Health Services Lesson Outcomes Summary Notes (BHS501)

Chapter 6: Using Age differences: Older individuals report more Health Services symptoms than younger individuals....

Chapter 6: Using Age differences: Older individuals report more Health Services symptoms than younger individuals. Neuroticism: o People high Lesson Outcomes in neuroticism detect and report symptoms quickly. By the end of this chapter, students should o They exaggerate be able to: symptoms and have a negative view of bodily 1. Determine the recognition and sensations. interpretation of symptoms. 2. Describe who uses health services. 3. Identify the misuse of health services. Attentional Differences People focused on themselves notice symptoms more quickly. 1. Recognition & People distracted by work, social Interpretation of activities, or responsibilities report fewer Symptoms symptoms. Although people have some awareness of People who report more symptoms tend their bodily functions, their perception of to: symptoms can be influenced by various individual, social, and situational Have boring jobs. factors. Be socially isolated. Stay home most of the Individual Differences in Symptom time (housekeepers, retirees). Recognition Live alone. Hypochondriacs: Individuals People who report fewer symptoms tend convinced that normal bodily to: sensations indicate illness. Common symptoms of Have engaging jobs. psychological distress converted Be socially active. into physical complaints: Work outside the home. o Back pain Live with others. o Joint pain o Pain in extremities o Headaches o Abdominal symptoms Situational Factors in Symptom (e.g., bloating) Recognition o "Allergies" to specific foods A boring day increases symptom o Cardiovascular symptoms awareness. (e.g., palpitations)  A busy day reduces symptom o Common recognition. disorders seem less Intense physical activity reduces serious than rare diseases. attention to symptoms. o Serious illnesses are Quiet or inactive states increase often underestimated if symptom awareness. they have been experienced before. Example: Medical Students' Disease Expected symptoms are amplified; unexpected symptoms Medical students often experience are ignored. symptoms of illnesses they study. Symptoms affecting important They focus on their own fatigue, body parts (e.g., heart, brain, stress, and minor sensations, eyes) are taken more seriously. interpreting them as signs of Painful symptoms prompt disease. quicker treatment-seeking. Stress & Symptom Recognition Cognitive Representation of Illness (Commonsense Model) Stressed individuals believe they are more vulnerable to illness. People form mental models of illnesses Stress produces physiological based on: changes (e.g., fast heartbeat, fatigue) that may Personal experience. be misinterpreted as Media information. symptoms of illness. Family & friends' experiences. Mood & Symptom Recognition These illness representations influence: Good mood: 1. Preventive health behaviors. o Perceive themselves 2. Reactions to symptoms. as healthier. 3. Response to diagnosis. o Report fewer symptoms. 4. Adherence to treatment. o Recall fewer illness- 5. Expectations about recovery. related memories. Bad mood: o Perceive themselves as unhealthy. Types of Illness Models o Report more symptoms. o Are pessimistic about 1. Acute Illness: Short-term, caused treatments. by specific agents (e.g., flu). 2. Chronic Illness: Long-term, caused by multiple factors (e.g., diabetes). Interpretation of Symptoms 3. Cyclic Illness: Alternates between symptom-free periods and flare-ups Past experiences shape symptom (e.g., asthma). interpretation. Example: Gender Differences One person may see diabetes as Women use health services more a temporary condition caused by than men. sugar intake, while another may Reasons: see it as a lifelong disease with o Pregnancy & severe complications. childbirth increase medical visits. Ambiguity about illness leads to poorer o Women detect bodily well-being. changes faster. o Women have lower pain tolerance. o Men are culturally Lay Referral Network expected to endure pain and avoid medical help. People first consult family, o Women's healthcare is friends, or online sources before more fragmented (e.g., seeking medical help. gynecologists, primary Lay practitioners (experienced care, specialists). non-medical individuals) may give advice. The Internet acts as a modern lay referral network, but Social Class & Cultural Differences information may be inaccurate. Lower-income groups use Telemedicine: Virtual consultations with medical services less. doctors are becoming more common. Barriers: o Financial issues (no insurance, high costs). o Limited access to quality 2. Who Uses Health healthcare. The biggest gap is in preventive Services? care (e.g., vaccinations, cancer screenings). Age & Health Services Use Children & elderly use health services the most. Social Psychological Factors Children experience frequent infections and need vaccinations. Parents influence children's Young adults use health services health behaviors. the least. Socially isolated people seek Elderly use health services more medical help more often (for due to chronic diseases. social interaction).  