Health Psych Exam 3

Illness Behavior

ways in which people respond to symptoms and illness, the experience of being ill, healthcare-seeking behavior

Illness Behavior (David Mechanic & Edmund Volkart)

ways in which different people perceive, evaluate, and act upon (or do not act upon) the emergence of physical symptoms

Illness

reflects the experience of being ill and the meanings we attribute to our condition

Healthcare-Seeking Behavior

the ways in which we seek help when we are ill

• seek not only traditional healthcare services, such as medical services, but also informal channels, such as the internet; laypersons such as friends, family members, and colleagues; homespun or traditional remedies; or complementary and alternative medicine

Symptom

a physical or psychological feature that is regarded as indicating a condition of disease, particularly a feature that is apparent to the individual with the disease

Active Coping

more adaptive form of adjustment, people seek information and engage in problem solving to deal directly with a health challenge, resulting in better adjustment in outcomes

Passive Coping

involves avoidance of stressor, typically resulting in maladaptive or ineffective ways of handling a threat such as ignoring it, not consulting with a healthcare professional, avoiding diagnostic tests; ultimately can lead to life-threatening circumstances

Cognitive Dimension

appraising, or making judgement about, the threat posed by a stressor, such as a physical symptom

Primary Appraisal

evaluate the degree to which a stressful threat poses a risk to our health and well-being

Secondary Appraisal

evaluate what can be done to address the threat while taking into account the resources and coping strategies we have available or can readily access

Problem Focused Coping

coping with stressful life events in which a person takes steps to directly confront the stressor to reduce or remove it

Emotion Focused Coping

coping with stressful life events in which a person takes steps to regulate the emotional response to a stressor

Self-Regulation

the process by which individuals manage their behaviors, emotions, and thoughts in pursuing their life goals and reacting to life events, including how they deal with the treat of physical illness

Common Sense Model (CSM) of Self Regulation

posits people react to illness by forming 2 types of representations: cognitive representations (how they make sense of health threat) and emotional representations (how they react to it); the representations determine how they cope and whether they seek services

Illness Consequences

people adjust more poorly to illness when they perceive more negative consequences

Illness Identity

people adjust more poorly to illness when they identify themselves more closely with the illness

Illness Controllability

people adjust more poorly to illness when they perceive a lack of control over the illness

Determinants of Illness Behavior

• patient-related variables

• healthcare-related variables

• response to preventive screenings

• adherence to medical regimens

• use of health care services

• illness-related variables

Illness Related Variables

variables are biological factors linked to disease processes, such as the type and severity of symptoms, the course of the disease, and disability and functional limitations associated with the disease

Patient Related Variables

demographic factors, such as gender and age; ability to self-regulate one’s own health-related behavior; people with disabilities deterred from seeking healthcare services because of limited mobility; personality factors; family interactions

Healthcare Related Variables

patient-physician relationship, good doctor-patient communication, access to services as well as costs/insurance coverage, cultural mistrust and discrimination

Microaggressions

subtle expressions of implicit bias or prejudice that often occur without conscious awareness

Sick Role

a set of rights and responsibilities of people who are sick

Health Disparities

differences in health outcomes or health status between groups based on race, ethnicity, or level of income

Stigma

• a mark of social disgrace that carries with it the social perception of taint or untrustworthiness

• often assigned to physical conditions that have observable physical marks, such as herpes or acne, leading others to devalue or discredit people with the conditions

• healthcare workers less willing to help patients who have visual marks or characteristics they believe are the patients’ own fault, such as patients with obesity, lung cancer, or addictions

• social identity

Social Identity

• another basis for stigmatization and unfair treatment

• the identification with particular social groups, such as ethnic and racial groups; family, kindship, and religious groups; or sports clubs or teams

• speaks about the ways in which we categorize or classify people based on the groups to which they belong or identify with, or to which they are assigned by others

Family Physician

• first line

• treat

• refer to specialist

Nursing Homes

long-term medical and personal care, majority are disabled or frail older adults

Competing Stimuli

the extent to which people pay attention to internal stimuli at any given time depends partly on the nature or degree of environmental stimuli present at that time

Lay Referral Network

internet as this: more than 100,000 health-related websites, most physicians believe the Internet affects health care positively

