Health Psychology Flashcards
What is health psychology?
A field concerned with applying psychological knowledge/techniques to health, illness and health care.
What do health psychologist study?
Social, behavioural, cognitive, and emotional factors.
What do the factors health psychologist study influence?
Maintenance of health, development of illness/disease, patient’s families responses to illness/disease
How do you become a health psychologist?
- psychology degree
2.BPS accredited MSc course
3.Stage 2 of the qualification in health psychology (2 years supervised practice)
What is the Biomedical Model?
1.Reductionist (Reduce illness)
2.Uni-causal (Illness in terms of one factor)
3.Ilness solely biological
4.Mind and body are separate
5.Focus on illness rather than health
What is the Biopsychosocial Model and who is it by?
-Engel, 1977.
-Illness as a multi-causal (bio, psyc, social factors)
-Holistic (considers whole person)
-Mind and body interact
-Health and illness as a continuum
What is a health behaviour, illness behaviour, and sick role behaviour?
Health behaviour is a behaviour aimed to prevent disease.
Illness behaviour is a behaviour aimed to seek remedy.
Sick role behaviour is an activity aimed at getting well.
What are health impairing habits?
Behavioural pathogens
What are health protective behaviours?
Behavioural immunogens
What is behaviour change approach?
Goals to bring change in individual behaviours by changing individual cognitions
What is health belief model?
It assumes a relationship between cognitions and beliefs and changing behaviours.
What are the aims of public health campaigns?
-Increase knowledge and awareness of risks
-Changing attitudes and motivations
-Increasing physical or interpersonal skills
-Changing beliefs and perceptions
-Influencing social norms
-Changing structural factors and influencing wider determinates of health
-Influencing the availability of services
What is self-empowerment approach?
Empower individuals to make healthy choices
What are critiques of self-empowerment approach?
- assumes rational choices are healthy choices
- skills practised can be applied to the real world
3.social inequalities
What are community interventions?
Target the individual but within a community context
What are health belief model’s limitations?
-Conflicting results
-No account for habitual behaviours
-Emphasises rational processes
-Emphasises factors related to the individual
-Methodological problems such as standard measuring
What is primary care?
They are the first point of contact
What is secondary care?
Specialised health care professionals that are referred to by GP’s
What are Mechanic (1978) reasons for consulting?
-visibility of symptoms
-perceived severity of symptoms
-does the symptoms interfere with normal life
-frequency of symptoms
-inability to explain symptoms
What are Scambler & Scambler (1986) reasons for consulting?
-outcome of a lay consultation
-change in the nature of the symptoms
What are Ingham & Miller (1986) reasons for consulting?
More likely to consult if cause unknow with internal causes rather external
What are Robinson & Granfield (1986) reasons consulting?
Frequent consulters, recurring symptoms but not suggestive of major illness
What are Ogden (2012) decisions about seeking medical help?
-social triggers
-illness cognition
-symptom perception
-costs & benefits of going to GP
Examples of social triggers on seeking medical help
-perceived interference with work or physical activities
-perceived interference with social interactions
-interpersonal crisis
-sanctioning
-delay
Examples of illness cognition crisis on seeking medical help
-mental representation of the problem
-influenced by social messages & health history
-normalisation
-delay
Examples of symptom perception on seeking medical advice
-bodily data
-mood
-cognition
-social context
-delay
Examples of costs & benefits going to GP
-therapeutic
-practical
-emotional
-the sick role
-delay
Who uses telephone/online consultations?
-NHS
-Private suppliers
When and who created the Choose Well Insight Project?
Spencer & Neill, 2013
What is the Choose Well Insight Project?
It gather evidence to inform social marketing and child health services in Northamptonshire
What is the Choose Well Insight Project objectives?
-gather info about parents awareness of services available for sick children under 5
-identify reported pattern of, and rationale for service across Northamptonshire
-find out what service improvements parents perceive are needed in primary care
What were the phase 1 findings of the Choose Well Insight Project?
improve:
-parents awareness of services
-access to health care services
-factors influencing service use
-reasons for seeking help
-services development ideas
What were the phase 2 findings of the Choose Well Insight Project?
-general agreement with phase 1 findings
-GP reported to be the service used most often and most trusted
-reported difficulties in getting appointments at convenient times, discomfort with receptionists & time taken for the call
-26.7% reported lack of knowledge of walk in centre service, almost one fifth lacked knowledge of 111
-more info on childhood illnesses
What were the Choose Well Insight Projects recommendations?
-a need for review of child patients pathways into & through services (to identify facilitators and barriers to access services) (may relate to use of emergency depts for non-urgent illness or late presentation
-duty doctor systems (faster access to medical opinion without need for appointments
-triage systems in primary care, in & out of hours
-role of receptionists (not be involve in medical decision making
-easy access to info about health care services
-children to be cared for by HCPs educated to care for children and in environments suitable for young children
How are medical consultations meant to go?
-patient describes the problem
-problem diagnosed
-treatment advice/medication given
What did Stimson & Webb (1975) say to help medical consultations?
Rehearsal of problems before consultation
What are the issues with communication during medical consultations?
-the setting & patient anxiety
-use of jargon & medical language
-different in doctors & patients
-fear of serious illness (withholding relevant info)
-prior experiences of the illness
-doctor variability
What is non-adherence? (Horwitz & Horwitz, 1993)
The extent to which a persons behaviour (in terms of taking meds, following diets) coincides with medical or health advice
What percentage of medication is not taken? (Meichenbaum & Turk, 1987)
30-40%
What percentage of people did not follow advice correctly in a stress management programme? (Hoelscher et al. 1986)
78%
What percentage of people with chronic illness do not comply with medication regimes? (Ogden, 1996)
50%
What are two types of non-adherence in a medical sense?
