Health Believes

Question 1

What beliefs are thought to regulate health behavior?

Answer 1

Perceived threat of illness the perceived susceptibility of the person to the disease as well as the perceived benefits and costs of performing the health behaviour

Question 2

What guides patients heath behaviours

Answer 2

Perceptions of threat and possible outcomes of a disease not the actual threat and susceptibility of a disease or its outcomes

Question 3

Why do we want to modify health behaviours? (Taylors model)

Answer 3

Reduces the number of deaths from diseases related to lifestyle

increases individuals quality of life and longevity

reduces the amount of money and resources spent on managing diseases caused by lifestyle choices and health behaviours if you spend the money to prevent it you don’t have to pay the large costs of treating the disease further down the line

Question 4

What is the health belief model? what does it show?

Answer 4

Shows a persons readiness to take a health action is determined by:

Perceived susceptibility to the disease

Perceived severity of the disease e.g. brain tumour lots of people perceive this as very severe

Perceived benefits of taking action

Perceived barriers to taking action

Other more minor factors can include:
health motivation in the patient
demographic variables age gender ethnicity
psychological variables
cues for medial action e.g. media scare pain

Question 5

How do attributions influence health behavior?

Answer 5

How individuals perceive the world as predictable and controllable many health related conditions are not as simple as cause and effect and many people may not appreciate or see certain health behaviours as causative agents of a disease

Question 6

What is the theory of planned behaviour?

Answer 6

Model that shows the various components that predict the likelihood of someone being able to make a change or regress to a poor health behaviour

Three major components
Attitude towards behaviour
Subjective norm
Perceived behavioural benefits

that lead to intention to perform behaviour

that then leads to performing the health behaviour

Question 7

What contributes to the attitude towards behaviour in the the theory of planned behaviour?

Answer 7

Beliefs about outcomes and evaluation of these outcomes

What are the pros and cons of giving up this certain behaviour and taking up a better health behaviour

Question 8

What contribute to the subjective norm in the theory of planned behaviour?

Answer 8

Beliefs of important others to the preposed/current health behaviour
Social network and media attention towards health behaviour is it known and is the risk made clear by the media and popular sector

Your motivation to comply with subjective norms and the values of society and your significant others

Question 9

What contributes to the perceived behavioural control int he theory of planned behaviour?

Answer 9

Perceived likelihood of occurrence
Internal and external control factors
does the person have self efficacy self determination and support network to help them if times get tough?
Is it hard to do and maintain if it is they are unlikely to do the behaviour can skip straight past intention to do it

Question 10

What is the clinical significance of health behaviours what makes a person more likely to undertake a health related behaviour?

Answer 10

Person more likely to undertake health behaviour when they believe:

Their health is important
There are susceptible to a threat that could have serious consequences
The preposed actions will be of benefit and do not have too many costs
(GP can directly help in terms of education and awareness of the above)
Others approve the action and their improvable is important
They can successfully carry out the health behaviour.

Question 11

Give an example fo some cultural differences that influence health behaviour’s

Answer 11

Some Hawaiian cultures:
Cabbage and cucumber eaten during pregnancy will lead to an ill baby
Spiced food will lead to an agitated baby
If you are jealous of someone your baby will be born crippled,

In some Vietnamese cultures : no prenatal care sought and due date is not known; after birth, mothers forbidden to shower for 1 month.

Question 12

What is the difference between compliance and adherance?

Answer 12

Compliance is a passive behaviour whereby the patient follows the instructions from the doctor more of a paternalistic approach

Adherence is a more positive proactive behaviour that results in a lifestyle change by the patient who must follow a daily regime such as wearing a prescribed brace
(is more communication and discussion between doctor and patient along the lines on concordance)

Question 13

What is Concordance?

Answer 13

A two way dialect between the patient and doctor that allows the patient to lead the discussion and express there concerns questions and issues about a treatment or available treatments and the doctor facilitates discussion by providing information and then patient and doctor come to a joint decision

Question 14

What is non adherence?

Answer 14

The failure of a patient to follow recommenced health treatment & behaviours given by a clinician

may be intentional where they purposely and actively don’t comply with the treatment perhaps due to side effects or lack of understand

Unintentional they forget to take the treatment or cannot remember how to take the treatment

Question 15

What factors contribute to adherence in leys model?

Answer 15

understanding of the treatment what you need to do and why
memory can you remember how to take the treatment
satisfaction with care that is formed form understanding and memory of health care encounters that lead to adherence to a treatment

If you cant remember how to take it or you don’t understand how or why you are taking it this can lead to non adherence directly

Question 16

What factors contribute to adherence in Stantons model?

Answer 16

Good doctor communication

increased knowledge and satisfaction (is linked with doctor communication if you have a strong rapport and understand doctor more likely to follow instructions trust them)

patients beliefs, locus of control and perceived social support (do they belI’ve in the treatment and that it can work do they believe they have control, do there social support network support or hinder them)

Question 17

What factors contribute to adherence in Martin’s model?

Answer 17

Information
(patient must understand what they are supposed to do)

Motivation
(patients must be motivated to carry out treatment and want to get better)

Strategy
(patients must have a workable strategy for following treatment recommendations)

Question 18

Why don’t patients comply (adhere)

Answer 18

Fear of side effects (or not worth benefit of treatment)
Fear of dependency
Does not fit in with lifestyle
Dissatisfaction with the doctors diagnosis or recommendations
Doctor fails to communicate properly
Financial may not be able to afford prescription
Forgetfulness
Confused about dosage
Religious reasons and societal norms that drugs are deemed a sign of weakness

Question 19

How can we improve adherence?

