307 study guide Flashcards
Health Behaviours
Any activity undertaken for the purpose of preventing or detecting disease, or for improving health and well-being
Classification of Health Behaviours
Health enhancing behaviours –> e.g., exercise, healthy eating
Health protective behaviours –> screening behaviours, vaccination, safer sex
Avoidance of health / harming behaviours –> smoking, binge drinking
Illness behaviour –> seeking advice about symptoms
Sick-role behaviour –> e.g., treatment, adhering to medication regimes
What risk factors impact our health?
The five risk factors that caused the most disease burden in Australia in 2018 were:
1. Tobacco use
2. Overweight and obesity
3. Dietary risks
4. High blood pressure
5. Alcohol use
Individual barriers to positive health behaviour
–> enjoyment of potentially adverse behaviours
–> no immediate adverse effects
–> effort involved in change
–> fear / denial
–> false consequences
–> unrealistic optimism
–> fatalism
Health Belief Model
Postulates that behaviour depends on two subjective assessments which are informed by two key beliefs:
1. Threat perception
–> perceived susceptibility to illnesses (will I get this?)
–> perceived severity of consequences of illnesses (if I get it, how bad will it be for me?)
2. Behavioural evaluation (i.e., effectiveness of action)
–> benefits of health behaviours
–> barriers to performing the health behaviour
Protection motivation theory
created to understand how humans respond to fear appeals. the protection motivation theory proposes that people protect themselves based on two factors:
1. threat appraisal
2. coping appraisal
theory of planned behaviour
–> perceptions of control over performing the behaviour, comprised of:
–> Perceived control (control over performing the behaviour)
–> Perceived self-efficacy (ease / difficulty in performing the behaviour)
Prototype / willingness model
Dual-process approach:
1. reasoned pathway –> deliberate route involving analytic processing: attitude and subjective norm
- intention leads to behaviour
2. social-reaction pathway –> more heuristic processing: prototypes - willingness leads to behaviour
Health action process approach
–> overlap with theory of reasoned action and theory of planned behaviour but includes a focus on the intention-behaviour gap
–> focus on post-intentional processes of:
–> Planning: action and coping planning
–> Self-efficacy: maintenance and recovery self-
efficacy
–> also action self-efficacy, outcome expectancies, and risk perception as predictors of intention and action control’s role on behaviour where behaviour is continuously evaluated regarding a standard (like self-monitoring)
Transtheoretical model
Precontemplation – not thinking about changing behaviour; unaware that health issues exist
Contemplation – aware of issue; considering change within next several months, but not ready to make a commitment
Preparation – ready to try and change and plan to pursue a behavioural goal within next month
Action – active efforts to change behaviour for around 6 months
Maintenance – maintain behaviour change and avoid temptations to return to old habit
Health behaviour change
Primary prevention –> actions taken to avoid disease or injury
Secondary prevention –> actions taken to identify and treat an illness or injury with the aim of stopping or reversing the problem
Tertiary prevention –> actions to contain or slow damage caused by serious injury or disease to prevent disability or rehabilitation
Persuasive health messages
Persuasion: form of social influence in which one peson uses an appeal to change the attitudes and behaviours of another person
Health messages can be processed in two ways
(1) central processing route –> motivation and ability to focus on and evaluate the content and strength of the arguments
(2) peripheral route of processing –> focus on cues (e.g., credibility of the source) instead of the strength of the arguments or ideas in the message
Using fear appeals to promote health
Fear appeals: threatening or fear arousing messages are usually unsuccessful in changing attitudes
protection motivation theory was developed to understand the role of fear appeals and persuasive communication in behaviour change
may be successful if the content includes information on:
- Seriousness of physiological and social consequences
- Behavioural recommendations – a behavioural strategy will be successful in managing the health problem
- Self-efficacy information – person is capable of performing the behaviour
Conscientiousness and health
Conscientiousness = prudent, dependable, well organised, persistent etc.