Mild or painless symptoms cause 3. Misuse of Health delays. Services Symptoms that are not disruptive are ignored. Using Health Services for Emotional Disturbances Medical System Delays Up to 66% of doctor visits are for Doctors may misdiagnose or psychological/social issues. overlook symptoms. Stress & anxiety can cause Doctors rule out common physical symptoms, leading conditions before serious ones. people to seek medical care. Atypical patients (e.g., young Risks: people with heart disease) face o Unnecessary medical longer delays. tests. o Prolonged hospital stays. o Inappropriate treatments. Conclusion Example: Secondary Gains Symptom perception varies by Some people benefit from being ill personality, mood, and (e.g., avoiding work, receiving environment. attention). Social and psychological factors influence healthcare use. Misuse of medical services is common, either through Delay Behavior: Not Seeking unnecessary visits or delaying Timely Medical Care needed care. Four Types of Delay: 1. Appraisal Delay: Time taken to recognize a symptom as serious. 2. Illness Delay: Time taken to decide to seek medical help. 3. Behavioral Delay: Time between deciding to seek help and taking action. 4. Medical Delay: Time taken to receive proper medical care. Causes of Delay People with no regular physician. Fear of medical procedures. Middle-aged individuals delay more than the elderly. Chapter 7: Patient- Patient-Related Issues: o Lack of Medical Provider Knowledge: Many patients struggle to recall or Interaction & understand their diagnosis and treatment. Treatment o Anxiety & Emotional Distress: Anxiety can impair a patient’s ability to The Nature of Patient- focus, process, and retain important health Provider Communication information. o Misinterpretation of Effective communication between patients Symptoms: Patients and healthcare providers is crucial, but it prioritize symptoms that often faces challenges due to multiple impact their daily life, factors. which may differ from the provider’s clinical focus. Challenges in Patient-Provider o Providing Misleading Communication Information: Due to embarrassment or Provider-Related Issues: misunderstanding, patients o Inattentiveness: Providers may not fully disclose their often interrupt patients medical history or within 23 seconds of symptoms. speaking, limiting the information they can share. Setting as a Barrier to o Use of Jargon: Medical Communication professionals frequently use technical language that The clinical setting itself is not patients struggle to ideal for effective communication. understand. Short consultation times (averaging o Baby Talk: Some 12-15 minutes) create pressure for providers simplify both patients and providers. explanations excessively, Patients experiencing pain, fever, underestimating patients’ or embarrassment may struggle to ability to understand articulate their symptoms medical concepts. effectively. o Nonperson Providers must extract crucial Treatment: Patients may information quickly while feel depersonalized, leading navigating patient self-treatment, to decreased trust and which can complicate diagnosis. engagement in care. o Stereotyping Results of Poor Communication Patients: Implicit biases may lead to assumptions Dissatisfaction with about a patient’s health, Care: Patients may feel unheard or leading to disrespected, reducing trust in miscommunication or healthcare providers. inadequate care.  Lower Adherence to Factors Influencing Adherence Treatment: Patients are less likely to follow prescribed treatments if Clear Communication: Patients they do not fully understand or are more likely to follow treatment trust their provider. plans when instructions are jargon- Increased Use of Alternative free and easy to understand. Therapies: When patients feel Repetition & emotionally unsatisfied, they may Reinforcement: Writing down turn to non-medical solutions. instructions and repeating them Frequent Provider enhances compliance. Switching: Dissatisfied patients Complexity of are more likely to seek care from Regimen: Treatments requiring different practitioners. frequent dosages or long-term Formal Complaints: Poor commitment have lower adherence communication can lead to rates. grievances against healthcare Perceived Importance: Adherence providers or institutions. is highest for "medical" advice (e.g., taking medication) and lower for lifestyle changes (e.g., avoiding stress). Nonadherence to Practical Barriers: Financial issues, lack of time, and personal Treatment Regimens conflicts can interfere with adherence. Understanding Nonadherence Creative Nonadherence: Patients may alter their treatment due to Nonadherence occurs when patients do not cost concerns or personal beliefs, follow prescribed medical such as adjusting medication recommendations, ranging from 15% to as dosages. high as 93%, depending on the treatment type. Highest Adherence Rates: Patients managing serious Improving Patient- conditions like HIV, cancer, and Provider Communication arthritis. Lowest Adherence Rates: Those Training Providers with