PCCP 3

Question 1

What is prejudice?

Answer 1

Evaluative and affective component of a stereotype. Often negative judgement and attitudes.

Question 2

What is discrimination?

Answer 2

Behavioural component of a stereotype.

Acting upon a negatively prejudiced attitude.

Question 3

What is a Stereotype?

Answer 3

Cognitive social schema of a type of person or group that discounts individual differences. Mechanism of saving processing power.

Question 4

What is classical conditioning?

Answer 4

Pavlovs dogs

Theory of learned behaviour in which stimulus-response can become automatic over time.

Question 5

How can classical conditioning be used to change health behaviour?

Answer 5

Aversive stimuli to prevent bad habits. Eg alcohol + medication to induce nausea

Question 6

What is operant conditioning?

Answer 6

Theory of learning behaviour.

Negative reinforcement prevents behaviour and positive reinforcement increases behaviour.

Question 7

How can operant conditioning be used to change health behaviour?

Answer 7

Money saved towards holiday by giving up smoking.

Question 8

What is social learning theory?

Answer 8

Theory of learnt behaviour in which people learn by modelling themselves on the behaviour of others.

More likely to copy if

1. Behaviour is rewarded
2. We feel able to copy the behaviour
3. Copying a high status person

Question 9

How can social learning theory be used to change health behaviour?

Answer 9

Celebrities in public health campaigns.

Question 10

What is the cognitive dissonance theory?

Answer 10

Theory of behaviour in which we aim to reduce the discomfort that occurs when our beliefs and behaviour/outside events are inconsistent by either changing beliefs or changing our behaviour.

Question 11

How can cognitive dissonance theory be used to change health behaviour?

Answer 11

Provide uncomfortable information about smoking to create dissonance.
But….push people to rerationalise in the wrong direction

Question 12

What is the health belief model of behaviour?

Answer 12

Model of behaviour in which decision to act is a cost benefit balance between between beliefs about threat to health and beliefs about health related behaviour.

Eg weigh up threat of sti (likelihood/severity etc) vs wearing a condom (pros and cons)

Question 13

What is the Theory of planned behaviour ?

Answer 13

Theory of behaviour in which 
1. Attitude
2. Subjective norm
3. Perceived control
Affect an intention to act. 
May or may not translate into action

Question 14

What is the intention behaviour gap? How can it be reduced?

Answer 14

Intention does not translate into behaviour.

Reduced by Implementation intentions- write down concrete plans.

Question 15

What are the main stages of behaviour change?

Answer 15

Pre contemplation
Contemplation
Preparation
Action
Maintenance
Relapse

Question 16

What is the difference between compliance and adherence? Which is preferable?

Answer 16

Compliance - extent to which the patient does what the doctor orders them
Adherence - extent to which patient behaviour coincides with agreed medical advice.

Adherence is better because more patient centred.

Question 17

Give 4 reasons it may be difficult to measure adherence.

Answer 17

Hard to define what counts as adherence
Hard to compare different conditions
Adherence can be masked by taking medication when they know they will be tested
Can’t know medication has been taken

Question 18

How can we test adherence? What might be the problem with these methods?

Answer 18

Observation of consumption
Pill counters
Self report

But still can’t guarantee that the medication has been taken

Question 19

Give 3 patient- related factors which might influence whether the patient adheres to treatment.

Answer 19

Understanding of the illness and how the treatment works.

Recall of treatment regime

Beliefs about treatment and illness

Question 20

Give 2 illness - related factors which might influence whether the patient adheres to treatment.

Answer 20

Presence and severity of symptoms

Question 21

Give 4 treatment- related factors which might influence whether the patient adheres to treatment.

Answer 21

Complexity
Duration
Side effect profile

Question 22

Give 2 psychosocial- related factors which might influence whether the patient adheres to treatment.

Answer 22

Psychological health

Social support

Question 23

Give 2 healthcare- related factors which might influence whether the patient adheres to treatment.

Answer 23

Continuity of care

Communication skills of prescriber - perception of manner and competence.