Shown to be associated with:
- Reduced disease development
- Better coping
- Fewer symptoms
- Increased longevity
Optimism and health
Optimism = positive expectations, confidence to cope with challenges. This is consistently linked with better health outcomes as individuals are more likely to set goals, and respond to challenges (e.g., illness)
Self-efficacy
Self-efficacy is often incorporated into studies to explain how thought links to behaviour.
self-efficacy is an important predictor for self-care behaviours (e.g., checking blood sugar levels, dietary plans)
Locus of control
The extent to which an individual believes they have control over their body
Biological determinants of health
–> sex hormones can modulate the immune response
–> biological explanations of women’s longevity
- Protective effects of oestrogen
- Physiological systems associated with
childbearing hypothesised to lower risk of CHD
prior to menopause
Social/behavioural determinants of health
Drinking, smoking, drug use, diet, risky driving, risky sexual activity, employment in hazardous occupations (men are more likely to engage in these things than women).
Australian Aboriginal health beliefs
Diverse cultures and traditions. Common beliefs: health is interconnected with land, kinship obligations, and spiritual beliefs
Health practices: bush medicine and traditional healers
Aboriginal health promotion
–> culturally informed health promotion
- Broader notions of family than in Anglo-
Australian society
- Strong community networks
- Acknowledgement of diversity
Treatment delay
–> time between when a person first notices a symptom and medical care commences
–> stages of treatment delay
1. Appraisal delay – less likely to delay if in pain or bleeding
2. Illness delay – time taken between recognising one is ill and deciding to seek medical attention
3. Utilisation delay – time taken after deciding to seek medical advice and actually going to use the health service
Types of non-compliance with healthcare interventions
–> taking too much medication
–> taking too little medication
–> not taking medication at the correct intervals
–> not taking medication for long enough
–> taking additional, non-prescribed medicine
Stress
A negative emotional experience accompanied by predictable physical, psychological, and behavioural responses directed at alleviation or accommodation
Stressor = stimulus that contributes to stress
General response to stress
–> fight or flight = activation of sympathetic nervous system
–> tend and befriend = affiliation / nurturing
General adaptation syndrome
Early theory of stress. Rats exposed to a variety of stressors exhibit the same physiological changes. The stress response is therefore nonspecific in relation to the stressor. Provides a general theory of reactions to a wide range of stressors and explains a stress-illness relationship
Stress and illness
stressful life events associated with disease progression and mortality. this may be mediated by rather than directly resulting from stress:
Stressed people:
- More likely to engage in hazardous health behaviour (e.g., heavy smoking) - > illness
- Less likely to comply with protective health behaviours (e.g., medication adherence)
Coping
Thoughts and behaviours used to managed internal and external demands
Coping strategies
can be maladaptive (negative) or adaptive (positive)
Two main groups:
1. Problem-focused coping
2. Emotion-focused coping
Integration of social support is important –> reduces likelihood of illness and adverse life events
The process is coping with an illness
1 – cognitive appraisal - how serious is this task?
