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role of emotions in health
- health is conseridered as a whole
- fight or flight response
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anxiety & stress
- physicalogical stress response or biochemical fight or flight
- general adaption syndrome- how the body response to stressors
when person under stress, tension, or anxiety the body starts biochemicals, the body's command post the hypothalumus commnicates w/ pituitary gland which then notifies adrenal gland & releases hormones like dopamine, epinephrine, norepinepherine, & cortisol, body response to even sm. changes
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childhood sources
S/S of stress colics, atopic dermititis, allergic reactions, GI problems, asthma, aches, pain
kids that have support from parents deal better w/ stress
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common psychophysical problems
- the GI is the system that encounters most problems
- GI- indigestion, vomiting, constipation, diarrhea, ulcers,
- Resp.- asthma,
- Cardiac- increase in B/P,
- SEE PG 239
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psycholphysical theories
stress response theory- ppl are biochemically patterned to react to stress, the ANS prepares fight or flight, usually results to physical distrubance w/i body
carl jungs theory- believes stress leads to illness ( like GI problems or B/P)
Erich Fromm theory- certain personility prone to cretain illness from stress
Organic weakness theory- every person has body system that is more sensitive then other system
always believe pt compliants
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somatoform disorders
- feeling the physical symptoms in absence of disease
- defined as a person's symptoms suggest the presence of medical illness
Dx- excluding physical dysfunctions, presenceof drugs, or mental health problems, if no of these found itz concidered somatoform disorders
S/S- of illness may b pt way od coping w/ emotional distress
emotional distress depletes the body's energy leading to decrease immune function which make them at higher risk 4 illness
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cultural influences
- somatic illnesses based on cultural & spiritual beleifs
- assessments & TX shouldn't threaten or challenge beliefs
- health care providers need to learn & respect all cultural beliefs effective interventions
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Critiria 4 DX
- 1. no organic medial condition that explans the symptoms can b found
- 2. the disorder significantly disrupts or impairs ones level of functioning
- 3. pt is unaware of or is unable to expres their emotional distress
ppl have factitious disorders- they intentionally produce S/S of illness or disability so ppl could beleive them
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somatization disorders
- polysymptomatic disorders- many differant conditions
- genetic & enviromental factors contribute to risk of getting somatization disorder
- look 4 tx w/ many DR so they get different meds making it likely to have drug interactions
- complaints are usually exaggerated
- signs of depression & anxety all very likely
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differance between somatization disorder & medical problems
- many organ systems involved in somatization disoreder
- characterized by early onset & chronic condition w/ no changes over time
- absence of labs
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conversion disorders
- considered somatoform disorder where pt present problems RT sensory or motor functions
- more common in ppl w/ lower socioeconomic status, living in rural areas, ppl w/ low health care knowledge
- when assessed for this their social & cultural backgrounds are concidered
- in kids they get a gait problem, adults get sensory & motor disturbances
- symptoms appear slowly & increase w/ time & last a short time
- thought to b a emotional (psyphic) conflict
Tx- eliminating causes/stressors, referring to therapiest where RX antidepressants & antianxiety are given, & behavioral tech given
La Belle indifferance- lack of concerns about S/S
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criteria 4 DX conversion disorder
- 1.Atleast 1 symptom involves sensory or motor system & suggest nuerological problem
- 2.S/S brought on or worsened by stressors
- 3.S/S are not intentionally produced
- 4.S/S cause distress & impair ADL
- 5.after exam S/S cant be explained
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hypochondriasis
- thinking that they are always sick even when labs results come back clear (DANA), are usually dr. shoppers
- anxiety, depression, & commpulsive personality traits are present w/ hypochondiacs
patience, therapeutic communication skills, & alert observations are needed when caring for this pt
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criteria 4 DX hypochondiasis
- 1. fear of having illness
- 2. pt not delusional they admit that they have an unreasonable concern
- 3. still think they are sick even after labs shows no disease
- 4. pt under major stress or impaired ADL
- 5. has been present 4 @least 6 mon.
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other somatoform disorders
somatoform pain disorder- when pain or discomfort is the focus of distress & no other cause identified. pt benefit from seeing pain clinic
- body dysmorphic disorder- most common site is head & face or ear, nose, thinning hair, droopin chin, crooked teeth, & other imperfections
- they concider themselves as ugly/unacceptable, can lead to suicide
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facticious disorders & mallingering
they differ from somatoform disorders in that S/S are intentionally produced
- facticious disorders
- they produce S/S of illness for some kind of gain
- factisious disorder by proxy aka munchausen syndrome- producing S/S to others mostly done to kids
- hard to DX b/c caregiver changes DR. when they feel they are gonna be caught
- mallingering- produce symptoms to meet recognizable goal (to not go to school) sounds like MEEEEE DANA, or to get some
- type of compensation like food shelter
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implications 4 care providers
- rule out presence of any physical disease or dysfunction
- develope trust
- encourage expression of feelings & emotional stress rathr then physical complaints
- meet physical needs when necessary, but encourage independance
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