Exam Flashcards
(149 cards)
1
Q
Health care is the responsibility of which branch of the government?
A
Provincial
2
Q
What is the lowest and highest per-person health care cost in Canada?
A
Lowest: Quebec ($3,359)
Highest: Nunavut ($17,493)
3
Q
Why is it important to have a family physician?
A
Because people see them regularly so it provides a chance for early detection
4
Q
Percentage of family doctors who report patients can get same or next day appointments in Canada
A
22%
5
Q
What percentage of patients wait more than 2 months to see a specialist?
A
29%
6
Q
What are the satisfaction rates of health care?
A
85.7% are very to somewhat satisfied
7
Q
Do physicians think they get enough time with patients?
A
55% don’t feel they do
8
Q
What percentage of physicians think they can provide quality care to their patients?
A
Less than half
9
Q
How many people are admitted to the hospital every year?
A
2.8 million
10
Q
How are most people admitted to the hospital?
A
Through the emergency department
11
Q
Why would a person be seen in a hospital but not be admitted?
A
- Emergencies that can be solved quickly
- Day procedures
12
Q
How many visits to the emergency room are there every year?
A
15 million
13
Q
90% of people in emerg are seen in what time frame?
A
within 7.6 hours
14
Q
What proportion of people seen in emerg get admitted?
A
1/10
15
Q
30% of emergency room visits are made for__% of people
A
10%
16
Q
What aspects of a hospital stay must people adjust to?
A
- Lack of privacy
- strict schedule
- restricted activities
- dependent on others
17
Q
Often times people are seen by a team of people with frequent changes, what does this result in?
A
Depersonalization,
Patients feel a loss of autonomy and control
18
Q
What will guide a person’s sick behaviour?
A
Both their own and the doctor’s expectations
19
Q
Characteristics of an ideal patient according to the medical staff:
A
Cooperative, uncomplaining and stoical
20
Q
What do doctors consider a bad patient?
A
Uncooperative, complaining, overemotional and dependent
21
Q
Two types of “problem patients”
A
- Seriously ill patients with severe complications or poor prognosis who require a lot of attention
- People who are mot seriously ill but take more time than is warranted by their illness
> Usually get sedated or discharged early
22
Q
When is anxiety the highest in a hospital?
A
At admission and prior to surgeries
23
Q
Coping with hospitalization
A
Problem vs Emotion Focused
Blaming self and/or others
Helplessness or loss of control
24
Q
Things that help patients cope in a hospital ?
A
- Provide information
- Psychological counselling
- Increased control
- Room with a roommate recovering from a similar thing
- Humour
25
How to help patients prepare for surgical procedures
Enhance their sense of control and address expectations
26
Does information make attention-focused people more or less stressed?
Less
27
Does information make avoidance-focused people more or less stressed?
More
28
Discharge Planning
A process by which post-hospital care is organized and risks are assessed.
29
How long are wait times for a hospital bed?
1 in 10 people wait more than 30 hours
30
How many people contract infections from hospitals and how many people die from them?
As many as 1 in 9 get infections
| 8000-12000 die from the infection every year
31
Factors that enhance satisfaction with hospital experience:
- Respect through communication (avoid jargon, providing info)
- Maintenance of dignity
- Day-to-day control
32
What roles to psychologists play in hospitals?
- Assess adjustment
- help patients and families cope
- assist in rehabilitation
- research on making hospitals more effective and safer
33
What is pain
Unpleasant sensory or emotional experience with actual or potential tissue damage
34
What is the function of pain?
- Information (if something wrong)
- Warn of potential serious injury
- Promote learning to avoid the same situation later
- Limit physical activity and promote rest
35
A-delta peripheral nerve fibers
Small, myelinated fibers that produce a feeling of sharp pain
>Terminate in sensory cortex
36
C Fibers in peripheral nervous system
Unmyelinated, produce a diffuse, dull, aching pain
| >terminate in brainstem and forebrain
37
Referred pain
Pain that originates in internal organs, but it is perceived as coming from other parts of the body
38
Organic Pain
Comes from the body, tissue damage
39
Psychogenic pain
No visible tissue damage
| > Experienced like organic pain
40
Gate control theory of pain
Pain is not just the result of a linear process from sensory stimulation to brain receptions & the experience of pain
41
Modulation of pain in the spinal cord
Small A-delta & C Fiber activation --> opens gate --> pain
Large A-beta fiber activation --> closes gate --> inhibits pain
42
Pain modulation descending from the brain
Central Control Trigger = activates cognitive processes that can open or close gate
43
Emotional triggers that open the pain gate
Anxiety
Tension
Depression
44
Emotional triggers that close the pain gate
Positive emotions
| Relaxation
45
Cognitive factors that open the pain gate
Attention
| Boredom
46
Cognitive factors that close the pain gate
Distraction
| Involvement
47
Physical factors that open the gate
Level of injury
| Activity level
48
Physical factors that close the gate
Medication
| Counter stimulation
49
Acute pain
Temporary, lasts less than 6 months
50
Recurrent acute pain
Intermittent pain for longer than 6 months
51
Chronic pain
Lasts more than 6 months and gets worse over time
52
What cells in the brain are responsible for pain distortion
Glial cells
53
Criticism for pain questionnaires
It requires a high level of language and many people cannot tell the difference between the different descriptions
54
What is highest and lowest on the McGill pain index?