2 – adaptive tasks - dealing with pain / symptoms / hospitalisation / treatment
3 – coping skills
- Appraisal focused
- Problem focused
- Emotion focused
Classifications of pain
Nociceptive –> maintained by continual tissue injury (somatic, visceral
Non-nociceptive –> neuropathic, idiopathic (psychogenic)
Acute pain
Temporary discomfort lasting less than 3 months. Actual / potential tissue damage, corresponds to a common sense view of pain
Chronic pain
Discomfort lasting more than 3 months. Different types:
–> Chronic recurrent pain: intense, but not
continuously present
–> Chronic intractable pain: intensity varies
–> Chronic progressive pain: intensity increases
Chronic pain is more common in women than men
–> peaks in women for the 80-84 age group
–> peaks in men for the 65-69 age group
Gate control theory of pain
–> pain transmission is not direct from nociceptors to brain
accounts for:
- Variable relationship between severity of injury and amount of pain
- How pain does not necessarily require actual injury
- How pain can persist beyond physical recovery
- How the nature and location of pain can vary across time
Neuromatrix theory
–> further develops gate control theory
–> pain is more than a direct response to sensory input following injury
–> subjective experience of pain determined through integration of cognitive-evaluate, sensory-discriminative, and affective components
Fear-avoidance model of pain
–> pain usually originates with injury, strain, etc
–> its ongoing impact can depend upon how the original injury is dealt with
–> the FAM is useful for explaining chronic pain as it utilised three cognitive factors:
1. Attitudes and beliefs
2. Expectancies
3. Self-efficacy
Factors influencing perception of pain
- sex and gender norms
- women usually report more pain than men
- women experience more frequent episodes of pain
- women may feel pain more intensely
- men with strong traditional masculine role beliefs more likely to have stronger pain thresholds
- lesbian and bisexual women reported higher pain threshold and tolerance than heterosexual women in similar study
- women who report pain treated differently by health professionals
Pain assessment
Important for things like:
–> Differential diagnosis
–> Pain control
–> Treatment success
4 categories of assessment:
1. Physiological e.g., Muscle tension
2. Pain questionnaires e.g., McGill Pain Questionnaire (MPQ)
3. Mood assessment questionnaires e.g., Pain Anxiety Symptoms Scale (PASS)
4. Observational e.g., Facial Action Coding System (FACS)
Chronic illness in Australia
Conditions with long-lasting and persistent effects: physical, social, economic, and quality of life.
Major types: arthritis, asthma, back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, mental health conditions
Impact of chronic illness
- functioning (physical, psychological, social)
- quality of life
- pain
- fatigue
- anxiety
- depression
Emotional impact of chronic illness
Emotional consequences common impact of chronic illnesses –> denial, anxiety and depression
Physical interventions
pharmacological – antidepressants commonly used
psychotherapy – different approach to treating mental illness
- Episodic rather than continuous
- Works with an individual’s psychological
defences
- Therapists require high level of understanding
about condition and treatment
–> Brief interventions can be effective – e.g., telephone-based support, websites about coping
Social interventions
Social support associated with improved outcomes.
promotes the use of support groups
Dying and mental health
Increases prevalence of depression - especially as the illness progresses. This depression is said to be associated with:
- increased risk of death
- prolonged hospitalisation
- reduced quality of life
- increased suicidality and requests to hasten
death
–> increases prevalence of anxiety can be associated with the confronting condition / prognosis. This is problematic when it interferes with functioning and quality of life
Culture and death
There is cultural diversity when it comes to death and the talk about death and dying. Understanding of different cultural contexts are important.
Children and death
Even young children can development understandings about death, particularly when they are exposed to healthcare settings where they can witness death.
Promoting ‘good death’ in Australia
‘good death’ focuses on 6 components:
1. pain and symptom management
2. clear decision making
3. preparing for death
4. completion
5. contributing to others
6. affirmation of the whole person
promoting ‘good death’ in Australia:
- promote public discussions about the limits of health care as death approaches, and what Australians want for the end of life
- increase planning of individual end-of-life choices to support improved compliance with choices
- increase compliance with an individual’s expressed choices
- reorientation services providing end-of-life care to focus on people’s wishes to die at home and homelike settings rather than institutions
Advanced care planning
Advance care planning enables individuals to define goals and preferences for future medical treatment and care, to discuss these goals and preferences with family and health-care providers, and to record and review these preferences. This enhances the quality of life and the end of life care.
Palliative care
An approach that improves the quality of life of patients and their families through facing problems associated with life-threatening illnesses, through the prevention and suffering by means of early identification and assessment of treatment of pain and other problems.
Salutogenesis and Pathogenesis
Salutogenic conceptualisation of health:
- what influences positive health outcomes?
- what helps people adopt and maintain positive health behaviours
Pathogenic conceptualisation of health:
- what influences adverse health outcomes?
- what prevents people from adopting and maintaining positive health behaviours
Tobacco smoking
Tobacco smoking remains one of the largest preventable causes of death in Australia.
