Impact of life events on patient well being

Question 1

Definition of life event

Answer 1

Major happenings that can occur in a person’s life that require spe degree of psychological readjustment.

Question 2

Main sources of life events stressors

Answer 2

-Individual
-Family
-Society

Question 3

Explain and give examples of individual source of stressors

Answer 3

Illness, conflict, personal relationships, lack of control.

Question 4

Describe the possible internal conflicts

Answer 4

Can be:
+Approach-approach: patient make choice between 2 positive options.

+Approach-avoidance: patient had to make a choice between something positive and something negative.

+Avoidance-avoidance: patient has to make choice between two negative options. Example choose between chemotherapy or radiotherapy for cancer treatment.
Internal conflicts can cause anxiety, depression, headaches, nausea, etc.

Question 5

Explain and give examples of family source of stressors

Answer 5

-Divorce, marriage, death of family member, birth of baby. disability.

-Caring for someone with chronic illness can increase financial burden, depression, anxiety, sadness, stress

Question 6

Explain and give examples of society source of stressors

Answer 6

Job, social environment, workload, relationships with coworker, deadlines, etc.

Question 7

What systems do life events impact on?

Answer 7

+ Physiological system- Leads to a Fight or Flight response due to activation of SNS and adrenaline.

+Psychological system- affects cognitive functioning like memory, attention, emotions. Can cause, fear, excitement, depression, anger…

+Social aspect- Involves social behaviour, socio-cultural differences, gender…

Question 8

How can we measure stress?

Answer 8

• Self report: Interview, questionnaire, rating scales
• Physiological: galvanic skin response( electrical conductance of skin), changes in BP and HR, biochemical markers like cortisol levels.

Question 9

Characteristics of SRRS(Social Re-adjustment Rating Score

Answer 9

-Based on adjustment required for various life events
-Scale of 0-100
-Time period: last 12 months
-Total stress score: values of all life events added.

Question 10

What are the levels of stress according to the total stress score?

Answer 10

Low- Less than 149
Mild- 150 to 200
Moderate- 200 to 299
Major- more than 300

Question 11

Advantages of SRRS

Answer 11

-Wide range of events
-Easy and quick
- Useful to assess stress and illness
-Positive correlation between life events and illness.

Question 12

Disadvantages of SRRS

Answer 12

-Some items are very vague or ambiguous as it depends on severity of item
-Doesn’t consider impact of event on patient: can be positive or negative.

• Failure to distinguish between desirable and undesirable( undesirable events correlated with illness)

-Can be inaccurate as patient must remember how they felt during the life event- retrospective approach.

-Causality- did the illness cause the life event or viceversa?

Question 13

Examples of other life events scales

Answer 13

LES- 57 events
PERI- 102 events
UES- 320 events ( most precise)
(SRRS has 43 events)

Question 14

Limitations of physiological measures

Answer 14

• Measure might induce stress
  -influenced by other factors aside from just stress
  -expensive, time-consuming

Question 15

High stress can increase risk of what illnesses?

Answer 15

-High BP
-breast cancer
- depression
-burnout
-heart disease
-immune function

Question 16

Results from Life events and breast cancer study

Answer 16

-High lifetime change and several life events increase risk of breast cancer.
-Health care actions can be aimed to early detection and prevention of breast cancer.

Question 17

Results from life events and immune function study

Answer 17

Several life events increase risk of multiple sclerosis by up to 30 %

Question 18

Results from life event and asthma

Answer 18

Risk of asthma attacks increase with negative life events, but is also magnified when patient experiences multiple chronic stressors.

Question 19

Definition of hassle

Answer 19

Minor stressors that occur regularly.
Accumulation of hassles can impact health

Question 20

Describe the Hassles scale

Answer 20

Includes daily unpleasant/ harmful events.
- It is associated with health status
- Strong predictor of psychological and physical well being.

Question 21

Describe Uplifts scale

Answer 21

Includes positive events that bring peace and satisfaction.
-Has little association with health status.

Question 22

Name and describe the 2 different types of stress according to Selye

Answer 22

Distress- harmful and damaging (neg. effects)
Eustress- beneficial and constructive (pos. effects)

Question 23

Quality of functioning and stress

Answer 23

-Very low and very high levels linked to low levels of performance.
-Moderate level of stress leads to maximum level of performance.