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154 Cards in this Set
- Front
- Back
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What influences wellness?
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Individual factors
Interpersonal factors Community factors |
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What are the community factors that affect Wellness?
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Prevention vs. Treatment
-sometimes focuses more on treatment and getting better, than preventing the problem in the first place Environment factors—Examples? -hard to find good fruits and vegetables, taco bell is cheaper than healthy food -but there is more bike lanes, parks etc. Economy -where is the money being spent? Spending on war or health care or aids research? Poor health care/ insurance (preventative) -not having health care, when it comes to preventative care not insured only fix the problem when problem is there (dentists and cavities) |
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What are interpersonal factors that affect Wellness?
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Friends/ Family
-social support -social praise, support in change -modeling -if you live with your family, are they having the same good habits? Makes it difficult if you try to implement your own personal change, and create conflict -Interpersonal Conflict |
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What are the individual factors that influence wellness?
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Problems in promoting wellness:
-little incentive to change; inconvenience -habitual behaviors, addiction -if you don’t know how to cook, and not interested, no problem finding food every night, more difficult to break that habit -Cognitive resources( knowledge, skills, plans) -need certain knowledge to change their behavior -Self-Efficacy: if you don’t feel that you have the ability or power or control, then chances are it’s an uphill battle to think that you will be successful -Sickness, substance use -affect cognitive resources, impair appraisals of things, doesn’t help behavioral change |
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How do we develop our health behaviors?
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Genetics
Social Factors Learning |
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How do social factors affect our health behaviors?
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-Modeling
-what sorts of health behaviors did your parents raise you with? -were you active in getting enrolled in sports? -were you home alone in front of TV? -Consequences -whether or not you are rewarded or punished for health behaviors -Gender Differences -boys tend to be encouraged to be more active, play rough, involve in sports |
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What are the learning factors that affect our health behaviors?
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Operant conditioning
Consequences behaviors change -what influences the change 1)Reinforcement: increases behaviors Positive reinforcement: positive consequence is added Ex: get a treat, buy self new things Negative Reinforcement: take away, unwanted consequence being removed Ex: have a headache, take aspirin to remove headache, next time will go back to aspirin 2) Extinction the behavior starts to go into extinction if you don’t keep up the reward 3)Punishment -decreasing behaviors -unpleasant consequences (adding or removing) -Positive Punishment: Giving up money -Negative Punishment: Taking away favorite show 4) Modeling -similar to self -more likely to model after them if they are like yourself -higher status: celebrities, athletes -advertisers feed off of this 5) Antecedents: internal/external stimuli that precede and prime a behavior -ex: smoker just smelling cigarette smoke makes them want to smoke -seeing bag of chips make you want to eat it Habitual: automatic -less dependent on consequences, now more dependent on antecedent cues ex: some smokers, I can’t go to work in the morning or cup of coffee without having cigarette of the day -just seeing someone light a cigarette, makes them want to 6) Personality (conscientiousness) -being agreeable to things, aware of things, more associated with more positive health behaviors Emotions: Stress poor health behaviors (diet, sleep, exercise) Distress preventative behaviors -can affect you from taking preventative behaviors -if you know someone who has breast cancer and distressful for you, it causes internal stress, less likely to go get tested yourself 7) Cognitive Factors -knowledge, education -understanding the physical effects—short term, long term -how do you fit in an exercise schedule? How do you devise a plan to fit it in? -Judgements (misconceptions) -we assess our current condition of health -make decisions based on these judgments to see if any of these need to be changed -harmful health behavior -people with hypertension, list symptoms, but the symptoms they are reporting are poor indicators of what their actual blood pressure is -Unrealistic optimism & pessimism- illogical ideas -people believe that they are less likely than other people to experience negative health problems or symptoms -ex: college students surveyed they are less likely to get a STD or diabetes or develop coronary heart disease in comparison to them -think more likely to develop ulcers -hard to be optimistic when you are sick |
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What is the Health Belief Model, Preventative action steps?
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1) Threat:
-seriousness -susceptibility- if more vulnerable then you are more likely to take action -cues to action-if you are reminded of it, you will more likely do something about it 2) Benefits vs. Barriers ex: physical (sick,tired), financial (can’t afford gym membership), psychosocial(own belief or successful will impact self esteem, less committed to do it, embarrassed to work out in front of other people) Pros-Cons= Sum -benefits need to outweigh the barriers in order for change, is it worth it? What are the incentives? |
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What is Theory of planned behavior?
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Intentions predict behaviors
Judgements about behaviors… -Attitudes (outcome/reward) -Subjective norm (social pressure to make change) ex: wife is making you because don’t want husband to get second heart attack -Perceived Control (self-efficacy) -level of perceived control -problems: -ignores other factors, no pros and cons of things -think things are beyond control -may intend to do something, but do not do it, may not follow through with behavior More likely to carry out if: 1) have a plan 2) keep track of effort 3) recognize commitment |
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What is the stages of Change model?
