Leren Flashcards
(94 cards)
1
Q
Health psychology is the study of social, behavioural, cognitive and emotional aspect of what 4 things?
A
- Promoting and maintaining health;
- Manage and prevent illnesses;
- Identify psychological factors that add to physical illnesses;
- Improve the health care system.
2
Q
Health psychology is the study of four aspects. What four?
A
Social, behavioural, cognitive and emotional aspect
3
Q
Health psychology is the study of social, behavioural, cognitive and emotional aspects of some things, AKA…?
A
all the psychological processes that contribute to health and illness.
4
Q
What aims primary prevention for? And how is this done (3 things)?
A
Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur.
5
Q
What does secondary prevention aim for? How is this done (3 things)?
A
Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress, encouraging personal strategies to prevent reinjury or recurrence, and implementing programs to return people to their original health and function to prevent long-term problems.
6
Q
What does tertiairy prevention aim for? How is this done (1 thing) and what does that improve (3 things)?
A
Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy.
7
Q
What is a disease?
A
A disease is a biomedically defined pathology within the human system which may or may not be apparent to the individual.
8
Q
What is the difference between a disease and an illness?
A
A disease is a biomedically defined pathology within the human system which may or may not be apparent to the individual. You can have a disease without feeling ill. An illness is a person’s subjective experience of their symptoms.
9
Q
In what four domains can delay in getting healthcare arise?
A
Noticing the symptoms, interpreting them, reacting to them and the healthcare itself. See picture in samenvatting
10
Q
What is illness cognition? What are the five dimensions of illness cognition?
A
Illness cognition is how patients thinks of their illness. There are five dimensions:
- Identity. This is about the diagnosis (e.g. a cold) and symptoms (e.g. a runny nose, fever…);
- Perceived cause of the illness. Could be stress, a virus, an unhealthy lifestyle, etc.;
- Timeline (either acute or chronic);
- Consequences. Can be physical (pain, mobility problems) and emotional (lack of social contact, anxiety);
- Cure and control. Is about for instance taking ones medication of getting plenty of rest.
11
Q
Is an illness a crisis? Why (not)?
A
Illness is a crisis because it is a turning point in an individual’s life. Disruption to established patterns of personal and social functioning produces a state of psychological, social, and physical disequilibrium.
12
Q
What must people adjust to when getting ill? (7 things)
A
- The symptoms of a disease;
- Stress of the treatment;
- Feelings of vulnerability;
- Loss of control;
- Threat to ones’ self-esteem;
- Financial concerns;
- Changes in family structure.
13
Q
What has happened to the number of hospitalisations and mean days of hospital stays over the past years?
A
It has decreased
14
Q
What are the effects of hospital stressors (5 things)
A
- It is unpleasant;
- It forms a barrier for postoperative recovery;
- It affects post-operative mood and pain;
- In children: interference with their normal cognitive and socio-emotional development;
- Depression is linked to a longer stay and a higher risk of readmission within 30 days of discharge.
15
Q
Coping is about the efforts to… (3 things)?
A
Coping is about the efforts to deal in some manner with a threatening or harmful situation, to remove the stressor or to diminish the ways in which it can have an adverse impact on the person.
16
Q
Coping with a stressor is the process of…?
A
Coping with a stressor is the process of dealing with both internal and environmental demands that are perceived to be overwhelming and exceeding the personal resources of the individual.
17
Q
What two kinds of appraisal are there? What do they hold?
A
Primary appraisal (is the stressor harmful?) and secundary appraisal (are you able to cope with it?)
18
Q
What does coping well with an illness mean? (5 things)
A
- Achieving good physical health outcomes;
- Having comprehensive knowledge of the illness and symptoms;
- Being able to manage the illness;
- Being satisfied with the treatment;
- Having a good quality of life.
19
Q
What are the goals of coping (not illness-related)? (5 things)
A
- Recovery;
- Tolerating or adjusting to negative events or realities;
- Maintaining a positive self-image;
- Maintaining an emotional equilibrium;
- Continuing satisfying relationships with others.
