Physical Emotional And Cognitive Behaviour Of An Individual

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QUESTION:

Discuss the physical, emotional, cognitive and behavioural responses an
individual is likely to experience in response to a newly diagnosed condition with a poor prognosis.
For this assessment you are required to: Write a formal academic essay

ANSWER:

Introduction
The study is based on the on meta-analysis of a diseased person, aiming to prospectively understand the effects of physical, emotional and cognitive behaviour that results when diagnosed with disease of poor prognosis. Disease is something, which alters the state of body and mind that may lead to profound effect on the behaviour of the person. The emotional wellbeing consists of an effective component concentrating on the positive emotions such as a feeling of happiness, and the cognitive component such as satisfaction of life will totally at loss in  this condition. In sum, this meta-analysis will synthesise evidences drawn from the prospective studies on the relationship between emotional well being and the prognosis of physical illness.

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Physical Behaviour
Physical activity (Thompson et al. 2006) in relation to bodily movements that results in energy expenditure  or the importance of maintaining the physical fitness, that includes cardio respiratory , fitness, muscle strength , body composition , flexibility, nutritional balance , daily physiological activities, comprising of a set of attributes that the individual have relates to the ability to perform the physical activity.  In case of physical behaviour the activities has a interrelationship between the total amount activity and the intensity in which these are performed. Several researches (Mirtazapine, 2006) have shown there will be low or diminished physical behaviour or physical activity in diseased person with poor prognosis. The impact of this condition and the disability that   is experienced by the individual or his family are not assessable always. The two non-modifiable risk factors contributing to the development of chronic disease are age and heredity. Limitations are noted in such activities like self care, mobility and communication. The difficulty in behaviour depends on the nature iof illness, or the disability determines the person’s individual situation. A person suffering in this condition may result in frequent hospitalisation that reduces the person’s quality of life, burden to the family and disruption in the normal routine.  A person living with chronic illness , with or without  chances of survival  covers three aspects; the demands created by the disease, maintenance of everyday life and an altered view of the future relating to frustration, anger and depression. These persons sometimes demonstrate rapid changing of mood in processing emotional stimuli, regulating behaviour, and social emotional functioning. The common disorders in physical aspects include disturbed sleep, impaired appetite and lack of energy that already exists because of the disease. Inhibited responding is seen in reactive attachment disorder and excessive attention seeking is seen in distributed social engagement disorder (Downing, 2006).

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Emotional behaviour
In patients with poor prognosis, the emotional dimensions are mostly overlooked while providing medical care. The concepts of sick role and illness behaviour have helped in understanding the impact of the disease (Breitbart & Cohen, 2000). It is difficult to diagnose a depressed condition. Patient in this context often have to adjust to their aspirations, lifestyle and employment. Many patients have protracted distress and develope psychiatric disorders like depression and anxiety.   In some chronic illness have a direct cerebral impact in mood. The risk factors for depression may account for a history, a major functional disability, pain or adverse social circum stances, like unemployment, lack of emotional support. Even a mild depression may reduce a person’s motivation to gain access to medical care and follow treatment plan. This depression and a feeling of hopelessness exert a corrosive effect in family relationships. In some patients with incurable medical illness often have tendency to commit suicide. People who have become depressed after cebrovascular accident have an increased risk of dying, and significant less recovery in terms of daily physical activities, the clinical outcome of heart disease is depression (Payne & Massie, 2000). These sometimes lead to an impaired capacity in communicating their systems and thereby delay in diagnosis. Depression in women is often associated with bone mineral density (Herek et al. 1990).  There may be development of new systems that suggest a emotionally depressed condition. This may lead to adjustment difficulties, or complex social relationship problems. These patients may sometimes incite feelings of anxiety and professional inadequacy, posing an emotional burden on the clinician. The side effects in treating these patients may accounts for frustration and anger.

Cognitive behaviour
These amounts to the psychological variables, that develops in this context relates to mood, stress as noted by depression scores, anxiety level, and other social situations where thsdes illness occur. The other factors (Carter, 2012)  of past experience, age, sex, anxiety, fear and depression all have a bearing in chronic illness. The problems get worse not only due to the progression of the disease but also due to the vicious circle that the people find themselves.  Inability to functions lead to a loss of role and self esteem, with progression of other conditions like, financial hardship and strained relationships (Denholm, 2012). All these difficulties cause worry and low mood that fuels a sense off desperation. The cognitive behavioural approach tries to improve the physical as well as the psychological distress. This helps to reduce the negative thinking such as loss of interest in life, and tries to develop effective challenges to improve physical functions.  A patient may react in several ways in a life threatening illness. These may be a period of denial, followed by anger, bargaining, depression and finally acceptance of the condition. The patient may exhibit;

  • Fighting spirit
  • Avoidance or denial
  • Fatalism
  • Helplessness and hopelessness
  • Anxious preoccupation

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These attitudes may be present from initial diagnosis and helps to understand subsequent difficulties. In evaluating a terminally ill patient (Guest, 2011) more emphasis is given to psychological symptoms such as hopelessness, guilt and worthlessness than to other somatic conditions. In a number of patients, there may be increased suicidal risk, poor social support, delirium, alcohol abuse, recent bereavement, advanced age, and other conditions. There may be persistent dysphoric mood, which shows no reactivity in pleasant situations such as relative’s visit and voicing a wish to die may be prevalent. Patients with previous history of depression and suicide attempts are at more risks (Herek et al. 1990).  There may be present of delirium that may exist with depressive illness. Sometimes the patient may appear apathetic or lethargic, or may be agitated (Tallmer, 2004). There may exist vague depressive or persecutory ideas, which change from day to day. The behavioural disturbances are worse at night, hallucinations may occur but no frequently. There may be deficit in memory, and disorientation, sometimes it is seen that the patient is in denial to accept their illness when they are unable to register or retain information regarding their illness.

Conclusion
All the above discussions suggest that there needs a more scientific and rational approach to deal with these types of patients. They need more care and family support in terms of physical, emotional and cognitive behavioural therapy, to cope with diseases that have poor prognosis.

In patients suffering from serious diseases where there is little chance of survival, the conditions of the patient do suffer from all aspects regarding, physical, emotional and cognitive behaviour. As discussed the patient do develope a change of mood with frustration and anger that diminishes the desire to live and the most common disorder that develops is depression that have profound effect in the life of the patient. The patient even refuses to talk with his near and dear ones, or these is no urge to talk or meet them. They sometimes develop a mood of anger that may lead to several misuses like alcohol abuse, with a suicidal tendency or other bad behaviours.  They may be loss of self-esteem, a state of dysphoric mood, delirium, with a feeling of hopelessness and guilt, sometimes the patient developes hallucination along with these. All these emotional or psychological symptoms may be associated with other physical ailments, like loss of appetite, insomnia, and lack of energy that is already associated with the disease.

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