pulmonary diseases, diabetes, and sleep disorders. Emphasizing warmth and confidence in communication Measuring Adherence enhances patient satisfaction and adherence. Directly asking patients often Nonverbal communication (eye results in overestimation. contact, body language) plays a key Indirect methods include tracking role in building trust. follow-up appointments, but these Providers should avoid jargon and may also be biased. engage in active listening. Many patients fail to fully comply, diminishing the effectiveness of treatments. Training Patients primary care physician (PCP) and referrals for specialists. Encouraging patients to list Preferred Provider questions in advance improves Organizations (PPOs): Offer a information retention. network of providers with lower Teaching strategies for effectively rates and fewer restrictions. eliciting information from Point-of-Service Plans providers can lead to more (POS): Allow out-of-network care productive consultations. but at a higher cost. Traditional Indemnity Addressing Barriers to Adherence Plans: Offer full provider choice but require upfront payment and Providers should ask open-ended reimbursement claims. questions to uncover challenges patients face in following their Challenges in Managed Care treatment. Breaking recommendations into Prepaid healthcare plans prioritize manageable steps increases the efficiency, sometimes at the cost of likelihood of compliance. patient satisfaction. Clarifying the medical importance Providers are incentivized to see as of lifestyle changes can improve many patients as possible, reducing adherence. consultation time. Frequent referrals to specialists can disrupt continuity of care. Patient-centered care has emerged as a response, ensuring patients Healthcare System & consistently see the same provider. Patient Experiences Types of Healthcare Providers Patient Experiences in Nurse Practitioners (NPs): Provide routine care, Hospitals prescribe treatment, and monitor chronic conditions. The Hospital Environment Advanced-Practice Nurses (APNs): Specialize in areas like The hospital setting is designed cardiac care, oncology, and around three primary goals: anesthesia. o CURE: Physicians focus Physician Assistants on restoring health through (PAs): Perform routine healthcare treatment. tasks, such as taking medical o CARE: Nurses provide histories and explaining treatment emotional and physical plans. support. o CORE: Administrators Types of Health Plans manage hospital operations and resources. Health Maintenance Organizations (HMOs): Require a Psychological Impact of Yoga & Meditation: Can help Hospitalization manage chronic pain, stress, and emotional well-being. Patients often experience anxiety, Massage Therapy & depression, and sleep disturbances. Chiropractic Care: Used for pain Many feel uninformed about their relief and overall health condition and treatment options. improvement. Children may experience heightened distress and benefit The Placebo Effect from emotional support strategies. A placebo is a treatment that Interventions to Improve produces benefits due to the Hospitalization Experiences patient’s belief in its effectiveness rather than its active properties. Provider Influence: A warm, Pre-surgery preparation can reduce anxiety and post-operative confident provider can enhance the complications. placebo effect. Patient Characteristics: Those Matching patients with supportive roommates may ease distress. with high suggestibility or anxiety Coping strategies such as are more likely to experience relaxation techniques and guided placebo benefits. Situational Factors: Shape, color, imagery help patients manage stress. and presentation of a treatment can affect its perceived effectiveness. Use of Placebos in Research Complementary & Double-Blind Studies: Both the Alternative Medicine patient and researcher remain unaware of placebo vs. actual (CAM) treatment. Medical Application: Placebos Types of CAM Treatments can be used to assess the true effectiveness of new drugs. Traditional Chinese Medicine: Includes acupuncture, herbal remedies, and energy balancing. Ayurvedic Medicine: Focuses on Key Takeaways balance between mind, body, and Clear, patient-centered spirit. Homeopathy & communication improves Naturopathy: Use natural adherence and satisfaction. Training both providers and remedies and lifestyle changes to promote healing. patients can bridge Dietary Supplements: Often taken communication gaps. The healthcare system's for perceived health benefits, though scientific support varies. structure impacts provider- patient interactions.  