Psychology Of Serious Ilness Flashcards
Illness brings changes
Identity - worker to patient
Location - home to hospital
Role - independent adult to passive dependant adult
Social support - isolation eg : co workers, family, friends
Future - previous certain plans may become uncertain
Problems associated with illness
- Unpredicted - no preparations made
- unclear info - don’t understand and feel stupid
- Ambiguous meaning - even if message clear consequences may not be
- Quick decisions - health decisions need to be made when person least able to think
- limited experience - dont know what to do or how to cope
Cytokines
In common with other health problems MI results in release of cytokines
Psycho result in lethargy
The result is a decrease inactivity
This reduction in activity adaptive in acute illness but maladaptive when long-term.
Makes the activity of rehabilitation hard to motivate .
Adaptive tasks
+ preserving an emotional balance
+ preserving self image, competence, and mastery
+ sustaining relationships with family and friends
+ preparing for uncertain future.
Lazarus and Folkman : stress cycle
Primary appraisal - does situation require a coping response? ——> yes
——> secondary appraisal - Are resources available to cope? ——-> no ——->
STRESS
Coping
Divided into
- problems focused coping - more effective
- emotion focused coping
People use a combination of
By Lazarus and Folkman
A crisis:
- occurs when various coping strategies don’t work
- Results in a state of despair and disorganisation
- Tends to be self limiting
= people tend to find their way out of a crisis - help maybe needed to resolve
emotional regulation
- expression of negative motion is often adaptive
- Expression of positive emotion: finding growth and meaning in illness is also adaptive
Males tend to
Focus on practical problems and their solution and not address, emotional issues
Use humour to distance from problems
Females tend to
Want to express emotional response as an initial form of coping
Anxiety may be caused by
~ acute pain
~ Onset of serious illness
~ events in course of illness
~ uncertainty
~ collapse of denial
~ poor communication
Anxiety may result in
- excess use of services
- Hyper-vigilance
- use of maladaptive behaviours - eg: smoking or drinking
- Avoidance of adaptive behaviours
- eg excersise for mI
Depressive disorders are more common in those with physical illness than without
Depression and physical illness:
- severe forms of depression are relatively common
- poor outcomes in terms of physical and mental health
- increased incidence of morbidity and mortality
Depressed physically ill patients:
- undergo more investigations and treatments than non-depressed ‘- have worse function
- less likely to comply with treatment
NICE - depression
Professional should bear in mind that
- the potential physical causes of depression
- depression may be caused my medication
High risks for depression
- previous history of depression
- Significant physical illnesses causing disability
- other mental health problems
