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Chapter 11

Chapter 11, Health Psychology

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PSYC 3170
Gerry Goldberg

Chapter 11 Notes: Management of Chronic Illness  60 percent have; 80 elders have; 1/3 young adults have;  Common among low income; common in women; aboriginals;  Self-management: involvement of the patient in all aspects of a chronic illness and its implications, including medical management, changes in social and vocational roles, and coping  Quality of life: has several components, specifically physical functioning, psychological status, social functioning, and disease or treatment related symptomology o Perceptions important of ones life o Impteus to study come from psych factors o Chronic=anxiety and depressions so important to see quality o Stress excrabates effects of most illnesses o How much the disease and illness is interfering with their activities of daily living such as sleeping, eating, going to work, etc.  One way in understanding how chronic illness can impact life is by examining how the quality of life of people living with chronic disease or condition compares with that of the general population o Establishing quality of life population from norms in each country and compare to individuals with illness o Candian highest; men higher  Quality of life my fluctuate depending on the characteristics o the illness, acute changes in symptoms, age related changes in health over time o Diseases such a MS are progressive and may rapidly decline the quality of life Why study quality of life? 1. Documentation of exactly how illness effects vocational, social, and personal activities and well as general activities of daily living provide and important basis for interventions to improve quality of life 2. Measures can help pinpoint which problems are likely to emerge for patients with diseases and be helpful in anticipating the interventions that are required 3. Assess impact of treatments on quality of life 4. Quality of life information can be sued to compare therapies 5. Quality of life information can inform decision makers about care that will maximize long-term survival with the highest quality of life possible 6. Present of multiple chronic physical or mental health conditions  Many people live with multiple chronic pain and treatment is only for one specific kind (having multiple diseases has an additive impact on life; mos target one) o ½ arthritis or high bp; 1/3 diabetes or heart Emotional responses to chronic illness?  After chronic disorder diagnosed: patient can be in a state of crisis marked by social, physical, and psychological o This phase then passes and develop a sense of how the chronic illness will alter their lives o These problems then fall it daily physical, vocational and psychological rehabilitation     Denial: is a defense mechanism by which people avoid the implications of an illness o Common reaction to chronic illness and common in heart disease patients (who had a stroke) o During acute phase of the illness denial acts as a protective functioning (allows patient to comes with terms of illness when they are ready) o Can mask fear  Anxiety: After the diagnosis of a disease anxiety is common  This is a problem not only because it is intrinsically distressing but also because it can interfere with good functioning o Anxiety about possible complications in life also occur (assessment and treatment of anxiety is needed)  Depression: is a common and often deliberating reaction to a chronic illness o One third of patients who find out they have a chronic illness are depressed o Common among cancer, stroke, and heart disease patients o Depression can be a sign of impending physical decline especially in elderly men o Once acute phase is over with the chronic illness then the patient might sink in the disorder and get depressed o Delayed reaction to chronic illness  Signif: Depression is important not only for distress but also for the impact on experienced symptoms and the process of rehabilitation or recovery  Depression over illness have been linked to suicide  Depression increases with severity of the illness  Long term o Experiences of pain and disability o Physical limitations o Treatment for depression might alleviate physiological distress but improve functioning by reducing symptoms of illness o Found in ppl who have previous tsress events o Physical limits may predict depression early; psychological later on… o Lack of social support  Self-concept: is a stable set of belief about one’s qualities and attributions o Body image/achieve/social fn  Self-esteem: refers to general evaluation of the self-concept, whether one feels good or bad about personal qualities and attributions o Chronis illness can drastically change one self-concept and self-esteem … have significant impact on future goals  Body-image: is the perception and evaluation of one’s physical functioning and appearance  1. Related to low self esteem  2. How adherent or not  3.Can be improved thro psych changes o Two expectations are patients with facial disfigurations or with extensive burins (low body-image) … produce chronic alterations in body image  Face is often associated w
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