Understanding psychological aspects of hospitalization can enhance care experiences. Alternative medicine is widely used, though scientific support varies. The placebo effect plays a significant role in medical treatment outcomes. Chapter 8: to psychological distress, worsening physical pain. Management of Pain and The Elusive Nature of Discomfort Pain Pain as a Psychological Introduction to Pain Experience: o Interpretation of pain Definition: Pain is a sensory determines its impact. experience that brings discomfort o Example: Some people see and signals potential bodily harm. pain as proof of being alive, Importance: while others see it as an o It plays a crucial role in obstacle to valued survival by providing activities. feedback about bodily Pain Perception & Psychological functions, prompting Factors: adjustments (e.g., shifting o Athletes: Can continue posture). playing despite injuries due o Pain symptoms drive to sympathetic arousal, people to seek medical reducing pain sensitivity treatment. (Fillingham & Maixner, Pain & Disease Severity: 1996). o Pain is not always o Stress & Pain: proportional to the severity Psychological of an underlying condition. distress amplifies pain o Example: A cancerous perception (Strigo et al., lump might cause no pain, 2008). whereas a minor injury can o Cultural Influence: Pain be extremely painful. perception varies across Patient-Provider Discrepancy: cultures. Example: In o Patients often perceive pain Mexico, labor is referred to as the primary problem, as “dolor” (sorrow), whereas practitioners shaping how childbirth pain consider it a symptom of is experienced. an underlying disorder. o If practitioners neglect pain, patients may feel ignored, leading to non-compliance with medical Measuring Pain recommendations. Psychological Significance of Pain is subjective and cannot be Pain: measured directly, but several tools o Many patients fear pain exist: more than disability or even 1. Verbal Reports: Patients death. describe their pain using o Social rejection due to chronic pain can contribute  terms like dull, aching, o Small, myelinated sharp, or shooting. fibers for rapid 2. Pain Questionnaires: transmission. ▪ Example: McGill o Respond to mechanical Pain and thermal pain (sharp, Questionnaire helps brief pain). in understanding o Linked to sensory pain intensity and aspects of pain (thalamus type. and sensory cortex). 3. Neuroscientific Methods: 2. C-Fibers (Slow Pain): Advanced techniques o Unmyelinated analyze pain responses in fibers transmitting dull, the central nervous system. aching pain. 4. Pain Behaviors: o Linked to emotional and Observing facial motivational aspects expressions, posture (thalamus, hypothalamus, distortions, activity cortical regions). avoidance, and audible o Balance between A-delta expressions (groaning, and C-fiber activity moaning) (Turk et al., determines overall pain 1995). experience. Neurochemical Pain Inhibition Physiology of Pain Endogenous Pain Control: The brain modulates pain by sending Pain serves as a protective inhibitory signals to the spinal mechanism, alerting the brain to cord. Natural Painkillers: Opiates tissue damage. Gate Control Theory of Pain: like morphine and heroin mimic o Nociceptors detect injury the body’s endogenous opioid and release chemical system, reducing pain perception. Stress-Induced Analgesia (SIA): messengers that transmit o Stress can temporarily signals to the spinal cord (afferent pathway). suppress pain perception o Signals reach the reticular (D.V. Reynolds, 1969). formation, thalamus, and cerebral cortex for pain processing. o The brain then sends Clinical Issues in Pain signals back via the efferent pathway, leading to Management muscle contractions or altered bodily functions Types of Pain (e.g., breathing changes). 1. Acute Pain: Types of Peripheral Nerve Fibers o Linked to specific injuries (e.g., burns, 1. A-Delta Fibers (Fast Pain): fractures).  o Disappears once tissue heals (lasts ≤6 months). Pain & Personality 2. Chronic Pain: Is there a “pain-prone” o Begins as acute but persists personality? despite treatment. o Studies suggest o Often leads to emotional that neuroticism, distress and lifestyle introversion, and passive disruptions. coping styles contribute to o Persists for 6+ months. chronic pain (Ramirez- Maestre et al., 2004). Types of Chronic Pain Pain Profiles: o Chronic pain patients score 1. Chronic Benign Pain: high on hypochondriasis, o Persistent, unchanging hysteria, and intensity. depression (Minnesota o Example: Chronic lower Multiphasic Personality back pain. Inventory – MMPI). 2. Recurrent Acute Pain: o Intermittent episodes of acute pain that persist for months. o Example: Migraines, Pain Control Techniques temporomandibular disorders (TMD). 1. Pharmacological Control 3. Chronic Progressive Pain: o Morphine, Local o Worsens over time, often Anesthetics, linked to degenerative Antidepressants, Nerve disorders. Blocks. o Example: Cancer, o Drawbacks: Addiction, rheumatoid arthritis. tolerance, mental fog, nerve damage. Differences Between Acute & 2. Surgical Control Chronic Pain o Cutting pain fibers in the nervous system (last Chronic pain has a resort). o Drawback: May strong psychological component (anxiety, depression, cause permanent nerve anger). damage and worsen Acute pain control techniques are chronic pain. often ineffective for chronic pain. 3. Sensory Control Chronic pain involves complex (Counterirritation) o Mild irritation of another psychological, social, and behavioral interactions. body part reduces pain. o Temporary relief only. 4. Biofeedback o Training patients to control physiological responses (e.g., migraines, TMJ pain). 