WEEK 10

Question 1

1. According to Bonino, what do patients fear most about death? What does she mean by
   “therapeutic obstinacy” and how does it relate to this fear?

Answer 1

not death itself, but the poor conditions in which life is lived before death (Prolonged pain, los of dependence, burden).

Therapeutic obstinacy refers to the persistent and aggressive use of medical treatments and technologies to prolong a patient’s biological life at all costs

-* Exacerbates the very fears patients

Question 2

1. What is phytotherapy?

Answer 2

form of treatment that uses plants and plant-derived substances for therapeutic purposes. It is considered closest to official Western medicine because its effectiveness is often based on empirical knowledge and, at times, scientific experimentation. Many modern drugs are derived from or inspired by plant-based compounds.

Question 3

What is the key feature that distinguishes so-called alternative medicine from official
Western medicine?

Answer 3

The discriminant lies in the systematic and objective verification of the usefulness of a therapy

Question 4

3. What is the “availability heuristic”?

Answer 4

events, mentally recalled with greater ease, due to their strong emotional relevance, are wrongly considered as more probable.

Question 5

According to the scientific method, what does it take to prove the validity of a
hypothesis?

Answer 5

Therapies that have shown, in respect to a control group, to be more effective than “chance” are considered valid.

Question 6

5. What is it about chronic diseases that makes a patient vulnerable to the appeal of
   alternative medicine?

Answer 6

having an incurable disease, unable to heal or alleviate serious symptoms, one believes they are not risking anything, desire to act personally comes into play

Question 7

6. What does Bonino mean by suggesting that the attraction to alternative medicine
   represent patients’ attempts to recover their subjectivity?

Answer 7

Bonino suggests that many patients turn to alternative medicine as a way to reclaim personal agency, autonomy, and decision-making power in the face of a healthcare system that often overlooks their individuality. By choosing treatments outside the official system, they assert their identity and personal control

Question 8

According to Bonino, what is an effective method for combatting depression?

Answer 8

Learn to actively change their explanatory style and ones control over reality. Use of cognitive theory.

Question 9

2. When are pharmacological interventions ineffective for treating depression?

Answer 9

When it becomes the only way to deal with depressive feeling, Makes wellness dependent on the drug

Question 10

3. What are “positive illusions” and what role do they play?

Answer 10

Real cognitive distortion about oneself and their assessment of their health which would allow them to maintain optimism for the future

Question 11

4. Define “effective optimism”.

Answer 11

Realizing ones limits realistically while maintaining optimism about what can be achieved within the constraints

Question 12

5. Why is social isolation a problem?

Answer 12

Important of social exchange to develop new identity not as only the person who needs help but to be useful to others

Question 13

Why do some people resort to magical thinking in situations of illness?

Answer 13

Way of explain unknown and potential threatening events , defensive and proprietary function (protect oneself and gain the favor of positive forces, so that they can counteract negative events.)

When faced with a situation that is too incomprehensible and threatening the use of logical thinking is insufficient to meet their cognitive and emotional need

Question 14

2. Should magical thinking always be discouraged in people who are ill?

Answer 14

Can be accepted occasionally. Becomes a problem when strong and persistent, leads to abandoning consolidate therapies and a dependence on a charismatic figure

Question 15

How can the use of magical thinking by people who are ill be reduced?

Answer 15

Greater knowledge about disease and its evolution
Addressing emotional needs (openly talk abt fears)

Question 16

How can storytelling be important in helping someone who is seriously ill?

Answer 16

Finding coherence in yourself and what happens to us.
- Allows us to redesign our identity to be reborn where the disease had wreaked havoc
- Find comfort, participation, help and advice
- Way to find oneself and potential for development

Question 17

What are examples of violations of patient confidentiality that occur often in
hospitals?

Answer 17

• having to yell across protective glass to book specific exam or type of pathology
  o small towns can be embarrassing
• Leaving hospital room doors open

Question 18

1. According to Bonino, what is the correct way to interpret the phrase, “survival of the
   fittest”?

Answer 18

the winner is the one who best knows how to live in a group, who is most able to recognize and share the emotions of others, establish collaborative relationships, protect and help companions

Question 19

What are “double-link communications and how can they be harmful?