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Intentional Change:
-not all in one step -can’t happen all at once -progress through stages -progress though stages at own rate -useful for intervention (match with stage of readiness) -take each of these stages and match it based on where they are for change -success in… 1)Precontemplation -unaware, resistance, increase aweareness 2)Contemplation (problem identified) -awareness, openness, motivate, encourage 3)Preparation (motivational force for change) -anticipation, willingness, training, plan assist 4)Action (action plan developed) -enthusiasm, momentum, assist problem solving, reinforcement 5) Maintenance (new behavior reinforced) -performance, consolidation -good for quitting smoking |
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What are the problems with the change models?
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-assuming that people are making good decisions (rational decisions)
-should be able to make these decisions, but why aren’t they? -people’s actions do not make sense -irrational/unwise decisions -influenced more by emotions and motivational processes |
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What is Motivated Reasoning?
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-Desires/ Preferences influence judgments of new information (cognitive biases)
causes irrational behavior |
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What happens when we are irrational?
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-less likely to follow advice
-defense mechanisms-denial about behaviors and health problems -Who me? |
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What is false hope?
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- believe in success without rational basis
-misinterpret failures (High expectations) -I was successful..until certain point, that is reinforcing to want to try again -expectation is not matching up with reality on how to make it successful |
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How does spontaneous risky behavior affect irrationality?
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Willingness
-attitude (about that particular behavior) -subjective norms (about that particular behavior) -previous experience (more positive attitude you have on the behavior, increase in willingness to that behavior) -positive social image of who would engage in the behavior -not that you do or do not intend to do a harmful behavior, but more of if you are willing to do it -gets to willingness |
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How do emotions affect our irrationality?
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-stress has a negative effect on cognitive processing
-affects rational decisions you make |
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What is conflict theory and how does that affect irrationality?
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-describes cognitive sequence they use when making decisions
-Accounts for rational and irrational decision making -some event that will challenge your life style -all experience stress with making major decisions -have conflicts about what to do about it behaviorally -Decisions= Stress -how do you view that event? -Threat or Opportunity -Risk, hope, adequate time coping these three components influence how you will cope with this stress -difference combinations then influence different coping patterns Coping Hypervigiliance vs. Vigilance Hypervigilance: become freaked out, running out of time, make a hasty decision -not feeling enough time, feel like need to lose weight for something, use crash diet Vigilance: -spend time researching and changing behaviors -less stress -if it is serious, vigilance is most adaptive pattern |
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What are the key factors of conflict theory?
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Risk, Hope Adequate Time
Current Behavior--> Challenge: threat or opportunity--> Risk Appraisal--> resume behavior or new behavior -making decisions is stressful |
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Why do women live longer?
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Women—4 to 5 years longer than men
Why? Estrogen levels in women delay heart disease, reduces blood cholesterol levels and platelet clotting, protective factor -men are more embarrassed stubborn denial for going to doctors and seek treatment -men have higher stress reactivity to stressors, particularly to interpersonal stressors, take longer to recover and get back to baseline -men not chosing how to cope wisely, use behavioral actions—drinking smoking unhealthy diets, more risky with driving and sexual behavior What do men do right? -exercise more -Lower SES, more health problems like infant mortality -ethnic minority differences as well -hazardous microorganisms and chemicals that happen to be in her blood -mother may be malnourished due to inadequate food supplies or knowledge of nutritional needs -if mother has infections -substances that mother use may enter bloodstream ex: cocaine, alcohol, cigarette exposure |
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How do we promote health?
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provide information
enhance motivation behavioral methods |
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How does providing information promote health?
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-mass media (television, radio, newspaper, magazines)
-just supplying this info has limited success if people don’t want to change -especially when people are particularly stressed -people don’t want to change, not effective -but if people are interested, then using television tends to be the most effective medium -internet -doctors office |
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How does enhancing motivation help promote health?
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-tailored content
-tailor the information, specific to person they are targeting -message framing -gain framed: attain good, avoid bad ex: exercise- benefit physically, psychological, and avoid the bad, avoid heart disease obesity -loss framed: change now or lose later ex: emphasize benefits or cost of behavior, fear is included in loss framed, play up fear to act as the stimulus for change ex: if you don’t quit smoking you will develop X, Y and Z |
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How does behavioral methods help promote health?
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Rewards and Punishment
-changing ancedents: plan, have calendar of what you need to do -don’t buy junk food and bring it into the house -if you want to reward self, can go out and get the treat (removing antecedent in environment) Reward: if you quit smoking, then you can treat yourself to a massage |
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What is addiction?
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repeated consumption
-physical and psychological dependence |
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What is physical dependence?
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when your body has adjusted to the substance at this point
-requires it for functioning ex: you need it to function physically 1) Tolerance -process body develops over time -increasingly adapt to substance so you need larger doses to produce same effect 2) Withdrawal -psychological symptom that is associated and experience when the substance is no longer in the system or drastically reduced |
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What is psychological dependence?