20
Q
What are illness-related goals of coping? (3 things)
A
- Dealing with pain and other symptoms;
- Dealing with the hospital environment and other procedures;
- Developing and maintaining relationships with health professionals.
21
Q
What are the two coping styles? What are they about?
A
- Dispositional coping is a personality trait and a person uses the same coping style in different situations.
- Situational coping is when a person has diverse coping styles and uses one or the other depending on the situation. This one is more usual now.
22
Q
What are the two forms of coping? What do they hold and what strategies are used? Which form does everybody use?
A
- Problem-focused (fight). Here, the problem is addressed. Action is taken to change the situation and confront the stressor. Problem solving strategies are used. E.g.: changing or eliminating the source of the stress.
- Emotion-focused (flight). Here, emotions are regulated. The situation is not changed, but your reaction to the situation is. Distance from the situation is taken, the situation is redefined, and behaviour is avoided. It is about seeking distraction.
Everybody uses both forms.
23
Q
What form of coping is assoiated with better adjustment and less depression?
A
Problem-focussed coping
24
Q
What is the difference between approach and avoidance of a stressor? Which one leads to less stress? Are they problem- or emotion-focused?
A
Approaching means dealing with the stressor and related emotions. This is both problem-focused and emotion-focused. Avoidance is attempting to escape from having to deal with the stressor. This is always emotion-focused. Approach leads to less stress in the end.
25
What is the difference between approach and avoidance of a stressor? Which one leads to less stress?
Approaching means dealing with the stressor and related emotions. This is both problem-focused and emotion-focused. Avoidance is attempting to escape from having to deal with the stressor. This is always emotion-focused. Approach leads to less stress in the end.
26
What does self-regulation refer to?
Self-regulation refers to efforts of humans to alter thoughts, feelings, and desires away from short term temptations towards longer term goals.
27
Why do patients need self-regulation skills?
Patients need self-regulation skills in order to be able to cope with their disease.
28
What are three important concepts in self-regulation? What do they hold?
- Self-monitoring: what am I doing?
- Self-evaluation: how am I doing relative to my goals?
- Self-reaction: how do I think and feel about how I’m doing?
29
What are the three phases in self-regulation?
Goal selection/setting, active goal pursuit and goal attainment/maintenance
30
Why would you wanna make goals? (6 things)
- Goals motivate;
- They increase the quantity/quality of performances;
- They direct attention and allocation of cognitive resources;
- They mobilise effort;
- They help to develop strategies for goal achievement;
- They help people to continue making an effort.
31
What three things must goals be?
- Specific/measurable;
- Difficult and challenging (but realistic);
- Proximate.
32
What 5 things must be explored in intervention in phase 1 of self-regulation? What needs to be targeted?
Interventions in phase 1 must explore:
- risk perception;
- perceived cost/benefit of target behaviour;
- perceived social support;
- The patient’s competence to carry out recommended behaviour;
- Patients’ illness cognitions
Inaccurate illness perceptions need to be targeted.
33
What should be made in phase 1 of self-regulation? What do they hold and how should they be formulated?
Make action plans. Action plans are specific plans of action, which specify when, where and how to act: If situation X arises, I will perform action Y (if –then).
34
How should an action plan be formulated and what do the different components hold?
If situation X arises, I will perform action Y (if –then). The If-component is a cue (an automatic signal to prompt a behavioural response). The Then-component is an action function (link a specific action to the cue).
35
What is phase 2 of self-regulation about? What must interventions help with (2 things)? How do these interventions do that (3 things)?
Phase 2 is about active goal pursuing. Interventions must help to monitor behaviour, and emotions that facilitate or hinder effective action. They encourage the patient to use self-incentives when progress is made. They teach skills to control negative moods and reassure that relapse is not a failure. The patient is taught how to cope with relapse.
36
What is phase 3 of self-regulation about? What two things do interventions do?
Phase 3 is about short- and long-term change and goal disengagement. Interventions discuss satisfaction with the outcomes and help to reformulate a goal in a more manageable way if it is unattainable in the present form.