5. Relaxation Techniques  o Progressive muscle relaxation, meditation, deep breathing. Conclusion o Effective for reducing stress-induced Pain is a complex experience with pain. physiological, psychological, and 6. Distraction Techniques social dimensions. o Shifting attention away Effective pain from pain (e.g., music, management requires a games). combination of medical, o Works best for acute pain. behavioral, and cognitive 7. Cognitive-Behavioral Therapy strategies. (CBT) Chronic pain is best managed o Altering negative through structured, thoughts about pain, multidisciplinary improving coping skills. programs rather than medication alone. Pain Management Programs Comprehensive approach to chronic pain treatment. Goals: o Reduce pain intensity. o Increase physical activity. o Decrease reliance on medication. o Improve psychosocial well- being. o Return patients to work and daily life. Family & Social Support Family involvement can improve or worsen pain outcomes. Spouses may unintentionally reinforce disability behaviors. Relapse Prevention Strategies help patients maintain pain control post-treatment. Challenges: Cost and coordination across multiple healthcare professionals. Chapter 9: Importance of Assessing Quality of Life Management of Understanding daily life Chronic Illnesses impact to guide medical intervention. Identifying disease-specific Understanding Chronic challenges for tailored care. Comparing effectiveness of Health Disorders and treatments to enhance outcomes. Quality of Life Maximizing long-term health while maintaining the Quality of Life (QoL) in Chronic highest QoL. Evaluating treatment effects, Illness helping patients cope better. Higher QoL reduces illness Definition: The extent to which a progression, symptom severity, person can enjoy normal life and medical interventions. activities despite a chronic illness. Why QoL Matters in Healthcare: o Helps medical professionals improve patient well-being. Emotional Responses to o Guides interventions to enhance patient Chronic Illness happiness and overall health. Psychological Impact of Chronic o Disease and treatment may Health Disorders interfere with daily activities, requiring Chronic conditions affect physical, adjustment. social, and emotional well-being. Inadequate coping can worsen Components of Quality of Life symptoms and overall health. Patients with chronic illnesses are 1. Physical Functioning: Mobility, at higher risk of depression, energy levels, and ability to anxiety, and distress. perform tasks. 2. Psychological Status: Emotional Common Emotional Reactions health, stress, anxiety, and overall mental well-being. 1. Denial 3. Social Functioning: Interpersonal relationships and social support. A defense mechanism where 4. Disease/Treatment-Related patients refuse to acknowledge the Symptoms: How symptoms and severity of their illness. treatments impact daily life. Early-stage reaction; can initially be protective, preventing overwhelming distress. Long-term effects: If prolonged, denial can interfere with treatment adherence.  Body image: How patients view their physical appearance and 2. Anxiety function. Poor body image effects: Common in newly diagnosed o Increases depression risk. patients, as they worry about life o Affects treatment changes. acceptance and Issues caused by anxiety: adherence. o Increases distress and hinders treatment 2. Achieving Self adherence. o Anxiety symptoms Work and personal may mimic disease achievements define self-worth. symptoms, complicating Chronic illness can threaten life diagnosis. goals, leading to reduced self- o Anxious patients recover esteem. poorly from surgery and other treatments. 3. Social Self 3. Depression Chronic illness can result in social withdrawal and fear of A widespread reaction to chronic abandonment. illness; 1 in 4 patients experience Lack of support (family, friends) severe depression. negatively affects recovery and Most common in: mental health. o Stroke, cancer, and heart disease patients. 4. Private Self Health Consequences: o Depression increases risk Personal goals and of heart disease, aspirations may feel out of reach atherosclerosis, due to illness. hypertension, stroke, and Patients struggle with loss of osteoporosis. independence and identity. o It worsens chronic conditions by impairing adherence to medical treatment. o Can be delayed and emerge Coping with Chronic after prolonged illness Health Disorders struggles. Patient Beliefs and Coping Strategies Personal Issues in Chronic 1. Understanding the Disorder: Illness o Accurate knowledge reduces distress 1. Physical Self-Concept and improves self- management. 