Study Guide

• CONCEPTUAL OVERVIEW
• Social support → An umbrella term for various theories and concepts that link involvement with social relationships to health and well-being

• Behaviors that, whether directly or indirectly, communicate to an individual that she or he is valued and cared for by others
• Increasing a person’s sense of control
• People cope best when they’re well informed and actively involved

• Several reasons for the link between social ties and good health
• COPING → the process of managing stressful situations
• SENSE OF CONTROL

• Health self-efficacy
• Internal locus of control
• External locus of control

• COPING AND COMMUNCIAITON
• Two kinds of coping strategies and social support:
• 1) ACTION-FACILITATING SUPPORT → performing tasks and providing information

• instrumental support → tasks and favor

• research shows that instrumental is most appreciated when care receivers feel they are active participants and are involved in decision making

• informational support → might involve performing an Internet data search, sharing personal experiences, passing along news clips, and so on

• information can help people increase their understanding and make wise decisions

• those who are knowledgeable about what is happening usually feel more in control, experience less pain, and recover more quickly than others

• NUTURING SUPPORT

• Typically involved three types of support:

1) esteem support → involves efforts to make another person feel value and competent

• emotional support/ praise

• encouraging words may ease feelings of helplessness and despair
• people often report that unconditional approval is the most helpful form of support
• listening is also important, studies show that most distressed individuals are not looking for advice; they just want to talk and be heard

2) emotional support → includes efforts to acknowledge and understand what another person is feeling

• particularly valuable when people must adapt to what they cannot change

• 3) social network support/ support groups → common sources include family members, friends, professionals, support groups, virtual communities, and self-help literature; are made up of people of similar concerns who meet regularly to discuss their feelings and experiences

• self-help groups, treatment groups, online support groups

• COMMUNCIAITON BUILDER: SUPPORTIVE LISTENING
• COMMUNICAITON BUILDER: ALLOWING EMOTIONAL EXPRESSION
• SOCIAL NETOWRKS

• Advantages to support groups:

• Bring around other similar to you may help feel that you’re not alone or abnormal
• They can give firsthand information
• Support group members may feel better about themselves because they’re helping others
• Convenient and low cost

• Disadvantages to support groups

• Can become counterproductive gripe sessions
• Will develop an us-versus-them view-point

• WHEN SOCIAL SUPPORT GOES WRONG
• FRIENDS DISAPPEAR
• HURTFUL JETS
• TOO MUCH SUPPORT
• NOTE OF ENCOURAGEMENT
• FAMILY AND FRIENDS AS CAREGIVERS
• PROFILE OF THE FAMILY CAREGIVER
• THE ECONOMICS OF FAMILY CAREGIVING
• STRESS AND BURNOUT
• CARING FOR CAREGIVERS
• END OF LIFE EXPERIENCES
• LIFE AT ALL COSTS
• DEATH WITH DIGNITY → in the United States, described as one that includes being surrounded by loved ones and familiar, comforting surroundings

• Hospice  → programs that provide support for care for people in the last phases of an incurable disease, with a focus on maintaining the quality of their remaining life by providing services that both aid physical comfort and address psychological and spiritual healing

• Central to this philosophy is the belief that death is a natural part of life, and thus personal and unique
• Hospice is more oriented toward personal expression, emotions, spirituality, ad social concerns, than is conventional Western medicine

• Loved ones are considered important participants in the dying process

• Barriers to hospice care

• Hospice eligibility requirements:

• Patients must have 6 months
• Physicians fear [puritive]?? Damages from insurance company oversight committees
• Insurance options do not provide many financial incentives

• Palliative care → hospices provide this, this is care designed to keep a person as comfortable and fulfilled as possible at he end of life but not designed to cure the mental illness once it has been determined that medical care will not improve it

• Palliation → any treatments, care, or support that relives symptoms and suffering
• Palliative care does NOT equal curative care
• Palliative care with curative approaches
• Hospice care without curative approaches
• Barriers to palliative care

• Shortage of well-trained healthcare providers
• Medical community’s own ignorance and lack of health literacy
• Lack information about the appropriate dosages of narcotics used in pain control
• Insurance reimbursements requirements
• Managed care organizations delay referrals to hospice and palliative care programs

• ADVANCE-CARE DIRECTIVES

• Advance – care directives → describe in advance the medical care a person wishes to receive (or not receive) if he or she becomes too ill to communicate

• Takes some pressure off caregivers and loved ones who might otherwise forced to make these decisions on their own

• Coping strategies and health outcomes

• Problem-focused coping
• Emotional-focused coping
• Avoidance-focused coping
• Humor and coping