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-compelled to use substance (needed to adjust)
-feel like you can get by the day -cravings, motivation, desire -ex: anxiety, loneliness-->Alcohol just having that pack of cigarettes with you can be comforting |
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What is substance abuse?
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Dependence + one of these three:
-impaired functioning, cannot fulfill obligations -hard time meeting responsibilities needed to perform in life -repeated risk to self or others ex: drunk driving -substance related legal problems ex: arrested for drunk driving? Getting into problems because unable to control? |
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What leads to dependence?
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Operant Conditioning
+/- reinforcement +: ex: alcohol buzz -: headache from alcohol etc. Classical conditioning Cues: once a neutral stimulus with a substance becomes a cue 1) allows body to anticipate and then compensate for the substance effects ex: body increases tolerance for alcohol 2) Incentive-sensitization theory: dopamine strengthens connection between stimuli/ cues and substance (reward!) -dopamine neurotransmitter for reward and reinforcement for feeling good -make more salient for substance to be stronger |
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How does genetics affect substance abuse?
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tobacco and alcohol
might have a stronger dependency for it |
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Who smokes more?
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Men: 23%
Women 18% Teenagers who don’t progress to college, low SES, develop higher smoking habits -level off in adult hood and decline when 40 |
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What are the risks for regular smoking?
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-need to smoke at least 4 cigarettes will increase the odds for be a regular smoker
-at least one parent that smoked -positive attitude about smoking (not seeing the health consequences as being a big deal) -believed that they can quit -did not think it harmed health -have lots of stress in life -have poor coping skills -genetics |
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Why do people start smoking?
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-usually begin in adolescence
-usually have to do with modeling, more likely to start smoking if your parents smoke, if your friends, celebrity, or people you look up to smoke -Modeling -Peer pressure ( first smoke is usually among friends) -Personal characteristics ( rebellious, risk taker) -Expectations (image) does it look cool, mature, older, exciting to do this -Biology |
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What are the health effects of smoking?
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-dependency due to chemicals (4,000)
-amonia, arsenic, -carbon monoxide -reduced O2 capacity of blood -Tars -residue in lungs, plugs air sacs -causes people to cough -Nicotine -addictive chemicals -sympathetic nervous system -arouses body, once its inhaled, reaches the brain in 10 seconds and can be found all over the body |
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What is the nicotine regulation model?
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-Maintain certain level of nicotine in body to avoid withdrawal symptoms
-not consuming less nicotine, just smoking more low nicotine cigarettes Does not explain why: 1) cravings continue after quitting 2) some people do not show tolerance maybe it's genetics? -still feel psychological cravings |
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How do genetics affect smoking habits?
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-genotypes associated with smoking initiation, dependence, persistence (how difficult is it to quit)
-increased risk for lung cancer |
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What is the Insula?
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-brain structure that is embedded in the frontal and temperal lobe
-damage to the insula makes you lose the desire to smoke -however, doesnt make you lose the desire to eat, maybe it's only with learned pleasures |
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How does the dopamine transfer gene affect smoking habits?
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-less likely to be smoker
if smoker-less likely to start before 16, and easier to quit -less novelty seeking traits |
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How many smoking related deaths/year is there in the US?
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1/5 or 438,000
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Is smoking the #1 killer in the world?
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No,
Cardivascular disease causes more than 652,000/yr but smoking is the #1 cause for preventable diseases across the world |
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How does smoking affect CHD and Stroke?
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CHD- 2 to 4 times more likely
Stroke 2 times higher risk for smokers |
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How does nicotine affect atherosclerosis?
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Nicotine+ CO causes a decrease of oxygen to the heart
-this causes atherosclerosis faster |
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How does stress affect smoking?
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-increase stress reactivity after smoking
-increase in stress, increases smoking |
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How does nicotine act as a stimulant and a depressant?
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Stimulant:
-affects sympathetic vasoconstricters depressant: -releases dopamine and endorphins(pain), epinephrine (concentration) -feel good chemicals -psych effects |
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What is chronic obstructive pulmonary disease?
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-emphysema and chronic bronchitis
-permanently reduced airflow -80% due to smoking |
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How can smoking affect other respirator issues?
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increases respiratory infections and lasts longer
ex: pneumonia decreases immune functioning -poor health and more likely to get sick |
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How does smoking affect cancer?
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#2 killer: Cancer
-559,000 deaths with cancer and 30% is due to smoking up to 90% lung cancer deaths -decline in men, increase in women in lung cancer recently -mouth, esophagus, bladder, kidney, stomach cancer -it's from the carcinogens in smoke and tobacco |
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Females typically get more intoxicated than males from the same amount of alcohol? True or false?
why? |
true
Why? 1) women have smaller blood volume 2) unable to metabolize alcohol as well as men because women have more body fat and less water 3) fewer metabolic enzymes in stomach -metabolic disadvantage |
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Who drinks more?