Highest: Causalgia
Lowest: sprain
55
What are the common pain behaviours
- Facial and audible expressions of distress
- Distortions of posture and gait
- Negative affect
- Avoidance of activity
56
How is pain induced in the lab
Cold pressor test (sticking hand in ice water)
57
The ____ attached to pain influences its experience
Meaning
| > feeling pain for a good cause makes it feel less severe
58
Learning and pain
Learn to associate cues with pain such that cues can produce distress and may heighten pain perception
59
What are the secondary gains of pain?
Get more attention from others
Get treated well
Disability pay
60
Social support is associated with more or less pain?
Less
61
How can support make pain worse?
If it is given too much attention or if a person is helped too much then they feel a lack of control
62
Pain-prone personality
Neuroticism, introversion and passive coping
63
What is the most common factor in care seeking?
Pain
64
How do different genders experience pain differently
Men and women have similar pain thresholds
- differences in intensity
- differences in frequency
65
Socio-cultural differences in pain
- Culture differences in dealing with pain
| - SES diffs in frequency and intensity of pain
66
What are ways to deal with pain?
- Coping
- Medication
- Behavioural and relaxation techniques
- Cognitive techniques
67
How many people in hospitals are under medicated?
About half
68
Who are at most risk for poor control of medication and why
Children
| >Doctors are afraid to over do it
69
What 2 ways are medications given?
1. PRN "as needed"
| 2. On a schedule
70
Behavioural and relaxation techniques in coping with pain
Rear reduction
Resuming daily activities
Biofeedback
71
Cognitive techniques for dealing with pain
Distraction
Guided imagery
Redefinition of pain
72
Has swearing been shown to reduce pain?
Yes
73
What are the goals of a multidisciplinary approach to chronic pain management?
- Reduce pain experience
- Improve physical functioning
- Decrease medication and use of other medical services
- Enhance family life
74
Lifestyle changes for dealing with illness
Diet, exercise, developing regular activities
75
Strategies for coping with high mortality illnesses
- Finding meaning in illness
- Gaining a sense of control over illness
- Restoring self-esteem
76
____ perceived social support is relates to poorer adjustment
Low
77
What is coronary heart disease
A general term that describes the narrowing of the artery that causes less blood to through through
78
How can arteries narrow?
Clogged with plaque and fat
79
What is bad about arteries narrowing?
There is insufficient oxygen to the heart
| May feel pain and lead to a heart attack or stroke
80
2 groups of risk factors for coronary heart disease
1. Non-modifiable risk factors
- genetics, gender, age
2. Modifiable risk factors
- lifestyle and cognition
81
What are 3 positive factors that lead to less mortality with CHD?
Exercise
Optimism
Being religious
82
What is the leading killer of women in Canada?
Coronary heart disease
83
Why is CHD not identified or treated well in women?
Because doctors use a model created for men
84
3 treatment approaches to CHD
1. Medical (surgery, pump implant, drugs)
2. Rehabilitation
3. Psychosocial interventions
85
Clot dissolving medication only works if administered in the first ____ hours
3
86
What factors do the best cardiac rehabilitation programs have?
Both education and counselling
87
___ is most important for predicting short term behaviours, ____ is most effective for predicting long term change
Self-efficacy
Motivation
88
Psychosocial consequences of recovering from CHD
```
Work (most return within 1 year)
Family (support makes recovery go faster, over protection and past problems might make it worse)
General adjusting (can be anxious and depressed for 1-2 years)
```
89
Neoplasm
Unrestricted cell growth
90
Metastasize
Spreading of cancer
91
5 types of cancer
1. Carcinomas - skin or organ cells
2. Melanoma - skin
3. Lymphomas - lymph system
4. Sarcomas - muscle, bone or connective tissue
5. Leukemias - blood forming organs
92
Cancer is the ____ cause of death world wide and number __ in canada
Leading
| 1
93
What percentage of males and females get cancer in their life?
45% males
| 41% females
94
What are the chances of dying from cancer
29% males die from it and 24% of females
95
Physical effects of cancer
- Interfere with normal cell functioning
- creates pressure on tissue and nerves, blocks blood and liquid flow
- Pain comes later
96
How does cancer directly kill?
By spreading to vital organs and taking nutrients so organ dies
97
How does cancer indirectly kill
By weakening the victim, impairing appetite and immune function
98
2 Types of risk factors for cancer
1. Non-modifiable (age, gender)
| 2. Modifiable (lifestyle)
99
Warning signs of cancer acronym
CAUTION
100
Detecting cancer
Physician and self administered tests
101
Diagnostic Procedures
- blood or urine tests for abnormal levels of hormones or enzymes
- Imaging to look for tumours
- Biopsy
102
What does treatment of cancer depend on?
