and promote recovery.
• People who desire control especially benefit from control-based interventions.
• Control could be aversive if it gives people more responsibility than they want.
What factors contribute to faulty communication between provider and patient?
Use of jargon
Stereotypes of patients
What are situational factors in the context of health services?
• General context: political, demographic, economic, and social factors
• Medical Students' Disease: As they study each illness, many medical students imagine that they have it. Studying the symptoms leads the students to focus on their own fatigue and other internal states; as a consequence symptoms consistent with the illness under study seem to emerge.
Psychological Control's Effects
○ The belief that one can exert control over stressful situations improves emotional well-being, coping with a stressful event, health behaviors, physiological stress indicators such as immune functioning and cardiovascular risk factors, and health.
○ Basis for interventions to promote good health habits
○ Perceived control fosters physical activity, which may be one reason why it contributes to good health.
What are the three models of illness most people have, and what are the overviews of each?
• Acute illness: Believed to be caused by specific viral or bacterial agents and is short in duration, with no long-term consequences. Example is the flu.
• Chronic illness: Believed to be caused by multiple factors, including health habits, and is long in duration, often with severe consequences. An example is heart disease
• Cyclic illness: Marked by alternating periods during which there are either no symptoms or many symptoms. An example is herpes.
What types of social supports are there?
• Tangible assistance
• Informational support
• Emotional support
• Invisible support
How does age affect the likelihood of using health services?
The very young and the elderly use health services more frequently.
Identify the different types of delay behavior associated with health services.
Delay behavior - when a person lives with one or more potentially serious symptoms for months without seeking care
• Appraisal delay: The time it takes an individual to decide that a symptom is serious
• Illness delay: The time between the recognition that a symptom implies an illness and the decision to seek treatment.
• Behavioral delay: The time between deciding to seek treatment and actually doing so
• Medical delay: The time that elapses between the person's calling for an appointment and his or her receiving appropriate medical care.
What are illness representations or schemas?
Commonsense models of illness.
What is nociception and how are nerve fibers involved in this process?
The nerve fibers send pain impulses to the brain as well as surrounding areas
What methods can providers utilize to improve adherence?
Provide patients with information, listen, encourage, build trust, enhance recall
Help patients believe in their treatment and become motivated to adhere to it
Helping patients to overcome any practical barriers, such as cost or time.
Ask the patient to repeat
Keep the instructions as simple as possible
Use short words and short sentences
Make advice detailed, specific, and concrete
Adopt a friendly rather than businesslike attitude
Avoid medical jargon
What is creative nonadherence?
Modifying and supplementing a prescribed treatment regimen.
○ A poor patient may change the dosage level to make the medicine last as long as possible or may keep some medicine under reserve.
○ Patients supplement the treatment regimen with over-the-counter preparations to treat symptoms they think were ignored by the physician.
How does socioeconomic status affect the likelihood of using health services?
• Lower SES use medical services less than do more affluent social classes
What is the subtype(s) of acute pain and what are the characteristics?
Recurrent acute pain
Intermittent episodes that are acute in character but chronic inasmuch as the condition recurs for more than six months
(ex. migraines, TMJ)
What is the subtype(s) of chronic pain and what are the characteristics?
Chronic benign pain: Persists for six months or longer and is relatively unresponsive to treatment. Pain varies in severity and may involve any of several muscle groups. (ex. Low back pain)
Chronic progressive pain: Persists longer than six months and increases in severity over time. (ex, rheumatoid arthritis)
What are advantages and disadvantages of using internet resources for obtaining health care information?
• Advantages: Lots of information available and people can use some of this information to treat themselves
• Disadvantages: Lots of information is inaccurate and may make the illness worse
Describe the approach coping style
• More successful than avoidant coping and it is tied to better mental and physical health outcomes
• The vigilant coper may fret over the visit to the dentist but take active efforts to reduce job stress
• Most effective with long-term stress
Types of coping with chronic pain?
What are common characteristics for those who experience chronic pain?
Depression, anxiety, and anger
Maladaptive coping strategies such as catastrophizing their illness, engaging in wishful thinking, or withdrawing socially
Negative Affectivity Definition
A pervasive negative mood marked by anxiety, depression, and hostility. People high in negative affectivity (also called neuroticism) express distress, discomfort, and dissatisfaction in many situations
What are the major ways to apply emotional-approach coping
• Clarifying, focusing on, and working through the emotions experienced in response to a stressor
• Improves adjustment to many chronic conditions, including chronic pain, and medical conditions such as pregnancy and breast cancer.
• Coping via emotional approach appears to be especially beneficial for women.
• It may be soothing and beneficially affect stress regulatory systems
• It leads people to affirm important aspects of their identity, which leads to health benefits
What is negative affectivity linked to?
• Related to poor health, including chronic conditions such as arthritis, diabetes, chronic pain, and coronary artery disease.
• Also related to all-cause mortality
• Psychological Distress involving depression, anger, hostility, and anxiety may form the core of a "disease-prone personality" That predisposes people high in negative effect on illness.
• Negative affectivity links to chronic illness by negative affectivity related to elevated levels of stress indicators such as cortisol, inflammation, and risk factors for coronary heart disease. A second link is poor health habits.
Self-esteem & Coping
• High self-esteem is tied to effective coping
• Most protective at low levels of stress
• At higher levels of stress, the stressful events themselves can overwhelm the benefits of self-esteem.
Compare and contrast with problem-focused coping and emotion-focused coping
Problem-focused coping involves attempts to do something constructive about the stressful conditions that are harming, threatening, or challenging as an individual
Emotion-focused coping involves efforts to regulate emotions experienced due to the stressful event.
What are the three typical goals related to hospital functioning, and what do each of them involve? (Hint: they all start with the same letter.)
• Cure: Physician's responsibility through performing any treatment action that has the potential to restore patients to good health, that is, to cure them.
• Care: Orientation of the nursing staff. Involves the humanitarian side of medicine and is to do as much possible to keep the patient's emotional and physical state in balance
• Core: Ensuring the smooth functioning of the system and the flow of resources, services, and personnel