PSY 456 Chapter 7

question

How people respond to illness is shaped by _
answer

personality, psychological makeup, family patterns, and social environment
question

T/F Religious faith and spiritual beliefs can be important allies in coping with life-threatening illness
answer

True
question

Four major dimensions i coping with dying
answer

physical- involves satisfying bodily needs and minimizing physical distress in ways consistent with other values psychological- involves maximizing psychological security, autonomy, and richness in living. social- involves sustaining and enhancing significant interpersonal relationships and addressing the social implication of dying. spiritual- identifying, developing, or reaffirming sources of spiritual energy or meaning and, in so doing, fostering hope. not just religion, encompasses a person’s basic values and sources of meaning about life and death.
question

According to Arthur Frank, critical illness teaches us that to be alive is to be constantly at risk, but the risk greater than dying is _
answer

living less than well.
question

closed awareness
answer

the dying person is not aware of his or her impending death, although others my know. lack of communication about the person’s illness.
question

suspected awareness
answer

a person suspects his or her prognosis, but this suspicion is not verified by those who know.
question

T/F: In a suspected awareness context, a dying person has no desire to verify his or her prognosis
answer

False
question

Mutual pretense
answer

participants sidestep direct communication about the patient’s condition. Can lead to complicated though usually unspoken rules of behavior intended to sustain the illusion that the patient is getting well.
question

open awareness
answer

death is acknowledged and discussed. does not make death easier to accept, but allows possibility of sharing support in ways that are no readily available with the other awareness contexts.
question

\”living-dying\”
answer

living with a life threatening illness. patients and families fluctuate between denial and acceptance.
question

middle knowledge
answer

individuals seek balance between sustaining hope and acknowledging the reality.
question

reactive depression
answer

a response to disruptions cause by disease
question

preparatory depression
answer

related to the awareness that on is dying and must prepare for death
question

Kubler-Ross’s model
answer

denial anger bargaining depression acceptance
question

Kenneth Doka’s model of the chronology of living-dying
answer

-acute phase: initiated by diagnosis -chronic: living with the disease -terminal: coping with impending death two additional phases may occur first: -pre-diagnositc: during which a person suspects the illness and may seek medical attention -recovery phase: follows the cure or remission of a previously life-threatening disease.
question

Avery Weisman’s 3 tasks
answer

-confronting the problem & revising one’s plans as necessary -keeping communication open & wisely using the help offered by others -maintaining a sense of optimism & hope
question

Weisman’s 3 phases of coping with terminal illness
answer

1. from the time symptoms are noticed until the diagnosis is confirmed 2. the time between diagnosis and the final decline 3. from decline to death
question

ID the landmarks that characterize the journey through terminal illness
answer

Mitigation & accommodation existential plight preterminality & terminality
question

existential plight
answer

a crisis of self-identity begins with the initial shock of diagnosis a the person attempts to come to terms with the life-altering news
question

mitigation and accommodation
answer

when treatment begins, the reality of the illness becomes part of the person’s life as adjustments and accommodations are made.
question

preterminality and terminality
answer

when no cure or extension of life is in the offing, the individual confronts progressive decline and deterioration as the limits of life become increasingly clear.
question

Theresa Rando’s 3 major psychological and behavioral patterns that individuals use in coping with the threat of death
answer

1. retreat and conservation of energy 2. exclusion from the threat of death 3. attempting to master or control the threat of death
question

emotion focused coping
answer

-helps regulate the level of distress -allows a person to escape the impact of the stressful situation by reframing it or distancing himself from it.
question

problem focused coping
answer

-deals with managing the problem that is causing distress. -an individual who seeks out information about a diagnosis and takes an active role in determining options -pursuit of personally meaningful goals -greater sense of control
question

meaning based coping
answer

-helps maintain a person’s sense of positive well-being -giving up goals that are no longer achievable and formulating new ones, making some sense of what is happening, and finding benefit in the distressing situation. -people often turn to spiritual beliefs for insight in making the best of a bad situation.
question

From the moment one notices unusual symptoms, through the ups and downs of treatment, and on the final moments of life __ are often delicately balances.
answer

hope and honesty honesty to face reality as it is, hope that the outcome is positive
question

coping potency can be reflected by __
answer

The capacity to maintain a sense of self-worth, to set goals and strive to meet them, to exercise choice out of an awareness of one’s power to meet challenges, to engage in active interactions with one’s environment. sustains the will to live in the face of death.
question

dignity defined as
answer

Harvey Max Chochinov: the quality or state of being worthy, honored, or esteemed. dignity provided an overarching framework that may guide the physician, patient, and family in defining the objectives and therapeutic considerations fundamental at the end of life.
question

The options for treating life-threatening illness vary with the _
answer

nature of the disease and a patient’s particular situation
question

staging
answer

denote the extent of disease and helps determine treatment decisions as well as prognosis
question

The classification of cancer according to how it has spread in the body is called _
answer

staging
question

tumors are assessed in three ways:
answer

1. extent of the primary tumor 2. absence of presence of lymph node involvement 2. absence or presence of distant metastases
question

metastasis
answer

cancer may spread by invading adjacent tissues… a process whereby diseased cells travel in the blood or lymphatic system or though body tracts to more distant parts of the body.
question

adjuvant therapy
answer

an auxiliary remedy which aids or assists another
question

Surgery
answer

usually involves removing the malignant organ or tissue and the adjacent healthy tissue. primary treatment for many types of cancer & sometimes used as a therapeutic option in treating pain.
question

radiation therapy
answer

uses ionization radiation to preferentially destroy cells that divide rapidly. used as adjunct to chemotherapy in some or as key role in treatment. may be used as palliative therapy to receive symptoms and improve quality of life.
question