2. Beliefs About Cause:  o Attributing illness to Treatment Adherence external factors (e.g., stress, genetics) affects Chronic illness patients often coping. struggle with lifestyle 3. Beliefs About Control: modifications. o Patients who feel in control Ways to improve adherence: of their health are more o Education on disease and likely to adhere to treatment. treatment. o Enhancing self- efficacy (belief in their ability to manage illness). Comanagement of Vocational & Financial Challenges Chronic Illness Chronic illness may restrict work options and cause job Role of Physical Therapists discrimination. Early assessment of work-related Help patients: issues helps plan treatment. o Use their body Financial strain impacts both the effectively despite patient and their family. limitations. o Adapt to environmental changes to enhance mobility. o Learn physical Social and Family management skills and Challenges energy conservation. o Follow treatment Negative Social Responses regimens for optimal recovery. Stigma and stereotypes about Examples: diseases like cancer or AIDS. o Knee osteoarthritis Difficulty adapting to the patient’s patients improve changing needs. balance with leg- strengthening exercises. Family Impact o Post-coronary bypass patients prevent Family disruption affects all complications through members, increasing stress and therapy. responsibility. Quality of life of the caregiver Impact on Sexuality affects patient well-being. Many patients experience reduced Caregiver Role sexual activity due to chronic illness. Women are more likely to Psychological factors: become caregivers. o Loss of desire. o Fear of worsening condition.  Long-term caregiving (e.g., leading to confusion and emotional Parkinson’s, stroke) increases distress. caregiver distress. Parental involvement is crucial, Mental health support for but it can also create family caregivers: tension. o Online discussions with Strategies to support children: therapists. o Parental emotional o Yoga and relaxation stability provides comfort. techniques improve o Encouraging school cognitive and emotional attendance and well-being. activity fosters normalcy. o Family therapy improves Gender & Chronic Illness coping. Women receive less social support than men when chronically ill. Psychological Disabled women are less likely to be married and receive spousal Interventions for Chronic care. Illness Women are more likely to be institutionalized for chronic 1. Pharmacological Interventions illness than men. o Antidepressants treat depression linked to chronic illness. 2. Individual Therapy Positive Adaptation to o Coping skills training increases Chronic Illness knowledge and reduces anxiety. Many people find strength in o Internet-based overcoming chronic illness support improves access to challenges. medical information. Positive Outcomes: o Telephone o Increased sense of support encourages healthy control over life. behaviors. o Optimistic expectations 3. Relaxation & Stress for the future. Management o Enhanced self-worth and o Mindfulness-Based Stress personal growth. Reduction (MBSR): Increases awareness and acceptance. o Acceptance and Managing Chronic Illness Commitment Therapy (ACT): Helps patients in Children accept their condition. o Exercise releases endorphi Children may not fully ns, improving mood and understand their condition, physical health.  4. Social Support Interventions o Family support enhances adherence and well-being. o Support groups offer emotional connection and practical advice. Conclusion Chronic illness affects all aspects of life, requiring medical, emotional, and social support. Quality of life assessment is essential for personalized treatment. Effective coping strategies, social support, and medical interventions improve patient outcomes. Chapter 10: Psychological Issues Causes of Mortality Across the Lifespan in Advancing and Terminal Illness 1. Death in Infancy and Childhood Main Causes of Death in Learning Outcomes Children: o Poor prenatal By the end of this chapter, students should care (maternal health be able to: impacts newborn survival). o Congenital 1. Explain death across different life abnormalities (birth stages. defects). o Sudden Infant Death 2. Describe psychological challenges faced by terminally ill patients. Syndrome (SIDS). o Accidents (e.g., car 3. Understand the stages of adjustment to dying. crashes, poisoning, falls). o Cancer and leukemia. 4. Identify key issues surrounding terminal illness. 5. Compare alternatives to hospital 2. Children's Understanding of care for the terminally ill. Death 6. Recognize the challenges survivors face after a loved one’s Age 5: Death is seen as a "long death. sleep"; children are curious but not frightened. Ages 5-9: Death is personified (e.g., ghosts, the devil). Introduction Age 9-10: Children grasp the finality of death and understand Modern causes of death are burial, cremation, mainly due to cumulative health and irreversibility. habits such as: o Smoking o Poor diet o Lack of exercise 3. Death in Adolescence and Young o Obesity 100 years ago, most deaths were Adulthood caused by infectious diseases (e.g., tuberculosis, influenza, pneumonia) Common causes of death: or chronic illnesses (e.g., heart o Unintentional disease, cancer). injuries (e.g., car Understanding the psychology of accidents). dying requires examining o Homicide. how death occurs at different life o Suicide. stages. o Cancer, heart disease, AIDS.  