Key psychological models which explain health related behaviour & behaviour change- application to clinical setting Flashcards
Define Health
The state of complete physical, mental & social wellbeing & not merely the absence of disease & infirmity
6 different ways health is seen?
- Not having symptoms
- Having physical or
- Having healthy lifestyles
- Being physically fit
- Psychological wellbeing
- Being able to function
What are psychological factors that affect health/illness?
- stress
- depression
- coping mechanisms e.g. smoking, drinking, over eating
- stigma
- embarrassment
- beliefs
- pain
Any given combinations of psychological factors can work together to influence the health behaviours we choose to carry out or not- Psychological determinants of health behaviours & illness behaviours
- Reactive influence will lead to health compromising behaviours
- Proactive influence will lead to health promoting
What are health behaviours?
Behaviours that affect our health positively or negatively
E.g.
smoking, drinking, exercise, lack of sleep
2 types:
- Health promoting
- Health compromising
What is health promoting behaviours?
An activity undertaken by people that decreases risk of disease e.g. healthy diet, exercise → usually preventative & aim to maintain health.
What is health compromising behaviours?
an activity that increases risk of disease e.g. smoking, drinking, low physical activity → usually reactive & are in response to an illness.
Why is it important to discuss & encourage positive health behaviours?
Treatment adherence- behaviour is key- there is clear relationship between medication adherence & improved illness outcomes.
If we understand why people carry out health risk behaviours we can help them change these behaviours (illness prevention & health promotion).
What are the different psychological models that explain health related behaviour & behaviour change?
1.Biomedical model
- Biopsychosocial model
- Social cognitive models:
- Theory of Planned Behaviour
- Health Belief Model
- COM-B Model
- Theory of Reasoned Action
- Stages of Change Model
What is the biomedical model?
Assumes all disease can be explained using physiological processeS
Treatment is for the disease, not the person.
- Treatment involves eradicating pathogens
Psychological and social processes are separate; it separates body and mind (dualism)
- Makes Doctors fully responsible for health
Pathogen > physiological & biochemical changes > Disease> Biological treatment > Recovery, chronic illness or death
What are the limitations of the biomedical model?
- reduces disease down to having only biomedical causes.
- If psychological factors have no influence on disease, how can we explain the placebo effect?
- Ignores influence of psychological factors on health (e.g. the impact of stress on health, attitudes towards certain health related behaviours, emotions, coping strategies etc)
- Ignores influence of social factors (e.g. the link between social class and health. Lower socio economic groups are at more risk of illness and death, due to different lifestyles – more smoking, poorer diets etc)
What is the biopsychosocial model?
Health is a combination of biological, psychological & social factors rather than purely in biological terms.
Responsibility for health & illness lies on individuals rather than doctor alone.
- Treatment considers all these contributing factors as well.
Individual behaviour is therefore a key aspect of health.
An improvement on the biomedical model- makes the link between psychological, social factors & health more explicit.
- Illness is viewed as the result of many factors, rather than by pathogens alone.
Addressing all three areas are important for influencing:
- Maintenance of health
- Development of illness
- Help seeking behaviour
- Responses to treatment
What are the components of biopsychosocial model?
Bio
- viruses
- bacteria
- gender
- disability
- physical health
Psychological
- stress
- coping
- pain
- behaviour
- personality
- Attitudes/ beliefs
Social
- class
-employment
- culture
- ethnicity
- education
Social cognitive model: what is the theory of planned behaviour model? limitation?
Allows clinicians to
1- understand &
2- predict whether patient will change an unhealthy behaviour or not &
3- focus on those aspects that need strongest support in intervention
Describes key factors that explain behaviour & predict behaviour change.
Limitation:
- Intentions don’t always lead to action.
Social cognitive model: theory of planned behaviour- what are the 3 factors that influence behaviour?
TPB allows the doctor to explore the patients attitudes, norms, perceived control &/or intentions.
- Attitude - individual believes that a certain behaviour or act makes a positive or negative impact on their life.
- Subjective norm - overall social pressure to engage by others, social network, cultural norms.
- Perceived behavioural control - a persons belief on how easy or hard it is to display a certain behaviour.
Positive attitude + favourable norm + belief in behaviour = ACT (if one of these are not favourable, person will not perform act)
Social cognitive model: what is the health belief model?
Behaviour is a result of a set of core beliefs such as susceptibility or severity.
- E.g. People who believe Covid-19 isn’t be very severe for them may decide against a vaccine.
Core beliefs:
- susceptibility- how susceptible patient thinks they are to -ve consequences of behaviour
- severity- how severe consequences might be
- costs- costs of carrying out or stopping behaviour
- benefits- benefits of carrying out or stopping behaviour
- cues to action- what made patient make changes to their behaviour
- health motivation- how concerned are they about their health due to behaviours
- perceived control- patients perception on how much control they have to stop behaviour
So changing someone’s core beliefs can change their behaviour such as increasing adherence to treatment or following lifestyle changes.