- unintentional non-adherence is when intentions are foiled
2.delibrate/intentional non-adherence is when its on purpose
What are the issues in assessing/measuring non-adherence?
-self-report measures (patients don’t admit it & medics overestimate it)
-objective measures (counting the numbers of pills only says they are gone, physiology tests only provide info on recent drugs)
What are the predictors of adherence?
-patients satisfaction
-patients understanding
-patients recall
-beliefs about illness
-beliefs about behaviour
-beliefs about medication
How can you improve adherence?
-info giving
-improving health care services
-improving communications
-involving the family
-involving self help groups
When and who says the use of humour in consultations?
Sala et al, 2002
What are the three views on stress?
1.Focus on the environment; stress as a stimulus (stressors)
2.Reaction to stress; as a response (distress)
3.Relationship between person and the environment; stress as an interaction (coping)
Three examples of stressors?
1.Cataclysmic Stressor (natural disasters)
2.Personal stressors (failing an exam)
3.Background Stressors (daily hassles)
What is the fight or flight response?
(Walter Cannon, 1914,1929)
The way in which people undergo physiological changes in order to prepare their body to react to the threat.
What are the two branches to the autonomic nervous system?
1.Sympathetic (fight or flight)
2.Parasympathic (rest & digest)
What increases during the fight or flight response?
-Epinephrine & norepinephrine
-Cortisol
-Heart rate & blood pressure
-Levels & mobilisation of free fatty acids, cholesterol & triglycerides
-Platelet adhesiveness & aggregation
What decreases during the fight or flight response?
-Blood flow to the kidneys, skin and gut
What is Selye’s General Adaptation Syndrome (1956, 1976, 1958)?
-Perceived stressor
-Alarm Reaction (fight or flight)
-Resistance (arousal high as body tries to defend and adapt)
-Exhaustion (limited resources; resistance to disease collapse; death)
What are personal factors affecting stress appraisal?
-Intellectual
-Motivational
-Personality
-Beliefs
What are situational factors affecting stress appraisal?
-Strong demands
-Imminent
-Life transaction
-Timing
-Ambiguity role or harm)
-Desirability
-Controllability (behavioural & cognitive)
What are behavioural aspects of stress?
-Increased alcohol
-Smoking
-Increased caffeine
-Poor diet
-Inattention leading to carelessness
What are physiological aspects of stress?
-Cardiovascular (increased blood pressure)
-Endocrine (increase corticosteroids)
-Immune (increased hormones impairs immune function)
What are psychophysiological reactions to stress?
-Digestive system (ulcers, IBS)
-Respiratory system (asthma)
-Cardiovascular system (hypertension, heart attack)
What are two ways of measuring psycho-social stress?
-Social Readjustment Rating Scale (SRRS) (Holmes & Rahe, 1967)
-Hassles and Uplifts Scale (Kanner et al. 1981)
What is the Approach Vs Avoidance (Roth & Cohen, 1986)?
-Approach is confronting the problem/gathering info & taking action
-Avoidant is minimising the importance of the event
What is emotion focused coping?
-Aimed at controlling emotional response to the stressor
-Behavioural (smoking, drinking)
-Cognitive (change the meaning of the stress)
-Often used when stressor can’t change (bereavement)
What is problem focused coping?
-Aimed at reducing the demands of the situation/gaining more resources to deal with it
-Often used when the persona believes the demand is changeable
-Planful problem solving (analyse the situation to make a solution)
-Confrontive Coping (taking assertive action like risk taking to make the change)
What is social support?
-Emotional support (empathy)
-Esteem support (validating)
-Tangible/instrumental (lending a helpful hand)
-Info support (advice)
-Network support (belonging)
What is pain?
A biological safety mechanism (survival functions)
What is the racial bias in medicine?
-Some doctors believe that African-Americans are tolerant to pain
-One study found that physicians are twice as likely to underestimate black patient’s pain
What are the types of pain behaviours (Turk, Wack & Kerns, 1985)?
-Facial/audible expressions of distress
-Distorted movement or posture
-Negative emotions or feelings
-Avoiding activity
What are psychological treatments for pain?
-Biofeedback
-Relaxation techniques
-Cognitive techniques
-Imagery
-Pain redefinition
-Mindfulness meditation
What is a chronic illness?
Diseases of long duration and generally slow progression. Has no cure. No time limit.
What % of deaths are chronic illnesses?
63%
What is a noncommunicable diseases?
Diseases of long duration and generally slow progression.
Main types of noncommunicable diseases?
-Cardiovascular
-Cancer
-Chronic respiratory
What are the risk factors for CHD?
-Inherent
-Physiological
-Behavioural
-Psychosocial
-Dispositional
What are the research designs for CHD?
-Prospective studies
-Cross sectional studies
What is type A behaviour?
-pushy
-go go go person
-competitive
-go getting
-risk taking extreme
What are the structured interviews to measure type A behaviour?
-The Jenkins Activity Survey
(Jenkins et al. 1978)
-The Framingham Type A Scale
(Haynes at al. 1979)
-The Bortner Rating Scale
(price, 1979)
How does type A behaviour contribute to heart disease?
-May react more strongly to physiological stress
-Behaviour may be a way of coping with heightened level of arousal
-May create more stressful environment for themselves
