Week 5 Flashcards

1
Q

Persisent Somatic Symptoms (PSS)

A

30-50% of the symptoms are unexplained and often disappear spontaneously, but sometimes persist. This causes a high burden of disease and symptom perception and interpretation are important.

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2
Q

What makes you notice a symptom?

A
  • Painful or disruptive
  • Novel or rare
  • Persistent
  • Pre-existing chronic disease
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3
Q

Symptom perception model

A

Whether you notice a symptom or not is influences by:
- Negative affectivity (current emotions and personal traits)
- Selective attention (knowledge and distraction)
- External information (social context and vulnerability)

Other factors:
- Gender / sex (more women)
- Coping style (repression)
- Cognitions (expectations)

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4
Q

Placebo

A

Favourable treatment effects that cannot be ascribed to mechanisms of the treatment itself.

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5
Q

Nocebo

A

Unfavourable treatment effects that cannot be ascribed to mechanisms of the treatment itself.

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6
Q

Open vs. hidden treatment

A

Telling people about the effects of the drugs during the procedure causes more effect than just giving hem the drugs.

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7
Q

Formation of treatment expectations is influenced by

A
  • Instructions
  • Conditioning
  • Past experiences
  • Observation of other people
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8
Q

Underpredicting pain may help & harm

A
  • Help: reduces pain perception.
  • Harm: reduces trust and creates disappointment.
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9
Q

Placebo and nocebo effects on hyperalgesia (increased pain-sensitivity)

A
  • In placebo conditions verbal suggestion and conditioning together were the most effective.
  • In nocebo conditions the verbal suggestions are just as effective as conditioning.
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10
Q

Influences on symptoms interpretation

A
  • Culture
  • Individual differences
  • Self / social identity
  • Illness experiences
  • Causal attributions
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11
Q

Disease prototypes / cognitive schema’s

A

A mental representation of an illness, what it looks like and the duration of it.
Ex: you will experience a cold differently when you see it as a flu then when you see it as throat cancer.

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12
Q

Common-sense model of illness

A

There is a dual processing of symptoms:
- The cognitive response: how you interpret a certain sensation.
- The emotional response: how you feel about that sensation.

These 2 both influence our coping response and our appraisal.

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13
Q

5 themes of illness representations

A
  1. Identity
  2. Consequences
  3. Cause
  4. Timeline
  5. Curability / controllability
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14
Q

5 different kinds of delay in seeking health advice

A
  1. Appraisal delay: realising that you are ill.
  2. Illness delay: considering if you need help.
  3. Utilisation / behavioural delay: really acting upon it.
  4. Scheduling delay: when can you go?
  5. Treatment delay: when can you start the treatment?
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15
Q

Steps of a medical consultation

A
  1. Establish a relationship
  2. Reason for visit
  3. Examination
  4. Establish the condition
  5. Treatment or further investigation
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16
Q

Shared-decision making

A

The patient and health professional have an equal share and responsibility in any treatment decisions. Steps:
1. Choice
2. Options
3. Preferences
4 Decision
The majority of the patients and healthcare providers prefer this approach, but it’s often not clear if it’s really applied.

17
Q

Health professional factors

A
  • Type of health professional
  • Gender / sex
  • Culture and language
  • Technical or medical language
  • Framing matters
18
Q

Placebo and nocebo effects on consulation

A

Step 1 is awareness words can have on the treatment outcomes. Step 2 is acting upon it by emphasising positive effects, but no overoptimistic, being honest, being warm and emphatic, listening to the patient and asking questions.

19
Q

Warm doctor-patient relationships

A

Can have positive effects of the effectiveness of the treatment, on the satisfaction and adherence to the treatment and on the physical symptoms.

20
Q

Adherence to the treatment

A

Almost 25% of the patients don’t adhere to the treatment because of:
- Social factors
- Treatment factors
- Psychological factors

21
Q

Improving adherence during consultation

A
  • Achieving concordance
  • Maximising understating
  • Maximising memory
22
Q

Improving adherence to behavioural programs

A
  • Self-control strategies
  • Relapse prevention
  • Motivational stratagies
  • Make change habitual