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45 Cards in this Set
- Front
- Back
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Chronic conditions are more common in what three types of groups? |
Lower income, women, seniors |
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What is quality of life? What is the emphasis placed on? QoL is an important indicator of what? What is an important aspect of QoL? |
The amount one can maximize physical, psychological, vocational, and social functioning; including disease/treatment related symptoms Daily life (sleeping/eating/social activities/work) Recovery from/adjustment to chronic illness People's perception of their own health |
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Give two reasons why pain should be looked into What are the two purposes of pain? |
Pain is the symptom of greatest concern to patients Pain causes people to use health services Intrapersonal - Warns of injury/disease/damage Interpersonal - Warns others; evokes empathy/care |
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What are the three steps of physiology of pain experience? But the signal also goes up the spinal cord to the _______ where the pain is perceived |
Signal goes to spinal cord Passes to a motor nerve connected to a muscle Causes reflex action that doesn't involve brain Thalamus |
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What is the gate control theory? What two types of neurons does it involve? What do these respond to? What do they do in relation to the brain? |
Neural pain gate in the spine opening or closing to regulate pain signals to the brain Inhibitor and projector neurons Respond to somatosensory input Send certain signals to the brain |
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What are the three characteristics of the biomedical approach to pain? |
Assumption of 1-1 correspondence to injury/disease Bad practice (blaming patient/intentional faking/assuming psychiatric disorder) Focus on pharmacological/surgical/other medical interventions to control pain |
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What is pain without pathology called? What is it from? |
Fibromyalgia - chronic widespread pain & heightened pain response to pressure Neurochemical imbalances from abnormal pain processing |
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How does the biopsychosocial define pain? |
Unpleasant sensory and emotional experience associated with actual/potential tissue damage, or described in terms of damage |
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What are examples of adaptive coping? What's another way? What is the main maladaptive way of coping? Through what two ways? |
Relaxation/distraction/redefinition/readiness to change/taking active role (+ self efficacy) Acceptance - patients' lives are often consumed by trying to unsuccessfully eliminate pain Catastrophizing Primary appraisal - focusing/exaggerating the threat of pain Secondary appraisal - helplessness/inability to cope |
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What is the goal of the communal coping model of pain catastrophizing? |
To manage distress in a social context instead of an individual one |
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What are the three parts of initial response to a diagnosis of chronic disease? What happens after the initial response? What are three responses to chronic disease? |
Shock; emotion-focused coping (denial); secondary appraisal Patient gets clearer idea about the role of the illness in their life (usually after confirmation of diagnosis) Anxiety - awaiting test results/getting diagnosis/side effects of procedure Anger - expressed to family/friends/caretaker Depression - can be delayed while trying to understand the condition; directly impacts symptoms |
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Chronic pain affects what two types of the self?
What way in physical self? Chronic illness can also affect _______ functioning |
Mental self: Self-concept - belief of one's qualities/attributes Self-esteem - feeling good/bad about self-concept Physical self: Body image - perception of physical functioning & appearance Sexual functioning |
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What are the five most useful coping strategies cancer patients reported |
1 - Social support/direct problem solving (talked with someone to find out about illness) 2 - Distancing (I didn't let it get to me) 3 - Positive focus (I learned something from it) 4 - Cognitive escape/avoidance (Wish it would go away) 5 - Behavioural escape/avoidance (eating/drinking/sleeping) |
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What are three maladaptive coping strategies for chronic illness? |
- Rumination (exacerbates symptoms) - Avoidant coping (increased distress exacerbates disease; poor adjustment to illness) - Interpersonal withdrawal (loneliness/low relationship satisfaction) |
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What are four adaptive coping strategies for chronic illness? |
Active coping (seeking info/learning skills) Planning (considering future/setting goals) Support-seeking (instrumental/emotional) Positive reappraisal (finding meaning/purpose) |
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What are two social issues people and patients may have during chronic illness? |
Patients have trouble re-establishing normal social life (pity from others; sick-role behaviour) Other people have trouble adjusting to person's condition (negative stereotypes/stigmas) |
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What are five psychosocial benefits of support groups for cancer patients? Can stress increase risk of cancer? Why? What has been proven? |
Mood Certainty Self-esteem Coping skills QoL Dunno; no direct relationship and animal studies aren't accurate for us; stress = ^tumor in rats |
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Can stress increase risk of cancer? Why? What has been proven?