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Men, caucasians
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What's binge drinking and how many percentage of college students do that?
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49% of college students drink
45% of those students binge drink Binge drinking is when you have more than 5 drinks in a single occasion over past 30 days |
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How does binge drinking affect college students?
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Increased deaths 1,700
increased injuries 599,000 increased academic problems 25% increased sexual assaults 97,000 increased STDs Increased assault, property damage 1 out of 4 forgot where they were and what they were doing while drinking |
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What are risks for alcohol use and abuse?
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-social drinking/ modeling
-positive subjective norms -perceiving fewer negative consequences associated with drinking for use and abuse -positive and negative reinforcement -high stress -genetic predispositions x environment (stronger cravings, more pleasurable, higher tolerance level) |
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What are the alcohol affects on health?
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Cirrhosis:
-disesase of liver, unable to clean blood cancer: 2-4% -in liver and pancreas Ulcers Hypertension: -increase in blood pressure, weakens heart muscle Heart damage Brain damage (temporary or permanent, irreversible) Hepatitis |
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What are the positives of drinking alcohol?
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-light to moderate drinking
-red wine has antioxidants -increases HDLs and decreases LDLs -prevents blood clots -resveratrol- antioxidants found in grapes, but can get that from grape juice |
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What are the benefits of coffee?
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-antioxidants
reduces HD, diabetes, Parkinson, Alzheimer -pain reliever |
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What is caffeine?
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drug with addictive properties
has tolerance and withdrawal symptoms |
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What are the stats of americans drinking coffee?
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57% of american adults drink coffee every day
-avg 3-4 cups/day 400 mg/day "ok" too much is if its more than 600 mg |
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What are the pros of caffeine?
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-exaggerates stress response
-increases memory, concentration -increases antioxidants -decreases pain and increases reaction time |
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What are the cons of caffeine?
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-exaggerates stress response
-increases heart rate, blood pressure, stomach acid -increases anxiety and jitters -increase tolerance -physical and psychological dependence (makes you feel good, and cant function without it) |
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What are the withdrawal symptoms of caffeine?
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-headache
-irritability -excess fatigue -poor concentration |
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How do you break the addiction of smoking?
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-increase self-efficacy
-quit cold turkey is the best -oral substitutes (gum) -positive reinforcement -change environment -social support -strong motivation -break behavioral habit -throw away cigarettes, ashtray, lighters, washing clothes -Change routine, change food, the way you eat and exercise |
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How do you stop drinking?
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-increase self efficacy
-social support/ motivational methods -positive and negative reinforcements -aversion strategies: -emetic drugs- unpleasant stimuli that links to substance to stop behavior -in/out PT: produce nausea when alcohol is ingested -flooding: keep doing it till youre physically sick -cue exposure: -stop addiction with cue association -hold cig but behaviorally cant smoke and drink -write out unpleasant feelings -stress management with relaxation -medication -dulls euphoric feelings of alcohol |
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What are teh five dimensions of a high performance health system?
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1) quality
2) access 3) efficiency 4) equity 5) healthy lives |
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What did the U.S. rank last in?
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1) access
2) patient safety 3) efficiency 4) equity |
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What is the area that the U.S. performs the best in?
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preventative care
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What are the 4 categories of quality?
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1) right (effective) care
2) safe care 3) coordinated care 4) patient-centered care |
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In terms of quality what is the U.S. good in and poor in?
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The good:
-provision and receipt of preventative care---from the right care The Bad: -low schores on chronic care mangagement and safe, coordinated, and patient centered care |
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Why is access to health care so bad in the U.S.?
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-people who can't pay their health treatments, unless they are insured
-u.s. and canda lowest on prompt accessibility of appointments -waiting 6 or more days for an appointment when needing care |
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What are the problems in the U.K. and Canada for access?
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-patients have little to no financial burden, but experience long wait times for such specialized services
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Which country has the best perceptions of access?
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Germany
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In what terms is the U.S. bad for efficiency?
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-poor performances on measures of national health expenditures and administrative costs
-also measures of the use of information technology and mulitdisciplinary teams -also, sicker respondents who visited the emergency room could have been treated by a regular doctor if they were available |
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What is not equal about America's health system?
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-poor people could not :
-visit a physician when sick -not getting a recommended test -treatment or follow up care -not filling a prescription -not seeing a dentist |
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Who has the healthiest population?
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Australia, canada
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Who is covered under medicare?
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-all elderly people
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Who is covered under Medicaid?
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low income people
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What is fee-for service?
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can choose their physicians and insurance pays most of incurred charges
you choose, insurance pays |
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What is managed care programs?
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place restrictions on their member's choices and services
-charge annual fees for the members or employers pay we choose, insurance pays |
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What are the two types of managed care programs?
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HMO and PPO
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What is HMO?
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-members are entitled to use the services of any affiliated physician or hospital with little or no additional charges
-visits to specialists or for non emergency hospital treatment must be preapproved and referred by the primary care physician -HMO pays for treatments it arranges or recommends, and negotiates with specific hospitals and physicians for discounted rates |
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What is PPO?