• Perceptions of support providers

• Social comparison theory and social support
• Reciprocity and social support

• Strong tie vs. weak tie support networks

• Close ties

• Family and closest friends
• Benefits
• Tangible & emotional support
• Problems
• Role obligations
• Intimate knowledge, relational history

• Weak ties

• People who we are not particularly close to, yet we interact with them frequently
• Benefits of weak tie networks
• Dissimilar others (different perspectives)
• More objective feedback
• Greater network of information
• Don’t have to worry about info. getting back to close ties
• Less judgmental
• Can “sound off” problems without offending or burdening

• Support groups for people with health concerns

• Prevalence of support groups
• Reasons why people join support groups
• Difficulties communicating about illness within traditional social networks
• Other factors influencing support group participation

• Support groups

• Benefits
• Drawbacks
• Caregiver support groups

• STEPS TO REMEMBER

• Get patients perception / focus on the other person
• invitation / remain neutral
• knowledge (facts)
• acknowledge emotions / legitimize the other person’s emotions
• respond to emotions / concentrate on feelings
• close with summary (questions) / summarize what you’ve heard

• Typology of attitudes toward death and dying

• Positivists

• Achieved goals in life
• Reflect positively upon their lives

• Negativists

• Reflect negatively upon their lives
• Look on death with despair

• Activists

• View death as an end to future opportunities for achievement
• But largely satisfied with their past

• Pacifists

• See death as an end to life’s problems and suffering

• Coping with the death of a loved one

• Grief:

• normal process of reacting both internally and externally to the perception of loss

• Bereavement:

• period of time in which an individual experience grief and mourns the death of a loved one

• Reactions to grief

• Personality, relationship
• Relationship changes form

• The overarching category of eHealth includes mHealth, telemedicines, and a variety of other activities such as communication between everyday people via blogs, tweets, text messages, and other electronic means
• eHEALTH
• eHealth → the use of electronic means to transfer health information and resources
• WHY AND WHEN DO WE SEEL ELECTRONIC HEALTH INFORMATION?

• Uncertainty motivates information seeking, especially is we think we have an urgent need or risk
• Health information acquisition model → proposes that we are motivated to seek information when something calls our attention to concern, we don’t perceive that we are well-informed about it, it seems important to find out soon, and we think we’ll be able to find trustworthy and useful information

• Central to this theory is the idea that people first consider how much they already know, and then weigh the costs and rewards before seeking additional information

• Theory of motivated information management (TMIM) → has several aspects in common with the health information acquisition model in that both presume that people seek information when they are anxious about something and feel that it would be helpful to learn more about it.

• TMIM, however, also addresses coping confidence and people’s choice of information channels
• According to TMIM, the likelihood that we will seek information depends on our perceived need for it, our coping ability, and the way in which information is conveyed
• Address not just why we want information and what we hope to learn, but how we seek that information

• We seek information most readily from sources we believe to be relevant, accurate, and trustworthy

• Most people prefer that sensitive and important information be conveyed in emotionally immediate, information-rich ways
• Most of us prefer to hear serious news directly from an expert
• From TMIM, when the stakes are high, we typically prefer interpersonal communication with people we highly trust.  Partly for this reason, people who don’t feel their doctors are empathetic and patient-centered are more likely than satisfied patients to seek health information on the internet

• Integrative Model of Online Health Information Seeking → suggests that social structures and inequities manifest in individual differences, which influence how able and motivated we are to seek eHealth information.

• For example, if we believe health authorities font care about people like us, we’re unlikely to put much stock in their advice or actively seek health information
• Or perhaps, our reading skill or access to computers is limited, or we have more pressing concerns than long-term health, such as satisfying our hunger or surviving day-to-day in a violent neighborhood
• Important aspect of this theory is that it focuses on individual differences, but it recognizes that they don’t happen by chance
• People who feel they are proficient at finding health information online are more likely than others to be active internet users

• In this way, one set of advantages (skill and confidence) heightens others (knowledge and its benefits)
• Our chances of going on line are heightened if people who are important to us expect us to do so and if they support online information seeking as a valid effort (social expectation)

• Most theorists suggest that we are mist likely to seek health information if we are confident that we can find information and use it affectively, we feel emotionally capable of dealing with what we find, and we expect that the results  will be worth the effort
• Calls attention to social structures and opportunities that constrain individual action

• IS ONLINE HEALTH INFORMATION USEFUL?
• ADVANTAGES

1. The internet is typically engaging and in depth, which gives it a leg up on TV news

2. the internet is a gratifying source of practical advice, available whenever we need it

• People who find practical information online are usually more satisfied with their experience than people who seek to increase their knowledge about a health concern without an action goal in mind

3. The potential  for targeted messages

4. online resources offers a means to connect with other people to share information and social support