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22 Cards in this Set

  • Front
  • Back
Cancer: Post surgery treatments
1) Radiation: destruction of left over cancer cells; 5 days/wk for 6-8 wks; side effects: nausea, fatigue, swelling, burning
Cancer: Post surgery treatments - Targeted; Systemic Therapy (A)
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.
Cancer: Post surgery treatments - Targeted; Systemic Therapy (B)
Hormone Therapy: Drugs to block estrogen; common: Tamosifen (questioned lately) side effects; if receptors hormone positive.
Coping with Cancer
Islands of dysfunction vs. global
Psy. func. often indisting. 12-24 months later.
Psy distress: depression, anxiety, fatigue
Coping with Cancer
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)
Interpersonal Dynamics with Cancer
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.
HIV: 1981
HIV: 1981 (Reports of unus. phenmonia and rare cancers - immune sys depleted - Acq Immune Def Syn) Doubling, spreading rapidly; public alarmed; cause unknown
HIV: 1982
Modes of transmission; thought to be viral and spread through blood/fluids (not bel. by all)
HIV: 1983
Virus iden.; Infec. Control Guidelines (mask, priv. rms, emp affected given diff tasks; patients avoided)
HIV: 1985
Blood screened from donors
1988: Sur Gen mailed a brochure to every household in US (understanding AIDS, beh control) No treatments.
HIV: 1989
100,000 reported AIDS cases
1990: Stigmatized, bill in Am Disab Act
1995: __ reported cases; FDA approves first drug to slow virus
HIV: 1997
Decline in AIDS (dramatically) Def. changed
HIV: virus, may be asymptomatic
AIDS: virus attacked and low Tcell count; rare cancers from AIDS patients.
Est. patients in US living with HIV/AIDS (35 areas) Race
Black (not Hisp) 53% of cases. white (not H) 30%, Hisp, [Asian/PacIs and Am Ind/Alaska Nat: low, inc]
HIV/AIDS reporting
In Virginia name based reporting (HIV as well); some states: notify partner; some code based (anony); anony. testing also in states reporting.
1) Males:
2) Females:
Male to male:
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.
1)Est. Prev. (States)
3)Number of new infec
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...
Sub-Sah Africa HIV/AIDS
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.
Medical Care for HIV/AIDS
Phy Demands
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)
Medical Care for HIV/AIDS
Psy Burdens
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
Medical Care for HIV/AIDS
Psy Burdens
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?
Medical Care for HIV/AIDS
Psy Burdens
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.
Medical Care for HIV/AIDS
Ethical, Legal Burdens
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.