Answer 19

Contradictory messages that place those who receive them in the unpleasant situation of not knowing what to give importance to and making mistakes regardless
- Go ahead, I am always alone

Question 20

What is self-efficacy and why is it important to promote it in people who are chronically ill?

Answer 20

self- efficacy, in asking for help as one of the basic skills which a patient must learn. Require lucid analysis of ones own potential to be done in concert with oneself and their support systems.
- Ability to identify when needing help without overestimating or underestimating

Question 21

What are reasons why some people who have a chronic illness might not want to disclose their suffering?

Answer 21

-do not one to be perceived differently
-risk for refusal attitude, exclusion, manipulation, morbid curiosity
-considered inappropriate to show one’s suffering
-fear of letting go too much, attempting to maintain a positive self- image, distrust of the interlocutor including his/ her capacity for understanding

Question 22

Why does Bonino say that being alone for a person with a chronic illness can be particularly contradictory?

Answer 22

-chronically ill cannot live without others
- disease alienate others (e.g. tiredness, immobility, participating in social events, relapse stop maintenance of friendships)

Question 23

When is it OK to respect an ill person’s request to be left alone?

Answer 23

-sometimes people want to be alone to recharge and realign their thoughts

Question 24

Why can receiving a diagnosis of a serious illness sometimes be a relief to a person?

Answer 24

-relief for those who experience strange ailments with no explanation and sense of power to fight against it

Question 25

What are appropriate ways to communicate a serious diagnosis to a patient?

Answer 25

- sufficient time, to allow listening and dialogue, with a genuine attitude of participation - No lying (creates illusions) o Patient feels betrayed later on

Question 26

Why does Bonino say that the doctor-patient relationship in chronic illness must be continuous and established over time?

Answer 26

This continuity is essential because the treatment involves “a relationship today described by many as a relationship between partners who work together for the same purpose.”

Question 27

What should “trust” mean in a doctor-patient relationship?

Answer 27

being able to perceive your doctor having the knowledge, responsibility and care to work with you to provide you with the best outcome

Question 28

What factors can undermine trust in this relationship?

Answer 28

by all situations where reciprocity and a sense of responsibility are lacking. (e.g. doubts about knowledge, belief that they are being used for monetary gain)

Question 29

How is empathy different from emotional contagion?

Answer 29

empathy is different from emotional contagion, in which the absence of a differentiation between self and other causes an automatic and involuntary affective sharing, which translates into an immediate motor imitation (for example, without realizing it, assuming the posture and the expression of another).

Question 30

What does Bonino consider the most advanced, evolved form of empathy? ability to understand that the experiences of others can be different from one’s own and to participate in it equally; for example, we can participate in the emotion of sadness experienced by a sick person, even if in a similar situation we would rather react with anger

Answer 30

ability to understand that the experiences of others can be different from one’s own and to participate in it equally; for example, we can participate in the emotion of sadness experienced by a sick person, even if in a similar situation we would rather react with anger

Question 31

1. What is the difference between statistical logic (paradigmatic thinking) and clinical logic (intensional thinking)?

Answer 31

Logical- paradigmatic thinking has been defined as “extensional,” since it seeks universally valid general laws (for example, how the heart works in humans) In this type of thought, the individual case is of interest not in itself, but in that it is related to general categories VS Clinical thinking, on the other hand, is typically “intensional” and applies to the individual case, considered and studied in depth in its irreducible specificity. No general laws are sought

Question 32

What are advantages to patients who seek knowledge about their illness or condition?

Answer 32

Allows one to act in an adequate way, therefore feeling more capable of dominating their disease in an effective exerting control over their symptoms

Question 33

Why shouldn’t patients have complete trust in information they obtain from the internet?

Answer 33

Too much info lacking scientific proof and may have ill intentions (monetary gain)

Question 34

Why does Bonino say that sharing experiences on social networks can in no way replace psychological work to learn how to live better with a chronic illness?

