Health Psychology Final Exam Flashcards

Question

Chronic Health Condition: Definition

Answer 1

* Long term health condition that is managed but not treated or cured (Tertiary Prevention) and that impacts daily physical, emotional and social functioning - QOL * 3 out of 5 Canadians have one * 1/3 adults 18-44 have at least one * most of us will get and die from one (2/3 deaths)

Answer 2

* NO tissue abnormality but suffering and disability * overlap in symptoms (fatigue, pain, sick-role behavior, negative affect - mood, depression, muscle soreness..) * Uncertain etiology: **diagnosis of exclusion**

Answer 3

* Emotional impact: felt in cage, jealous friends, lonely * Social impact: no pubs, bars, no school, can't initiate social interactions, can't be with friends * Biopsychosocial: family impact (table for 3 not 4), impact on marriage, like a bereavement) * Cognitive restructuring: better than before and does not focus on the "walls or door" - cage thing

Answer 4

* defense mechanism - avoid implication of illness * can work in short term - protective - slow you down while come to terms * later: can interfere

Answer 5

* lack of info, waiting for procedures and test results, side effects etc. * overwhelmed by potential change to life, or death * overly vigilant re physical changes * can exacerbate symptoms - create stress, pain

Answer 6

* Common, long term reaction * **mostly if unpredictable and progressive illness** * some higher risk: functional somatic syndromes * medical fallout: * **more pain and disability** * exacerbates risk / course of disease * **reduced treatment adherence** * assessment not easy cuz symptoms overlap

Answer 7

1. Illness-related factors: 1. disabling, disfiguring, painful, life-threatening 2. annoying or embarrassing bodily changes 3. side effects of treatment - e.g. erectile dysfunt. 2. Background & personal factors: personality **(resilience)**, **age** (young - inconvenient, teen - impact social life and acceptance), **gender** (men- not good re support grp or disability /**self image**) 3. Physical and Social Environmental Factors 1. **physical setting** (hospital or home) - stairs? need hospice? long term hospital care? 2. **Social support**: stigmas, relationship issues, need others who see it as manageable

Answer 8

* Go to doctor a lot, relationship with healthcare team * adjust to hospital, procedures and regimen * Cope with the symptoms or disability * Control negative feelings - maintain positive outlook * Prepare for an uncertain future * **Maintain satisfactory self-image & sense of competence & preserve good relationships (i.e. positive psychosocial functioning) - not feel dependent**

Answer 9

* Includes body image, achievement, social functioning and the private self * Attractiveness * Evaluate self-concept as good / bad (the "I am") * **Chronic illness can produce drastic changes in how we view the "self"** * **e.g.: "I am in a wheel chair" "I am no longer a sexual being"**

Answer 10

* Body image can be restored if possible (no burns) * Body image improved by stressing other aspects of health - re-evaluate how much weight we put on our physical appearance & focus on other aspects of the self to maintain a positive self image

Answer 11

* Achievement through **vocational and personal goals** * **study of spinal cord injury** ppl and their personal projects list (result: those who were depressed never changed their projects but held onto them hoping...those who were doing better modified their goals to "possible" ones or replaced them with something meaningful)

Answer 12

* **Social interactions are critical aspects of self-esteem** * worry that others will not support (especially if want to talk about the illness, not sure what else to say) * if stigmatized illness (neck cancer) hard to rebuild social identity * isolate to protect the self-esteem

Answer 13

* some find benefit - e.g. "wake up call" * become more present in life, value people more and simple things, can be easier on the "self" * can see the illness as a challenge (leukemia video where the guy said it made him a better husband, person, father - softened him) - small stuff np

Answer 14

1. Denying or minimizing - Passive 2. Seeking info - Active 3. Learning to provide one's own medical care - Active 4. Setting concrete, **limited** goals (doable projects) - Active 5. Recruit instrumental and emotional support - Passive 6. consider possible future events (& prepare for them) 7. Gain a manageable perspective

Answer 15

* Control-related beliefs: (will power, compliance, good health habits and self-treatment) - may cope better in the long run and experience less distress * BUT: if there really IS low control and try to control it, it could backfire....(e.g. try use diet for Stage 4 cancer) so: * **focus on aspects that are controllable which may facilitate better judgement**

