Deck 11: Management of Chronic Health Disorders

Question 1

Self-reports of health status

A) are an important aspect of quality of life
B) have found to predict morbidity beyond medical and psychological factors
C) have found to predict mortality beyond medical and psychological factors
D) are an important aspect of quality of life, have found to predict morbidity and mortality beyond medical and psychological factors
E) are unreliable

Answer 1

are an important aspect of quality of life, have found to predict morbidity and mortality beyond medical and psychological factors

Question 2

________ is a component of quality of life.

A) Physical functioning
B) Psychological status
C) Social functioning
D) Disease-related symptomatology
E) All of these answers are correct.

Answer 2

All of these answers are correct.

Question 3

Medical measures of quality of life are

A) seldom based on objective criteria.
B) poorly correlated with patients' and relatives' assessments.
C) poorly correlated with patients' assessments but are moderately correlated with relatives' assessments.
D) moderately correlated with health psychologists' assessments.
E) None of these answers are correct.

Answer 3

poorly correlated with patients' and relatives' assessments.

Question 4

Denial

A) is a defense mechanism that allows the patient to avoid the immediate implications of an illness.
B) may help the patient control her or his emotional reaction.
C) can mask the fear associated with a chronic disease.
D) is a defense mechanism that allows a patient to avoid the immediate implications, and can mask the fear associated with a chronic disease, however it may help the patient control his or her emotional reaction.
E) inhibits the success of medical treatments for chronic illness.

Question 5

Medical measures are only weakly related to patients' or relatives' assessments of quality of life.

Question 6

Simply telling patients that anxiety is a normal response to the stress of chronic illness does not alleviate their concerns about how they are reacting.

Question 7

Self-blame for chronic illness is widespread.

Question 8

Illness duration influences which types of coping strategies are used.

Question 9

Functional somatic disorders are more common in men than in women.

Question 10

Studying quality of life

A) makes it possible to determine what kinds of interventions may be needed.
B) is an unnecessary intrusion into patients' lives.
C) cannot be used to compare therapies.
D) tells us little that the diagnosis does not provide.
E) has always been a top priority in medicine.

Question 11

Due to the chronic strain involved, the divorce rate among families with a chronic illness is higher than that for the general population.

Question 12

Denial may serve a protective function

A) before the patient seeks medical treatment.
B) in the acute phase of the illness.
C) when patients must play an active role in the treatment regimen.
D) during the rehabilitative phase of the illness.
E) if the illness is chronic.

Question 13

The Internet is a good source of information about skills for coping with common illness-related problems.

Question 14

Assessment of quality of life considers

A) how much the disease and its treatment interferes with the activities of daily living.
B) the functional aspects of daily living.
C) the extent to which a patient's normal life activities have been compromised by disease and treatment.
D) differences depending on whether the chronic illness is in an acute phase or when symptoms are less active.
E) All of these answers are correct.

Question 15

Denial is useful in helping patients

A) control their emotional reaction to illness.
B) monitor their physical condition.
C) seek treatment.
D) become active in their treatment regimen.
E) denial is never helpful.

Question 16

There is evidence that depression may occur somewhat earlier in the adjustment process than denial or severe anxiety.

Question 17

Immediately after a chronic illness is diagnosed,

A) patients are in a state of crisis.
B) patients find their habitual ways of coping with problems do not work.
C) anxiety, fear, and depression often take over.
D) patients are in a state of crisis where they find their habitual ways of coping do not work and anxiety, fear, and depression take over.
E) patients begin to develop a sense of how the chronic illness will alter their lives right away.

Question 18

Anxiety

A) is especially prevalent among people with asthma.
B) is associated with poor glucose control and increased symptoms in diabetic patients.
C) interferes with assessments of severity of the disease and its treatment.
D) can increase the risk of subsequent heart attacks among patients with heart disease.
E) All of these answers are correct.

Question 19

Whereas disease severity and the presence of debilitating symptoms affect quality of life, they are unrelated to body image.

Question 20

Many chronic illnesses lead to a decrease in sexual activity.

Question 21

Which of the following is NOT one of the goals of rehabilitation discussed in your text?

A) redefining oneself as being chronically ill
B) adherence to one's treatment regimen
C) the control of energy expenditure
D) the ability to identify and respond to the onset of a medical crisis
E) they are all goals of rehabilitation discussed in your text.

Question 22

According to researchers at the University of British Columbia, children with asthma benefit most from

A) perceived control.
B) self-esteem.
C) parental support.
D) emotion focused coping.
E) self-efficacy.

Question 23

Which of the following is NOT a symptom of chronic, low-level inflammatory processes that characterize functional somatic syndromes?

A) fatigue
B) pain
C) sick-role behaviour
D) negative affect
E) All of these answers are symptoms.