Increases the risk of:
- heart disease
- diabetes
- stroke
- cancer
- kidney disease
- eye disease
- respiratory conditions
smoking rates are higher amongst certain population groups:
- adults with mental illness
- Indigenous Australians
Factors influencing tobacco smoking
psychological: personality (especially extraversion and neuroticism)
- Mental illness
- Stress
- Social – e.g., smoko breaks
- Conditioning (positive and negative
reinforcement)
biological:
–> Psychosociological effects = tranquilisation, weight loss, decreased irritability, increased alertness, improved cognitive functioning
–> Nicotine is highly addictive
Tobacco smoking interventions
pharmacological –> nicotine replacement therapy: gum, patches, nasal sprays etc
psychological –> target dependency through counselling
social –> e.g., buddy system
population / public health –> taxation, plain packaging, advertising campaigns
Health impact of alcohol consumption
Alcohol consumption is responsible for 5.3% of global mortality. Morbidity is due to neuropsychiatric disorders, gastrointestinal disease, cancer, injury, cardiovascular diseases, foetal alcohol syndrome.
Alcohol consumption in Australia
One in four Australians aged 18 and over exceed the Australian adult alcohol guideline.
Men are more likely than women to exceed the guidelines.
People born in Australia were almost twice as likely as those born overseas to exceed the guidelines
Alcohol interventions
Health promotion campaigns (although these are minimally effective)
Peer-interventions (e.g., alcoholics anonymous
Psychological interventions –> such as twelve-step facilitation therapy, cognitive behavioural therapy, motivational enhancement theory
Risk perception and vaccination
strong evidence that vaccination more likely when higher levels of:
- Perceived likelihood of getting an illness
- Perceived susceptibility to an illness
- Perceived severity of illness
–> parents are more likely to vaccinate their children than themselves
Physical effects of obesity
- respiratory disease
- stroke
- gall bladder disease
- hormone abnormalities
- cardiovascular issues
- diabetes
- osteoarthritis
- cancer
Adults are more likely to be obese than children
Set point theory
the point at which an individuals “weight thermostat” is set
when the body falls below this weight:
- An increase in hunger
- Lowered metabolic rate acts to restore the
lost weight
- Energy expenditure decreases
–> to maintain the body’s set point weight, your body adjusts not only food intake and energy output but also the metabolic rate (the body’s resting rate of energy expenditure).
Health at every size theory
Weight inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealising or pathologizing or specific weights
Health enhancement: Support health policies that improve and equalise access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional and other needs
Eating for well-being: Promote flexible, individualised eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control
Respectful care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities
Life-enhancing movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree they choose
Health at every size theory
Weight inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealising or pathologizing or specific weights
Health enhancement: Support health policies that improve and equalise access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional and other needs
Eating for well-being: Promote flexible, individualised eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control
Respectful care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities
Life-enhancing movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree they choose
Critical health psychology
Critically evaluates psychological theory and practice:
- Assumptions
- Social inequalities
- Power
- Diversity
- Discovery of objective facts vs upholding
predominant views
- Research methods
The individualism assumption in health psychology
individualism:
–> Western societies predominantly individualistic
–> Contributes to an assumption that individual health is predominantly influenced by individuals themselves
–> Psychology tends to downplay the role of social factors, institutions, etc or has them mediated by individual perception
An “ideology of individualism fits well with a discipline whose objective is the understanding of individual behaviour”
Epistemological assumptions
Social constructionism:
–> We understand our reality through ideas and ‘paradigms’
Relativism:
–> There are no grounds to assume a reality that is independent of us
Social power and health
health can be influenced via different levels (micro, meso, macro.
power differences exist at each level and power imbalances can influence health (e.g., mandated work practices, neoliberal market regulation).
Health promotion
Health promotion has contributed to health becoming a key cultural motif in identity construction –> being health linked to values and morals (and is an individual responsibility)
health psychology has traditionally ignored the relationship between health behaviours and moral identity –> potential for contributing to victim blaming