Answer 16

* MUST develop a realistic view of the illness in order to cope effectively * ALL require some change / alteration of activities * **If not realistic:** * non-adherence to treatment program * improperly attuned to signs of disease * engage in behaviors that pose a health risk instead of those that could make it better

Answer 17

* When is self-blame accurate (possibly): * Diabetes type II * Obesity * Heart Disease * Lung Cancer - if was smoker * Can be good if it leads to you making positive changes and not blaming others (or non-adaptive - e.g. "oh well I already had one" re smoker and heart attack so no desire to quit)

Answer 18

* attributes valued by patients including: * comfort or sense of well-being * exent to which they are able to maintain reasonale physical, emotional, social and intellectual cognitive functioning

Answer 19

* change in symptoms is not necessarily linked to improved quality of life * assess: physical, psychological and social function/ disease or treatment related symptomology * **how much the disease and treatment interferes with daily living activities** * **advanced disease: functional : (bathing, dressing, toileting, mobility, eating etc.)**

Answer 20

* CHC impacts psychological health (depression, anxiety, panic) * Psychological distress increases risk of mortality * Aim to reduce stress levels & manage stressors that can't be eliminated * **can help to design interventions** * **can pinpoint which problems are likely to emerge for each CHC population** * **help to measure impact of treatments/interventions** * **compare quality of treatments**

Answer 21

* Additive impact on QOL (if more than one CHC) * more complex management of the condition

Answer 22

* Chronic endocrine disorder in which the body is not able to manufacture or properly use insulin * Insulin (pancreas) binds to receptors on cells to let the glucose in the cell (for energy) & otherwise the glucose accumulates in the blood (hyperglycemia) * cells think starving, alert body to eat more, then sugar rises even more * 6.8% Canadian population * higher for men, increase with age highest FN reserve

Answer 23

* Type I - insulin dependent diabetes mellitus * normally develops in childhood * cells on pancreas destroyed * need insulin injections * vulnerable to hyperglycemia and ketoacidosis (high fatty acids in blood - no glucose so cell burns fat as energy - kidney malfunction cuz can't rid all waste/fat so accumulates in body and poisons it - can be fatal )

Answer 24

* Non-insulin dependent diabetes * Pacreas produces some insulin but body resists the action of the insulin * managed usually through diet and meds * usually develops after 40

Answer 25

* Insulin resistence - cell receptors no longer respond * producing so much insulin (eat too much sugar) so receptors bombarded and get desensitized THEN pancreas thinks needs more insulin to use up extra glucose so balance off & insulin producing cells stop * Usually diets high in fats and sugars, stress OR * overprod. of protein that impairs metabolism of sugars and carbohydrates * Risk: obesity, sedentary, male, low SES, older, smoking

Answer 26

* Heart disease, peripheral vascular disease, stroke * atherosclerosis due to excess glucose: CHD * If in tiny vessels: blindness, kidney disease * Neuropathy: from nerve disease (glucose destroys myelin sheath - numbness and tingling extremities * extreme: gangrene / amputation

Answer 27

* Education of health risks * Self-management * Meds: monitor glucose/inject insulin as needed * Diet: reduce sugar & carbs, use meal plan * Exercise: normal weight; uses up glucose

Answer 28

* 80% inject insulin in unhygienic manner or wrong dose * 77% interpret glucose levels incorrectly * 75% don't eat prescribed foods * 75% don't eat often to maintain blood sugar levels Why? complex regimen NOT designed to cure and for a long time and requires lifestyle changes and always faced with temptations (can feel "punished"); rely too much on symptoms (inaccurate), poor literacy; gets in the way

Answer 29

**EXAM** * Social support: if have this, increased adherence * Self-efficacy: feel can handle regimen &control disease - better self reports adherence, glucose control(programs, materials, reminders) * Stress: body thinks needs energy so more glucose prod.; indirect behavioral changes - eat crappy food (need to manage it to decrease stress) * Negative emotions/depression: worse adherence and glucose control, more risk complications (depression: get help to manage low mood)

Answer 30

1. Information about the disease 2. How to reduce anxiety 3. How to increase feeling of purpose/meaning 4. Understand what is "normal" 5. Increase adherence

Answer 31

Treatment needs to work for the person's life so: * visual graphs for rehab to show improvement * find stress trigger that lead to poor diet, lack exercise * contract with rewards * add prompts and reminders * tailor it to the person's habits

