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-patients adopting the behaviors and treatments their providers recommend
-estimates of nonadherance range from 15% to 93%
-informal network of family & friends who offer their own interpretations of symptoms b4 any med treatment is sought
-in many communities the lay referral network is the preferred mode of treatment
-typically results from a specific injury (ie wound or broken limb)
-typically disappears when damaged tissue is repaired
-last for 6 months or less
-typically begins w/ an acute episode
-however: pain doesnt decrease w/ treatment or as time passes
1) Chronic Benign Pain (chronic back pain)
2) Recurrent Acute Pain (migraines)
3) Chronic Progressive Pain (rheumatoid arthritis)
Pain that may begin after an injury but that does not respond to treatment and persists over time.
The ability to reduce the experience of pain, report of pain, emotional concern over pain, inability to tolerate pain, or presence of pain-related behaviors.
A method whereby an individual is provided with ongoing, specific information or feedback about how a particular physiological process operates, so that he or she can learn how to modify that process.
A technique of healing and pain control, developed in China, in which long, thin needles are inserted into designated areas of the body to reduce discomfort in a target area.
A technique of relaxation and pain control in which a person conjures up a picture that is held in mind during a painful or stressful experience
-medical procedure that produces an effect bc of therapeutic intent
-Generalizability of effects:
-achieve greatest success in absence of tissue damage
-about 65% of symptoms presented to Dr's are emotional in origin
The medically beneficial impact of an inert treatment.
-ppl respond to stress w/ social affiliation & nurturant behavior
-esp true for women
-in a stressful event, ppl protect not only themself but also their offspring (tend)
-ppl seek out their social group for help when threatened (befriending)
-attempts to do something constructive about stressful conditions
-problem focused coping skills emerge during childhood
-this type of coping is favored in situations where something constructive can be done (ex: a work related problem)
-Tangible assistance- material support, services, $, etc
-Informational support- providing knowledge about a stressful event
-Emotional Support-prov. reassurance, nurturance, etc
-Invisible Support-receiving social support w/o being aware of it
-Positive Life Events
-Opportunities for rest, relaxation, & renewal (ex: vacationing)
-Sense of purpose
-having meaningful ties w/ others
-resilience depends on individual differences in how ppl cope w/ stressful events
-lowers likelihood of illness
-speeds recovery from illness
-reduces risk of death from serious illness
-Social support is associated w/ better adjustment to chronic disease
-efforts to regulate emotions experienced b/c of a stressful event
-emotion focused coping skills develop in late childhood or early adolescence
-this coping type is favored in situations that simply must be accepted (ex: health problems)
-ppl w/ greater resources typically cope w/ stressful events better
-time, friends, $, etc. provide more ways of dealing w/ a stressful event
-ex: ppl w/ higher income, educational achievement & more close friends= less distress in divorce
-control of many infectious diseases that once were common in the US
-protects health of the community, especially ppl who are not immunized
-think there's a link between the MMR shot and increased rate of autism
-ingredients in shots are "scary"
-not convinced that vaccines do more good than harm
-women diagnosed w/ EDs have been found to ruminate more than women w/o EDs
-theory that ruminative coping may account for the association between EDs and depressive symptoms
-repeated sampling of subjects current behaviors & experiences in real time & natural environments
-aims to min recall bias, max ecological validity & allow study of microprocesses influencing behavior
-often use random time sampling
-identify stressors/find reassurance from others
-identify stress causes
-avoid negative self-talk
-aquire stress mgmt skills, relaxation techniques, etc
-set new goals
-use other cognitive-behavioral techniques
-Negative affectivity- negative mood
-Pessimistic explanatory style- negative events explained as internal, stable qualities
-Psychological control- perceived control over one's self and environment
-Dispositional optimism- positive expectations
-optimistic nature can lead people to cope more effectively w/ stress and thereby reduce risk for illness
-positive moods may lead to a state of physiological resilience
-thoughts & behaviors used to manage the internal & external demands of situations that are appraised as stressful
-relationship between coping and a stressful event is a dynamic one
-coping efforts depend on resources available to ppl
-most adults have many roles (worker, partner, parent, etc) that each entail different obligations
-attempt to combine multiple roles can result in stress
-acute problem for women bc they typically bear majority of household/child responsibilities
-living in poverty
-exposure to crime
-jobs high in demand and low in control
-Being in a bad relationship
-Negative childhood experiences
-physiological changes from stress are designed for short-term mobilization (fight or flight)
-long-term exposure to stress can have detrimental physical consequences
-HPA activation= more significant than SAM activation in long-term stress
-effects often persist long after the stressful event itself is no longer present
-ex: decreases in performance & attn span
-Post-Traumatic Stress Disorder- after a stressor of extreme magnitude
-can occur after a highly-stressful event
-changes body's response to stress
-Ex symptoms: psychic numbing; constricting emotions; detachment from friends; impaired memory/concentration; startle response to loud noise; reliving aspects of trauma
-pervasive negative mood marked by anxiety, depression & hostility
-ppl high in neg affectivity express distress/dissatisfaction across wide range of situations
-more prone to heavily drink
-more likely to be suicidal
-related to poor health
-Events that are negative, uncontrollable, ambiguous, overwhelming, or that involve central life tasks are perceived as more stressful than events that are positive, controllable, clear-cut, manageable, or that involve peripheral life tasks
-events appraised for harm, threat, & challenge to determine if they're positive, neutral, or negative
-individual asks- what is at stake in the stress situation?