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-PPO consists of a network of affiliated physicians and hospitals that discount their fees
-patients usually may go to any affiliated specialists without pre-approval |
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How do HMO patients compare to PPO patients?
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-Use more preventative examinations and procedures
-have more trouble getting to see a physician when seriously ill -are less likely to be admitted to a hospital, and when admitted, they are likely to leave sooner -Often face major obstacles getting treatment they need -(HMO's vary in willingness to approve procedures) but medical care is comparable for most patients otherwise -Report being somewhat less satisfied with the care they received but much more satisfied with the costs to them |
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What is the universal health care system?
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-provide medical coverage for virtually all of their citizens
-usually funded by taxes and payroll deductions Ex: Australia, Canada, Germany, Italy, Netherlands, Sweden, and U.K. |
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How do perceiving symptoms, individual differences, environmental stimuli, and psychosocial influence affect us getting treatment?
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Perceiving symptoms:
-not sure how to assess symptoms, might think it will go away Individual differences: -can think that it's not that big a deal, have different thresholds Competing Environmental Stimuli -may not feel the injury because they are paying attention to the environment instead of internal state Psychosocial influences: -expectations can influence them to think that they are getting better by using placebos |
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What is nocebo?
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-perceive side effects such as dizziness or fatigue, but not from drug because it's a placebo
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What is mass psychogenic illness?
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-involves widespread symptom perception across individual, even though the tests say they don't have the condition
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What are the gender and sociocultural differences on pain?
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women report feeling discomfort at lower stimulus intensities than men
-request sooner that a painful stimulus be terminated Culture: Asian cultures report more physical symptoms with psychological base than people of other cultures -back pain: americans most impaired italians and new zealanders next Japanese Colombian Mexican |
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Who visits doctors more?
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-young and elderly
women more than men |
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Why do women visit doctors more than men?
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Women:
-because they develop more illnesses -higher drug use and illness from acute conditions Men: more hesitant to admit having symptoms and to seek medical care for the symptoms they experience |
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What are some sociocultural factors in using health services?
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1) people seeking medical care increases with family income
2) Blacks and low income families more likely than whites to use ER 3) People of lower class seem to think they are less susceptible to illness than those from the higher classes do -seek less preventative care 4) In poor regions, less doctors that set up practice there 5) language barrier |
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What is iatrogenic conditions?
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when patients develop health problems as a result of medical treatment
-maybe from practitioner's error, wrong type or dose of medication |
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What are the effects of people not trusting practitioners?
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1) individuals may avoid getting care because hey worry that their practitioners will not keep info confidential
ex: adolescents have health concerns they want to keep private from parents 2) minority group members have heard stories of discriminatory practices and atrocities carried out by medical personnel against them |
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What is the Health belief model?
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Seek treatment upon perceived threat
1) cues to action 2) perceived susceptibility 3) perceived seriousness Perceived benefits- perceived barriers |
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What is adherence and compliance?
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-both mean to carry out the behaviors and treatments their practitioners recommend
Adherence is a better term because it's more collaborative compliance means you will give in to a request or demand, obeying reluctantly |
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What are some examples of nonadherence?
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-stop doing rehabilitation exercises
-or cheating a little on a diet -not taking the medication, forget the doses |
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What is the rate of nonadherence?
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40% failure
2/5 patients fail to adhere to their regimen |
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What characteristics does adherence depend on?
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1) the illness or regimen
2) the person 3) the interactions between the practitioner and patient |
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For the regimen, what influences adherence?
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1) duration
2)expense 3) side effects 4) severity |
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How does age affect adherence?
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-younger children were better than older children even though parents were controlling it
-adolescents less adherent to their diets than children -middle aged people with very busy lives made more errors than older patients |
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What is rational nonadherence?
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when they have a deliberate or valid reason for not taking medication
-have reason to believe the medication isnt helping -feel that its side effects are unpleasant, worrisome, or seriously reducing the quality of their lives -are confused about when to take it or how much -don't have the money to buy the next refill -want to see if the illness is still there |
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What are two psycho social factors that are associated with adherence?
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self efficacy and social support
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What are some biological ways in which pain is managed?
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-take over the counter pain relievers
-prescrpition medication and surgery -body triggers endogenous opioids which are our body's natural pain killers |
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Describe the four types of pain-relieving chemicals
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1) Peripherally Active analgesics
a) acetaminophen (tylenol) b) NSAIDS (aspirin, ibuprofen) 2) Centrally acting analgesics a) narcotics (morphine, heroine) 3) Local Anesthetics a) novocaine 4) Indirectly acting drugs a) depressants and antidepressants like alcohol |
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Discuss the key research findings on using chemicals to treat chronic pain
ex: using narcotics for cancer vs. non-cancer chronic pain; risk for addiction |
Opioids
-helpful for Cancer, rheumatoid arthritis -Not as effective for chronic back pain and linked to abuse the risk for addiction is high for chronic back pain, but low for cancer people with higher depression and anxiety disorders are more likely to be at risk for addiction and abuse -but low when used in low doses and appropriately |
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Why are chemicals alone usually not sufficient for getting rid of pain?