37
What does self-management refer to? What does it incorporate?
Self-management refers to the ability of the individual to cope with symptoms, treatment, physical and social consequences of chronic illness and related changes in lifestyle. Self-management is more than simple adherence to treatment guidelines: it incorporates the psychological and social management of living with a chronic illness.
38
What are the 5 core skills of self-management?
- Problem-solving;
- Decision-making;
- Resource utilisation;
- Forming of a relationship with the healthcare provider;
- Taking action.
39
What do the core skills of self-management lead to? (8 things, 6 improvements and 2 decreases)
```
These skills lead to improved:
- Adherence;
- Communication;
- Quality of life;
- Emotional wellbeing;
- Feeling in control;
- Self-efficacy,
And to reduced:
- Hospitalisations;
- Emergency department visits.
```
40
Name examples of potential elements of self-management interventions (10 things)
- Educate people about their disease;
- Shared decision making;
- Information provision;
- Help people to monitor symptoms and take appropriate action;
- Training (relaxation, mindfulness, stress management);
- Problem-solving techniques;
- Increasing self-efficacy;
- Increasing motivation;
- Goal-setting components (action plans) and follow up;
- Help people with communication.
41
What is self-guidance?
Being able to bring yourself to a goal.
42
What is self-efficacy?
A person’s confidence that he/she can perform certain behaviors.
43
What is a behaviour change technique?
A behaviour change technique is a systematic procedure included as an active component of an intervention designed to change behaviour.
44
What is a theoretical method?
A theoretical method is a general technique or process for influencing changes in the determinants of behaviour and environmental conditions.
45
Name five examples of theoretical methods.
- Guided practice to increase skills;
- Stimulate communication to mobilise social support;
- Personalise risk to improve risk perception;
- Arguments to change attitude;
- Self-monitoring to increase self-efficacy and skills.
46
What is adherence (according to the WHO)?
According to the WHO, adherence is the extent to which a person’s behaviour-taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider.
47
What three things does non-adherence lead to?
- Poor treatment outcomes;
- Higher amount of complications, physician visits, hospital admissions and healthcare costs;
- Lower quality of life.
48
What are the two types of non-adherence? What do they hold?
- Intentional. This is when a rational decision is made.
| - Non-intentional. Then, somebody might forget to take his medicine for example.
49
What are the four steps in adherence?
1. Acceptance of the regimen.
2. Adoption of the regimen;
3. Initiation of the regimen;
4. Treatment continuation.
50
What does acceptance of the regimen (step 1 of adherence) depend on? (4 things)
a. The readiness for change;
b. Patients’ preference for specific interventions;
c. Trust in a provider;
d. The consistency of the advice with previous interventions.
51
By what five things can adherence be measured?
- Questionnaires;
- Daily diaries;
- Drug concentration in blood samples;
- Prescription refills;
- Pill counts.
52
What is ADAPT? What are its functions? (6 things)
ADAPT is an m-Health application for adolescents with asthma. Functions of the app are:
- Monitoring disease control;
- Medication reminder alarm;
- Short educational and motivational movies;
- Chatting with peers;
- Chatting with pharmacists;
- Monitoring adherence (two questions about intentional and non-intentional adherence).
53
What did a study to the ADAPT app find? Does this apply to everyone? What were specific effective elements? (2)
A study to this app (including 66 pharmacies, 234 respondents, and control/intervention group and measurement of adherence (self-reported with the Medication Adherence Report Scale)) showed that there is an improvement in adolescents who were non-adherent and had poor asthma control. However, this did not apply to everyone. Specific effective elements were chatting with a pharmacists and monitoring complaints.
54
What are the five dimensions of adherence, according to the WHO?
- Social and economic factors;
- Therapy-related factors;
- Patient-related factors;
- Condition-related factors;
- Health system-/HCT-factors.
55
What do you call it when there is high physician control and low patient control?
Paternalism
56
What is is called when there is low physician control and high patient control? When does this occur? (2)
Consumerism. Occurs when being referred or with medication prescriptions
57
What is it called when there is high physician control and high patient control?
