Final Flashcards
health behavior is
any activity people perform to maintain or improve their health, regardless of their perceived health status
well behavior is
any activity people undertake to maintain or improve current good health and avoid illness. (checkups, getting vaccinations)
symptom-based behavior
is any activity people who are ill undertake to determine the problem and find a remedy (seeking advice from relatives or medical professionals).
sick-role behavior
refers to any activity people undertake to treat or adjust to a health problem after deciding that they are ill and what the illness is. (staying home from work)
Which type of health promotion programs are most effective in schools?
the programs that involve the children’s family and community over a long period
Pros in health promotion programs in school
they have access to virtually all children during the years that are the most critical time in the development of health-related behaviors.
Pros in health promotion programs in religious organizations
they can reach many minority and immigrant adults who are at high risk of serious illnesses
Health promotion programs at work (work wellness programs) include
fitness or diet challenges that have financial incentives
Why are wellness programs important to businesses
American workers with poor health habits cost employers substantially more in health benefits
problems promoting wellness
- healthy behaviors can be unappealing
- interpersonal factors- family/environment
- community factors-insufficient funding
Which is an important factor in determining whether a person will adopt a wellness lifestyle?
- encouraging few barriers to changing behaviors
- motivation to engage in the new behaviors
- knowledge and skills to change an existing behavior
Live for life
is a program that is designed to improve employees’ health knowledge, stress management, and efforts to exercise, stop smoking, and control weight.
For each participating employee, live for life provides
a health screen, showing a detailed assessment of the persons current health
community wellness programs
can address a variety of health issues such as exercise programs or preventative behavior, like drinking and driving
What represents a benefit of school health programs?
They help children establish healthy behaviors early.
Are we always able to maintain a healthy behavior, especially on the first try
No, however abstinence violation is not a reason to give up.
Hebb’s Axiom
neurons that fire together, wire together
Why may people find it hard to maintain healthy behaviors
-people relapse (on any behavior)
-change is messy and hard
-abstinence violation
abstinence violation
when people violate habits in a small way, they will just give up when the habit is not done perfectly (wrong way to maintain healthy behaviors)
efforts to reduce HIV infection
- safer-sex practices
- people should avoid having sex outside of long-term monogamous relationships
- get tested regularly
Factors contributing to unsafe behaviors that can lead to HIV and AIDS
- promiscuity
- intoxication (drugs or alcohol)
- youth are much more likely to engage in risky sex if their parents reject their sexuality
- LGB teens are more likely to abuse alcohol and engage in risky sex
- unmarried partners are less likely to use condoms if they perceive their relationship to be close
- social pressures (women may be embarrassed to buy condoms)
HIV prevention efforts
- education
- enhance interpersonal skills when engaging in sex
- training for specific skills
Safer Sex study
a study done between two groups. Both groups attended an AIDS education session, however one group were also taught self-efficacy regarding talking to potential partners about condom use. The intervention did significantly better in practicing safer sex for up to a year later compared to the control group. (control group also improved from their own results)
Adolescence is sometimes a difficult time for health because adolescent ____ ____ behavior increases
risk taking
addiction
condition occurs after repeated consumption of a substance
physical dependence
the body has incorporated substance into normal functioning (heroin, alcohol), when you need it to feel ok
tolerance
occurs as body adapts to substance
withdrawal
physical and physiological symptoms that occur when substance when stops or decreases
psychological dependences,dependence on the effect (weed)
substance use disorder and some criteria
must impair functioning:
1. increasing tolerance
2. wanting to cut down on use
3. failing to meet obligations
4. putting yourself and others at risk
5. substance related legal difficulties
6. withdrawal symptoms
levels of substance use disorder
mild: your symptoms match 2 or 3 of the criteria
moderate: symptoms match 4 or 5
severe: symptoms match 6 or more
Howard has developed a physical dependence on nicotine, which means
his body requires it for “normal” functioning and he’ll most likely experience withdrawal symptoms if he tries to quit smoking
Dependence-positive reinforcement
people feel rewarded when using the substance (feeling “buzzed”)
Dependence- negative reinforcement
removing an aversive feeling (stress is removed when drinking)
Classical conditioning
a conditioned stimulus (the smell of cigarette smoke) comes to elicit a response through association with an unconditioned stimulus (the substances effect, the “buzz” feeling)
classical conditioning is a
substance-related cue
examples of classical conditioning
seeing everyone at a party having a good time:
1. increases cravings (party associated with drinking)
2. activate neural pathways associated with behavior (activated a desire to drink)
3. (people having fun drinking= you will have fun drinking)
Steve grew up seeing his parents have fun at parties that included large amounts of alcohol. According the expectancy theory, Steve is likely to develop ___ attitudes toward alcohol via _____
positive; classical conditioning
Incentive Sensitization
dopamine increases when a person comes into contact with salient reminders of the substance, which compels the person to use more
Addiction and genetics
MZ’s are more likely to share an addiction compared to DZ’s
Tobacco was originally
thought to have medicinal properties
tobacco is the #1
controllable cause of death in the US
Why is smoking still legal?