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-might have maladaptive coping
ex: chronic headaches (as opposed to people who don't have chronic headaches) -increased helplessness in patients reported poorer treatment success -success of placebo drugs work in pain relief -benefits in pain groups, so if someone has the support, then more likely they will heal faster |
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What are psychological goals of pain treatments?
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1) reduce pain
2) improve emotional adjustment 3) increase social activity 4)reduce analgesic drug use |
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Compare the effectiveness of relaxation and biofeedback skills for pain reduction
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Relaxation & Biofeedback
-Electromyograph (EMG) -measures electrical activity in muscle and muscle tension -then ask them to relax -relaxation plus biofeedback was the most successful for people with headaches -than just by itself or nothing at all Best: 1)Relaxation and Biofeedback 2)biofeedback only 3)Relaxation only 4) placebo 5) Monitor headache (negative effect) |
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What is the Operant approach?
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ignore the pain behaviors they paid attention to in the past
-extinction -provide rewards for compliant behavior-telling her for instance: "if you don't cry while i put your splints on, you can have some cookies when i'm finished" or "if you do this exercise we can play a game" -praise her if she helps in putting on the splints, sleeps through nap time, goes for a period of time without complaining or doing an exercise Goal: -reduce their reliance on medication -reduces the disability that accompanies pain conditions -try not to reinforce their complaining |
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Does hypnosis reduce pain?
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yes
-both chronic and acute good for: arthritis and headaches But.. not for everyone -as effective as cognitive and relaxation strategies -effective for highly suggestible people |
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What are the different cognitive treatments for reducing pain?
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1) Distraction
The effectiveness depends on: -attention (how much attention is on the other thing?) -interest (how engaged) -credibility -useful for reducing acute pain, such as some medical or dental procedures -also provides relief for chronic pain patients in some circumstances 2) Imagery -scene incompatible with pain "happy place" -reliance depends on how well they can imagine -works best when it attracts high levels of the person’s attention or involvement -works better with mild or moderate pain than with strong pain 3) redefinition: -coping “Be brave—you can take it” re-interpretive statements "it's not so bad" " i can do this" "it will be better" - providing information on what sensations they will feel next 4) Hypnosis—does it work? yes -both chronic and acute good for: arthritis and headaches But.. not for everyone -as effective as cognitive and relaxation strategies -effective for highly suggestible people |
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What are the physical and stimulation therapies for pain reduction?
How effective is it? |
-Counter Irritation:
- reducing target pain by creating another milder pain -TENS: -putting electrodes on the skin near where the patient feels pain -not effective in reducing acute pain, and not sure about chronic conditions Acupuncture -put needles to create stimulation -do not support its use for surgical anesthesia -can help reduce pain in some patient -not long term relief for chronic pain -good for low back pain though Physical Therapy -good for enhancing muscular strength and flexibility -good for arthritis and low back pain |
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What is type 1 Diabetes?
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-autoimmune disease
-pancreas cells destroyed-insufficient insulin -typically in childhood -involves a viral infection that stimulates the immune system to attack pancreas cells |
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What is type 2 diabetes?
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-genetics, obesity, physical inactivity
-may produce insulin (even high) but their body is still insulin resistant -3 possible conditions: -diets high in fat and sugar -stress -and overproduction of a protein that impairs the metabolism of sugar and carbohydrates |
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What are the health effects and complications associated with diabetes?
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-death
-neuropathy: nerve disease -high blood glucose cause destruction in the myelin sheath that insulate nerve fibers -causes them to loose sensation in the affected area or pain -blindness, kidney disease, gangrene(might have to amputate), heart disease, stroke |
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Discuss psychosocial factors that influence adherence to medical regimens among diabetics
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-stress may reduce treatment adherence
-if regimen is complex, it is hard for them to comply -social support and self efficacy is the best way to help them -higher their subsequent self-reports of adherence, the better their actual glucose control -need to be relaxed so the hormones don't interact with it |
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How does stress affect diabetes?
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-stress impairs blood sugar control
1) people under stress, adrenal glands release epinephrine and cortisol in the blood stream epinephrine causes the pancreas to decrease insulin production -cortisol causes the liver to increase glucose production and body tissues to decrease their use of glucose -this worsens the glucose regulation problem 2) stress can affect the blood glucose levels indirectly by reducing adherence to diabetes regimens -more depressed they feel, the worse their glucose control and the greater their risk of resulting health problems |
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What is organic pain?
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actual tissue damage
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What is psychogenic pain?
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no physical damage, psychological perception of discomfort
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What is acute pain?