Answer 32

* More likely to adjust positively if good support * Support groups: * online / face to face * tips re what works, what does not * can share emotional responses * provide coping tips * everyone same problem so no shame * motivating for treatment adherence * Family: can help with day to day life, diet, motivation, reminders, work into "family" schedule, better adherence

Answer 33

* Most common intervention for psychological complications arising from CHC * Used for: * flare ups , crises, recurrences * collaboration with doctor and family * help with depression * alleviate emotional distress even if temporary

Answer 34

* Relaxation and Biofeedback (to decrease anxiety and increase energy) * Cognitive: congitive restructuring, problem solving training, mindfulness based stress reduction (let go negative thoughts....)

Answer 35

It carries: * oxygen from lungs to tissues * carbon dioxide from tissues to lungs * nutrients from digestive tract to cells in body * waste products from cells to kidneys * hormones from endocrine glands to other organs * heat from center of body to surfact of skin

Answer 36

* CHD: disease of the blood vessels supplying the heart muscle * Cerebrovascular disease - vessels supplying brain * Peripheral arterial disease - vessels supplying arms/legs

Answer 37

* 2nd largest killer in Canada of men AND women * Chronic disease * caused by blockage (plaque) that prevents blood from flowing to the heart * atherosclerosis most common cause

Answer 38

* deposits of cholesterol & other stuff on arterial walls - forms plaque and narrows the arteries * reduces flow of blood thru arteries * less oxygen and fewer nutrients getting to cells * damaged arterial walls - potential site blood clots * associated with lots poor health habits (smoking, high fat, salt and sugar diet)

Answer 39

1. LDL & waste accumulates within artery wall 2. LDL pass through the thin inner layer (endothelial) of cells - oxidized LDL is toxic and creates inflammatory response 3. Macrophages eat the cholesterol and form plaque 4. When full the cells burst and die and more inflammat. 5. More plaque - wall hardens and thickens 6. smooth muscle cells in arterial wall multiply and move to surface ot the plaque & forms cap 7. Cap can erode or open, plaque releases into bloodstream - can contribute to formation of blood clots - heart attack or stroke

Answer 40

* **Angina pectoris**: painful cramp in chest, arm, neck or back due to lack oxygen blood to heart * little or no permanent damage * **Myocardial Infarction:** (heart attack) * part of muscle tissue of heart can be destroyed * many die suddenly without any prior symptoms

Answer 41

* Heart muscle has grown to meet the demands of having to pump more blood so enlarged and just can't keep up to meet body's needs * shortnes of breath with almost no exertion * elderly, those with risk factors for CHD, previous heart attacks

Answer 42

* produced in liver in response to inflammation * if have the protein it's a sign that damage may be occurring (it's in the bloodstream) * some doctors think that high CRP can increase your risk of heart attack

Answer 43

* 45+ men \> women * genetics (predisposed to cardiac reactivity) * High BP (hypertension) * **High cholesterol diet (#1 risk)** * **Smoking (#2 risk)** * Diabetes * Low physical activity * Stress * Hostility/anger

Answer 44

* Amount of force that is pushing against the sides of our arteries / vessels * BP determined by: * how much blood your heart pumps (output) * amount of resistance to blood flow in arteries (arteries not as elastic - push harder) * damage or clogged arterial walls * Not static - changes all time

Answer 45

* Persistently high pressure in the arteries * contributes to atherosclerosis: artery walls defend itself against the high BP by becoming rigid or thicker and narrower * **90% is essential hypertension - unknown cause**

Answer 46

Risk factors:(NO CONTROL) * Age (45+) * Race - South Asian, FN, Inuit, Afrian descent * Genetics: runs in families Risk factors: (YES CONTROL) * Salt intake * Smoking * Lack exercise * Obesity * High cholesterol and fatty diet * Too much alcohol * Caffeine * Stress / Emotional factors

Answer 47

* suspicious, resentful, antagonizing, verbally aggressive, distrustful of others - results aggression * strong Cardiovascular response under stress (BP) * high proinflammatory cytokines * higher males

Answer 48

Why heart disease linked to negative emotions? * less healthy lifestyle * bad mood eat crap, drink, smoke, no gym * NE same as stress reactions: high BP, release corticosteroids and endorphins (fight or flight), blood clotting to prevent an attack on body