Complementary and Alternative Medicine (CAM)

natural products, mind and body practices

Iatrogenic Conditions

a mental health symptom, behavioral shift, or psychological disorder that is inadvertently caused, induced, or worsened by medical, psychiatric, or psychological treatment, diagnostic labeling, or clinician-patient interactions

Appraisal Delay

the time a person takes to interpret a symptom as an indication of illness

Illness Delay

the time taken between recognizing one is ill and deciding to seek medical attention

Utilization Delay

the time after deciding to seek medical care until actually going in to use that health service

Adherence

the extent to which a patient’s behavior matches agreed recommendations from a healthcare provider

Self-Efficacy

confidence in ability to carry out treatment

Ancient Greek Temples

places dedicated to healing gods, hoping for healing; these places combined religious practices with early forms of medical care

Roman Military

the Roman army establishes facilities to treat injured and sick soldiers; these facilities helped develop more organized medical care

Religious Orders

monks, nuns, and other religious groups cared for the sick, poor, and vulnerable; religious institutions often provided shelter, food, and basic medical treatment

18th - 19th Century

hospitals begin changing, increasingly focused on specific groups of patients and particular diseases

Disease Specific Wards

early step toward specialized medical departments in modern hospitals

Health Hazards

healthcare workers may be exposed to harmful substances while performing their duties; these can cause infections, skin irritations, breathing problems and other injuries

Chemical Hazards

disinfectants, cleaning products, sterilizing agents, and certain medications

Microorganism Hazards

bacteria, viruses, fungi, and other infectious agents

Medicare

U.S. federal health insurance program that primarily covers people 65 years as older as well as some younger people with disabilities or specific medical conditions, uniform across states, not income based, provided limited long-term care

Medicaid

jointly funded program by federal and state governments for low-income individuals, families, children, pregnant women, elderly and people with disabilities; run individually by each state within federal guidelines (rules vary by state), based on income and asset limits, provides comprehensive long-term care

Outpatient Procedure

medical service or procedure that does not require the patient to stay overnight at the hospital, this way patient avoids the cost of an overnight hospital bed, extended nursing care, other inpaitnet services

Inpatient Procedure

patient is formally admitted to a hospital and stays at least for one night or longer for treatment, monitoring, or recovery

• medical: treat illnesses requiring surgery

• surgical: care for patients before and after surgery

• ICU

Intensive Care Unit (ICU)

care for critically ill patients who need continuous monitoring and advanced medical support e.g. organ failure, severe breathing problems, life threatening injuries, need of a ventilator

Oncology

cancer unit

Psychiatric Unit

serious mental health illness

Neonatal Intensive Care Unit (NICU)

for newborn babies who are premature, critically ill, need extra medical support, need help breathing, temperature regulation, specialized feeding

Rehabilitation / Recovery Units

help patients regain strength, movement, independence and daily living skills after an illness, injury or surgery

Social Role of Being a Patient

• dependent on medical staff for care & survival

• unfamiliar with hospital structure, procedures and terminology

Depersonalization

treating patient more like a medical case/task/room number or as if patient is not in the room instead of treating them like a human being

Caregiver Burnout

psychosocial and physical exhaustion that results from chronic exposure to high levels of stress with little personal control

Health Psychologists

work with psychological problems that lead to/or result from disease

• correct (change) factors that produce disease

• help cope with illness

• provide counseling to reduce depression and pessimism

• consulting with patients’ specialists and treatment team

• assessing client’s needs

• helping with adherence

• developing behavioral programs

• assisting with rehabilitation

Minnesota Multiphasic Personality Inventory (MMPI)

test personality characteristics associated with psychological disorders, specific scales relevant to health

Hypochondriasis

preoccupation with health

Hysteria

tendency to use avoidance strategies

Millon Behavioral Health Inventory

assesses specific psychosocial factors and decision-making issues relevant to patients (coping style, negative habits, etc.)

Psychological Adjustment to Illness Scale

7 psychosocial characteristics of life associated with adjustment to illness (healthcare orientation, domestic environment, family relationships, etc.)