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less than 6 months, temporary
-high initial anxiety, but later subsides |
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What is chronic pain?
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longer than expected, recurrent, and 3-6 months
-high anxiety consistent, hopelessness -estimated prevalence of chronic pain in America 36% |
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How is pain associated with sleep?
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pain sufferers experience sleep problems because:
physical pain, anxiety, and negative thoughts make it harder to sleep -lack of sleep causes pain sensitivity -which cause the three physical pain, anxiety, and negative thoughts |
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What are the three chronic pains?
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Chronic- recurrent
-repeated, intense episodes -tension and migraine headaches Chronic-intractable-benign (non malignant) -consistent, intensity, varies -low back pain Chronic-progressive (malignant) -consistent, increasingly worse -rheumatoid arthritis and cancer |
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What is the process of the physiology of pain perception? (the body's reaction to physical damage)
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Noxious stimulant causes:
chemical release Chemical release: 1) activate immune system inflamation or 2) Nociceptors: -a-delta fiber or C fibers The body has no specific receptor cells that transmit only pain info |
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What are nociceptors?
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the afferent nerve endings that respond to pain stimuli and signal injury
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What are A-delta fibers?
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coated with myelin sheath
-sent quicker -feel sharp pain |
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What are C fibers?
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dull aching pain
-burning or aching pain -affects mood, motivation -not coated with myelin |
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What is referred pain and how is it explained?
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-pain from internal organs misperceived as originating from other parts of the body
-sensory impulses from internal organ and skin use the same pathway in the spinal cord Ex: when you're having a heart attack, you feel pain in the neck shoulders and back or brain freeze |
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What are the three pain syndromes in which there is no known/identified reason that explains the pain?
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1) Neuralgia
2) Causalgia 3) Phantom Limb Pain |
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What is neuralgia?
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-very painful syndrome in which patient experiences recurrent episodes of intense shooting or stabbing pain along the course of a nerve
-occur very suddenly and without any apparent cause -attacks can often be provoked more readily by innocuous stimuli than noxious ones ex: cotton ball = attack where needle prick does not |
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What is causalgia?
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-recurrent episodes of severe burning pain that can be triggered by minor stimuli
ex: clothes touching it "arm is pressed against a hot stove" place where they used to be wounded |
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What is phantom limb pain?
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-pain perceived in limb that is removed or has no functioning nerves
-maybe caused by neural damage before the condition -pain memory -neural remapping, sensations due to cross firing, mix up of signals |
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How do Dr. Breecher's studies show how the meaning of pain affects people's experience of it?
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-reported that soldiers needed less pain killers when they were injured because that meant that they were going home
-it was a relief that they got injured vs. for civilians, it was the beginning of their problems -needed more pain killers |
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What is the gate control theory?
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physiological mechanism can affect people's experience of pain
-gate control theory can account for many phenomena in pain perception that have vexed earlier theories |
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What does the neural gate do?
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modulates pain signals before reaching brain
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Explain the relationship between learning and pain
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-classical conditioning
conditioned stimuli (symptoms) -conditioned responses (muscular) there are the anticedent cues, and its consequences -we learn from these cues that something bad is going to happen -feel more distressed, a conditioned response, and may heighten the perception of pain |
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What are the four types of pain behaviors?
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1) facial or audible expressions of distress
ex: clench their teeth and grimace 2) distorted ambulation or posture ex:rubbing or holding the painful area, stooping while walking, moving in a guarded or protective fashion 3)Negative affect -being irritable 4) Avoidance of activity -stay home from work, refrain from motor or strenuous behavior |
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How do placebos affect the pscyho part of pain?
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medication, sham surgery
-expect there to be an effect -they trigger endogenas opiods Ethical dilema: -think they got knee surgery with improvement, but had no surgery -deceiving -pain reduction with placebos |
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What are secondary gains?
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social:
-reinforcement of sick behavior and life style habits -make them not want to change or get better since life is easier -you get out of doing things you don't want to do -disability payment, say that they have more pain, and less success -reinforces pain behaviors |
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What is social reinforcement of the social aspects of pain?
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-if you reinforce their pain behaviors:
-say they have more pain and disability -increase physical deterioration because they have less activity -increases dependency and impairment -less self efficacy and self esteem -if you ignore their pain behavior, their pain behavior decreases |
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How does emotion affect pain?
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pain induces negative affect
-emotions effect expectations and memory of pain emotions (stress) induce pain (headaches) stress can induce or increase sensitivity of headaches |
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How does chronic pain patients differ from emotion to problem focused coping skills?
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-if neurotic, increases their pain scale
-also hypochondriac, depression, and hysterics -negative skew to thoughts -depressed, more likely to develop pain in future pain causes depression and depression causes pain |
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What is pain acceptance?
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don't control or avoid pain
-less attention to pain -recognize it's there, but don't ruminate about it -try completing daily activities -increase self efficacy -less pain medication -use adaptive coping process instead |
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What does pain perception involve? What does pain affect and what is affected by pain?
