Psychology - Chronic Illness

Question 1

Define chronic illness

Answer 1

• Lasts more than 3 MONTHS
• Progresses SLOW
• May include REMISSION and RELAPSE
• NO CURE

Question 2

Initial reactions to diagnosis

Answer 2

-SHOCK: emotional distress, bewildered, feeling detached, disorganised thinking

• EMOTION focussed strategies: grief, fear, helplessness, overwhelmed, anxiety, depression
• Retreat and DENIAL: denying and avoiding to control emotional responses

Question 3

Anxiety and Depression in the context of illness

Answer 3

Anxiety: Response to threat, exacerbated by feeling out of control, unpredictability.

Depression: 2-3 x more common in Chronic Disease. Difficult to diagnose due to similarities between symptoms.

Impacts, compliance, increased risk of dying, reduced recovery.

Question 4

Crisis Theory and factors influencing adjustment

Answer 4

Diagnosis of Chronic illness seen as a LIFE CRISIS - the COPING process restores EQUILIBRIUM

ILLNESS factors: level of disability, embarrassment, pain, threat to life, lifestyle changes

PERSONAL factors: Age, stage of life, gender, socio-economic status, personal beliefs, previous illness experience, personality factors (high neuroticism, low conscientiousness = greater health risk.

PHYSICAL, SOCIAL AND ENVIROMENTAL : social support, hospital, home, loneliness, social environment

Question 5

Coping strategies in chronic illness

Answer 5

Cognitive appraisal: examines the MEANING of the illness in their life (threat or challenge)

Adaptive tasks related to illness/treatment - coping with physical changes, self care routines, developing relationships with staff

Adaptive tasks related to general psychosocial functioning - preserve relationship and social network, preparing for an uncertain future, maintain sense of competence and self image.

Denial, avoiding, blaming, guilt and shame

Acceptance, adherence to treatment, self management and goal setting

Question 6

Adherence behaviours

Answer 6

Unintentional non adherence - want to adhere but practical barriers such as capacity, resources, or unclear directions

Intentional non adherence - deliberate, due to perceptual barrier such as motivational beliefs and preferences e.g. do not trust medicine

Question 7

Psychological interventions to support adjustment and coping

Answer 7

EDUCATIONAL, SOCIAL and BEHAVIOURAL approaches - reminders/alerts, support groups

RELAXATION measures - manage stress and anxiety

COGNITIVE methods, e.g. CBT to change maladaptive beliefs

INSIGHT and FAMILY THERAPY therapy

Question 8

Define habits

Answer 8

Triggered in RESPONSE to contextual CUES such as washing hands after toilet

Question 9

Habit loop

Answer 9

CUES - internal or external TRIGGERS (place, person, time)

ROUTINE - behaviour to REINFORCE or change

Reward - makes the routine worthwhile, positively reinforces the habit

Question 10

Habit formation

Answer 10

Initiation phase- define new behaviour and plan

Learning - behaviour repeated to strengthen context

Stability - habit has strengthened and we miss it when its not performed