Study Guides (248,338)
Canada (121,491)
Psychology (700)
PSY333H1 (9)
Midterm

PSY333H1 Lecture 7 (first lecture after the midterm)

10 Pages
107 Views
Unlock Document

Department
Psychology
Course
PSY333H1
Professor
Lisa Lipschitz
Semester
Fall

Description
PSY333H1F L7 Oct 31, 2013 (first lecture after the midterm) Cultural Differences  There are differences in the recognition & reporting of Ch. 8: Using Health Services symptoms o Ex. A study in Vancouver found that Chinese Using Health Services… respondents were less likely (w the same symptoms) to recommend enlisting emergency medical aid than  When & how does a person decide they are sick?  When are symptoms dismissed as inconsequential? English or Punjabi respondents in response to  When does a person decide that they are in need of treatment symptoms  The reason for the differences are less well from a professional? known 3 types of health-related bhvrs:  Learning is an important component o As children learn which symptoms to attend to & which 1. Health bhvr: bhvr that is designed to promote a person’s good to ignore from parents health & prevent illness  May be related to cultural variations in emotional responses & o Ex. wearing seatbelt, exercising learning 2. Symptom or Illness bhvr: bhvr that is directed toward o Ex. Western culture men have been socialized to avoid determining one’s health status after experiencing symptoms complaining about emotional & physical symptoms of o Ex. talking to other ppl (family, health care discomfort professionals), o Men are less likely than women to report such o doing research, symptoms o taking no-action (most common) 3. Sick-role bhvr: bhvr that is directed at helping ppl who are iSituational Factors return to good health; helping yourself Boring situation, isolation makes ppl more attentive to o Ex. receive sympathy & care, responsibility to try get symptoms better o Not necessarily more accurate, just more likely to notice it at this time Sick-role bhvr o Ppl are more likely to recognize a symptom when that  When ppl are sick, they exhibit a sick-role bhvr & hhave are less busy vs. excited, demanding situation certain privileges and responsibilities  Competition of cues – useful short-term coping method 3 rights/privileges: o Salient symptoms 1. Right to make decisions  If person or envt (ex. hospital) reminds us of 2. Right to be exempt from normal duties (ex. go to school) symptoms 3. Right to become dependent  Visible symptoms  Pay more attention 3 duties/responsibilities:  ex. Medical students’ disease 1. Duty to maintain health & get well  Studying symptoms of a disease cause 2. Duty to perform health care management med students to focus on their own 3. Duty to use range of health care resources fatigue & internal states; symptoms _______________________________________________________________ related to the disease being studied seem How Do We Recognize & Interpret Symptoms? to emerge  Individual Differences: There are different levels of bodily  As they begin to learn more about the awareness symptoms & disease, it appears that the  Hypochondriacs distress decrease o Ppl who are preoccupied and worried that normal  As we learn about the reaction, realize it’s bodily symptoms are indicators of illness just a psychological factor making you  Ex. think a headache means a brain tumour worry o 4-5% of the population o Older ppl Age  Neuroticism o Characterized by (-)ve emotions, self-consciousness,  Elderly ppl: o frequently complain of physical symptoms that prompt and a concern w bodily fns them to seek medical intervention o Symptom perception hypothesis: ppl high in o perceive normal age-related bodily changes as illness neuroticism recognize their symptoms more quickly o experience more severe & lengthy symptoms and report more quickly, report higher levels of o more likely to attribute their symptoms to some other distress and dissatisfaction disorder o May exaggerate symptoms or may be more attentive to  Mild cognitive impairment is associated w the perception of real symptoms poorer body fn’ing  Ex. Exaggerate pain of a headache  Older men delay seeking care due to embarrassing symptoms o See a physician more often than hypochondriac o Will experience more psychological distress from a Stress diagnosis, need to see counselor  Ppl who are under stress may believe that they are more vulnerable to illness  attend more closely to their bodies Recognition of a Symptom  May be the result of experiencing the physiological reactions o Can be underdeveloped, inaccurate or accurate and to stress (ex. heart rate, breathing) complete  Stressful periods can result in precipitated or aggravated  Illness schemas have 5 distinct components: experiences of symptoms 1. Identity (name of illness) o Ex. Panic disorder (tingling, dizziness, etc.) – think they2. Conseqs are going to die 3. Causes  Those experiencing tremendous stress are more likely to seek 4. Duration health care (even w