Physical Setting

hospital vs home setting

Kubler-Ross Model of Grief/Loss

1. Denial

2. Anger

3. Bargaining

4. Depression

5. Final Acceptance

Palliative Care

form of medical care that focuses on support and pain relief rather than active treatment of a terminal condition

Hospice

approach to caring for dying people using palliative care in a homelike and supportive treatment setting

Euthanasia

purposeful taking of life to relieve suffering; “mercy killing”

Active Euthanasia

lethal treatment administered (usually medication)

Passive Euthanasia

withholding life-saving treatments

Living Will

also called advance directive, a legal document that directs healthcare providers to follow a person’s wishes regarding end-of-life medical treatment; specifies the medical procedures or medications the person would like doctors to use or not use to prolong their life if they’re unable to communicate directly

Bereavement

refers to the emotional state of people who have experienced a loss, involves feelings of sadness and loneliness as well as a process of mourning as survivors adjust to the loss of a loved one

Dementia

progressive loss of cognitive functions that often occurs in old age, irreversible and progressive, beta-amyloid buildup in brain

Alzheimer’s Disease

chronic brain disorder with progressive deterioration of attention, memory, and personality, accounts for 60-80% of cases

• decrease in brain size

• degradation of myelin sheath surround neuron fibers

• beta-amyloid peptides fail to clear properly and stick together

• difficulty planning, organizing, and memory

• aphasia & agnosia

Frontal Cortex

involved in problem solving, language, memory, emotional expression

Aphasia

loss of ability to understand or express speech

Agnosia

loss of ability to recognize objects

Facial Agnosia

loss of ability to recognize faces

Early Stages of Alzheimer’s Disease

• memory for recent events and attention decrease

• mild irritability

Later Stages of Alzheimer’s Disease

• more severe deficits start to emerge

• memory deterioration becomes more profound (long-term memory)

• disorientation to time / place / person

• self-care deteriorates

• drastic personality changes / changes in behavior

Cerebral Reserve Hypothesis

clinical symptoms of dementia or cognitive decline only emerge once accumulated pathological damage surpasses a critical baseline threshold

Asthma

chronic disease of the lungs involving temporary obstruction of bronchial airways, overreaction of immune system to allergens leading to narrowing of airways

Arthritis

a general term for a group of diseases characterized by the inflammation of one or more body joints and typically accompanied by pain, stiffness, and swelling of joints

Osteoarthritis

a painful, degenerative disease characterized by wear and tear on the joints

Rheumatoid Arthritis

a chronic inflammation of the membranes lining the joints that causes joint pain and can lead to physical limitations due to joint damage if the disease is not controlled

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

anti-inflammatory drugs which includes aspirin, ibuprofen, and naproxen, that are used to treat inflammation and pain (arthritis)

Cardiovascular System

network of heart, blood, and blood vessels that carries life sustaining oxygen and nutrients throughout the body and removes cellular wastes

Cardiovascular Disease (CVD)

disorders of the heart and circulatory system, leading cause of death in the U.S. (1 in 3 deaths)

Heart

• 11 oz

• muscular pump capable of pushing more than 5 quarts of blood through circulatory system every minute

• approximately 72 beats per minute at rest, faster when exerting

• main function is to supply oxygen and nutrients to tissues of body and remove carbon dioxide

• protected by the rib cage in the middle of chest between lungs

Atrium

upper heart chamber on either side

Ventricle

lower heart chamber on either side

Circulatory System

network of blood vessels that furnishes cellular tissues with oxygen and nutrients and removes waste products

Blood

liquid of life that ferries oxygen, nutrients, hormones, and antibodies through the circulatory system

Blood Vessels

carry blood, 3 types: arteries, capillaries, and veins

Arteriosclerosis

hardening of the arteries where walls become thicker, harder, and less elastic

• muscles need oxygen to function

• restriction of oxygenated blood is a problem

Lumen

• structure in the heart and circulatory system

• hollow, internal space through which blood flows

Myocardium

muscle tissue of the heart

Ischemia

when insufficient oxygen available for the muscles of the heart; little or no damage may occur if ends quickly

Infarction

local death of tissue due to cutting off of blood supply

Myocardial Infarction (heart attack)

when the myocardium is damaged and dies off if ischemia persists long enough