Psychological response: o Organ failure due to o Death is perceived physical decline. as unfair. Health goals for the elderly focus o Reactions include shock, on improving quality of life anger, and injustice. rather than preventing death. o Diagnosis of terminal illness leads to deep Why Do Women Live Longer Than frustration and resentment. Men? Women’s average lifespan is 5 years longer than men’s. 4. Death in Middle Age Biological, social, and behavioral factors contribute: Death becomes more real and is o Stronger immune system. often symbolized by: o Lower exposure to o Loss of physical occupational appearance. hazards (e.g., construction, o Decline in sexual prowess firefighting). and athletic ability. o Less alcohol and drug Mid-life crisis behaviors (e.g., consumption. remarriage, drastic career changes) o Less risk-taking may reflect fear of death. behaviors (e.g., reckless driving). 5. Premature Death in Adulthood o Better social support systems. Defined as death before 79 years old. Common causes: o Heart attack. o Stroke. Psychological Issues in People prefer a sudden Advancing Illness death because it avoids prolonged suffering and deterioration. 1. Continued Treatment and Life expectancy disparities: Advancing Illness o Higher socioeconomic status = longer lifespan. Terminal illnesses often o Declining mortality rates require painful, long-term are linked to reductions in treatments with severe side smoking-related illnesses. effects. o Cancer patients: Chemotherapy and radiation cause nausea, 6. Death in Old Age (65+) fatigue, and discomfort. o Diabetes patients: The elderly expect death more than Advanced cases may younger people. require amputation. Death is usually caused by: Patients may question whether to o Cancer. continue treatment. o Stroke. o Heart failure.  o Refusing treatment may 5. Social Withdrawal reflect depression or hopelessness but can also Terminally ill patients often reduce be a rational choice. social contact to protect loved ones from distress. 2. Right to Die Debate Families can help by preparing visitors for the patient’s condition. Patients may sign a Do Not Resuscitate (DNR) order, 6. Breakdown in Communication instructing medical staff not to perform life-saving measures. As prognosis worsens, families The Right-to-Die and medical staff may avoid movement argues that dying discussing death. should be a personal choice. This can lead to isolation and Some advocate for physician- confusion for the patient. assisted suicide, which is legal in some places. 3. Euthanasia and Assisted Suicide Kubler-Ross’s Five Stages Euthanasia: Ending a terminally of Dying ill patient’s life to relieve suffering. Legal & ethical concerns: 1. Denial: Initial shock, disbelief. o Oregon was the first U.S. 2. Anger: Frustration, resentment state to legalize physician- toward healthy people. assisted suicide. 3. Bargaining: Making deals to o Patients must be: prolong life (e.g., “If I do good, I’ll ▪ Mentally get better”). competent. 4. Depression: Sadness, withdrawal, ▪ Diagnosed with a and grief. terminal illness (≤6 5. Acceptance: Coming to terms with months to live). death, making final preparations. ▪ Reviewed by two doctors to ensure they are not coerced. o Patients must be informed of hospice care Alternatives to Hospital alternatives. Care for the Terminally Ill 4. Changes in Self-Perception 1. Hospice Care Patients lose control over bodily Focuses on comfort, dignity, and functions (e.g., incontinence, facial quality of life rather than curative distortion, vomiting). treatment. Cognitive decline due to illness or Provides pain medication worsens distress. management and emotional support for patients and families. Patients personalize their space (e.g., bring personal items).  Open visiting hours with trained Psychological support, open counselors for support. communication, and palliative care help patients die with dignity. 2. Home Care Support for survivors is crucial to help them navigate grief and loss. Allows patients to stay with family in familiar surroundings. Patients maintain more control over daily activities. Challenges: o Emotional and financial stress on caregivers. o Caregivers struggle between wanting the patient to live and ending suffering. The Experience of Survivors Bereavement response: o Grief symptoms: Hollow feelings, preoccupation with the deceased, guilt, anger. o Financial strain is a major burden. Cultural Attitudes Toward Death: o Hinduism: Death is part of reincarnation. o Japan: Ritualized mourning with multiple ceremonies. o U.S.: Focus on efficiency; professional funeral directors manage the process. Conclusion Death and dying impact not just patients, but families, healthcare systems, and societies. Chapter 11: Aspirin: Prevents blood clots. Statins: Lower cholesterol levels. Chronic Illness and 2. Psychological Treatments Disorders Stress management: Reduces heart disease risk. Exercise programs: Improve 1. Coronary Heart Disease cardiovascular health. (CHD) Cognitive-behavioral therapy (CBT): Helps patients cope with Definition stress and anxiety. CHD is a condition caused by narrowing or blockage of coronary arteries due 2. Hypertension (High to atherosclerosis (plaque buildup). Blood Pressure) Leading cause of death worldwide. Risk Factors Risk Factors Heart disease Kidney failure High