Psychology - health behaviours and behaviour change Flashcards
What is health behaviour?
- Any activity undertaken by “a person believing itself to be healthy for the purpose of preventing disease or detecting it in an asymptomatic stage**” (PROBLEM: may think healthy but not = subjective & exludes those that are ill or taking medications ) OR “an individul regardless of actual or pereived health status, for the purpose of **promoting, protecting or maintaining health, whether or not such behaviour is objectively effective towards that end”
- Individual choices
- = responsible for a large proportion of poor health
Health behaviours dont actually have to work, but you do it to get better:
e.g. Tooth ache cures:
Wrap black pepper seeds in a thin fabric and put on the aching tooth
Freeze marbles in the freezer and apply on the aching tooth
A cabbage leaf warmed in front of the fire, spread with butter & pepper then held against the face
Cooked pine needles
What are the two types of health behaviours?
Health-directed behaviours (primarily to prevent disease e.g. if loosing weight to reduce high bp etc.)
Health-related behaviours (primarily to improve an individual characteristic with a second ‘spin off’ for health i.e. appearance & self esteem e.g. loosing weight to look better)
In order to change health habits and behaviours we need to think about…
- Knowledge
- Attitudes (responses to people and situtions)
- Beliefs (how things ‘really’ are = not an intellectual fact -> not everyone will agree)
- Skills
- Values (how things ought to be)
Health behaviour assessment:
Assess:
- Level of understanding of contition, severitu & behaviour (Fact)
- Oral health knowledge (Fact)
- Previous compliance with health advice
- Ability for self-care
- Attitudes towards oral health
- Family/peer experiences/attitudes towards oral health care
What is self-efficacy?
An individuals confidence in determining ‘how well he or she can take the actions neccessary for producing certain results (improve the indicators & maintanance of their health)
How can we improve self-efficacy?
- Mastery (success vs failure)
- Vicarious experience (watching others & modelling)
- Verbal persuasion (suggestion, coaching & feedback e.g. get their tast back)
- Physiology/effect (well-being/mood)
e.g. with smoking: be positive (they can stop), figure out trigger points & put into place action plan (if doesn’t work see where problems were & help them to maintain)
what is the newer theory of the health behaviour model?
Theory of planned behaviour
What is the main critisism of the health behaviour model?
Focus is primaily on the individual (not context!)
List two critisisms of the health behaviour model and the theiry of planned behaviour model:
- Big assumptions (that health behaviours and intention = weighing up pros and cons; to change are based upon rationality and not habit & the patient is static -> their views dont change)
- Emotion (fear and denial)
What are the 3 types of health needs?
- Normative need (professionally defined = disease diagnosis, falls into acceptable standards & value judgements)
- Percieved need (what patient feel about what they want and what needs to be done e.g. percieves should have a GOLD crown = potential source of conflict)
- Expressed need = percieved need but vocalised
What are the different stages of change?
- Precomtemplation = no awareness = dont think you have a problem
- Contemplation = aware, motivated, confident in ability to change
- **Preparation **= negotiate e.g. give chocolate away/eating any you have/stop buying any
- Action
- Maintanance (keep it up even if someone else brings chocolate home you wont eat it = termination = achieved) or Relapse (can’t do this any more -> back into preparation)
How do you motivationally interveiw (determine which stage of change they are at) and individual?
- Precontemplation (patient set own agenda = their idea not yours!)
- Contemplation (is the patient ready to change)
- Preparation (wait/understand ambivalence = mixed feelings & negotiate & help plan)
- Action (act according to patients state)
NO DIRECT ADVICE
NO SUGGESTIONS ABOUT WHAT TO DO (get them to think it through… reflect, open questions, highlighting mixed feelings, engage patients)
How are attitudes and behaviour related?
Attitudes change behaviour & behaviour changes attitudes (no relationshop between attitudes & behaviour)
Asking someone to change their behaviour = far reaching implications
It is more useful to understand underlying processes behund attitudes & behaviour so we understand how, why and when attitudes affect behaviour
social influence process
- Conformity (= change behaviour due to percieved pressure from others e.g. being accepted/liked, social control, rules/codes of conduct = important for treatment programme compliance)
- Obedience (= response to anothers power to punish/reward = can produce extremes of behaviour n.b. electrocuting experiment video)
- Power (reward -> compliance & coersion -> compliance = short term change only! depends on how powerful you think the person is e.g. legitimate & expert -> internalisation = change behaviour)
*
How does conformity (identification) influence behaviour?
Changes behaviour to maintain relationship (want to be liked/ respected = short term)
How does compliance (obedience) influence behaviour?
changing outward behaviour for reward = short term & depends on power of other
How does internalisation influence behaviour?
Changing behaviour because of what is appropriate
Credivle, expert & trustowrthy source = long lasting
n.b. internalisation = process of consolidating and embedding one’s own beliefs, attitudes, and values when it comes to moral behavior
What is minority influence? and who has it?
= Private beliefs not public behaviour
e.g. Clinicians
(still effect if they understand the cause of events, consistant & has expertise, honest & trustworthy, credible)
How do you maintain change?
Consistency (between what you know, feel & do; internalisation)
Inconsistency (acting out of character -> cognititve dissonance = need to make sure their thoughts are in line with what they are doing)
More likely to change if… commit publicly, self-image is effected, they perceive free choice
More likely to resist change if… they have interalised (developed) their own argument
What is another word of adherance?
Compliance
What is adherance/compliance?
a patients correct following of medical advice
Important to remember:
half of what patients are told is misunderstood
half is forgotten within two hours
non compliance (e.g. stop taking painkillers/anibiotics because not getting better fast enough) or mis-compliance (dont understand what it is they have to do -> avoid by repeating, recap at end of consultation & ask them to recap)
List some predictors of non adherance:
Perceived seriousness/vulnerability/benefits
Intentional
No relief from pain or symptoms
Long-term treatments
Complex/unpleasant side effects
Complicated schedule
Age
What are the consequences of non-adherance?
Personal:
Persistance of symptoms/disease
Higher mortality
Measles after MMR scare
Societal:
Widespread disease (drug resistant virus strains)
Loss of quality of life
Loss of productivity
What are the strategies to increase adherance?
- Patient centred style (reminders, incentives/rewards, increase convenience/simplify regimes)
- Persuasive messages (clear understandable information, written materials)
- Self monitoring
- Social influence (conformiy)
What are the three routes of persuasion?
- Cognitive (thinking about it - topic matter information is imprtant; difficult but can be long lasting due to internalisation = better processing and think about why they are changing it)
- Peripheral (topic doesn’t matter just told, superficial e.g. how/where/by whom; unlikely to last = distracted )
- Inoculation (small amount of controversial ecidence, people will develop arguments & defend their views e.g. my grandad lived to 93 and smoked all his life) = give evidence!
Instructions:
Simple
Repeated by dentist & patient
Specific
Written where possible
In face of opposition (present both sides of argument)
What makes a patient more likely to follow recommendations?
If they and the dentist agree & if expectations are met during consultation