Mutuality
58
What six things are well-functioning relationships between doctors and patients characterised by?
- Accuracy and completeness of information about symptoms;
- Better comprehension of medical information;
- Improved adherence;
- Improved physical, psychological and daily functioning;
- Increased patient and doctor satisfaction;
- Faster recovery.
59
What are common mistakes made by health providers (not typical for low SES)? (4)
- The use of jargon;
- Baby-talking;
- Non-person treatment;
- Stereotyping patients (e.g. giving less information to migrants).
60
What are typical mistakes made by healthcare providers in low SES patients?
- Less information provision;
- Less positive socio-emotional support;
- More directive, less participating style.
61
What are common flaws in patients (not typical for low SES/non-natives)? (4)
- Neuroticism (leading to exaggeration of symptoms);
- Anxiety (leading to less attention);
- Low health literacy (leading to difficulties in understanding);
- Embarrassment (leading to not reporting important information).
62
What are typical flaws by low SES patients? (3)
- Asking less questions;
- Less affective expressiveness;
- Less opinion giving.
63
What are typical flaws in non-natives (3)?
- Language difficulties;
- Not asking questions if something is unclear;
- Expectations of doctors are unclear.
64
What skills do healthcare professionals need to communicate better with patients? (9)
- Welcoming and introducing yourself;
- Listening;
- Expressing empathy;
- Asking open questions;
- Ask questions about patient feelings;
- Paying attention to non-verbal signals;
- Communication with significant others of patient;
- Bringing bad news;
- Using motivational interviewing.
65
What skills do patients need in order to communicate better with their doctors? (3)
- Information seeking and verifying behaviour (e.g. asking questions);
- Assertive statements (e.g. articulating treatment preferences);
- Expressing emotions or concerns.
66
Skill-training led to what (according to studies)? And what was this not associated with?
Studies showed that skill-training les to more active participation. This was not associated with longer consultations.
67
What is motivational interviewing?
Motivational interviewing is a collaborative conversation style for strengthening a person’s own motivation and commitment to change.
68
What are the four tasks in motivational interviewing?
- Engage through having sensitive conversations with patients;
- Focus on what’s important to the patient regarding behaviour, health and welfare;
- Evoke the patient’s personal motivation for change;
- Negotiate plans.
69
What are change talks?
Change talk are statements made by patients that indicate that they are moving towards making a positive change in a problematic behaviour.
70
What is health literacy?
Health literacy refers to the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.
71
What do new medication leaflets contain and what is that for?
New medication leaflets contain icons and simple language, to help people with low health literacy.
72
What three types of health literacy exist?
Functional health literacy, interactive health literacy (or communicative health literacy), critical health literacy.
73
What is interactive health literacy? What 5 things is it needed to?
These are skills to participate actively, to extract health information, derive meaning from it and apply it to changing circumstances. It is needed to:
o Search online for health information;
o Ask questions to your doctor;
o Discuss your health problems with a professional;
o Apply information to your own life;
o Distinguish major and minor issues.
74
What is functional health literacy about? What four things is it needed to?
This is about the basic skills in reading, writing and calculating. It is needed to:
o Read medicine labels and consent forms;
o Keeping appointment schedules;
o Read written information provided by healthcare professionals;
o Find the way in hospitals.
75
What is critical health literacy? What 3 things is it needed to?
This is about critically analysing and reflecting on information or advice an using information to exert control over you own health. It is needed to:
o Make informed health decisions;
o Take responsibility over one’s own health;
o Appraise the reliability of obtained health information.
76
Name 4 guidelines in communication for health professionals
- Identify patients with limited health literacy.
- Avoid difficult language and medical terminology;
- Make use of visuals;
- Use the teach-back-method.
77
Name 4 examples of how you can identify patients with limited health literacy
o Excuses like “I forgot my glasses”;
o Incomplete registration forms;
o Frequently missing appointments;
o Non-compliance.