Question 24

With respect to the vocational issues in chronic illness

A) job counselling, retraining programs, and advice on how to avoid or combat discrimination should be assessed later in the recovery process so as to not interrupt the healing process.
B) some people may have to find ways to cope with working conditions that are not ideal but necessary to stay employed.
C) cancer patients are rarely fired or laid off.
D) employers will often allow for a patient to take more sick days than an average employee.
E) many people who suffer from chronic illness are able to keep their jobs with no complications.

Question 25

Which of the following is NOT a predictor of depression among chronically ill patients?

A) the severity of the illness
B) chronic pain
C) marital status
D) becoming disabled
E) they are all predictors of depression among chronically ill patients

Question 26

The perception and evaluation of one's physical functioning and appearance comprises one's

A) physical self.
B) self-concept.
C) body image.
D) self-evaluation.
E) All of these answers are correct.

Question 27

___________ are visions of the self for the future, which can help to motivate, organize, and direct an individual's current goals and aspirations.

A) Social selves
B) Achieving selves
C) Possible selves
D) Physical selves
E) Potential selves

Question 28

Body image can be improved by

A) ignoring the area of disfigurement.
B) reconstructive surgery.
C) medication.
D) stressing other aspects of appearance and health.
E) biofeedback.

Question 29

The study by Lacaille and colleagues (2007) on the work-related problems of people with arthritis found that

A) fatigue was the most limiting symptom of arthritis that created problems at work.
B) co-workers' relationships were supportive.
C) job satisfaction, aspirations for advancement, and salary were unaffected by their arthritis.
D) they avoided working too hard so they could save their energy for their home lives.
E) ergonomic solutions in the office were not helpful.

Question 30

Depression in chronically ill patients is

A) independent of illness severity.
B) most commonly found in the acute phase of illness.
C) easily and reliably assessed.
D) related to long-term rehabilitation and recovery.
E) All of these answers are correct.

Question 31

Blaming another person for one's disorder

A) is maladaptive.
B) may be tied to unresolved hostility.
C) can interfere with adjustment to the disease.
D) is most effective when the person being blamed is not a close friend or family member.
E) is maladaptive, may be tied to unresolved hostility, and can interfere with adjustment to the disease.

Question 32

Adherence to treatment regimens in chronically ill patients is

A) significantly higher than in patients being treated for acute disorders.
B) significantly lower than in patients being treated for acute disorders.
C) unaffected by the side effects of treatment.
D) especially problematic in complex and long-term treatment regimens.
E) significantly lower in women than in men.

Question 33

Fibromyalgia

A) affects almost 400,000 Canadians.
B) is associated with sleep apnea.
C) is associated with increased parasympathetic system stress responses.
D) is more common among men than women.
E) is not a real disease.

Question 34

Analyses of the effectiveness of coping strategies in managing the stress associated with chronic illness conclude that

A) the coping strategies used by chronically ill patients are significantly different from the strategies observed in healthy samples.
B) avoidant coping is associated with reduced psychological distress and better psychological adjustment.
C) confrontative coping is associated with better adjustment than the use of multiple coping strategies.
D) active coping is more consistently associated with good adjustment.
E) vigilant coping is associated with reduced psychological distress over the long-term.

Question 35

According to Clarke and Currie (2009), anxiety is more common in

A) women.
B) men.
C) children with life threatening illnesses.
D) people with stroke, heart disease, and cancer.
E) people who are not in a significant relationship.

Question 36

According to a study of cancer patients conducted by Dunkel-Schetter and her colleagues (1988), the most frequently cited stressor was

A) fear and uncertainty about the future.
B) limitations in physical abilities.
C) pain management.
D) altered physical appearance and lifestyle.
E) financial worries.

Question 37

In general, high levels of perceived control facilitate adjustment, EXCEPT in cases where

A) patients are seriously debilitated, both physically and psychosocially.
B) patients must cope with long-term chronic illness.
C) patients must cope with acute disorders and treatment.
D) where actual control is low.
E) patients are seriously debilitated and must cope with long-term chronic illness.

Question 38

Creative non-adherence to treatment regimens among people with chronic illness

A) is rare.
B) may occur because they know their disease extremely well.
C) occurs because they are not tuned into their internal feedback.
D) is recommended by doctors when there are no traditional methods left to try.
E) is not an issue that health psychologists are concerned with.

Question 39

Successful adjustment to chronic illness is NOT associated with

A) having an appropriate or accurate illness schema about the nature of one's illness.
B) developing an acute model of one's disorder.
C) blaming others for one's illness and thus minimizing self-blame.
D) having a personal sense of control, even in medical situations, in which little personal control is possible.
E) avoidant coping.

