PSYC 3170 Lecture Notes - Disfigurement, Sick Role, Exhalation

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2 Feb 2013

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Terminal and Chronic Illness
Example: Heart Disease
Chronic diseases are not just for older people (yes their risks are higher but it affects
Example: asthma is on the rise
Reactions to Chronic Illness
A lot of psychological factors play a role
Shock -they cannot believe that they have this illness, feel confused, bewildered
Encounter-a phase of the reaction where people have very negative emotions: feel
overwhelmed, helpless, hopeless. Very similar to a grieving process. It can last from a few
days to several months. It is all within the so called normal range of reactions.
Example: cancer
People think of it as automatically terminal which is not necessarily true
Stigmatization and diagnosis of cancer leads to a negative reaction
Challenges for health practitioners because it is not just biological aspects that they
have to look at.
Psychological symptoms
More doctors are becoming more sensitive to this so that they can try and work
with symptoms from different angles
Retreat -deny or avoid thinking about the diagnosis.
Emotion-focused coping example
Deny or avoid is so that they do not obtain negative emotions and reactions
Example: cancer
Maybe they will not follow through with treatment
They may skip appointments if in denial
Some people do not even tell loved ones they have been diagnosed
Whatever you push on them will be met with resistance
Example: lung cancer
Is in denial and keeps smoking
Example: asthma
Does not take steps to avoid allergens that cause an attack
Crisis Theory: Illness-Related Factors
Example: amputation, scarring, visible disfigurement
Objective Threat: how threatening the diagnosis is in reality and Perceived Threat: how
threatening it is in your view.
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Your perceived threat determines your reaction
Embarrassing problems
Perceive a test for cancer as embarrassing
Embarrassed talking about being diagnosed with cancer for example
Men diagnosed with breast cancer (embarrassing because it is thought to be a female
cancer) -difficult to cope, threat to gender role
Visible conditions
Changes they can see
Painful conditions
Time commitment for treatment regimen
Difficult to cope with large time commitments (such as going to the hospital all the time
for treatment)
Lifestyle changes
Having to change your routine, health habits etc
Personal Factors
Hardy or resilient personality
Resilience with crisis
Example: lost of a loved one and such
Good at coping
Remain positive even when the situation is negative
Strong level of appropriate social support
Social support that is not helpful could be damaging
Example: introverted -people constantly calling a shy person may not be helpful
because they like their personal alone time
People high on this trait are good at obtaining the right level of social support
Men have a much harder time with the stress of a diagnosis
Concerned about finances
Have a harder time taking on the role of a patient → in conflict with the almost
global, cross cultural representation of men being strong and responsible
Women cope better with this role
For kids it makes no difference until they reach adolescence because they really start
to take on gender roles
Timing during the lifespan
Example: young moms being diagnosed with breast cancer for example (under age 45)
Have young families making it especially stressful
Treatments are severe, a lot of time commitment
Psychological: these women are in the prime of their life so they are forging a career
and family when stopped in their tracks with cancer
Mother: nurturer role → cannot fulfill role when sick → threat because you feel like
you are not a good mother (gender factor and timing)
Young people who just started high school or who are almost done University being
thrown off by a chronic illness putting them behind because they had to take time
Lifestyle challenge
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Personal health beliefs
How you perceive people in the sick role
Feel you have control → cope better
Leukemia Example
Two young people are candidates for a bone marrow transplant
One threw himself right into the preparation into the transplant
Saw a personal trainer
Learned how to cook
Took time off to be the best possible patient he could be
The other person became very depressed and had insomnia
No sleep → health deteriorates
Saw psychologist for issues
Got things back on track
Very different experiences and reactions to the same situation
In psychology we cannot predict how one will react
Doctors need to prepare for this
Environmental Factors
Depressive environments
A lot of medical environments are like this
Dirty floors, chipping paint, depressing
Hospitals differ in different places (i.e. Australia, United States)
Public versus Private System in terms of going to a hospital in another country (different
payment amounts)
Public System
Look like Canadian hospitals
Run down
Good care
Medical school based
Private System
Crystal chandelier
Bell Boys
Front desk resembles one from a hotel
Classical music playing
Fancy oriental rugs on the floor
Lower ratio of patients to nurses
Quality of doctors -doctors have to in their early stages have to split their time
between both systems in Australia. The care is the same. The environment is
different → this makes a difference.
Less anxiety
More relaxed
Lots of room for family to visit
Environment may not foster self-sufficiency
The patient's attitude that he or she could do things for themselves → self-sufficiency
Low self-sufficiency → confined to bed and had to be waited on 100%
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