cholesterol Genetic factors High blood pressure Emotional factors (e.g., chronic Elevated levels of inflammation stress) Diabetes Family environment fostering Cigarette smoking chronic anger Obesity Stressful life events Lack of exercise Treatment Metabolic Syndrome & CHD 1. Lifestyle Modifications Obesity centered around the waist Low-sodium diet High blood pressure Reducing alcohol consumption Low levels of HDL ("good" Weight reduction in overweight cholesterol) patients Difficulty metabolizing blood Regular exercise sugar Caffeine restriction High levels of triglycerides 2. Cognitive-Behavioral Treatments Management of Heart Disease Biofeedback: Patients learn to 1. Medication Treatments control physiological responses. Progressive muscle relaxation: Beta-adrenergic blocking agents: Helps lower blood pressure. Reduce heart rate & blood Hypnosis, meditation, deep pressure. breathing, and imagery: Improve relaxation.  Anger management training: Movement therapy: Helps restore Helps reduce emotional triggers of mobility and motor skills. hypertension. 4. Diabetes 3. Stroke Definition Definition Type 1 Diabetes: Autoimmune A stroke occurs when blood flow condition where the body cannot to the brain is disrupted, leading produce insulin. to brain cell damage. Type 2 Diabetes: Develops over time due to insulin Warning Signs of Stroke resistance (often linked to obesity). Sudden numbness/weakness in the face, arm, or leg (especially on Health Implications of Type 2 one side). Diabetes Sudden confusion or trouble speaking/understanding. Increased risk of CHD Sudden vision problems in one or Blindness among adults both eyes. Kidney failure Sudden trouble walking, Foot ulcers (due to poor dizziness, loss of coordination. circulation) Severe headache with no known Nervous system damage cause. Alzheimer’s disease & vascular dementia Risk Factors Difficulties in sexual functioning Increased risk of depression High blood pressure Cognitive dysfunction Heart disease Higher risk of heart attacks & Smoking strokes High red blood cell count Transient ischemic attacks (mini- Treatment Management strokes) Psychological distress Lifestyle modifications (diet & Startling events exercise). Monitoring blood glucose levels. Stroke Management Medications to regulate blood sugar. Medications: Reduce clot Weight management programs. formation & improve blood flow. Psychotherapy: Helps stroke survivors cope with emotional challenges. Cognitive remedial training: Helps regain cognitive abilities.  Optimism & active coping. 5. HIV and AIDS Extraversion & conscientiousness. Definition Spirituality (linked to better psychological resilience). HIV (Human Immunodeficiency Virus) attacks the immune system. AIDS (Acquired Immunodeficiency Syndrome) is the advanced stage of HIV. 6. Cancer Progression of HIV Risk Factors 1. First few weeks: Rapid growth of Genetic factors (family history). infection. Ethnicity (some groups are at 2. 3-6 weeks: Virus attacks T-helper higher risk). cells, increasing vulnerability to Culture & lifestyle choices (e.g., infections. smoking, diet). Socioeconomic status (access to Antiretroviral Therapy (ART) healthcare). Marital status (support systems Slows down HIV progression and affect recovery). boosts immune function. Chronic stress. Interventions to Reduce HIV Psychosocial Issues in Cancer Spread Emotional distress: Anxiety & Cognitive-behavioral depression are common. Social isolation: Patients may interventions: Encourage safe behaviors. withdraw from family/friends. Financial burden: Treatment costs Health education programs: Promote awareness. can be high. Coping mechanisms: Strong Social support & coping skills training: Improve adherence to support systems & therapy improve treatment. outcomes. Factors Influencing Disease Interventions for Cancer Patients Progression Cognitive-behavioral therapy (CBT). Factors that Increase Disease Support groups for emotional Progression well-being. Stress management Negative beliefs about self & techniques (meditation, future. relaxation). Depression, stress, trauma. Psychotherapy to address Psychological inhibition emotional distress. (suppressing emotions). Factors that Decrease Disease Progression  Behavioral and cognitive interventions help patients cope with chronic conditions. 7. Arthritis Social support & therapy play a crucial role in improving patient Types of Arthritis outcomes. 1. Rheumatoid Arthritis (RA) Autoimmune disease that attacks joints. Leads to chronic inflammation, joint deformity, and disability. Symptoms: Joint pain, swelling, fatigue. 2. Osteoarthritis (OA) Degenerative joint disease caused by cartilage breakdown. Common in older adults & athletes. Symptoms: Joint pain, stiffness, limited mobility. Treatment for Arthritis Medications: Pain relievers, anti- inflammatory drugs. Physical therapy & exercise: Helps maintain joint mobility. Weight management: Reduces stress on joints. Assistive devices: Canes, braces, orthopedic shoes. Conclusion Chronic illnesses impact physical, psychological, and social well-being. Effective management includes medical treatment, lifestyle changes, and psychological support.