Answer 34

Does not mean greater awareness of what you are feeling and the best way to deal with various situations of your disease

Question 35

Why does Bonino say that “fear is a bad advisor”?

Answer 35

Leads us to see future in a negative and distorted way, anticipating situations in reality that would never occur.

Question 36

What is meant by the term “disability rights”?

Answer 36

Belief that people with disabilities are fully human with rights and dignities enjoyed by all people and address gaps between the circumstance’s barriers and opportunities that people with disabilities and those without disabilities experience

Question 37

What does the author describe as the “real shift” in disability rights policy in the 2000s?

Answer 37

National Act plan put in place allowing those with disabilities to live independently, become educated and employed and alleviate poverty rates

Question 38

How are people with disabilities viewed in Canadian Indigenous cultures?

Answer 38

“the gifted one/special ones”, seen as teachers and purposely put here

Question 39

What is “Jordan’s Principle”?

Answer 39

Law that government of first contact to pay for services and treatments and then seek reimbursement afterwards

Question 40

What is the significance of the Tracy Latimer case?

Answer 40

Showed society perception of disabled individuals as undervalued, worthless, and burdening. Perception that all people with disabilities would be better off not being alive.

Question 41

How easy is it for Canadian parents of children who have disabilities to get childcare?

Answer 41

1 in 5 have been refused care (20-30% refusal rate). Not inclusive or accessible

Question 42

2. What is the percentage of students on Canadian university campuses who have disabilities?

Answer 42

6-7%

Question 43

What are the employment rates in Canada of people with and without disabilities?

Answer 43

3 in 5 (59.4%) and 4 in 5 (80.1%)

Question 44

What is a significant barrier or disincentive to work for people with disabilities in Canada?

Answer 44

Loss of benefits once employed

Question 45

How does the poverty rate in Canada for Indigenous people with disabilities compare with the rate for other people with disabilities?

Answer 45

Rate of low income is twice as likely to be in poverty than those who are not visible minorities/indigenous

Question 46

Is workplace accommodation for people with disabilities in Canada a right? Explain.

Answer 46

Accommodation is both right and duty. Right is in the Canadian human rights act and employment equity act requiring employers to demonstrate they have taken every reasonable step, short of undue hardship to accommodate a worker with disabilities

Question 47

What are examples of significant air travel challenges faced by people with disabilities?

Answer 47

-small plane= no wheelchair can fit - less boarding ramps and deplaning on tarmac -inaccessible entertainment systems Inadequate space for guide dogs

Question 48

In Canada, are people with disabilities more likely than those without disabilities to have unmet health needs? Explain.

Answer 48

- They have a lot of out of pocket costs fo medication, disability aids, and uninsured visits - Improper access to the system (e.g. non adjustable examination tables, accesbile parking a transport, halls and doors not wide enough) - Belief that disability is illness so it a PA’s concern not societies

Question 49

How is Universal Design defined? What are the 7 principles of Universal Design?

Answer 49

- Principle use: equal use for all diverse abilities; avoid segregation/stigmatization - Flexibility in use: accommodates ranges of preferences and disabilities (left or right hand) - Simple and intuitive: easy to understand, regardless of level of knowledge - Perceptible info: communicates necessary info effectively - Tolerance for errors: minimizes hazards and adverse consequence of accidental or unintended actions - Low physical effort: efficient and comfortable with minimum of fatigue - Size and Space: for approach and use: enough space and room to provide reach, manipulation and use

Question 50

What are examples of Universal Design in education?

Answer 50

- Learning material and methods accessible to all students - Available in multiple formats (e.g. print, electronic, audio) - Flexible material and activities for students with differing abilities

Question 51

What does the author mean by “belonging and being home”?

Answer 51

Being surrounded by people who care and are interested in you, not only because they get paid take care of you

Question 52

The author says the “experiences with disability are an extraordinary teacher”. Explain.

Answer 52

- Teaches how to deal with bodies that function differently and allow for improvements in the system

Question 53

Is having a disability the same thing as lacking independence? Explain.

Answer 53

-Independence is about being able to achieve goas and having control over one’s life; Independence is created by having assistance when and how one requires it