-Assessment of one's coping abilities and psychological resources
-whether they'll be sufficient to meet the harm, threat, and challenge of the event
-Cannon (1932)- one of the earliest contributions to stress research
-when an organism perceives threat the body's physiological response is to attack the threat or flee
-fight= aggressive response to stress
-flight- withdraw from the situation
1) assigns a limited role to psychological factors
2) assumption that responses to stress are uniform is false
-stress response depends on personality, perception, and genes
3) assesses stress as an outcome
-Nonspecific Response- the body responds to all stressors w/ same physiological reaction
-3 phases in reacting to stressor:
1) alarm- realizes threat
2) resistance- cope w/ the threat
3) exhaustion- occurs if person fails to overcome the threat
-stress is determined by assessment of whether personal resources are sufficient to meet demands of environment
-more than adequate resources= little stress
-sufficient resources w/ effort= moderate stress
-non-sufficient resources= high stress
-SAM- Sympathetic adrenomedullary system
-Cannon's "fight-or-flight" response
-Selye's General Adaptation Syndrome
-body's resistance to harm from invading organisms is called immunity
-Disorders related to the immune system: AIDS, lymphangitis, lymphadenitis, tonsilitis, Lymphoma, mononucleosis
-STDs- most common and problematic
-testicular cancer (men)
-gynecologic cancers (women)
-amenorrhea: absence of menses
-oligomenorrhea: infrequent menstruation
-fertility problems (affects approximately 7% of US couples)
-development of the reproductive system is controlled by the pituitary gland
-female: 2 ovaries (located in the pelvis)
-Urinary Tract Infections (UTI's)
-Acute glomerular nephritis: inflammed glomeruli of the kidneys
-Tubular necrosis: destruction of the epithelial cells in the tubules of the kidneys
-Kidney Failure: severe disorder
-measure of dispositional optimism
-aimed at identifying generalized expectations that outcomes will be positive
-general expectations that outcomes will be positive
-optimists=less stress & depression, more social support
-positive mood can lead to a state of physiological resilience
-optimism is assoc w/ more usage of problem focused coping
-examples: noise; crowding; a bad relationship; important job interview; big exam
-kidneys, ureters, urinary bladder, & urethra
-critically important in metabolism
-kidneys regulate bodily fluids & produce urine
-ureters contract muscles & move urine to the bladder
-urethra conducts urine from bladder out of body
Part of the metabolic system; responsible for the regulation of bodily fluids and the elimination of wastes; regulates bodily fluids by removing surplus water, surplus electrolytes, and waste products generated by the metabolism of food.
