Healthpsy3B

Front 1

Cancer: Post surgery treatments

Back 1

1) Radiation: destruction of left over cancer cells; 5 days/wk for 6-8 wks; side effects: nausea, fatigue, swelling, burning

Front 2

Cancer: Post surgery treatments - Targeted; Systemic Therapy (A)

Back 2

Chemotherapy: Deplete immune sys interven/pills in cycles with recovery. Hair loss with some. Over 100 types of drugs currently. Many extra dugs (ex. yeast inf. in mouth); Effective anti-nausea drugs; higher survival rates than no chem. th.

Front 3

Cancer: Post surgery treatments - Targeted; Systemic Therapy (B)

Back 3

Hormone Therapy: Drugs to block estrogen; common: Tamosifen (questioned lately) side effects; if receptors hormone positive.

Front 4

Coping with Cancer

Back 4

Islands of dysfunction vs. global
Psy. func. often indisting. 12-24 months later.
Psy distress: depression, anxiety, fatigue

Front 5

Coping with Cancer

Back 5

Stress inc between lump and diagnosis, then decreases until treatment decsion, dec when dec made/treatment finished, then increases with recurrence higher than before.
Small diff. in body image from lump or masec (and phy func)

Front 6

Interpersonal Dynamics with Cancer

Back 6

1) Your feelings about friend and his/her illness
2) What to say (act normal, cheer up, nothing)
Potentially Harmful: Avoidance (nurses taking longer to come on call buttons for terminal patients and counseling shorter) Patients have no chance to talk about it (support groups) Not honest with emotions. Support groups for spouse.

Front 7

HIV: 1981

Back 7

HIV: 1981 (Reports of unus. phenmonia and rare cancers - immune sys depleted - Acq Immune Def Syn) Doubling, spreading rapidly; public alarmed; cause unknown

Front 8

HIV: 1982

Back 8

Modes of transmission; thought to be viral and spread through blood/fluids (not bel. by all)

Front 9

HIV: 1983

Back 9

Virus iden.; Infec. Control Guidelines (mask, priv. rms, emp affected given diff tasks; patients avoided)

Front 10

HIV: 1985
1988

Back 10

Blood screened from donors
1988: Sur Gen mailed a brochure to every household in US (understanding AIDS, beh control) No treatments.

Front 11

HIV: 1989
1990
1995

Back 11

100,000 reported AIDS cases
1990: Stigmatized, bill in Am Disab Act
1995: __ reported cases; FDA approves first drug to slow virus

Front 12

HIV: 1997

Back 12

Decline in AIDS (dramatically) Def. changed
HIV: virus, may be asymptomatic
AIDS: virus attacked and low Tcell count; rare cancers from AIDS patients.

Front 13

Est. patients in US living with HIV/AIDS (35 areas) Race

Back 13

Black (not Hisp) 53% of cases. white (not H) 30%, Hisp, [Asian/PacIs and Am Ind/Alaska Nat: low, inc]

Front 14

HIV/AIDS reporting

Back 14

In Virginia name based reporting (HIV as well); some states: notify partner; some code based (anony); anony. testing also in states reporting.

Front 15

HIV/AIDS
1) Males:
2) Females:
Male to male:

Back 15

1) maletomale 65%, high risk het cont 16%, injec drug 14%
2) het cont 78%
Male to Male: biggest prop of AIDS patients, rising; inject drug use Decreasing.

Front 16

HIV/AIDS
1)Est. Prev. (States)
2)Reporting:
3)Number of new infec

Back 16

1)NY, Cal (does not report), Fl; esp south (rates > 150 per 100,000 pop)
2)More states reporting (more money and testing to states) Children born HIV pos (NY)
3) Ex. Virginia 800...

Front 17

Sub-Sah Africa HIV/AIDS

Back 17

26 mill (vs. US 1.2 mill); mainly het contact; cross cult diff (females cannt ask men to use condoms); Bill Gates' AIDS support proj for drugs for Sub Sah Af.

Front 18

Medical Care for HIV/AIDS
Phy Demands

Back 18

Physical demands:
- Rapid changes for physicians:
- Expanded workload, shortage in internal med, treaters had insuff info/training (61%), terminal patients usu; req. more time, psy needs of patients, stigma (nurses, no training)

Front 19

Medical Care for HIV/AIDS
Psy Burdens

Back 19

Fear of infec (not to treat; 6 non surgeons, lab tech, dent contracted) Perceived (by 59%) high risk. Univ Percaution (goggles); Not unus for surgeons to cut themselves/needle; NY (over 30% stuck themselves from infec person), redesigned needles

Front 20

Medical Care for HIV/AIDS
Psy Burdens

Back 20

Fear of Conseq: 1980s case from AIDS dentist; lose practice? Hosital rules, state laws. Uncertainty after sticking (up to 18 months later, take drugs? sleep with spouse? Disclose?) Test doctors?

Front 21

Medical Care for HIV/AIDS
Psy Burdens

Back 21

Reactions to Marginal Groups: Ex. Drug users, homosexuals stig; various responses from physicians about treating drug users... Stigma spread: losing housing/discrim for treating AIDS patients; dentists: lose other patients; IV drug users hard to manage (leaving, drugs; 41% would not treat for AIDS if given choice; excuse of not having skills.

Front 22

Medical Care for HIV/AIDS
Ethical, Legal Burdens

Back 22

Legal mandates vs. ethics; confidentiality vs. duty to warn (ex. still sleeping with spouse); no clear guidelines (states diff; ex. court ruling should not have told partner but upheld to tell preg mother) More likely to inform white partners; some states' physicians req to report name (lose health insurance for patients); do not res. orders in the past; cases must be reported by phy in all states but penalties from 5 to 1500 dollars.
Drug companies not funding vaccines.