Because it makes money
Who smokes?
-Less than 15% of the US population smokes
-most smokers develop habit in teens
-non-college attendees are more likely
Why do people smoke?
-low self-esteem
-weight gain
-perceiving low risk with high benefit associated with starting
In which ways has smoking been targeted to women?
-hunger suppressant
-high prestige models smoke
Factors in becoming a regular smoker
- at least one parent smokes
- percieved parental indifference
- friends/siblings who smoke
- thrill-seeking personality
- positive attitudes toward smoking
- belief that they can quit at will
Why would people smoke?
-teens who usually start (and have a positive interaction with it)
normative social influence
-peers and/or family
-high prestige models
Informational social influence
-knowing every consequence, so you do not partake in bad habits, like smoking
Tobacco smoke is
the only thing where nicotine naturally occurs
Niccotine is
-the addictive chemical in tobacco
-quickly travels to the brain
-increases alertness, heart rate, bp
Nicotine regulation model
A study which tested the idea that smokers will continue to smoke to maintain nicotine levels. Smokers who were given cigarettes with less nicotine, smoked a higher volume of cigarettes in order to maintain the normal level of nicotine they usually get.
How long does it take for nicotine to leave the system
half of the nicotine will be out of your system in two hours from time of use
Researchers have found that when habitual smokers are provided with low-nicotine cigarettes they:
smoke more to maintain their nicotine intake
smoking decreases
life expectancy and quality of life in older age
What is the worst single health behavior
smoking
Both ____ and ____ damage lungs
tobacco and marijuana
Compare the health overall between people who never smoked regularly and former smokers who stopped BEFORE 35
virtually the same, showing if you stop smoking tobacco or marijuana before the age of 35, you can continue to have good health
How does smoking affect the chances of lung cancer and heart disease
increases the chances of both
what are the substances identified in nicotine
nitrosamines- highly carcinogenic
PAH’s- linked to cancers of lung, mouth, esophagus, bladder, and kidney
Temperance movement
people realized the negative effects alcohol had on peoples behaviors in the 18th century, resulted in prohibition
Why was the 18th amendment repealed
Great Depression
Frugality by-hypothesis
evolutionary hypothesis that helps us understand why people enjoy drinking; primates would get “drunk” when consuming fermented fruit
The movement in America which advocated total abstinence from alcohol was called
temperance
Binge drinking is
5 or more drinks for men
4 or more drinks for women
Adolescent drinkers
are more likely to become heavy drinkers as they age
Alcohol use disorder’s criteria
1.drink heavily on regular basis
2. social/occupational impairment
3. frequently drunk
4. drink alone
5. drive under the influence
Why do people abuse alcohol?