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perception:
-physiology -neurochemicals -psychosocial process Affects: - learning -cognition -social experience -emotions |
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What are the strengths and weaknesses of the health belief model?
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strengths: research supported
-people thought they would be more susceptible -perceived barriers -cues to action Weaknesses: -does not take into account for health related behaviors people perform habitually ex: toothbrushing -behaviors that originated and continued without the person's considering health threats, benefits, and costs -no standard way of measuring its components -different studies have used different questionnaires to measure the same factors, hard to compare results -can't assume that people think about diseases and risk factors all the time |
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What are the strengths and weaknesses of Theory of Planned behavior?
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-many studies that support the
--attitudes toward a behavior --subjective norms --perceived behavioral control influences intentions and behaviors Weaknesses: -intentions and behavior are only moderated related -people do not always do what they plan to do -another is that it's incomplete -doesn't include experience prior to behavior -can't assume that people think about diseases and risk factors all the time |
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What are the strengths and weaknesses of the Stages of Change Model?
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Strengths:
-confirmed that people at higher stages are more likely to adopt healthful behavirs -confrimed that the processes the model describes as leading to advancemnt or regression within the stages and the value of matching an intervention to people's stage of readiness to improve its success in changing unhealthful behaviors Weakness: -factors taht are sensible for individuals to consider, maybe changed by irrational or unwise decisions -theories that focus on rational thinking do not consider the processes we're about to see that can override logical decision making |
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How do health behaviors in adulthood and old age differ from those during younger developmental periods?
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-Less likely than they were in adolescenec to adopt new behavioral risks to health
-more likely than younger ones to practice vairous health behaviors ex: eating healthy diets, medical checkups -adults perceive themselves as more vulnerable to these illnesses than younger adults -thats why they engage in preventative acts -exercise declines over time |
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Describe the relationship between social class/ethnicity and health
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main characteristic differences:
-income, occupational prestige, and education more likely to: -born with lower birth weight -die in infancy or childhood -die in adult hood before 65 -have poorer overall health and develop longstanding illness in adulthood -experience major stressors, followed by poorer health and greater limitations in everyday functioning They don't have as good health behaviors: -exercise less -smoke more -less knowledge about risk factors for disease -don't receive as much health info |
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What works better Gain-framed or Loss framed messaging?
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Depends:
Gain-framed: best for motivating behaviors that serve to prevent or recover from illness or injury ex: condoms and performing physical therapy Loss framed: -best for behaviors that serve to detect a health program early ex: getting a mammogram |
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Why do some people relapse immediately and overtime?
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-withdrawal symptoms contribute strongly to immediate relapses
-but declines over time Ex: nicotine withdrawal declines sharply in the first week or so after stopping -need reassurance that their craving and negative feelings will decrease greatly in less than a month -Satisfaction: -the more satisfied people are with the results of having quit the less likely they are to relapse |
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Why are family involvement approaches between parents and children needed for preventing drug use?
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-gets parents to actively supervise their children
1) children of parents who provide little monitoring, rules and supervision are four times more likely to try drugs in teh future than children with actively involved parents 2) children are far less likely to use a substance if they know their parents would disapprove of it and would punish that behavior 3) most parents of teens who use a substance are not aware of it -percentages of parental awareness for each substance are 39% for tobacco, 34% for alcohol, and 11% for drugs |
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What are factors that cause relapse?
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-Low self efficacy
-Negative emotions and poor coping -High craving -Expectations of reinforcement -Low motivation -Interpersonal issues |
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What is the Gating mechanism?
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-neural gate that can be opened or closed in varying degrees
-this regulates the incoming pain signals before they reach the brain -the amount of activity in the pain fibers: -activity in these fibers tends to open the gate -stronger the noxious stimulation the more active the pain fibers -the amount of activity in other peripheral fivers -A-beta fibers, carry information about harmless stimuli or mild irritation such as grabbing or touching -activity in the A fibers tend to close the gate ex: massaging muscles decreases the pain -messages that descend from the brain: -effects of brain processes, such as those in anxiety or excitement, open or close the gate for all inputs from any areas of the body |
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What are the physical conditions, emotional and mental conditions that open the gate?
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-Physical conditions:
-extent of the injury -inappropriate activity level Emotional conditions: -anxiety/ worry -tension -depression Mental conditions: -focusing on the pain -boredom; little involvement in life activities |
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What are conditions that close the gate?
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Physical:
-medication -counter stimulation (heat/ massage) Emotional: -positive emotions (happiness or optimism) -relaxation -rest Mental Conditions -intense concentration or distraction -involvement and interest in life activities |
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Describe relationship between periaquaductal gray area and pain
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rats with the electrodes in the periaqueductal gray area did not show any pain
-it produced a state of not being able to feel pain, or analgesia -periaqueductal gray area can induce analgesia in humans and animals -ex: morphine works as a painkiller by activating the brain stem to send impulses down the spinal cord |