What has been found in women with breast cancer in relation to depression? |
Dunno; no direct relationship and animal studies aren't accurate for us; stress = ^tumor in rats
Survival time was double that of the group that had higher depression rates over the year |
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What five psychosocial interventions are used to manage chronic illness? How do those with chronic illness and those with terminal illness both come to terms with their condition? |
Psychopharmacological Interventions Patient education Individual therapy Stress management/relaxation Support groups Find meaning |
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Whose three perspectives to consider in a terminal illness? |
Care providers Person dying Surviving loved ones |
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For the 4.5 million Canadian caregivers, in addition to the economic burden (extra expenses/missed work/reduce hours), what are five factors in caregiver stress? What are three positives do caregivers (children of patients) report? |
1 - Not having time for themselves 2 - Engaging in unhealthy behaviours due to lack of time (overeating/skipping meal) 3 - Disrupted/insufficient sleep 4 - Poor stress management (ex. TV) & stress prevention 5 - Degrading social relationships and poor support Providing best care, sense of accomplishment, becoming closer |
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What reduces the impact of caregiver stress (which can lead to depression/distress/declining health) What is the goal of palliative care? What is the goal of palliative home care? Why is it favoured by terminally ill patients? What are two downsides of it for caretakers? |
Social support Relief suffering from illness/disease (chronic/terminal/otherwise) = Improve QoL Relief of suffering in familiar setting Increased personal control and social support |
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What four things were found in 151 patients diagnosed with metastatic lung cancer when randomly placed into either early palliative care integrated with standard oncologic care vs standard oncologic care alone and then assessed QoL at baseline and 12 weeks? Palliative care is associated with what five things for patients? |
Lower depression (1/2)/anxiety/MDD (3/4 less) Higher survival rates ^QoL; lower anxiety & depression; lower pain; reduced symptoms; ^ survival |
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Give four reasons why terminal care is more difficult for hospital staff and care providers What are five goals for medical staff in their work with dying patients? |
Emotionally draining/unpleasant custodial work/not curative care/less interesting/stimulating Informed consent; safe conduct; significant survival; anticipatory grief; timely/appropriate death |
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From the patient perspective, what are the four main requirements of an appropriate death? |
Reduction of conflicts (inner and outer) Compatibility with ego ideal Continuity of relationships is preserved/restored Fulfillment of prevailing wishes |
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Bill C-14 allows for physician-assisted suicide as long as what four things are met? What three things should be kept in mind for physician-assisted suicide? |
Mentally competent Incurable situation 18 y/o 15-day reflection period Pain ratings, low family support, depression |
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What are Kubler-Ross' five-stage theory of dying? What is meant by acceptance? What are the two advantages of this theory? What are two criticisms? |
Denial --> Anger --> Bargaining --> Depression --> Acceptance Giving in to the inevitability of death Describes range of reactions to death (and counseling needs); breaks down barriers/taboos Order isn't universal/stages aren't concrete Doesn't acknowledge importance of anxiety |
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What is the main factor, at the end of life, that underlies regrets/wishes/reminiscence/life review/religion/etc.? What are two ways to describe it? |
Personal meaning (sense of purpose) Making sense of one's inner life/outer environment Endowing life w/personal significance & satisfaction |
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What are four methods to finding meaning at the end of life? |
Autobiographical methods Cross-generational methods Religious methods Spiritual methods |
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What are the three parts to autobiographical methods? |
Reminiscence - recollecting experiences/life events; spontaneous Life review - return of memories/conflicts at end of life; reconciliation of one's life Guided autobiography - reconstructing past and integrating it with present; systematic |
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What are the two parts to cross generational methods? |
Generativity - loncern for guiding next generation; vs. stagnation Symbolic immortality - leaving a legacy/wisdom |