Question 40

Unlike anxiety and denial, depression

A) may be a long-term reaction to chronic illness.
B) is at a steady state during the course of chronic illness.
C) is the first response to chronic illness.
D) may be intermittent and unrelenting.
E) is usually a short-term reaction to chronic illness.

Question 41

Studies have found that the quality of life reported by cancer patients is higher than healthy community samples. Explain how chronically ill patients cope with their illnesses and maintain a positive self-concept.

Question 42

Which one of the following would hamper a child's ability to cope effectively with a chronic illness?

A) The parents do not appear distressed.
B) The child continues to attend school throughout their illness.
C) The parents have a history of depression or other mental illness.
D) The child takes part in physical activities.
E) The parents giving them some control over their treatment.

Question 43

Collins et al. (1990) reported that more than _______________ of the cancer patients in their study reported at least some beneficial changes in their life as a result of the cancer.

A) 20 percent
B) 45 percent
C) 75 percent
D) 90 percent
E) 50 percent

Question 44

Answer the question posed in the text: "How is the self changed by chronic disease?"

Question 45

Family support of patients with a chronic illness is especially important because

A) they encourage the patient to be cheerful.
B) they are the only ones available when friends cannot be counted on.
C) they promote adherence to treatment.
D) they help the patient cope with the stigma associated with certain disorders.
E) they allow the patient to make his or her own choices.

Question 46

Explain the role of social support in coping with chronic illness. In your answer, consider both the benefits and the costs of social support, and the different forms that it can take.

Question 47

Researchers investigating gender and the impact of chronic illness have found that

A) women with chronic illness also experience less distress than men.
B) women have a higher burden of disease than men.
C) married women spend fewer days in nursing homes than married men.
D) men with chronic illness are less likely to be married than disabled women.
E) hospitalization of one's spouse does not increase risk of death for husbands or wives.

Question 48

Physical rehabilitation of patients with chronic illness involves learning

A) how to use one's body as much as possible.
B) new physical management skills.
C) how to control the expenditure of energy.
D) a necessary treatment regimen.
E) All of these answers are goals of physical rehabilitation.

Question 49

Negative reactions to chronically ill patients include

A) discrimination.
B) distress.
C) feeling worn down.
D) stereotypes.
E) shunning.

Question 50

What are the common emotional responses to chronic illness? How do these responses impact care and adjustment?

Question 51

Most caregiving for the chronically ill is provided by

A) formal services such as home health nurses or nursing homes.
B) men.
C) family members.
D) friends.
E) hospices.

Question 52

Regarding caregiving for people with chronic illness,

A) care for people with chronic illness is notoriously irregular.
B) the care-giving role more commonly falls to the oldest child.
C) caregiving is usually more rewarding for men than women.
D) the caregiver should only help with the psychological care of a patient.
E) the caregiving role requires a vast amount of medical knowledge or research in order to be effective.

Question 53

Divorce rates for families with a chronic illness are

A) higher when the patriarch is sick because they are the primary breadwinner.
B) lower than families without a chronic illness.
C) higher than families without a chronic illness.
D) no different than families without a chronic illness.
E) lower in families with children because they take on new roles to help out.

Question 54

Which of the following is NOT a result of caring for those with chronic illness

A) strains the relationship between patient and caregiver.
B) increases risk for depression.
C) compromises the health of the caregiver.
D) is linked to alterations in immune functioning.
E) increases resiliency in most people.

Question 55

Discuss the components of quality of life.

Question 56

A social support group is most likely to help

A) Fred, an insurance company executive who is recovering from a myocardial infarction (MI).
B) Mar'a, a recent immigrant from the Philippines who suffers from rheumatoid arthritis.
C) Sybil, a high-school dropout with three children who is recovering from a mastectomy.
D) All of them, because support groups have shown efficacy for cancer, rheumatoid arthritis, and myocardial infarction.
E) None of these people, as support groups are comforting but otherwise unhelpful.

Question 57

Research on the positive changes in response to chronic illness has found

A) that achieving a high quality of life is linked to having positive self-perceptions.
B) more than 90 percent of cancer patients reported at least some beneficial changes in their lives as a result of the cancer.
C) finding benefits in illness is not always associated with good adjustment.
D) All of these answers are correct.
E) None of these answers are correct.

Question 58

Patient education programs that include coping skills training

A) can increase knowledge about the disease.
B) increase patients' feelings of purpose and meaning in life.
C) increase adherence to treatment.
D) can increase knowledge about the disease and increase feelings of purpose and meaning in life but does not address adherence to treatment.
E) can increase knowledge about the disease and increase feelings of purpose and meaning in life, all the while addressing adherence to treatment.

Question 59

What are the coping strategies are commonly used to cope with chronic illness? Which ones are more adaptive and which ones are less adaptive and what factors influence which strategies are used?