Flashcards in Understanding Patient Behaviour Deck (17)
According to the Leventhal Et Al (1985) act, what are the factors that are believed to predict health behaviours?
1. Social factors- learning, reinforcement, modelling, social norms
2. Genetics- genetic basis for alcohol use
3. Emotional factors- stress, anxiety, tension and fear
4. Perceived symptoms like pain, breathlessness and fatigue
5. Beliefs of patients and healthcare professionals
What are the general risk factors for coronary heart disease?
1. Smoking and tobacco use
2. Poor diet
3. High blood cholesterol
4. High blood pressure
5. Insufficient physical activity
6. Overweight and obesity
8. Psychosocial stress
9. Excess alcohol consumption
10. Maternal nutrition and air pollution
What are the treatment goals for coronary heart disease?
1. Resuming appropriate levels of exercise
2. Smoking cessation
3. Weight management (BMI less than 30kg/m2)
4. Addressing alcohol use
5. Stress management
Describe the lay referral system?
1. If suffering from symptoms- decision is made to seek medical advice isn't often because of just themselves
2. They seek to discuss decision with:
Family, friends and colleagues
Why do patients regularly consult a pharmacist?
1. Minor aliments
2. Conformation of health status
3. Pharmacists' accessibility
4. Source of information, supplier of convention and unorthodox treatment
5. Have medicine dispensed
6. Receive health care promotion advice and/or diagnostic testing
What are the factors that influence an individuals response to an illness?
1. Symptom visibility and perceived importance
2. Assessment of symptom's significance (risk assessment)
3. Potential for individual's symptom to disrupt community
4. Symptom for denial for fear of conformation of serious disease
5. Deferring response to symptoms for competing demands like work, family commitments
6. Assessment of social and economically costs of RTS against potential health related benefits
7. Available information, knowledge and cultural assumptions
8. Frequency and persistence of symptoms
9. Competing interpretations of symptoms
What are the psychological needs to cardiac patients?
1. Concerns about the impact of symptoms and significance
2. Adherence to or side effects from treatment
3. Shock, disbelief and denial about having cardiac problem
4. Coping and engaging in everyday activities
5. Modifying behavioural risk factors for coronary heart disease
6. Changes in relationships and interactions with other people
7. Catastrophic interpretations about impact of cardiac disease on their lives and prospects in future
8. Re-emergence or worsening of pre-morbind psychological difficulties (past depression)
Describe what communication barriers can cause non adherence of medication and what it's caused by?
1. Non english as primary language
2. Low function literacy
3. Substance abuse
4. Mental illness
- Limited time with patient
- Complex medication regimens
- High level instructions
Describe what motivation factors can cause non adherence of medication and what it's caused by?
1. Poor understanding of disease state/illness
2. Lack of perceived need or benefit from medication
3. Fear of toxicity or side effects
-Limited time with patient
-Complex medication regimens
-Polypharmacy (4 or more medicine used by patient)
Describe what socioeconomic factors can cause non adherence of medication and what it's caused by?
1. Inadequete healthcare coverage
2. Unemployed and poverty
3. Concerns about costs
What can patients suffer from thats not cardiac related when they have a existing cardiovascular disease?
1. Anxiety and depression
2. Reluctant to accept diagnosis or anxiety or depression
What are the lifestyle changes after an MI?
1. Changing diet
2. Alcohol consumption
3. Regular physical activity
4. Smoking cessation
5. Weight management
How does a patient adjust to a long term condition, what are the long term characteristics and illness trajectory?
1. Body systems impacted
2. Symptom burden
Illness trajectory :
2. Complicated onset
3. Change in treatment
4. Relapse or flareup
What is the lazarus and folkman stress and coping model? (LONG ANSWER)
1. Stimulus- what is at stake?
2. Primary appraisal
- threat relevant? (harm & loss, threat, challenge)
- No threat = no worry
3. Secondary Appraisal - What can i do?
- What resources do i have?
- Will it be effective (expectations)
4. Coping behaviours
- Problem focused: managing the cause of distress
- Emotion focused: regulation of distress
5. Re-appraisal back to beginning of stimulus
What is the Leventhal ET AL common sense model? (LONG ANSWER)
Look in folder of PM2D
What influences behaviour changes?
1. Persuasive communication and interaction
2. Appropriate follow up
3. CPD to ensure best practice
4. Adherence tob best practice guidelines
5. Interventions which work:
- Targeting eating, physical activity, sexual behaviour, addictive behaviours, stress management, screening for women, use of health services
- Shorter interventions are more effective
- Targeting women and older people (more effective)