Question 24

What kind of interventions can improve unintentional lack of adherence?

Answer 24

Memory aids

Blister packs

Question 25

What kind of interventions can improve intentional lack of adherence?

Answer 25

Improving communication skills - becoming more patient centred

Question 26

What is concordance?

Answer 26

Not related to medication taking behaviour. More about the nature of the relationship between doctor and patient, allowing shared decision making. But applying concordance principles will lead to greater adherence.

Question 27

What are the main differences between the biomedical and biopsychosocial models?

Answer 27

Psychological and social factors also valued: Can't separate the mind from the body - psychological factors affect health Deprivation and unemployment can affect health Particularly relevant for chronic illness

Question 28

Describe the physiology of acute stress

Answer 28

Fight flight or freeze Up regulation of heart rate, resp rate, immune system Down regulation of GI, reproductive

Question 29

Describe the physiology of chronic stress

Answer 29

Increased metabolism Down regulation of immune system More prone to disease

Question 30

What is the transactional model of stress?

Answer 30

We are constantly exposed to stressors. We have resources that allow us to cope - social support, resilience, certainty Weigh up balance (appraisal) between stress level and ability to cope - leads to perception of stress level.

Question 31

What is primary and secondary appraisal of stress?

Answer 31

Part of transactional model. Weighing up stress level by looking at: Primary - how stressful is the event? Secondary - what resources/ coping strategies do we have?

Question 32

Give some physical disorders potentiated by health?

Answer 32

Peptic ulcers Cardiovascular disease Upregulate on of cortisol - decrease in immune system

Question 33

What non physical pathways may stress impact on health?

Answer 33

Increase unhealthy behaviour - smoking alcohol etc | Mental health

Question 34

Which stage of behaviour change is motivational interviewing designed for?

Answer 34

Pre contemplative

Question 35

What is motivational interviewing?

Answer 35

Method which allows patients to come up with their own strategies and plans for behaviour change.

Question 36

What are piagets 4 stages?

Answer 36

0-2 sensorimotor - development of object permanence 2-7 - preoperational - development of symbolic thought, still egocentric 7-12 - concrete operational - development of conservation, development of theory of mind

Question 37

Give some examples of good practice in communicating well with children.

Answer 37

1. Sit at same level as child 2. Use their name and address them directly rather than just the adult 3. Simple language 4. Use props to explain difficult or abstract concepts

Question 38

What are the consequences of attachment theory?

Answer 38

Damaging for a child to be separated from a parent for too long Make effort to allow parent to stay in hospital

Question 39

What are problem focussed and emotion focussed coping? Give an example of each.

Answer 39

Problem focussed: Expand resources eg research, buy equipment Emotion focussed: Change feeling eg Talking to friends, alcohol, denial

Question 40

How can you help a patient to cope?

Answer 40

Increase/mobilise social support Increase sense of personal control Reduce uncertainty

Question 41

What factors might mean that anxiety or depression may be missed?

Answer 41

Non disclosure | Doctor avoiding asking

Question 42

What level of drinking is considered to be dangerous?

Answer 42

Increasing risk - Greater than 3-4 per day (male) 2-3 (female) High risk - greater than 8 per day (male) 6 per day (female)

Question 43

What are the 5 stages of grief, described by Kubler Ross?

Answer 43

``` Denial Anger Bargaining Depression Acceptance ```

Question 44

Describe the SPIKES model of breaking bad news.

Answer 44

S - setting (private, few interruptions, sit down) P - perception (ask what they already know) I - information (how much would they like to know) K - knowledge (warning shot, small chunks, check understanding) E - emotional support (ask concerns) S - summarise

Question 45

Give 3 intentional causes of non adherence

Answer 45

Beliefs about taking medication/diagnosis Expectations about efficacy of treatment Expectations about side effects

Question 46

Give 3 unintentional causes of nonadherence.

Answer 46

Poor memory Lack of transport to the pharmacy Lack of understanding of need for treatment