-Gastroenteritis, Diarrhea & Dysentery
-Peptic Ulcer: open sore on stomach lining or duodenum
-Hepatitis: "inflammation of the liver"
-A,B,C,D, & E
-converts food (thru process of metabolism) into heat & energy; supplies nutrients for growth & tissue repair
-digestion=food conversion process
-includes esophagus, gallbladder, liver, stomach, pancreas, appendix, rectum, duodenum, colon
-Asphyxia, Anoxia, and Hyperventilation: typically short-lived
-Hay fever: seasonal allergies
-Asthma: > 130 mill worldwide
-Viral infections: ie influenza
-Bacterial infections: ie strep throat
-includes nose, mouth, pharynx, trachea, diaphragm, abdominal muscles & lungs
-Respiration (breathing) has 3 main functions:
1) take in oxygen
2) excrete carbon dioxide
3) regulate composition of the blood
-Atherosclerosis: major cause of heart disease
-Rheumatic fever: bacterial infection
-high blood pressure
-Leukemia: bone marrow disease
-Leukopenia- white blood cell deficiency
-Leukocytosis: excess WBCs
-Anemia: red blood cell deficiency
-transport system of the body
-heart, blood vessels & blood
-carries oxygen, waste, nutrients, hormones, etc
-heart acts as a pump & causes blood to circulate throughout the body
-2 phases of cardiac cycle: systole & diastole
-Diabetes: body can't manufacture/properly use insulin
-Type 2 is more common & less severe than Type 1
-3rd most common chronic illness in the US
-leading cause of blindness among adults
-Longitudinal Research- observe same group over long period of time
-Retrospective Research- look back in time to try & reconstruct conditions leading to a current situation
-3rd variables-why correlation doesnt imply causation!
-Mediating Variable: helps explain relationship between 2 other variables
-Moderating Var: qualitative or quan. variable affecting direction or strength of relation between 2 other variables
-Ancient Prehistory: mind & body seen as intertwined
-Ancient Greeks one of 1st civs to identify role of bodily factors in health
-Middle Ages: disease= punishment from God
-1600s- many scientific advancements
-1800s- rise of modern psych
-complements the Nervous System in controlling bodily activities
-mainly governs slow-acting responses of long duration
-regulated by the hypothalamus & pituitary gland
A bodily system of ductless glands that secrete hormones into the blood to stimulate target organs; interacts with nervous system functioning.
-Epilepsy: >3 mil ppl in the US (disease of the CNS)
-Cerebral Palsy: >500,000 ppl in US
-Polio: viral disease that attacks the spinal nerves
-Paraplegia & Quadriplegia
-Central Nervous System: brain & spinal cord
-Peripheral NS: rest of the body's nerves
-complex network of interconnected nerve fibers
-sensory NFs: provide input to CNS
-motor NFs: provide output from CNS to muscles & other organs
The system of the body responsible for the transmission of information from the brain to the rest of the body and from the rest of the body to the brain; it is composed of the central nervous system (the brain and the spinal cord) and the peripheral nervous system (which consists of the -remainder of the nerves in the body).
-causal effects vs. correlations
-diversity in the sample
-potential third variables
-Dunbar (1930s) & Alexander (1940s) helped shape this
-linked patterns of personality (rather than a single specific conflict) to illnesses
-argument that conflicts produce anxiety which becomes unconscious & takes a physical toll on body
A field within psychiatry, related to health psychology, that developed in the early 1900s to study and treat particular diseases believed to be caused by emotional conflicts, such as ulcers, hypertension, and asthma. The term is now used more broadly to mean an approach to health-related problems and diseases that examines psychological as well as somatic origins.
-says specific unconscious conflicts can produce particular physical disturbances that symbolize psychological conflicts
-patient converts conflict into a symptom & therefore becomes free of anxiety from the conflict
The viewpoint, originally advanced by Freud, that specific unconscious conflicts can produce physical disturbances symbolic of the repressed conflict; no longer a dominant viewpoint in health psychology.