Answer 49

1. Target those at risk: smokers, ppl with high cholesterol, alcohol abusers, ppl with diabetes, high stressed individuals, etc. 2. Blanket Campaign - public health initiative 3. Window of vulnerability & opportunity (menopause?) so good time to educate women about heart disease

Answer 50

* Estrogen protects against nervous system arousal, respond better to sress * higher risk after menopause (Higher BP, cholesterol, less exercise, more weight) * women misinformed re symptoms / risks CHD * less likely to receive & use treatment; more likely to be misdiagnosed (some docs don't even recognize when woman having heart attack - panic attack?) * more likely to die in hospital * lower QOL after treatment

Answer 51

* Why do people delay getting help? **EXAM** * expect symptoms to be like those on TV * unrealistically judge personal risk as low * Don't understand benefits of acting fast * feel like need permission to act (doc, family) * rarely discussed symptoms/responses before * wome often describe attack as "male problem"

Answer 52

* tell people about the symptoms * tell them they ARE vulnerable * tell them not a "wait around and see" thing * tell them to call 911 and to NOT drive themselves * get permission from doc in advance to seek help

Answer 53

* NO MI: have symptoms HD so get drugs to protect against MI and to stop/ reduce atherosclerosis; surgery * YES MI: * hospitalized coronary care unit * anxiety or even reoccurrance another attack * most return home from hospital * THEN: emotional adjustment to COMPLETE change in lifestyle

Answer 54

* Procedures: * Angioplasty (balloon / stent) * Bypass surgery (graft vessel), can have multiple * Meds: * clot-dissolving drugs * Beta blockers - lowers BP * Aspirin - prevent blood clots * Statins - lower LDL

Answer 55

* Bio goal: manage symptoms, limit progression disease * Psych & Soc: promote psych and soc adjustment * Education/Intervention: * how to take meds / schedule * how to stop smoking * stress management * how to adjust diet * Those who respond best: high self efficacy, optimism * Complication: adherence when MAJOR life changes

Answer 56

* Myth: exercise will bring on another attack * Truth: start slow then ramp up to vigorous level * Reduce risk of dying by 20-25% * BUT: of those who do start, 50% drop out 6 months (especially if they are depressed)

Answer 57

* good for self esteem * good financially: losing salary more stressful * show can bounce back, resilient * 80% return within a year, with modiefed job / hours

Answer 58

* Stress can trigger fatal cardiac events * need programs - doc's orders often way too vague (ie.: "reduce stress at home and work". HOW??) * Yoga, meditation good * More self care good * More positive thought good

Answer 59

* families important re cardiac rehab * can recognize symptoms of impending attack (**train families in CPR**) * No partner: 2x likely to die within 6 months after BUT: what is NEGATIVE Social Support: * symptoms worsen (from fighting,stress) * OR, wants independence and spouse babies patient (will make them more depressed, more "disabled", cardiac invalidism) * **Help?** have family watch stress test to see how capable patient really is (tend to underestimate)

Answer 60

* **tissue damage to brain due to disrupion in blood supply (oxygen deprivation)** * Ischemic stroke: blood flow cerebral artery interrupted (atherosclerosis, blood clot) * Hemorrhagic stroke: cerebral hemorrhage * 3rd leading cause of death Canada * 20% recurrence in 2 years * only 10% completely recover from stroke

Answer 61

* Sudden Onset * weakness/numbness face, arm or leg-1 side * dimness or loss vision (one eye) * loss speech - trouble talking, understanding * severe headache * dizziness, unsteadiness, sudden fall

Answer 62

* **Hypertension most important risk stroke** * 4-6 times more likely to have stroke * Why hypertension? atherosclerosis (hardening large arteries, weakening small ones) * Also: * smoking Family History * CHD / Diabletes Heart arrhythmia * High Cholesterol Drug/alcohol abuse * Obesity Mini-strokes * Physical inactivity Negative emotions/stress

Answer 63

* Left Brain Damage: **EXAM** * Communication Disorders (**Aphasia)** * Receptive aphasia: can't understand others * Expressive aphasia: can't express one's self * Right Brain Damage: * Visual Feedback issues (**Visual Neglect)** * One sided behaviors * Can't process visual information * Emotional Issues: **Alexithymia** * ****hard time understanding and verbalizing emotions