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What are three parts to religious methods? What are two parts to spiritual methods? |
Religiosity - organized beliefs/practice/rituals Extrinsic religiosity - external/self-serving motivation; based on guilt/fear/social pressures Intrinsic religiosity - internalized/altruistic; goal of developing meaning/purpose Spirituality - personal quest to understand life & relationship to transcendent Self-transcendence - adjusting self-concept to recognize one's place in the world/universe |
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What is the ultimate end-of-life goal? What's the opposite? What's the worst case scenario |
Death acceptance - willingness to let go/detach self from events and things we valued Death anxiety Sense of meaninglessness - neurosis/crisis/existential vacuum |
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From the perspective of the surviving loved ones, what are the three types of grief they may deal with? |
Anticipatory grief - expect them to die, reactions anticipated, scenarios played out Sudden loss - no time to prepare, acceptance takes longer Complicated grief - when the grieving process doesn't go as expected |
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What four factors affect grief? |
Nature of relationship w/deceased - type/strength/attachment/conflicts/type of support Nature of death - natural/accidental/suicide/violent/traumatic/stigmatized/preventable Individual differences - personality/coping strategies/stressors/previous expereicne Social variables - support network/type of support/cultural differences |
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What is considered successful aging? What's the difference between successful aging and life satisfaction? |
Having a positive perspective on aging Life satisfaction considered 'basic needs' and a precursor to successful aging |
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What are the three goals of medical/public health perspectives? What does this imply? In the biopsychosocial perspective, what three intrinsic/extrinsic factors are emphasized? |
Minimizing physical/psychological/social morbidity Compressing morbidity into a shorter/later time period to experience the disease for shortest amount of time at latest period of life |
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In the lifespan/developmental perspective, there are focuses on goal attainment & life management; maximizing positive outcomes and minimizing outcomes. How is this achieved? |
Selective optimization (of abilities through practice and technology) with compensation (for loss of abilities by engaging in new strategies) |
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Is goal disengagement good in old age? What four things is it associated with? What hormone is it associated with? |
Yes, adaptive to avoid goal failure and depression ^Physical health/^subjective well-being/lower depression/lower stress Lower cortisol output |
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The main focus of old age (65+) is reflection of one's life and past events, how is success and failure defined? |
Success - feelings of wisdom/acceptance Failure - regret, bitterness, and despair |
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What was found in telomeres in relation to stress? How can telomere shortening be prevented? What three health benefits has been happiness been associated? |
High psychological stress = shorter telomeres = faster aging Exercising consistently during the week Better self-reported health; better health outcomes (reduced inflammation/heart disease/cortisol output); better health behaviours (exercise/eating/sleeping/not smoking/less risk-taking) |
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What's the goal of positive psychology? How does flow affect elderly people? |
To understand how to get things right (make regular life more fulfilling) Better self-reported health (raises happiness/reduces anxiety) |
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What is mindfulness? What were five effects of MBSR (Mindfulness-Based Stress Reduction)? |
Intentionally focusing awareness on immediate inner and outer experience (simple observation/no judgement/moment-moment) Improvements in QoL Symptoms of stress Sleep Improved HPA functioning Lower morning cortisol levels |
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What is transcendental meditation (TM)? What three things is TM linked to? What two things were found in meta-analyses with TM and health? |
Meditation using mantras practiced for 15-20 minutes 2x daily while sitting with eyes closed Improved cardiovascular health QoL in cancer patients Psychological health and well-being Incomplete evidence for link to cardiovascular health; may be effective to treat hypertension |
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What are three health benefits in forgiving? |
Suffering less from variety of illnesses Improved cardiovascular and nervous system functioning Better perceived health |
