HEALTH PSYCHOLOGY

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HEALTH PSYCHOLOGY
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What is Health Psychology?

• Contributes to
• The promotion and maintenance of health
• The prevention and treatment of illness
• The identification of the causes of illness
• The analysis and improvement of healthcare systems

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Areas of Health Psychology

• Predicting healthy behaviour
• Compliance with healthcare advice
• Communicating with health professionals
• The psychology of illness
• Stress and coping
• The psychology of pain

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Predicting Healthy Behaviour

• Health locus of control
• Unrealistic optimism

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Health Locus of Control

• 1. If I take care of myself, I can avoid illness
  (Internal)
• 2. Whenever I get sick it is because of something
  Ive done or not done (Internal)
• 3. Good health is largely a matter of good
  fortune (External)
• 4. No matter what I do, if I am going to get sick
  I will get sick (External)
• 5. Most people do not realise the extent to which
  their illnesses are controlled by accidental
  happenings (External)
• 6. I can only do what my doctor tells me to do
  (External)
• 7. There are so many strange disease around that
  you can never know how or when you might pick one
  up (External)
• 8. When I feel ill, I know its because I have
  not been getting the proper exercise or eating
  right (Internal)
• 9. People who never get sick are just plain lucky
  (External)
• 10. Peoples ill-health results from their own
  carelessness (Internal)
• 11. I am directly responsible for my health
  (Internal)

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Health Belief Models

• The Health Belief Model (HBM) (Rosenstock, 1966)
• The Theory of Planned Behaviour (Fishbein
  Ajzen, 1975)

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The Health Belief Model (HBM)

• An individual will take preventative health
  action if
• They feel susceptible to disease through genetic
  factors
• They believe an illness could have serious
  consequences
• They think preventative action will be beneficial
• They believe the costs (such as pain) do not
  outweigh the benefits of the health action

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The Health Belief Model
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Theory of Planned Behaviour

• Health intentions are determined by
• Personal attitudes towards a behaviour (e.g. I
  will enjoy giving up smoking because I will save
  money)
• Beliefs about what is an acceptable way to behave
• Beliefs about whether the behavioural goals can
  be achieved

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Theory of Planned Behaviour
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Communication Compliance

• Good health is dependent on
• Whether we decide to seek professional medical
  help for our illness symptoms
• How we communicate our symptoms to health
  professionals

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DoctorPatient Communication

• During GP consultations
• Over 60 of all psychosocial or psychiatric
  problems are missed
• Over 50 of a patients symptoms fail to be
  identified
• Around 50 of all consultations end in
  patientdoctor disagreement about symptoms

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Consultation Guidelines (Pendleton et al., 1984)

• Reason for patients attendance needs to be
  defined
• Consider problems other than those mentioned by
  patient
• Choose appropriate action for each problem
• Achieve shared understanding of problem with
  patient
• Involve patient in management of problem
• Use time and resources effectively
• Try and ensure achievement of future goals

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Patient Compliance

• Patient satisfaction and compliance derives from
• The doctor appearing friendly
• The doctor appearing to understand the patients
  concerns
• The patients expectations of success
• The doctor being a good communicator
• The doctor providing full and clear information

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Leys Model of Compliance
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Psychosomatic Illness

• The physical effects of stress
• Reduced numbers of lymphocytes
• Reduced levels of antibodies
• The psychological effects of stress
• Increases desire to smoke
• Increases consumption of alcohol
• Increases tendency to eat

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Definitions of Stress

• External or environmental forces that create a
  stressful reaction (e.g. difficulties at work)
• Something experienced by the individual (e.g.
  feelings of tension or pressure)
• A physiological reaction affecting the autonomic
  nervous system (ANS)

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Stress and Life Events

• Stressful life events
• Daily hassles

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Life Event Stressors (Moos Swindle, 1990)

• Health stresses and medical conditions
• Home and neighbourhood stressors (e.g. safety,
  cleanliness)
• Financial stressors
• Work stressors
• Spouse/partner stressors
• Child stressors (e.g. childcare problems)
• Extended family stressors (e.g. caring for ill or
  elderly relatives)
• Friend stressors (e.g. maintaining relationships
  with friends)

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Coping with Stress

• Transactional models (e.g. Lazarus Folkman,
  1984)
• Primary appraisal
• Secondary appraisal
• Cognitive coping strategies (e.g. Davey
  McDonald, 2000)

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Cognitive Coping Strategies

• Downward comparison This is not as bad as the
  things that happen to other people they are
  much worse off than me reduces the relative
  impact of the stressor
• Positive reappraisal I will come out of this
  experience better than I went in redefines the
  stressor as a challenge from which personal
  growth is a positive outcome
• Cognitive disengagement This situation isnt
  worth getting upset about downgrades the
  stressor as something that is irrelevant
• Optimism Everything will work itself out OK in
  the end reduces the impact of the stressor by
  focusing on a positive rather than negative
  outcome
• Faith in social support I have others who can
  help me through this focuses on a positive
  outcome based on existing support and resources
• Life perspective I can put up with this as long
  as everything else in my life is OK reduces the
  relative impact of the stressor by comparing it
  with positive features of life

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Pain

• Gate control theory (Melzack Wall, 1965)
• Cognitive models

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Gate Control Theory of Pain