The key to life-saving help for a heart attack victim is a
answer

rapid emergency response
question

successful treatment of cancer requires that all cancerous tissue be
answer

destroyed or removed
question

Nausea, vomiting, tiredness, and general weakness are some of the side effects that a patient needs to withstand to undergo _
answer

radiation therapy
question

chemotherapy involves the use of _ to kill cancer cells
answer

toxic drugs
question

Despite the fact that it usually causes distressing side effects, __ is an important treatment in many types of cancers
answer

chemotherapy
question

The conventional medical system is based on describing health-related phenomena by using scientific explanations that are:
answer

-empirical: based on evidence of the senses and objective observation -rational: follow rules of logic and are consistent with known facts -parsimonious: explain phenomena by use of fewest causes -rigorously evaluated: capable of verification -tentative: open to new or better evidence
question

The techniques that help patients mobilize their inner healing resources by imagining the diseased parts of the body becoming well again are called
answer

adjuvant mehtods
question

Method that include psychotherapy, and other mind-body interventions, as well as physical therapy and other forms of manual healing are called
answer

adjuvant methods
question

physicians have realized that practices other than the \”culture of biomedicine\” _
answer

can be effective
question

Placebo
answer

defined by Perlmutter: a substance with no known specific pharmacologic activity for the condition being treated
question

impure placebo
answer

substances that have known therapeutic actions but not for the disease in question example: antibiotic for nonbacterial infection. sham procedure for surgery.
question

placebo effect
answer

the positive response to a treatment that a person believes to be an effective therapy
question

Researchers believe that simply believing in a treatment can be
answer

as effective as the treatment
question

symbolic healing
answer

the varied therapies known under such names as faith healing, supernatural healing, and folk healing. (term used by Shupe & Hadden)
question

one of the most important diagnostic tools used today is the type and severity of __
answer

pain -most common symptom in terminally ill patients
question

accuse pain
answer

an essential biological signal of the potential for or the extent of injury a protective mechanism that prompts the sufferer to remove or withdraw from the source of the pain.
question

chronic pain
answer

pain that persists longer than 3-6 months -when pain lasts this long, it loses its adaptive role. -may be accompanied by sleep disturbances, loss of appetite, weight loss, and depression.
question

the most useful agents of the treatment of pain associated with advanced diseases are _
answer

opioid analgesics
question

morphine
answer

the gold standard of analgesics and a cornerstone for management of serious pain works effectively to manage pain because it taps into the body’s own pain relief system- neurotransmitters.
question

a variety of medical techniques, included nerve blocks, electrical stimulation of nerves, and neurosurgery are used to treat
answer

pain
question

expected trajectory
answer

an individual ma res a sudden exit, as in accidents or other emergency situations when life or death hangs in the balance
question

lingering trajectory
answer

a patient’s life fades away slowly and inevitably applies to people with progressive chronic illnesses who are receiving palliative care
question

3 distinct trajectories of lingering trajectory:
answer

trajectory 1: short period of evident decline. steady progression and usually a clear terminal phase. usually no time to anticipate palliative needs and plan for end-of-life care. typically the case with cancer. acute stroke 2: long-term limitations with intermittent serious episodes. gradual decline, periods of acute deterioration and some recovery, unexpected \”sudden\” death. heart failure and respiratory illness series of smaller stroked and recovery 3: prolonged gradual decline or \”dwindling\” progressive disability from an already low level of cognitive or physical functioning. death in old age form illnesses like Alzheimer’s or other dementia, or from generalized frailty of multiple body systems. gradual decline due to stroke sequelae
question

T/F Biological death may be preceded by social death when we focus on the passing of the person rather than the death of the body.
answer

False: when we focus on the death of the body and neglect the passing of the person, biological death may be preceded by social death.
question

physical phenomenon
answer

the death of the body
question

nonphysical phenomenon
answer

the passing of the person
question

near the end of life, an individual may attend to a variety of interrelated concerns and activities, such as:
answer

-re-examining beliefs -reconciling life choices -exploring lifetime contributions -examining loving relationships -exploring ideas and beliefs about an afterlife -discovering meaning
question

The only task that matters in being with someone who is dying is to
answer

sit still and listen to their stories
question

Defense mechanisms
answer

occur unintentionally and without conscious effort or awareness function to change a person’s internal psychological states, not the external reality
question

coping strategies
answer

involve conscious, purposeful effort, are employed with the intention of solving a problem situation. both defense and coping involve psychological processes that can help ease a distressful situation
question

Problems faced by patients with life-threatening illnesses
answer

costs related to hospitalization, outpatient therapy, office visits and medications costs of transportation, support services, child care, and temporary housing time off from work = lost earnings
question

assuming oneself responsible for anything, though not clear just how is called ____ ____
answer

magical thinking
question

Cancer
answer

refers to malignant, or potentially lethal, growths that occur in the body
question

ID Charles Corr’s primary dimensions in coping with dying
answer

physical, psychological, social, and spiritual
question

The object of __ changes over time while maintaining a coping potency
answer

hope
question

Mutual pretense can be a useful strategy for coping with a ____
answer

difficult and painful situation
question

__ are interdependent, each supplementing the others
answer

coping strategies
question

Mutual pretense may be carried on __
answer

until the death of a patient
question

Bioenergetics, homeopathic medicine, and yoga are what form of cancer treatment option
answer

complementary and alternative therapies
question

What did Eric Cassell write about the social role of the dying patient
answer

The death of the body is a physical phenomenon whereas the passing of the person is nonphysical
question

which of the following are spiritual needs of dying patients
answer

*1. need for hope and creativity* 2. need to complete a will for loved ones *3. need to give and receive love* *4. need for meaning and purpose*
question

What is the aim of meaning based coping
answer

to maintain a person’s sense of positive well-being

Get instant access to
all materials

Become a Member