01 830 377 02 Fall 2013 Health Psychology McCarthy Exam 2 Study Outline The exam will cover lectures 10 18 material from chapters 11 16 in your text and the Ditto 2005 Winzelberg 2005 Fagerlin 2001 ACHA 2006 and Visser Smith 2001 supplemental readings As before the exam will emphasize material that was discussed in class The exam will contain 32 multiple choice items with five response options per item 1 Cancer a Definitions of cancer neoplasm and metastasis b METASTASIS i Book To undergo metastasis the spread of malignancy from one part of the body to another by way of the blood or lymph systems Chapter 10 ii Metastatic cancer is cancer that has spread from the place where it first started to another place in the body iii c NEOPLASM d CANCER i Unregulated cell growth ii Book Characterized by new abnormal growth of cells Robs the host of nutrients and yields no health benefits Chapter 10 iii Benign these growths remain localized Chapter 10 iv Malignant growths or tumors that tend to spread and establish secondary colonies elsewhere in the body Chapter 10 i Unregulated cell growth neoplasm that takes nutrients offers no benefits ii Book A group of diseases characterized by the presence of new cells that grow and spread beyond control Chapter 10 iii May be malignant and metastasize or benign localized iv Types of cancer 1 Carcinomas a Cancers of the epithelial tissue cells that line the outer and inner surfaces of the body Chapter 10 b Includes SKIN STOMACH LINING MUCOUS MEMBRANES Chapter 10 c 95 malignancies 2 Sarcomas connective tissue a BONES MUSCLES CARTILAGE Chapter 10 b 95 malignancies a Originate in the blood or blood forming cells Chapter b Includes STEM CELLS in BONE MARROW Chapter 3 Leukemias 10 10 c 95 malignancies 4 Lymphoma a Cancer of the lymphatic system Chapter 10 b One of the RARER types Chapter 10 2 Living with chronic illness a CHRONIC ILLNESS i Long term illnesses ii iii Require adjustment Incurable although often treatable 1 Adherence to treatment 2 Lifestyle changes 3 Confronting loss and mortality 4 Social changes b Definition of and risk factors for asthma i ASTHMA 1 2 A chronic disease that causes CONSTRICTION of the Inflammatory lung disease BRONCHIAL TUBES which PREVENTS AIR from passing freely causing WHEEZING and DIFFICULTY BREATHING during attacks Chapter 11 ii TREATMENT 1 Adherence to preventive care regimen 2 Dilators tend to be overused 3 4 5 Emergency treatment 6 Moderate level of fear and belief in treatment efficacy predict Identifying and managing triggers Inflammation always present adherence iii RISK FACTORS 1 Genetic diathesis 2 Environmental triggers stress or allergens 3 4 Obesity and sedentary lifestyle Insufficient early exposure to dirt etc hygiene hypothesis c Definition of and course of Alzheimer s Disease i TREATMENT 1 Medications slow progress of disease 2 Behavioral approaches a Maintain your brain b Reality orientation c Behavior plans for problem behaviors d Compensatory strategies 3 Caregiver support a Caregiving associated with illness ii ALZHEIMER S DISEASE 1 Neurodegenerative disease 2 Degenerative disease of the brain major source of impairment among older people 3 Characterized by course of a Accelerated forgetting b Decline in daily living skills c Agitation and irritability d Sleep problems e Delusions e g paranoia f Hallucinations g Inappropriate sexual behavior h Incontinence i Depression d Risk factors for diabetes i Risk factors 1 Family history 2 Low income 3 Overweight 4 Sedentary lifestyle 5 Racial ethnic minority ii DIABETES 1 2 Type I Type II gestational Insufficient or insensitive insulin e Psychological behavioral and social effects of having a chronic illness i Adjusting to the Possibility or Prospect of Death 1 Chronic diseases are leading causes of death 2 Stages of grief for ill and family a Denial b Anger c Bargaining d Depression e Acceptance 3 Chance to shape legacy end of life care ii Adjusting to Chronic Illness 1 Therapy e g CBT and support groups help for patients and family a Invisible social support more effective 2 Disease requires change a Loss of health and grieving b Finding meaning c Self perception identity formation d Body image e Relationships 3 Adjustment also requires maintenance of routine iii Adapting to Treatment 1 Treatment challenges 2 Loss of mastery competency 3 Loss of dignity autonomy a Negotiating relationships with providers i Hopelessness and helplessness may hinder care in providers and patients 4 Avoidance coping is a problem for controllable problems f LIVING WITH CHRONIC DISEASE i Adjusting to diagnosis 1 Diagnosis as crisis 2 Diagnosis as psychosocial transition g Adaptive vs maladaptive adjustments to chronic illness i MALADAPTIVE 1 Denial 2 Hopelessness 3 Aggression ii ADAPTIVE 1 Maintaining optimism 2 Enhancing self understanding 3 Positive adjustment is possible 4 Good quality of life is possible 3 End of life issues a Definition of living will advance directive i LIVING WILL ADVANCE DIRECTIVE 1 Living will 2 Specify what measures you do or do not want taken in the future 3 Can be oral vs written informal vs formal general vs specific b Definition of durable power of attorney for health care i Designate a surrogate decision maker in case of incapacitation ii Can be oral vs written informal vs formal general vs specific c Prevalence of completion of living wills advance directives in the U S d Steps required for advance directive to be applied followed Ditto et al 2005 i 25 study i Individual completes a living will 1 Only 25 do not much higher in terminally ill ii Wishes are authentic and informed 1 Requires predictions about future wishes unstable over time 2 Answers depend on way questions posed depression past experiences functioning current state 3 People often want to think positive 4 Uncertainty leads to avoidance postponement iii Surrogate knows about living will iv Surrogate interprets living will correctly 1 Research suggests surrogate judgments are often inaccurate and based on projection tend to overestimate desire for treatment v Surrogate able to honor wishes 1 Can influence other participants vi Doctor willing to honor wishes 1 Ethical professional and personal values may influence care offered e Accuracy of children s interpretations of their parents wishes regarding future medical care Fagerlin et al 2001 study i Surrogate judgments often inaccurate and based on projection tend to overestimate desire for treatment f Principles in end of life decision