Size, site(s), and quality of living tissue
103
Cancer treatment options
Surgery - if cancer is localized
Radiation - destroys cancer cells so they cannot divide
Chemotherapy
104
Adherence to cancer treatment is not good for which population
Adolescents
105
Side effects and problems of cancer treatment
- health tissue can be damaged
- physical side effects
- Anxiety
- treatment is demanding, requires a change in lifestyle
106
Factors that influence adjustment from cancer
Physical condition
| Site of cancer, age, gender
107
Interventions to help people adjust with cancer
CBT
Exercise
Disclosure
Therapy
108
What are characteristics of chronic illnesses?
Persist for a long time
Do not go away by themselves
Rarely cured completely
109
Stages of coping with a chronic illness
Crisis --> Initial Reaction --> Coping Strategies --> Long-term adaptation
110
When can emotion focused coping be beneficial
At the beginning of a chronic illness
111
Is anxiety and depression normal in chronic illness?
Normal at first but them is maladaptive in the long term
112
Factors that contribute to illness being a crisis
Illness related factors (visibility, intrusion on life)
Background and personal factors (age, SES, religion)
Physical and Social Environment (hospital vs home, social support)
113
Cognitive appraisal in the coping process of a chronic disease
- Meaning or significance of illness
| - Beliefs about nature, cause, controllability of illness
114
Adaptive tasks in coping with chronic illness
Tasks related with illness or treatment
| Tasks related to psychosocial functioning
115
How can making beating an illness like a game helpful?
Gives person control
116
What does AIDS stand for?
Acquired Immune Deficiency Syndrome
117
What does the HIV virus attack in the body?
T-cells
118
How long between HIV and AIDS?
The time varies
119
Risk factors of HIV
- sexual activity
- sharing needles
- birth by infected mother
120
Groups most at risk for HIV in North America
IV drug users
| Homosexual men
121
Can HIV be managed?
Yes, people can use medication and lead a relatively normal life
> It will never turn into AIDS
122
Stigma around AIDS
Associated with drug users and homosexuality
123
What is the main thing that adaptation to HIV is affected by?
Access to medication to decrease symptoms
124
How do psychological factors affect the course of AIDS?
Stress makes it worse
Hope, self compassion and optimism help adjustment
125
What is the new initiative to abolish AIDS
Universal HIV testing
126
How many people who have AIDS are unaware of it?
1 in 4
127
What is the average lifespan in Canada
81. 1 years
men: 78.8
women: 83.3
128
Why is infant mortality rate relatively high in Canada for a developed country?
We have recently started making more of an effort to deliver premature babies
129
What are the 2 most common sources of death for children between 1 and 15
Accidents
| Cancer (especially leukemia)
130
Most common causes of death age 15-24
Accident
Suicide
Cancer
Homicide
131
When is fear of death highest and lowest?
Middle age highest
| Old age lowest
132
Why do women tend to live longer than men
- Less risk taking
- Hormonal differences
- Men have more risky jobs
- Women are more likely to seek help when they have a problem
133
What misconceptions to children have about death?
0-5 dont understand, think death is like sleep
5-11 begin to grasp finality of death
Teenagers understand death, tend to blame themselves
134
Terror Management Theory
The cultural world views that protect us from the idea of death
135
What is the goal of palliative care?
Reducing pain and discomfort
136
Kubler-Ross's 5 stages of dying
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
137
Are the stages of dying correct?
Has not been proven but they have provided a useful framework
138
Benefits of stages of dying theory
- Helped specify importance of counselling
| - initiated death research
139
Limitations of 5 stages of dying theory
- Not everyone goes through all stages
- no universal order
- does not acknowledge anxiety
140
Types of care for terminally ill patients
Life support
Palliative care
Hospital, nursing home, hospice
141
Hospice care
Medical and social support for patient and families to provide a better quality of life and death
142
8 C's of hospice care
```
Compassion
Competence
Confidence
Conscience
Commitment
Courage
Culture
Communication
```
143
Ways of ending life
Do not resuscitate order
Assisted suicide
Euthanasia
144
Conditions for Euthanasia in Canada
- Untreatable condition
- Voluntary
- Advance stage of disease
- Suffering cannot be relieved
- Over 18 and of sound mind
145
What happens to the survivors
Grief - emotional reaction to loss of loved one
Bereavement - objective situation of having lost someone
Mourning - public display of grief
146
Early models of coping with the loss of a loved one
Working through the grief, have to come to terms with it
147
Does finding meaning in the loss of a loved one help?
Yes
| But looking and not finding meaning makes it worse
148
What affect does losing a loved one have on death
People are more likely to die after losing someone
149
Different trajectories of Grief
```
Resilience
Recovery
Chronic dysfunction
Delayed grief or trauma
Chronic depression
```