equal symptoms) 5. Cure o Heightened to their bodily systems’ changes What Predicts the Use of Health Services? Mood  Self-regulatory model of illness bhvr (Leventhal et al., 1980)  Influences self-appraised health (ppl’s beliefs about their health status) o Ppl form commonsense illness representations about  Ppl in a (+)ve mood: their symptoms and these representations determine o rate themselves as more healthy the steps they take to manage their illness o report fewer illness related memories 1. Identify the nature of the illness o report fewer symptoms. o Heartburn vs. heart attack  Ppl in a (-)ve mood: 2. Identify its causes o report more symptoms o Out of the blue vs. knowing o more pessimistic 3. Try to figure out the time line, how long it will last o perceive themselves are more vulnerable. o Acute vs. chronic 4. Think about the conseqs  In sum, symptom recognition is determined by situational o Physical, social (ex. roles), emotional (adaptation) factors, personality traits, culture, stress, and mood 5. Can it be treated? Cured? o Controllability Interpretation of Symptoms (Heavily Involves Psychological Processes) Cognitive Represenations of Illness  Schemas influence: Prior Experience o preventative health bhvrs  Meaning is affected by history w symptom o reactions when they experience symptoms or are diagnosed o We know how to deal w it, make it go away, know it’s not serious o adherence to treatment regimens  Highly prevalent disorders are seen as less serious than rare o health expectations ones  In sum, interpreted as more serious & more likely to seek medical care if symptoms are: o Ex. High prevalence of colds in fall  taken less seriously o new  High anxiety more likely to seek medical care o unexpected o painful o Might not have prior experience o Ex. Think a headache is more serious than it is o disruptive  Coping resources o highly visible o affect highly valued parts of the body Expectations  Ppl may ignore symptoms they are not expecting & amplify Most ppl have 3 Disease Models of Illness:  Acute: symptoms they do  Ex. symptoms of a heart attack:, ppl may recognize a sharp o caused by bacterial or viral agents, short term, and no chest pain but ignore a dull chest pain (don’t expect that to be long term conseqs  ex. flu part of heart attack diagnosis)  Chronic: Seriousness of the Symptoms o multiple causal factors (health habits, genetics, envt) o long term  Symptoms affecting highly valued parts of the body are o possible severe conseqs interpreted as more serious (eyes, or face; limits mobility, highly valued organ)  ex. heart disease  Cyclic:  Perceived to have a profound impact on one’s life (hand, o alternates btwn symptoms & no symptoms throat) o ex. Affecting work  ex. herpes  Affects how one respond:  If a symptom causes pain, it will lead a person to seek o Ex. treat disorders differently, levels of vigilance, treatment more promptly patterns of treatment Cognitive Representations of Illness How does treatment of a symptom begin?  Illness representations (schemas): concepts of health and illness that influence how ppl react to symptoms and illness  The meaning of a symptom blends into diagnosis: a process o Acquired thru the media, personal experience, and the that begins not in the physician’s office but in an indiv’s conversations w friends, neighbors, and relatives experience of others  Lay referral network o Informal; family & friends (provide advice & support)   consequently, more sensitive to bodily changes  Ex. Getting your mom to make you chicken soup or disruptions for your cold o Social Norms: concerning the expression of pain o Provide own interpretations before medical  Men may be anxious but are reluctant to seek treatment care o Provide advice, personal views  Women who report devoting their time & o Provide support attention to the needs of others delay seeking o Sometimes this is the preferred method of treatment care  ex. an elder in the community o In regards to stress, women under high stress are o Ethnic communities judged as less likely to have a physical disease than  incorporate beliefs that may not be accepted by men traditional medicine  Discrimination  may recommend home remedies  Women told they are just stressed 7& that nothing is wrong Ex. Children’s hospital in Montreal Economic factors  Mothers who consulted their lay referral system about their child’s symptoms were less likely to take their children to he More women are part-time workers & non-workers than men emergency department unnecessarily o they do not have to take time off to seek treatment and they do not lose income when they are ill  But, Lay persons are more likely than health professionals to o However, underemployment & unemployment recommend actions: contribute to economic hardship which also contributes o that worsen the condition to poor health among women o or result in a delay in seeking appropriate & needed treatment Fragmented Health Care  Women visit a wide variety of doctors & specialists for the Internet as Source of Health Info wide variety of health care they require  ~4 million Canadians seek health info online on a typical day o  more visits & utilization of health services o Increase of 262% btwn 1998-2002 o Ex. pediatrician, gynecologist, GP, mammogram appts  Opens a vast source of medical info & misinformation to the public Socio-Economic Status  Who uses internet for health info?  