Answer 19

Tell patient what you are about to tell them and stress the importance of what you are about to say

Think about the primary effect (first thing you tell them will be remembered more than things that come later)

Give specific advice that is accessible to the patient

Negotiate regimes that suit the patients routines and lifestyle

Encourage patients to take notes

Address worries or concerns

Determine social support system in either promoting or contradicting treatment

Try to anticipate barriers to compliance e.g. sing-post support groups suggest at dosset box

Question 20

What is the link between physical and mental health and what model illustrates this well unlike the biomedical model that sees health and illness as qualitatively different and that illnesses don’t have psychological causes?

Answer 20

Psychological stress can lead to physical symptoms that can lead to symptoms

The biophscychosocial model
defines health and illness as a product of biological psychological, social, physical and spiritual facotrs

Question 21

What work did Holmes and Rhae do in determining the effect of stress on health?

Answer 21

Quantified life events that may cause stress
different events lead to different levels of emotional response and stress
150 or less only slight illness due to stress
150-300 moderate risk of illness due to stress
300 + high risk of falling ill due to stress

Question 22

What are the sings of stress?

Answer 22

Biochemical alterations in endorphins
physiological high blood pressure rapid shallow breathing digestive problems
behavioural sleep problems increased alcohol intake and more likely to make poor health choices such as smoking over eating
cognitive poor concentration (road traffic accidents)
emotional mood swings and irritability

Question 23

What are the effects of stress

Answer 23

Anxiety 
depression
low self steam
lower sexual desire
change in appetite
constipation or diarrhoea
high blood pressure
menstural irregularities
nausea
headaches

Question 24

What are the three phases of the general adaptation syndrome in response to stress

Answer 24

Alarm stage:
first reaction to stress body recognises danger and prepares to deal with the threat (adrenaline release activation of SNS hypertension body signs)

Resistance stage:
homeostasis begins to restore balance and there is a period of recovery for repair and renewal
(stress hormones return to normal)

Exhaustion stage:
stress has continued for some time the body cannot resist the stress anymore
body runs out of adaption energy to return stressor to normal level
this is hazardous to health signs of alarm appear but are irreversible

Question 25

Why are people keen to find a physical cause for mental ilnesses?

Answer 25

Stigma associated with phycological conditions
Many think there is more treatment for a physical cause than a phycological one
Think doctors will not take them seriously
Perception that physiological illness is not a real illness has been a big issue in men not talking about mental health as its does not fit the macho image of society there has been a shift

Question 26

What are placebos? What is the placebo effect?

Answer 26

pharmacologically inert treatment or inert surgery that results in a positive effect on patients as they feel they are having something productive done
works better for conditions that have a phycological element to them e.g. pain

Question 27

What is the nocido effect

Answer 27

develop symptoms of a disease even though you have not been exposed to a particular pathogen (e.g. given a sugar pill then told it was toxic substance will start to experience symptoms)

Question 28

How can we improve health behaviours

Answer 28

prevent/ reduce unhealthy behaviours

increase healthy behaviours

Question 29

What is the generic model of health promotion?

Answer 29

Persuade the individual via media education approaches (health belief model effects on perceived susceptibility severity benefits)

Change the environment to encourage a change in behaviour ( barriers benefits cue for action subjective norm) support groups suggest keeping a diary

Change the law either to force people to do something (seatbelts smoke fee zones) or to make a unhealthy behaviour expensive (tobacco alcohol sugar tax) Increases the barriers, increased perceived benefits of stopping ill have more money act as a cue for action and change societal subjective norms

Question 30

What is the Calo-Re taxonomy

Answer 30

Taxonomy that recognises the individual components of behavioural change

provide information on consequence of a behaviour to an individual (obese inc risk type II DM)

Encourage goal setting on behaviour (e.g. do more exercise) as well as on outcome (e.g. i want to loose 2 stone)

Self monitoring keeping a diary (motivational to look back and see how far you have come)

Barrier identification and problem solving identify potential barriers before they occur e.g. get a dosset box or lock away chocolate

Provide rewards for successful behaviour e.g. slimming group certificates clapping

Environmental restructuring locking away snacks and unhealthy shoes leaving a pair of trainers by the front door to tell you to go on a run

Question 31

How do we change behaviour on a population level and an individual level?

Answer 31

Population
Promote desirable behaviours
infrastructure food provision education
economic incentives e.g. sugar tax alcohol tax
(large no of people influenced but is expensive to do and difficult to implement)

Individual:
education and motivational strategies to promote health behaviour
(some success but not good at sustained long term change)

Question 32

What are the three categories of prevention?

Answer 32

Primary prevention (preventing the onset of a disease)

Secondary prevention aims to minimise the impacts of a disease after it has arisen by detection and treatment to prevent worsening

Tertiary prevention aims to prevent death or permanent disability once a disease has become established

Question 33

Give examples of primary prevention strategies

Answer 33

Education
Immunisation programmes
Laws enforcing the use of seatbelts and working hours etc

Question 34

Give examples of secondary prevention strategies

Answer 34

Screening programmes
reducing the impact of the disease
promote healthy lifestyle to reduce impacts of disease and prevent worsening

Question 35

Give example of tertiary prevention stratergies

Answer 35

Rehabilitation programmes
support groups
medical interventions and treatment
treating problems that arise because of a disease e.g. CHD hypertension as a result of obesity

Question 36

What must we consider when thinking about health promotion in diverse communities?

Answer 36

Religious beliefs may not be religiously acceptable/ are support groups diverse and welcoming
may also have negative consequences on the poorest socioeconomic groups who may not be able o afford fresh fruit and vegetables