78
What is done by the teach-back method? (3 aspects)
Here, you:
1. Confirm if you message to the patient is understood;
2. Ask the patient to explain in their own words what they need to know or to do;
3. Indicate how well you communicated. It is not to test a patient.
79
What is a lapse?
A lapse is when you show old, unwanted behaviour that you changed in the past. An individual may be able to cope with the reason for the lapse and continue with the new behaviour again.
80
What are four possible definitions of a relapse?
- A breakdown in the person's efforts to control a particular problem (i.e. continuing exercise participation) (Stiggelbout);
- Participants who went from sedentary to active at 6 months (at least 150 min of moderate intensity PA per week or at least 60 min of vigorous intensity PA per week), but went back to inactive at 12 months (Williams);
- Return to uncontrolled drinking or abandonment of the abstinence goal (full-blown relapse) (Marlatt & Larimer);
- A full return to previous unhealthy behaviour.
81
What are two possible definitoins for maintainance?
- An action sustained over a certain period of time (Rothman, 2000);
- A sustained behaviour shown during a given period and after an intervention complying with a threshold believed to improve well-being or health within a given population (Seymour et al., 2010).
82
What lead to relapse (2 things)?
Non-maintenance and non-adherence lead to relapse.
83
What is relapse caused by?
High risk situations
84
What are the four categories of high risk situations?
Negative feelings, interpersonal conflicts (conflicts you have with someone else), social pressure (people pressuring you to engage in unhealthy behaviour) and positive emotional states (you celebrate something (like life)).
85
How do people get in high-risk situations? (5 things)
- Lifestyle imbalance and stress.
- Desire for indulgence;
- Urges (relatively sudden impulse to engage in an act, such as alcohol consumption) and cravings (subjective desire to experience the effects or consequences of an act, such as alcohol consumption).
- Rationalisation (justification of certain behaviour with faulty logic/making excuses to explain behaviour (“I deserve it”));
- Apparently irrelevant decisions
86
What are urges and cravings?
Urges (relatively sudden impulse to engage in an act, such as alcohol consumption) and cravings (subjective desire to experience the effects or consequences of an act, such as alcohol consumption)
87
What are interventions that should be done when having an urge/craving? (4)
o Engage in another activity;
o Talk about the craving;
o Contact someone;
o Surf the urge (based on the assumption that an urge does not last forever and it can therefore be ridden out. Step back, observe and don’t act on the impulse).
88
What intervention can be done when there is a lifestyle imbalance/stress?
This can be intervened by a lifestyle balance intervention (in which you write down your should and wants, top 3 stressors in life and answer questions like “what little action could you take to improve your balance?”)
89
What are apparantly irrelevant decisions (talking about relapse)?
Apparently irrelevant decisions: a series of mini-decisions that take a person into a high-risk situation. These decisions may seem irrelevant at the time, but often lead to relapse.
90
Name 4 examples of what people can learn in coping skills training
- Say no;
- Plan;
- Solve problems;
- Manage stress.
91
What three things can be done as intervention in preventing relapse?
- Identifying warning signals and high-risk situations;
- training coping skills;
- cognitive restructuring. People tend to think black and white, so we must teach them to see shades of grey.
92
The self-determination theory stated that there are three things that influence one's motivation. What three things? What do they hold?
- Autonomy. This is about the need to control your own life and the feeling to have a choice.
- Competence. This is about being effective in actions.
- Relatedness. This is about the need to feel connected and belonginess with others.
93
Dumenci and his colleagues developed a specific questionnaire for cancer health literacy. What five tasks are needed for a certain level of cancer health literacy?
- Making diagnostic and treatment-based decisions;
- Discussing success rates of chemotherapy with doctor;
- Discussing 5-year survival rates with doctor;
- Distinguish credible medical evidence from myths;
- Adhere to medication.
94
An example of self-management interventions is 'reuma uitgedaagd'. What are the five goals of this program?
- Taking control of your own life;
- Better communication with your environment and health care professionals;
- Setting boundaries;
- Managing pain, fatigue and emotions;
- Finding trustworthy information.
