Psychobiology: Y2 LCRS 2: Coping with Treatment

A condition that results when the patient/environment transactions lead the individual to perceive a discrepancy between the demands of the situation and the coping resources available

For patients, there are mental demands of the threat of wellbeing from hospitalisation (pain, severity etc.) and there may be limited copingresources as there is little they can do

Procedural Information – information about the procedures to be undertaken
Sensory Information – information about the sensations that may be experienced

Dual process hypothesis

Procedural information allows patients to match on-going events with expectations in a non-emotional manner
Sensory information works by mapping a non-threatening interpretationonto these expectations

Problem focussed coping

Emotion focuses coping

Efforts directed at changing the environment in some way or changingone’s own actions or attitudes
Examples: seeking health information, finding out more about the procedures, pacing activity, changing behaviour

Efforts designed to manage the stress-related emotional responses in order to maintain one’s own morale and allow one to function
Examples: meditation, relaxation techniques, deep breathing, distraction, praying

Martelli et al
This was a study on the type of information given (problem focussed or emotion focussed) vs the individual’s desire for information
HIGH desire for information – problem-focussed prep DECREASED anxiety and emotion-focussed prep increased anxiety
LOW desire for information – problem-focussed prep INCREASED anxiety and emotion-focussed prep had little effect

Auerbach – looked at the relationship between the amount of information and distress
Patients undergoing a dental extraction were given either specific or general information about the procedure
HIGH desire for information – less distress with specific information
LOW desire for information – less distress with general information

An increase in perceived control decreases distress

The patients were given a device for expressing discomfort on a traffic light scale
The patients either did or did not know that the dentist could see the lights
The dentist either did or did not respond to the lights
For AVERSIVE treatments: discomfort decreased only if the patients signalled AND the dentist responded
For NON-AVERSIVE treatments: NO difference – if anxiety producing, information giving alone reduces discomfort

Nursing home had 2 floors and one of the floors was given MORE CHOICE than the other
This floor had greater engagement in activity, had a generally better wellbeing and lower 18 month mortality rate

Increased emotional support was a significant, independent predictor of better emotional status, quality of life and compliance with recommended behaviours

Tell, Show, Do
Tell – using simple language and a matter-of-fact style, the child is told what is going to happen before the procedure
Show – the procedure is demonstrated on an inanimate object, a member of staff or the dentist himself
Do – procedure does not begin until the child understand what will be done – prompt distraction strategies

Children’s distress correlates with the amount of distress shown by the parents
Parental behaviour explains the greatest amount of variability inchildren’s medical distress
Maternal behaviour has a much larger effect on GIRLS compared to boys (little or no effect in boys)