- Social/cultural reasons
- Modeling after someone they admire
- Normative social influence
- Adolescent depression
Alcohol use and college intentions
Adolescents with no intention of attending a 4-year college abuse alcohol more and often than those who plan on attending a 4-year
positive reinforcement (alcohol)
liking the taste of a cocktail, or the feeling
negative reinforcement (alcohol)
drinking takes away stress
heavy drinkers show these characteristics (5) in general
-perceive fewer negative consequences
-experience higher levels of stress
-live in environments that encourage
-heredity and family history
-craving more after 1 drink
Fetal Alcohol Syndrome involves
impaired nervous system development, and cognitive and physical defects
Jim has had 5 glasses of beer and decides he needs to drive to the grocery store. He says that he always sobers up as soon as he gets behind the wheel. He is _____ the effects of alcohol on his ability to drive
under-estimating
Liver cells
can repair completely in 30 days
Alcohol can cause long term damage such as:
-decreased liver function
-cirrhosis
-heart and brain damage
Moderate drinkers have
lower morbidity/mortality than heavy or non-drinkers (matter of debate)
Stimulants
caffeine, meth, cocaine
depressants
benzos, barbiturates
hallucinogens
LSD, mushrooms
narcotics
opiates, morphine, fentanyl
Perhaps the most important medical benefit of a more patient-centered approach is
greater amounts of diagnostic information
Affective neutrality
cold, indifferent attitudes of doctors
healthcare utilization between different demographics
women want more medical information than men, and white people want more medical information than black and hispanic people
Doctor-centered style
just asking “yes” or “no” questions, rely on just medical jargon that patients may not be familiar with
patient-centered style
tend to ask more and open ended questions, result in more diagnostic information (good thing)
Patient behavior that is upsetting to doctors
- not following prescribed treatment
- waiting too long to seek treatment
- insisting on unnecessary tests
- making sexual advances
- asking doctor to certify an untrue disability
Adherence vs compliance
adherence and compliance are terms associated with doing recommended behaviors. Adherence is the preferred term, compliance is a neg. connotation and suggests “following orders”
Nonadherence problems
-acute needs= 67% do not take prescribed medications
-chronic needs= 50%
-Adherence higher on days before going to doctor
-Very low adherence to lifestyle changes
Why do patients adhere
hebbs axiom can help with lifestyle changes
-People more frequently adhere to medicine regimens
Why do patients not adhere
-treatment complexity
-ex: The more pills, vitamins required, the less chance they will have a willingness to change
Age, gender, sociocultural differences in medical adherence
Little evidence that adherence is associated with demographics
Special examples in adherence differences
-adherence is more difficult for childhood cancer patients because they are dependent on their parents
- adolescent diabetes are less compliant to diet restrictions because they do not want to be socially different
-women are less likely to use some medications if it lead to weight gain
Rational nonadherence
good reasons not to adhere or take advice from their doctors
examples of rational nonadherence
- feeling the medicine isnt working/helping
- side effects are very unpleasant
- confused over when and how much medicine to take
- lack of money (cannot pay for prescriptions)
most common reason for not taking medicine
forgetting
To increase chances of patients adhering, doctors can:
- have a “patient-centered” style
- have cultural sensitivity and competence
Cultural competence: Hmong
The Hmong believe each person has 12 souls, and a soul is stolen results in illness. Hmong ceremony
Increasing patient adherence: behavioral methods
- motivational interviewing
- recruiting social support
- tailor treatment regimens to make compatible with existing lifestyle
- make a treatment contract
- provide reminders
Prevention
psychological prep for surgery
- informational control- learning about procedure
- cognitive control-recognizing signs of anxiety
children in the hospital can suffer from
seperation distress
separation distress
occurs in very young children (around 15 months) when primary guardian is not present
how do hospitals help children cope
-puppets
-video presentations (ethan video-study)
-tours around hospital
why might children experience distress?
-seperation distress
-children with avoidant coping strategies
-prior negative experiences
what can help children in distress?
information presented shortly before procedure, and keeping the information light and easy to understand
What kind of ailments can patients have where health psychologists in the room help
-alcoholism (damage to liver)
-intense anger issues (cardiac problems)
-some patients have psychosocial problems resulting from illness (depression, anxiety)
Millon Behavioral Medicine Diagnostic
assesses psychosocial factors related to health such as
terminal illness is when doctors focus treatment on
palliative treatment- aim to provide comfort to a dying person
adaptive value of pain
helps us respond to survive
pain definition
organic pain
pain linked to tissue damage
psychogenic pain
many pains= failure to find an organic cause
discomfort caused by tissue damage is referred to as
organic pain
acute pain
temporary painful conditions lasting less than 3 months
chronic pain
ongoing over three months
chronic pain (psychological effects)
psychologically damaging, anxiety, hopelessness
how do pain and sleep interact
pain is associated with poor sleep
chronic recurrent pain
benign causes, recurring, intense periods of pain separated by pain free periods
chronic-intractable benign pain
persistent discomfort not related to a malignant condition
chronic-progressive pain
worsens over time as underlying cause worsens
nocicepeptors
afferent nerve endings send pain messages to brain
A-delta fibers
transmit pain feelings quickly
C-fibers
slower, associated with transmission of dull pain signals
A-beta fibers
touch fibers
C fibers are involved in
dull pain sensations
reffered pain
pain is originates in internal organs often manifest in other structures
neuralgia
shooting, stabbing pains along a nerve pathway (ex. shingles)
causalgia
recurrent severe pain often in areas of prior injuries (ex. a shoot wound)
phantom limb pain
amputees often report pain/sensation in limbs present
specificity theory
suggests pain has own area in brain, separate paths and nerves (not true)
pattern theory
pain perception shares same systems but different patterns of neural activity and different magnitudes of arousal influence pain. (not widely accepted)
Gate control theory of pain
neural gates open and close in varying degrees, these gates mediate pain signals sent to the brain, activity in pain fibers open gates, activity in peripheral fibers can inhibit gate openings
gate control theory explains
-why distraction can lessen pain
-positive emotions tend to close of limit pain gates
-stress/anxiety can open the gate, increasing pain
stimulation produced analgesia (SPA)
is a process where pain relief is achieved by applying electrical or other types of stimulation to certain areas of the brain, spinal cord, or nerves.