SES & utilization of health services: paradoxical o Women 2x as likely relationship o Households w kids vs. w/o kids o Lower SES & w less than High School education use o Those w a higher education medical services less than upper SES   conditions worsen, need to make more visits  Topics searched: o Specific diseases & health conditions o Ppl w lower incomes & education who do use medical o Lifestyle info (ex. Diet, nutrition, exercise) services are more likely to make 4 or more visits vs. higher SES o Specific symptoms, drugs, medications, alternative & complementary therapies, health care system  Also make more ER visits & have more hospital  Ex. can help those in rural areas to find info they can’t get from admissions local  This is because those in low SES tend to wait longer before seeking care  treatment is What Predicts the Use of Health Services? difficult Age o Lower SES results in less access to medical care & travel longer to facilities  Young children o Childhood infectious disease  Ex. Parking costs; not all cancer drugs are o maturing of the immune system covered by health care o unintentional injuries  Young adults Culture o Greatest reluctance  Canadians from ethnic minorities make fewer specialist visits o may be due to cultural differences in how symptoms  Elderly o Frequently complain, over-report are expressed or disclosed o Chronic conditions & diseases  Linguistic barriers  Discrimination (trust) o Mild cognitive impairment associated w the perception of poorer body fn’ing; ageing o Older men delay seeking help for embarrassing Social Psychological Factors  Attitudes & beliefs about symptoms and health services symptoms  HBM explains ppl’s use of health services well (perceive Gender threat, bhvr will be affective)  Women use medical services more than men o Ppl also learn from the experiences of others o Pregnancy / childbirth account for some of the  Socialization (family members) differences - reproductive health o Homeostatic mechanisms: Women tend to report pain How are Health Services Misused? earlier, experience temperature changes more rapidly  One type of misuse occurs when ppl seek out health services o Time btwn deciding to seek treatment & making an for problems that are not exclusively medically significant appointment o Typically stems from anxiety & depression 4. Medical delay  Ppl w mental health might not realize their o The time elapse btwn the person making an appointment physical symptoms are due to a mental illness  & receiving appropriate medical care o Patient deviates from the profile of the avg person w go to hospital  Ex. anxiety, panic attacks, pain, fatigue the disease o Overloading the medical system  Why do ppl seek physician care when they should be Stages of Delay in Seeking Treatment for Symptoms addressed by a mental health specialist? o Don’t fully understand that their symptoms are due to mental illness o Certain types of mental illness disorders (specifically somaticizers) experience pain or symptoms but there is no actually reason for it Using Health Services for Emotional Disturbances Worried well  Concerned about physical & mental health, inclined to perceive minor symptoms as serious  Believe that they should take care of their own health  Actually leads them to use health services more Somaticizers  Indivs who express distress & conflict thru bodily symptoms  Convince themselves that they are physically ill o Threats to self esteem, accomplishments, may become depressed Secondary gains  Illness brings benefits o Include the ability to rest, to be freed from unpleasant tasks and to be cared for by others  Reinforcements for being ill Malingering  Ex. Doesn’t want to go to work/school o Exaggerate symptoms Research on Stages of Delay  Looks for a doctor that will provide documentation for  Longer delay: dismissal for absenteeism, or disability payments o Total delay in seeking care was significantly longer for those who had other problems in their lives, Stigma read about their symptoms, and waited for  Absence of mental health care coverage symptoms to go away o Psychologists not covered o Patients were more likely to view an old symptom o Psychiatrists covered since deal w medication at as normal and tolerate it for a long period hospital o Those who imagined (-)ve conseqs of being ill had lengthy delays o Need to have a referral from a family doctor  Worried about stigma of mental illness o Ppl who believed they could not be cured delayed o  so say they’re going to their family