-ex. patient converts the conflict into a symptom via the voluntary nervous system; becomes free of anxiety the conflict would otherwise produce
-biological-hand but no other part of hte arm, loses sensation
-Changing patterns of illness
-Advances in technology & research
-Expanded Health Care Services
-Increased Medical Acceptance
-Short term behavioral interventions to help patients manage pain, modify health habits, etc
1) Health is determined by both micro and macrolevel processes
2) multiple factors are involved in health & illness
3) mind & body aren't separated when considering matters of health & illness
4) emphasis on both health & illness
-Reductionism: reduces illnesses to low-level processes
-Single-factor model: doesnt recognize a variety of factors may be involved in illness development
-Mind-Body Dualism: mind & body seen as separate
-Emphasis on illness over health promo
-dominant model for health practitioners the past 300 yrs
-explains all illnesses on the basis of aberrant somatic bodily processers
-assumes that psychological & social processes are largely irrelevant to the disease process
-idea that mind & body together determine health & illness
-Systems Theory: all levels of organization in any entity are linked hierarchically (change at one level influences change at other levels)
-connection between vaccines & autism
-"natural immunity" vs. vaccines
-self-focused cognitive activity
-individuals passively focus on their distress & its related symptoms and consequences
-has been related to severe & prolonged periods of depression
-used more often by women than men
-physiological consequences of chronic stress
-physical wear & tear on the body from ongoing efforts to maintain stability in response to stressors
-positive emotions (love, joy, interest, etc) broaden ones thought action repertoire
-builds enduring personal, psychological & social resources
-related to psychological resiliency & emotional well-being
-opposite w/ negative emotions
-Approach (confrontative, vigilant): gathering information or taking direct action
-Both styles have their advantages & disadvantages
-men more likely to report stressors of financial strain & work stress
-women more likely to report stressors of adverse changes in the home
-religion can promote sense of psychological well-being
-Religion helpful in coping w/ a stressful event bc:
1) provides a belief system that lessens distress & helps ppl find meaning in stressful events
2) provides source of social support
-Questionnaires: most frequently used method
-The Ways of Coping Checklist & the COPE are the measures most used w/ adults
-can be dispositional or situation specific measurements of coping
-Pain Behaviors- behaviors that arise bc of chronic pain (ex: limping)
-Nature of Pain
-critical for survival
-gives low-level feedback about functioning of our bodily systems
-pain as basis for making minor adjustments, often done unconsciously
-is the symptom most likely to lead someone to seek treatment
-no drug can be marketed in the US until it's evaluated against a placebo
-Double blind experiment
-Anxiety: increases difficulty to focus attn and process/retain info
-Lack of med knowledge
-Age: as ppl age the # of med. problems usually increases but abilities to present complaints & follow treatment decreases
-30 mill. adults (14%) have "below basic" level of prose literacy
-over 1/3 of English-speaking patients have low health literacy
-Alternative presentation of info can help sometimes
-the information-motivation-behavioral skills model shows that to practice good health behavior and adhere to treatment, one needs:
-the right info
-motivation to adhere
-skills to perform the behavior
-postcards or phone calls to patients reminding of appt
-reduced amt. of time btwen appts
-writing down treatment recommendations & testing patient understanding
-giving info sheet about treatment
-take home pill-calendars
-warm & confident care perceived as competent
-satisfaction declines when physicians express uncertainty about a condition
-ppl often judge inadequacy of care by irrelevent critera to its technical quality
-med office setting doesnt promote effective communication
-patient may experience physical discomfort as well as anxiety/embarrassment
-provider is under time constraints and must obtain important info within that time
-until a few decades ago this was what most Americans received healthcare thru
-paid directly on a visit-by-visit basis
-each visit followed by a bill, typically paid out of patient's pocket
-until a few decades ago the majority of Americans received healthcare thru private physicians
-pd directly on a visit-by-visit basis
-pre-pd financing & delivery system
-Employer pays an agreed on monthly rate & employee is entitled to use services @ no addit. cost
-arrangement is called managed care
-more than 69 mill. Americans now receive healthcare this way
-setting barriers (time constraints, uncomfortable circumstances, etc)
-jargon use by physician/talking baby talk
-patient tude & knowledge
-medical jargon: too complex for patient to understand
-baby talk: using simplistic explanations
-non-person treatment: depersonalization of patient
-stereotypes: having negative perspectives on certain types of patients
-structure is organized very much like any other hierarchal bureaucracy
-admin. at top; physicians, nurses, & technicians as employees
-private hospitals have 2 lines of authority: medical and administrative
-Goals: cure, care, & core
-adverse reactions in some hospitalized children (ie social withdrawl, extreme fear, etc)
-personnel must recognize childs need for play and provide opportunities for it
-must prepare kids for the experience if possible (ex: coping skills prep)
-Associated with aspects of the treatment regimes:
-length of time
-interferance with other desirable behaviors in a persons life
-Anglos report symptoms that occur infrequently (like new pain)