evidence for gate control theory of pain
-periaqueductal gray area: around the cerebral duct. when it is stimulated, it blocks pain signal
-stimulation to this brain region blocks pain signals
conditions that “open gates”
-extent of the injury
-overexertion
-anxiety/worry
-tension
-depression
-focusing on the pain
-boredom
conditions that “close gates”
-medication
-counterstimulation
-positive emotions
-resting/relaxing
-concentrating on something other than pain
-distraction
pain behaviors
- facial or audible expression (ouch)
- dis (walking around w a limp
3.nega affect (hostile, anxiety - activity avoidance (no wantin to ride a bike
social processes and pain in children
pain beha can be a bad strategy for parenting, distracting children from pain decreases pain behavior. overly protective parents often results in mire disabled be. by children
pain differs between sexes
women tend to have more headaches and low back pain
2 types of coping strategies for dealing wih pain
over beh stra
covert
overt behavioral strategies
rest, taking medications
covert beh. strategies
hoping and/or praying or diverting attention
changes in causes of death since the 1960’s
COPD increased greatly in the late 60’s due to smoking
primary prevention
consists of actions taken to avoid disease or injury, can be directed toward almost any health behavior
a local physician encourages his patients to eat an appropriate diet, exercise, not smoke, use seat bels, and get plenty of sleep. This doctor is encouraging
secondary prevention
tertiary prevention
involves actions to contain this damage, prevent disabiliy, and rehabilitate the patient
secondary prevention
actions taken to identify and treat an illness or injury early with the aim of stopping or reversing the problem. Include symptom-based behavior
hypertension
when someone has high blood pressure consistently over a period of several weeks or more.
health belief model
the likelihood that a person will take preventative action depends directly on the outcome of perceived seriousness, perceived susceptibility, and cues to action that they make AND the pros and cons of a health behavior
perceived seriousness
people consider how severe the problem can be if it is left untreated
perceived susceptibility
people evaluate the likelihood of their developing the problem
cues to action
being reminded or alerted about a potential health problem increases the likelihood of perceiving a threat (seeing a billboard)
theory of planned behavior
people decide their intention in advance of most voluntary behaviors, and intentions are best predictors of what someone will do (asking an overweight friend if they plan on ordering dessert)
stages of change model
5 stages of change starting with precontemplation (i’m fine), contemplation (aware of the problem), preparation to change (planning), action (just doing it), maintenance (working to maintain change)
people develop expectancies
or ideas about the outcomes of a behavior from their own experiences or watching other people. Ex: children develop a positive expectancy of alcohol through family or movies
extinction
if the consequences that maintain a behavior are eliminated, the response tendency gradually weakens.
relapse
falling back to ones original patterns of the undesired behavior
passive smoking
secondhand smoking
dangerous substances in cigarette smoke
nicotine
public policy strategies for addressing drugs, alcohol, and smoking
- drug use: outlaw possessing, selling, and consuming drugs
- alcohol: increasing prices of alcohol and prohibiting underage people to buy it
- smoking: raising price and TV ads
response substitution in relation to changing substance related behaviors
competing response substitutions- rewarding a behavior that substituted the habit
5 components of food
1.carbohydrates
2. lipids (fats)
3. proteins
4. vitamins
5. minerals
fiber
needed in the process of digestion, can get it from grains
impact and those likely impacted by food additives
some additives may be carcinogenic, children may be vulnerable to the effects of additives because their body systems are still forming and maturing rapidly
what is the brain region associated with feelings of hunger and satiation
hypothalamus monitors the blood for levels of specific hormones: ghrelin, leptin, and insulin
Grehlin
is secreted and carried in the blood to the hypothalumus when energy intake is low or the stomach is empty; When ghrelin is secreted, we feel hungry and crave food.
leptin
regulates circuits in the hypothalumus that stimulate and inhibit eating and metabolism; When leptin levels are high, we feel less hungry and more satisfied.