doctor instead of treatment o Those low & high in fear are likely to delay their therapist   Denial  Want to have a medium level or fear to decrease delay Another Misuse of the Health Care System: Delay Bhvr  When you don’t use the health care system but you need it o Taking care of family members results in delay  Patient delay: Period btwn one’s 1 awareness of a symptom &  Shorter delay: o Least likely to delay treatment are those in the treatment for that symptom 1. Appraisal delay greatest pain o Time it takes an indiv to decide if a symptom is o Those who are trustful of others are less likely to serious (sign of illness) delay 2. Illness delay o Time btwn recognition of a symptom (one is ill) & How Does Hospitalization Impact the Patient? deciding to seek medical care  ~ 2.8 million ppl are admitted to Canadian hospitals each year  Hospitalizations have decreased over the last 12 years 3. Bhvr’al delay o More outpatient visits o More day surgery 4. Incorporating prevention & health promotion o Ppl refered to other places o Work together to enable patient to take required steps to o Staying in the hospital for surgery recovery has control & improve health decreased – can recover at home 5. Enhancing the patient-physician relationship o Build rapport Structure of Canadian Hospitals 6. Being realistic  How do hospitals receive funding if we do not pay for services o Physicians must recognize their own limits directly?  Ex. Can only see a certain amt of patients in a o Funded thru annual budgets negotiated w provincial or day to give them each enough patient-centred territorial ministries of health or regional health board care or authority o Both physician & patient have limits  How are hospitals organized? o Administration at the top, physicians, nurses and Role of Psychologists technicians as employees  1982: 1 full-time Psychologist per 131 hospital beds in Canada o Different goals:  1999: 1 for every 51 beds  To cure (physician) o # of psychologists increased in hospitals  To care for (nursing staff)  Psychologists have become more autonomous since 80’s;  To maintain the core (administration) given their own departments in hospitals o Communication patterns & hierarchy (occupational o Participate in patient diagnosis & determine level of segregation) fn’ing  Nosocomial infections: infection results from exposure to o Involved in pre- and post-surgery care, pain control disease in a hospital setting (ex. Anxiety), treatment compliance, and bhvr’al o Affect 250,000 Canadians every year programs such as self-care o Results in death for several thousand  Top 3 units in a hospital that psychologists are involved in: pain, eating disorders, cancer  How are hospitals organized? o This is beginning to change due to the rise in chronic Ex. illness (ex. heart disease, diabetes, etc) o Outpatient: o Ex. Preparation for own death of the death of a loved  A person who goes to the hospital for a procedure one or test but does not stay overnight  inpatient = stays overnight, 24hr surveillance byThe Impact of Hospitalization on the PATIENT stafff  When admitted to hospital: o Day care patient: o patients stay in an impersonal room  A person who goes to the hospital for a procedure o regimented schedule or test that is more involved than a routine test &  ex. Eating schedule, no control over which foods does not stay overnight given  ex. chemo daycare o invasion of privacy o Day surgery: o have no control  surgery that does not require the patient to stay in the hospital  White coat hypertension: elevated bp only when it is  ex. implant tubes in ears to treat recurring measured in the doctor’s office infections  Psychological symptoms: anxiety, nervousness, fear, depression, insomnia Patient-Centered Care  Need to integrate the conventional understanding of disease w  “Hospital patient role”: The patient is expected to be each patient’s unique experience of illness cooperative, dependent, and helpful w/o demanding excessive  Total-person approach to patient problems attention  Change over past years o Despite the fact that the “good” patient is the type most  6 interconnected components: appreciated by staff, the patient who fully takes on 1. Exploring both the disease & illness experience the patient roles is not necessarily well-adjusted or o What the patient believes is wrong, feelings about being satisfied. ill, impact of illness on their daily fn’ing, how they believe the physician should proceed  Reactance: the non-compliant bhvrs & attitudes of patients o Effected aspects of the patient’s life who perceive hospital rules and regimens to be unacceptable 2. Understanding the whole person challenges to their freedom o Patient’s disease & the experience of illness in the context o Attempts to regain control of pat
More Less

Related notes for PSY333H1

Log In


OR

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


OR

By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.


Submit