-Mexicans report symptoms that occur frequently (like diarrhea)
-culture diff. in symptom experience & reporting has been recognized for decades but reasons arent fully understood
-people's concept of health & illness that influence how they react to symptoms
-acquired through media, personal experience, & family/friends whove had experience w/ particular disorders
-include basic info about an illness
-Age: baby and elderly use most often
-Gender: women more than men (partly bc of pregnancy)
-Social Class & Culture: lower SES use less often (less $)
-Social psych factors: attitudes and beliefs of individuals about symptoms and services
-using healthservices for emotional disturbances (est. 2/3 patients w/ psych complaints rather than med)
-Delay Behavior: putting off seeking treatment for a symptom (major factor: perceived expense; more common with ppl who dont regularly see a dr)
-lower SES use med services less
-poor ppl have less $ for services
-Medicare/Medicaid/etc helping with this
-not as many high quality med services avail. to the poor
-services the poor have are often inadequate & understaffed
-new/increased use of med tech contributes 40-50% of annual cost increases
-reducing use will involve a large cultural shift bc cutting use of tech will seem wrong to many
-focus on prevention will result in less disease/problems in the long run
-US spends more on healthcare than others
-has had one of the highest growth rates in healthcare spending
-ppl pay more in the US for services than other countries
-US quality of care not superior overall
-access not substantially better
-appraisal delay: time to decide symptom is serious
-illness delay: time btween recognize & deciding to seek treatment
-Behavioral delay: time btween deciding 2 get treated & seeking
-Medical Delay: time btween making appt & med care
-health insurers limiting doctors you can visit
-also ration thru copays, deductibles, etc (encourages self ration)
-denying certain services/reimbursements for services
-gov. rationing thru medicare/etc
-ex: limit on amt spent on prescriptions
-healthcare disparities between social classes
-cost of services
-health services for children and elderly
-drugs used to alter birth process vs. natural
-idea that women cant give birth w/o help vs. simply providing a support system for the process
-Doctors make most decisions vs. empowerment of women to make decisions regarding the birth
-high c-section rate
-doctor's preferences in the birth process not always what's best
-idea that women cant handle own birth
-interventions during labor (drugs to make contractions stronger, epidurals to ease pain, etc)
-absence of midwives
-2-3 women die everyday in the US during pregnancy/childbirth
-esp. minorities, ppl in poverty, immigrants, NAs
-lifetime risk of maternal death greater in US than almost all industrialized nations
-mostly preventable w/ adequate maternal care
-reconceptualize problem from overwhelming to manageable
-enhance expectations of successful training
-client role is to be active, resourceful, and competent
-monitor maladaptive cognitions & stop negative self-talk
-taught specific behaviors
-Pharmacological- most common (ex: Morphine)
-Surgical: often only temp. relief
-Sensory control (ex: counterirritation)
-Cognitive (ex: biofeedback, positive thoughts)
-pain-prone personality: variety of personality traits that predispose a person to experience chronic pain
-personality correlates associated with chronic pain: neuroticism, introversion, use of passive coping strategies
-MMPI: Minnesota Multiphasic Personality Inventory
-Chronic pain patients show elevated scores on: ("neurotic triad")
-also assoc. w/ anxiety, substance use disorders, & etc.
A defense mechanism by which people avoid the implications of an illness. It is a common reaction to chronic illness that has been observed among heart patients, stroke patients, and cancer patients.
Functional somatic syndromes
Refers to involvement of the patient in all aspects of a chronic illness and its implications, including medical management, changes in social and vocational roles, and coping.
The viewpoint that illness can be -explained on the basis of aberrant somatic processes and that psychological and social processes are largely independent of the disease process; the dominant model in medical practice until recently.
Measuring two variables and -determining whether they are associated with each other. Studies relating smoking to lung cancer are correlational, for -example.
A research strategy in which people are followed forward in time to examine the relationship between one set of variables and later occurrences. For example, prospective research can enable researchers to identify risk factors for diseases that develop at a later time.
The view that all levels of an organization in any entity are linked to each other hierarchically and that change in any level will bring about change in other levels.
health psychologists concerns
1. health promotion and maintence
-2. study psychological aspects of prevention and treatment of illness
-3. etiology and correlates of health, illness, and dysfunction
3.health care system and the formulation of health policy
The absence of disease or infirmity, coupled with a complete state of physical, mental, and social well-being; health psychologists recognize health to be a state that is -actively achieved rather than the mere absence of illness.
1. reductionistic model. reduces illness to low level processes, such as disordered cells and chemical imbalances, rather than recognized cells and chemical imbalances, rather than reocgnizing the role of more general social and psychological processes.
2.single-factor model. explains illness in terms of biological malfunction rather than recognizing that a variety of factors, only some of which are biological may be responsible for the developmental of illness.