insulin
is produced by the pancreas and has a similar, smaller effect on the hypothalamus, but it also regulates the amount of sugar in the blood, the conversion of glucose to fat, and the storage of fat in adipose tissue.
obese people have high levels of
insulin
hyperinsulinemia
can increase ones sensation of hunger, perceived pleasantness of sweet tastes and food consumption
caloric intake and aging
reducing caloric intake can slow the aging process
body mass index- overweight
over 25
body mass index- obese
over 30
set point theory
proposes that each person has a “set” physiologically based weight level that the body strives to maintain
high conscientiousness is linked to
better fitness, healthier food choices, adherence, self-report health
unrealistic optimism
belief that you are less likely than similar others to vulnerability to a variety illnesses
subjective norms
their beliefs about how people care about will view the behavior in question
perceived behavioral control
how confident you feel that you can actually do something successfully, based on your resources, skills, and the situation.
the theory of planned behavior suggests that which of the following is most important when predicting whether a health behavior will be engaged in?
intentions
benefits of breast milk
antibodies and white blood cells are passed down from the mother
which of the following has been referred to as “natures vaccine”?
breast milk
teratogens
harmful agents through:
1. maternal infections
2. radiation
3. chemicals and drugs
hospitals are
the most complex medical facilities
hospitals offer
emergency and ongoing care
most people are covered by insurance through
-employer offered coverage
-medicare-covers the elederly
-medicaid- covers the very low income
how many people are not covered by insurance
40-50 million
how does being hospitalized add negative aspects to a persons sick-role behavior
-limits privacy
-restricts the individuals activity
-requires a high degree of dependency on others
-presents events that can be very distressing
health maintenance org (HMO)
can use network providers
preferred provider organizations (PPO)
generally can go to specialists without additional referrals
fee for service coverage
physicians often limited in amount they can collect
managed care
restrictions placed on members options for services, 85% of people in managed care
universal healthcare pros and cons
far less expensive than American care, tradeoffs: lower costs, but often waits for diagnostic tests and specialists
perceiving symptoms
-people are generally not good at estimating basic physiological processes
-symptoms can go unnoticed
-people vary in how much pain they will tolerate
psychosocial influences
perceptions of body sensations influenced by:
-cognitive processes- placebos
-social processes- how other people perceive symptoms
-emotional processes- empathic reactions
medical student disease and mass psychogenic symptoms are an example of
all three cognitive, social, and emotional processes
medical student disease is
as med students learn about illnesses, 2/3rds incorrectly believe they have that illness
mass psychogenic illness
involves a widespread symptom perception across individuals who has no illness
Why do placebos sometimes “work”?
-credibility of care provider
-people have an expectation of feeling better
-the stronger the expectation-the stronger the effect can be
-some people produce endorphins in response to placebos allowing them to feel better
gender/sociocultural differences in perceiving symptoms
-women generally experience pain at lower intensities
-asian culture of somaticize (turning mental distress into physical distress)
-black people in the us often wait longer to get treatment for heart attacks
commonsense models for response
- people not good at interpreting symptoms
- illness identity-name and symptoms
- causes and underlying pathologies
- consequences- likely seriousness
lay referral network
lay people make assessments based on prior experiences
-give advice base off of anecdotes
-recommend a remedy
-recommend another lay person for advice
iatrogenic conditions
health problems result from treatments based on medical errors
founder of iatrogenic conditions
Ignaz Semmelweis- 10-35% women died in childbirth due to poor sanitation
social and emotional factos of misusing health care services
depressed people often delay treatment seeking
-people highly fearful of symtoms seek treatment quickly
treatment delay is
time between symptom noticed and treatment sought
3 stages of treatment delay
appraisal delay-recognizing symptom as illness
-illness delay-time between recognizing illness and decision to seek treatment
-utilization delay- time between deciding to seek treatment and actually going
hypochondriasis
some people worry excessively for 6 or more months and causing emotional distress
complimentary medicine
if used with conventional medicine
alternative medicine
if used instead of conventional medicine
alternative methods of healing
- manipulation- chirpractic
- natural products- herbal and dietary supplements
- mind-body approached- yoga
- energy fields- psuedoscience
who uses health services: sociocultural
higher income: more likely to fill prescriptions
lower income: more likely to use outpatient clinics and ERs
board of trustees
“vision”
administrators in hosptials:
-purchasing
-billing
medical staff
-medical director
-staff physicians
-residents
-nurses
fragmented care
often little to no communication between medical staff
nosocomial infections
about 5%-10% of patients, MRSA
depersonalization in the hospital
is when physicians go about care as if you are not there in the room with them
