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Psyc 314 adjusting to chronic illness.docx

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PSYC 314
Frances Chen

Psyc 314: adjusting to chronic illness *** Final: nothing from before exam 2: chapter 3,9,11,12 3hrs Format: MC /40 (30 from text book and 10 from lectures—no stats questions, more general) and short answer (7 questions work 5 marks each—from lecture materials; when she asks for results write ”group A is higher or lower on this outcome compared to group B”) Issues in Chronic Illness: • With improvements in medicine, most of us will die of a chronic illness • In addition to improving survival times for chronic illness, it is important to understand quality of life issues How permanence of conditions affect quality of life • Smith et al., Health Psychology, 2009 • Patients with reversible or irreversible colostomies • Quality of life measured for 6 months after colostomy STUDY: Colostomies: irreversible or reversible. They wanted to see how quality of life was within six months of having this procedure. People are either told that their condition is reversible or irreversible Results: the irreversible group is associated with a better quality of life over the long term. At one week and one month there is no difference between the groups. At 6 months the irreversible group has a significantly better quality of life This could be because when you know it is permanent you find ways to adapt and if it is temporary you try to wait it out. Believing that a condition is temporary can impede their long term quality of life because knowing that it is permanent allows you to move on and adapt to your circumstances Fates worse than death—are there any conditions people consider worse than death? • Ditto et al., Health Psychology, 1996 • Adults ages 65 and older • Asked to imagine life in various health states • Rated Life-Death preference • Rated interference in valued life activities Ditto, 1996: Interviewing adults 65 + and they asked them to image a variety of different conditions with no chance of recovery (coma, chronic pain, not being able to communicate or reason, being confined to bed, being blind or deaf). They had to rate how much they would prefer life over death and how these conditions would impact their life Results: the idea of coma and losing mental faculties (reasoning and communication) are seen as having the greatest interference in life and also the factors which indicate lower levels of wanting to live and higher levels of wanting to die. People in general have a preference for their cognitive abilities and when these things are taken away they are more likely to prefer death. Physical impairments are not associated with preferring death over life. This is thought because if you take away the physical they still have ways in which they can enjoy life Stages of adjustment to dying: How do people respond to the idea that they do not have long to live? 5 stages: 1. Denial: it is often the first stage when someone is in sock and they are avoiding the implications of the illness. It can be a protective measure of stresses to the illness but can be a detriment because it may cause them to not adhere to treatment -defence mechanism -can be protective initially in reducing stress -but can have adverse effects if persists 2. Anger: the why me question. This is often projec
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