3. assumes mind-body dualism, maintaining that mind body are separate entities.
4. emphazes illness over health.
Two small glands, located on top of the kidneys, that are part of the endocrine system and secrete several hormones, including cortisol, epinephrine, and norepinephrine, that are involved in responses to stress.
A fast-acting immunologic reaction mediated by B lymphocytes that secrete antibodies into the bloodstream; effective in defending against bacterial infections and viral infections that have not yet invaded the cells.
The part of the forebrain responsible for regulating water balance and controlling hunger and sexual desire; assists in cardiac functioning, blood pressure regulation, and respiration regulation; plays a major role in regulation of the endocrine system, which controls the release of hormones, including those related to stress.
The body's resistance to injury from invading organisms, acquired from the mother at birth, through disease, or through vaccinations and inoculations.
A procedure in which blood is filtered to remove toxic substances and excess fluid from the blood of patients whose kidneys do not function properly.
The drainage system of the body; believed to be involved in immune functioning.
-tissue throughout body.
-capillaries drain water, proteins, microbes into vessels to nodes which filter out microbes, and other foreign material for ingestion by lymphocytes. vessels then drain any remaining substances into the blood
The part of the hindbrain that controls autonomic functions such as regulation of heart rate, blood pressure, and respiration.
Chemicals that regulate nervous system functioning
nonspecific immune mechanisms
The part of the nervous system responsible for vegetative functions, the conservation of energy, and the damping down of the effects of the sympathetic nervous system.
The process by which phagocytes ingest and attempt to eliminate a foreign invader.
A gland located at the base of and controlled by the brain that secretes the hormones responsible for growth and organ development.
Small disks found in vertebrate blood that contribute to blood coagulation.
The part of the hindbrain that links the hindbrain to the midbrain and helps control respiration.
specific immune mechanisms
The portion of the forebrain responsible for the recognition of sensory stimuli and the relay of sensory impulses to the cerebral cortex.
The tendency to cope with stressful events by tackling them directly and attempting to develop solutions; may ultimately be an especially effective method of coping, although it may -produce accompanying distress.
The tendency to cope with threatening events by withdrawing, minimizing, or avoiding them; believed to be an effective short-term, though not an effective long-term, response to stress.
The beneficial effects that are thought to result from successful coping; these include reducing stress, adjusting more successfully to it, maintaining emotional equilibrium, having satisfying relationships with others, and maintaining a positive self-image.
The theory that coping resources, such as social support, have beneficial psychological and health effects under conditions of both high stress and low stress.
Support received from another person that is outside the recipient's awareness.
The perception that one has at one's disposal a response that will reduce, minimize, eliminate, or offset the adverse effects of an unpleasant event, such as a medical procedure.
A global evaluation of one's qualities and -attributes.
Skills for learning how to use one's time more effectively to accomplish one's goals.
The clinical practice of counseling people who are dying on the basis of knowledge of reactions to dying.
Care designed to cure a patient's underlying disease.
Programs designed to inform people -realistically about death and dying, the purpose of which is to reduce the terror connected with and avoidance of the topic.
Ending the life of a person who has a painful terminal illness for the purpose of terminating the individual's suffering.
A response to bereavement involving a feeling of hollowness and sometimes marked by preoccupation with the dead person, expressions of hostility toward others, and guilt over the death; may also involve restlessness, an inability to concentrate, and other adverse psychological and physical symptoms.
Care for dying patients in the home; the choice of care for the majority of terminally ill patients, though sometimes problematic for family members.
An institution for dying patients that encourages personalized, warm, palliative care.
A will prepared by a person with a terminal illness, requesting that extraordinary life-sustaining procedures not be used in the event that the person's ability to make this decision is lost.
Care designed to make the patient comfortable, but not to cure or improve the patient's underlying disease; often part of terminal care.
Death that occurs before the projected age of 75.
A theory, developed by Elisabeth Kübler-Ross, maintaining that people go through five temporal stages in adjusting to the prospect of death: denial, anger, bargaining, depression, and acceptance; believed to characterize some but not all dying people.
A common cause of death among infants, in which an infant simply stops breathing.
The sense that one is leaving a lasting impact on the world, as through one's children or one's work, or that one is joining the afterlife and becoming one with God.
Medical care of the terminally ill.
the physician and other medical staff should help the patient use his or her remaining time as well as possible
those who study death and dying
The perception of pain.
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