Chapter 9 Pain 03 29 2012 Discussing Ogden chapter Cognitive representation of illness The self regulation model CSM Evidence for the CSM 4 Vital Signs things assessed no matter what sick well BP sign that can be measured over over again Respiration sign that can be measured over over again Temperature sign that can be measured over over again Pulse sign that can be measured over over again Pain why a good idea for comfort would be nice for patient to be comfortable being comfortable you would be able to think more clearly which in turns allows one to communicate better will have more energy 1 issue concern about making pain a 5th vital sign is b c pain is a symptom can be described symptoms are impossible to reproduce which makes it hare to measure BP Respiration Temperature pulse Signs are measureable observable and replicable Previous experiences can be compared Pain is not just a sensory process there is a psychological component pain can be rated differently among individuals even if pain was caused the same way pain can be different depending on individuals past experience I f we just use one method to measure pain we will most likely not get to the solution multiple methods will typically get us better results how else could we measure pain Look at behavior nonverbal different parts of the body touch looking at how one is walking are they favoring one side of the body functioning Pain seek care Ogden Chapter Cognitive representation vital part of a theory called the common sense model of illness self regulation CSM Common Sense Model Cognitive representation of Illness Think about the last time you were unwell now write about it describe nature of your wellness What you just wrote is a cognitive representation How well does your description fit the representations of illness 5 factors Identity attaching symptoms to a label o What label got you to seek care itching mucus etc Symptoms are represented differently depending on the symptoms in one cause you could have allergies or you could have an infection depending on the environment on o Cause how did this happen What did this to me Who did lives in this to me Timeline o A lot of things all in once o How long have you had theses symptoms o When did they start what was the onset o Acute short period of time prescribed medication you would o Chronic long period of time prescribe medication you take take it 5 to 10 days it for years o Salicylic seasonal alleges take medication now until sometime in the summer then again when you go back to school symptoms come go Consequences what could happen if I don t do anything o If we don t seek care we would worry Curability Controllability o Is it curable Can it be cured o Our illness representations are directed by our experiences when figuring out it these symptoms can be cured can influence what kind of treatment can or will not be useful for you o Represents how you feel about symptoms as you experience them can prevent you from or drive you to seek care o Mental model of illness your common sense of illness Levental a patient s own implicit common sense beliefs about their illness Here at Rutgers Based off of your experiences Factors that affect our decision to seek care Personal reluctance to seek care o Other vs self We are bias when we have symptoms we won t seek care but if it was someone else we would tell them they should seek care o Private vs public Certain parts of the body that are easier then other to seek care there is a delay seeking care for certain parts of the body embarrassment downfall it would become worse Social Demographic factors SES Age Gender SES o can I afford care that is necessary so I don t have to face other catrostrphic events o Who makes more money men Age o Positive correlation w older people seek care o Babies a lot of care seeking o Makes a U Shape Early in life infancy early childhood then dips down when individuals should get screenings they don t but as individuals get older you seek an increase in individuals seeking health care Gender o Who seeks more health care Women o Reason We live in a society that reinforces that if women asks for help men ask for help pertaining to the same symptoms it s a sign of weakness for the man We give in to gender roles what is expected Women are more likely to pay attention the symptoms they are having Women are better at noticing small details Women carry the babies more aware of medical signs more in tune w the body attend to symptoms Characteristics of the symptoms Mechanic o Visibility severity impairment frequency o The more the 4 above occurs the more likely one will seek care One s personal view of the illness Leventhal o Illness representations your common sense model Photo on slide a series of spots or smoothing more Sensation there are really big small spots in the photo Perception the spots mean something more such as a dog a sensory beach a tree a face Personal Views of Illness Sources o Top down Labels prototypes symptoms started w a label then looked for symptoms o Bottom Up Symptoms labels prototype Start w symptoms then give them meaning depending on the label you pick Final Exam Chapter 10 03 29 2012 Chronic Illness Pt 1 Chapter 10 Chronic Illness acute illness Multiple causes paths behavioral causes Slow onset o Many chronic illnesses take months years to develop we don t recognize when it develops o Chronic disease is not often detected on our own by the time we detected out ourselves we are further in the illness than we would have been if detected earlier Managed nut cured o If we know we have a chronic illness it is manageable o If caught early it is highly manageable Additional info 46 of Americans have at least 1 chronic illness majority are adults Assumptions about chronic illnesses o An old individual getting older 25 of children have an acute illness Those older then age of 65 88 chronic illness Someone who is 5 will have a completely different illness compared to those 75 of those who have a serious health condition 25 have an acute illness Older adults 3 quarters of the time we are talking about a chronic illness Association correlation Self fulfilling prophecies we have ideas about what the future holds we behave in certain ways that would be different then the way we would behave if we didn t have these ideas expectations Top 7 causes of death Classified by Rank Cause of death Behavior Top 7 causes of death o Heart disease chronic behavior smoking diet inactivity o Cancers