Answer 64

* Long recovery or maintenance if not recovery * deficits can be scary at first * "balance of reality and hope" - hope is when you start to recover and gain some function (BUT then can plateau and that can lead to depression)

Answer 65

* Thorough Assessment * brain scans, testing to see what areas affected * Tailored multi-disciplinary treatment * Psychotherapy for depression, coping new life * Cognitive training - restructuring * Neurorehabilitation - learning an entirely new way of living - new way of doing things * Physical therapy to regain motor function * Occupational and speech therapy * **Adherence / Co-management**

Answer 66

* dysfunction in cell DNA that causes rapid production of irregular cells forming a neoplasm (tumor) * The tumor fights the body for nutrients and oxygen * benign / malignent

Answer 67

1. **Carcinomas - malignant tumors of skin and organ cells (85% of all cancers) - breast, prostate, cervix** 2. **Melanomas - tumros of skin pigment (assoc moles)** 3. Lymphomas - cancer of lymphatic system 4. Sarcomas - malignant tumors of muscle, bone or connecive tissue 5. Leukemias - cancer of blood forming organs (bone marrow) - too many white cells suffocate the red which oxygnenate the body

Answer 68

* spread of cancer cells through bloodstream to other areas in the body * can have new tumors after metastasis

Answer 69

* **Direct:** spreads to vital organ and takes nutrients organ needs - organ failure * **Indirect:** weakens victim thru loss appetite (weight loss) and impaired immune function

Answer 70

1. Blood (leukemia, lymphoma) / urine (bladder cancer) 2. X-rays, Ct, MRI - looks for tumors 3. Biopsy: anaylze suspicious tissues / lumps 4. Self-examination of breast, testes

Answer 71

1. Genetics: breast, colon, prostate, ovarian 2. Environmental factors: (e.g. diet) 3. Lifestyle: more than 30% could be avoided (obesity, smoking, alcohol, HPV, fats, nitrates) 4. Married ppl - fewer cancers (social support?) 5. Stress - **link between uncontrollable stress and cancer progression** (with **suppressed immune system also can have fewer Natural Killer cells**)

Answer 72

* Cure disease forever * find and eliminate tumors * use 5 year survival rate

Answer 73

1. **Surgery** - cut out bad tissue if localized (BUT also can remove healthy tissue to biopsy to see if spread), doing less drastic now - more conservative removal - can create cosmetic problems (breast, neck) 2. **Radiation** - target cells - bad side effects (burned skin, hair loss, vomiting, loss appetite, possible sterility) - alter DNA cells which is good, can't repair 3. **Chemotherapy**- oral or infusion of drugs target at cells that rapidly reproduce (better for aggressive cancers) - reduced immunity, vomiting, nausea, hair loss

Answer 74

* classical condition process - become nauseous in anticipation of the treatment (25-50% patients) * Scapegoat foods: eat foods DON"T like before treatment so that don't ruin favorite food if you get "aversion"

Answer 75

* Pain, disability, fatigue, fear of remission, aversive treatments etc. so lots impact on person * **worst times for person: just after diagnosis or if it comes back after remission** * need meaningful interventions to help cope

Answer 76

* involve patient in treatment plan * **problem focused coping**: (can feel out of control) - so diet, exercise, relaxation exercises * **find meaning** - makes you live more, find gratitude, wake up call

Answer 77

* most receive bulk just after diagnosis but drops off * some just hide from friends so may have to be more present and engage them in problem solving discussions * Groups: in person and online; good for problem solving, good to speak to "survivors" can get important information that friends / family don't have * yoga, therapy good too but costs money

Answer 78

* Most important is the **diagnosis meeting**: how well that's done can make huge difference - give patient space to have emotional reaction THEN after can talk treatment options; need someone there with them * Support for diet, fatigue, nausea (can use **systematic desensitization and relaxation for nausea)** * **Individual Therapy** - issue specific (e.g. fear) * **Family Therapy** - help them to know how to support the person

Answer 79

* "you're tough", "you're a fighter" * can prevent a person with cancer from being honest with friends and family; result: loneliness, isolation

Answer 80

* SIDS biggest killer of children up to 1 year old * why: mom smokes, baby sleeps side or stomach, low SES * Public health campaigns - "Back is Better" so now 50% reduction SIDS

Answer 81

* motor vehicle accidents, injuries, poisoning, falls, accidental drownings * parent - could I have done something to protect them, feel failure * Cancer (2nd largest killer) but 80% survival rate childhood leukemia

Answer 82

* 1-5 - go away and come back, not permanent * 5-6: long sleep, curious instead of frightened * 7-9: know it's final and at 8 know biological aspect * 9-10: get that death is universal (get process)

Answer 83

* Unintentional injury (usually car accident) * suicide, cancer, homicide * **Reaction: shock, disbelief, LOTS anger (feel robbed), outrage, can be long death cuz otherwise healthy** * Parent: had a good glimpse of what their life would be so tragic, also feel robbed

Answer 84

* Premature death * Causes: heart attack, stroke from "usual suspects" * most would prefer to die quickly/painlessly - avoid deterioration and impact on family * possbily no "exit prep", financial impact on family, no opportunity to say good-bye if sudden * MOST prominent time to fear death - see others die, maybe have condition, mourn past lost ambitions

Answer 85

* Degenerative diseases (cancer, stroke, heart failure) or just physical decline; **shorter terminal illness due to already present biological competitors** * reactions: easier but not easy; more prepared, may have come to terms; can withdraw due to low energy

Answer 86

* psychological distress / lack of support

Answer 87

* more fit, better diet, genetics, hormones * men do riskier behavior, more substance use, less likely to seek social support for stress, more aggression

Answer 88

* less pain, more comfort * ability to make clear decisions * prepared * feeling of "completion" * affirmation of whole person * not a burden to others * sense of control * psychological and spiritual comfort

Answer 89

* "right to die" if terminal * think if should be a personal choice * no agreement on criteria * problem: if person is depressed is that a time to make that decision? (do psych evaluation) * contraty to physician's hypocratic oath * Living will: express instructions re death (need legal aspect) but no always in patient charts so not always respected

Answer 90

1. Coping with physical effects of worsening condition 2. Condition affects life as they know it now 3. Realize that the end is near - all the "nevers"

Answer 91

1. Denial - can be protective 2. Anger - why me 3. Bargaining 4. Depression 5. Acceptance Research: not verifiable and there is not really a specific order and some flip back and forth; good though to get an idea of what going through

Answer 92

* Goal: reduce pain and discomfort, improve QOL * Can specialize in this area (e.g. palliative care nurse) * found to be successful, higher survival rates, reduced anxiety and depression

Answer 93

1. Hospital - sterile, impersonal, limits visits from family, lower support, little control, under-medicated 2. Hospice: BETTER - 4 goals 1. dying in place of choice 2. maximize daily potential re what can still do 3. addresses family's needs 4. follow up care for family 3. Home Care - can be expensive but benefits and much more personal control (clothing, own bed, food)

Answer 94

* can be expensive if no coverage or grants * need training re medical stuff and lots contact with nurses and doctors * stress on family - can feel overwhelmed, full time job * caregivers cope best if feel appreciated

Answer 95

* hard job and nurses can withdraw to protect themselves - stop asking important questions like "how are you feeling" cuz can't take answer * bad for patient who needs the contact * heavy workloads * patient: ONLY person they see on regular basis so need a relationship and nurse is source information

Answer 96

* Talk about feelings re them, family, death * help resove unfinished business * behavioral: teach progressive relaxation or positive self-talk to help with depression * help them to find meaning in life so leave legacy

Answer 97

* trained interviewer asks questions of dying * makes a book of interview * permanent record for everyone to have after * helps enhance feeling of dignity and reduce stress for those in final life phase

Answer 98

* Bereavement - intense yearning for loved one * Worst time: couple days after funeral when all mourners gone and along with grief * new tasks to do (that spouse did before) * some less social support: gay men, elderly * if ruminate - less social support and more stress * reduced immune function - can lead to "dying of a heartache" * **Complicated grief**: more than 6 months, not fully accepting person gone

Answer 99

1. Accept the reality of the loss - accept person gone 2. Work through pain and grief - talk it out, acknowledgement, understand the assoc. emotions 3. Adjust to environment with person gone - can have new role or new identity (not partner, single) 4. Find appropriate connection in life with deceased (i.e. make a place for them but go on living)

Health Psychology Final Exam Flashcards

(123 cards)