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All TP1 and Some TP2 > Social and Psychosocial > Flashcards

Social and Psychosocial Flashcards

1
Q

What is the biomedical model?

A

Concept that the mind and body are separate

- body is treated like a machine it is fixed by replacing/ destroying cause of the problem

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2
Q

Criticism of biomedical model

A

Narrow - ignores social + psychosocial factors

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3
Q

What is the biopsychosocial model?

A

Health and illness emerge from an interplay of psycho social and bio factors (contributing
Causes of illness)

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4
Q

What is health?

A

Complete state of mental physical and social wellbeing . -not just the absence of disease

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5
Q

What are psychological factors?

A

Cognition, emotion, benaviour

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6
Q

What are social factors?

A

Housing, social class, employment, gender, social support etc.

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7
Q

What are biological factors?

A

Physiology, genetics pathogens (disease)

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8
Q

What are lay beliefs?

A

Beliefs of health and illness from people with no medical knowledge

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9
Q

Why are lay beliefs significant?

A

Impact on compliance + non compliance of treatment

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10
Q

What is the negative definition of health?

A

Health is the absence of illness

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11
Q

What is the functional definition of health?

A

A person is healthy if they can do certain things

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12
Q

What is the positive definition of health?

A

Good health is a state of wellbeing + fitness

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13
Q

What are lay theories?

A

How people understand their health using cultural, social and personal experience

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14
Q

What is lay epidemiology?

A
  • Trying to understand how and why they have this illness

- constructing a story

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15
Q

Why do people have lay beliefs?

A
  • they misunderstand the illness and who should/can get ill
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16
Q

What is the interplay between lay and medical beliefs ( public and professionals) ?

A
  • Public - are surrounded by complicated medical concepts with no background knowledge/context → so they develop their own beliefs
  • professionals - use medical concepts all the time and apply these to different experiences
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17
Q

What is health behaviour?

A

Impact on health or helps prevent illness

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18
Q

What is illness behaviour?

A

Activities of ill people to define illness and seek solutions

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19
Q

What is sick role behaviour?

A

The formal response to symptoms

- patients must act in a certain way to be a patient

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20
Q

Give an example of a health behaviour

A

Smoking → more prevalent in lower classes

  • higher classes = more likely to have positive health definitions and incentives to quit smoking
  • lower classes = tend to have unclear or negative definitions of health, smokingmay be used as a coping mechanism
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21
Q

What is illness behaviour?

A

How people act when they are sick

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22
Q

Describe the illness iceberg

A

Doctors only see the surface of the illness (top of iceberg above surface)
Most symptoms are never shown to a doctor (rest of iceberg beneath the surface)

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23
Q

Give 5 factors that influence illness behaviour

A 
→ culture 
→ understanding of illness
→ visibility of symptoms (how obvious)
→ Frequency and persistance of symptoms
→ availability of resources (accessibility)
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24
Q

What is lay referral?

A

When a patient decides whether or not to visit the doctor → they do this by discussing their symptoms with other lay people first

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25
Q

How do lay beliefs affect treatment

A

→ affect adherence to treatment

→ affects continuity of care and outcomes

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26
Q

Name the 4 types of patients

A
  • Deniers
  • distancers
  • acceptors
  • pragmatists
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27
Q

How do deniers react to illness?

A

→ they deny having their condition

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28
Q

How do distancers react to illness?

A
  • Deny having the illness and use complex strategies to hide and distance themselves from illness (maybe due to stigma).
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29
Q

How do acceptors react to illness?

A

→ accept diagnosis + advice
→ believe medication helps control symptoms
→ don’t worry about stigma

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30
Q

How do pragmatists react to illness?

A
  • accept they have a disease but do not accept the severity of it
  • use preventative meds when it is bad
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31
Q

What 4 factors influence a patient’s decision to get help 2

A

→ symptom experience (severity)
→ symptom evaluation (effect on life)
→ knowledge of health issues and treatments
→ experiences and attitudes towards professionals

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32
Q

Define chronic illness

A

Diseases which current Medical interventions can only control not cure
- no return to normal

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33
Q

Define long term condition

A

Condition that can’t at present be cured

→ but are controlled by meds or treatments

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34
Q

What is the impact of ltc’s on the NHS?

A
  • 70% off total spend on people with LTC

- biggest challenge for NHS = increasing prevalence

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35
Q

What is the sociological approach to chronic illness?

A

→ it focuses on the impact that chronic illness has on social interaction

  • experiences + meanings of chronic illness
  • now people manage chronic illness in every day life
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36
Q

Name a functional theory of experience of illness

A

Talcott Parsons ‘sick role’ 1951

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37
Q

Name an interpretive theory of experience of illness

A

‘Illness narratives’
‘stigma’
Biograpnical disruption’

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38
Q

What is Parsons ‘sick role’

A

A temporary, medically sanctioned form of deviant benaviour
→ sick person expected to seek medical help and follow treatment
→ can take blame off sick person with sick note

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39
Q

What are the limitations of Parsons sick role

A
  • Not all illnesses are temporary
  • doesn’t acknowledge individual differences
  • differences in defining/coping with illness
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40
Q

What is an illness narrative

A
  • Story telling that occurs in the face of illness= as a way to make sense of the illness
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40
Q

What is an illness narrative

A
  • Story telling that occurs in the face of illness= as a way to make sense of the illness
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41
Q

What does ‘work’ mean?

A

-> the types of activities that people with chronic illnesses engage in to make their lives work

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42
Q

List 5 types of ‘work’ of chronic illness

A
  • illness work
  • everyday life work
  • emotional work
  • biographical work
  • identity work
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43
Q

Describe the process of getting a diagnosis - illness work

A

Pre diagnosis → prolonged uncertainty for patient, back and forth communication
Diagnosis → doesn’t relieve uncertainty, some diagnosis are ambivalent
Post diagnosis → shocking or a relief for some patients

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44
Q

Describe the process of managing the symptoms - illness work

A
  • dealing with physical symptoms before social issues
  • interaction between body identity
  • changes in body can lead to changes in self concept
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45
Q

What are the 3 consequences of struggling with self management?
Illness work

A

Poor rates of treatment adherence
Reduced quality of life
Poor wellbeing

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46
Q

What interventions can be used to improve self management?

A

Deliver interventions over the phone or IRL

Desmond EPP

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47
Q

Advantages of self management interventions

A

→ coping + management skills

  • aims to reduce hospital admissions
  • patient entered
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48
Q

Disadvantages of self management interventions

A
  • Responsibility placed on very ill patients

- may give little understanding

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49
Q

What is ‘coping’?

A

The mental/cognitive process of dealing with illness

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50
Q

What is strategy?

A

The actions and processes involved in managing the condition

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51
Q

What is the process of normalisation?

A

When the patient signals a change in their identity → designating their new illness life as their normal life

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52
Q

What is emotional work?

A

Activities that people do to protecti emotional Wellbeing

  • downplaying pain/symptoms
  • disrupted friendship
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53
Q

What is biographical work?

A

→ loss of self
Change in self image, struggle to maintain positive view
Focuses on physical discomfort to minimise broader effect

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54
Q

What are the 3 aspects of biographical disruption

A

→ disruption of taken for granted benceviours
→ disruption of explanatory systems = explanation for their illness
→ mobilisation of resources - changes patients must make in life

55
Q

What is ‘biographical disruption’ (bury)?

A

→ it focuses on people’s experience of the onset of illness as a disruptive event

56
Q

What are the 3 limitations of biographical disruption?

A

Doesn’t account for conditions that occurred since birth

Not everyone will view an illness to be equally disruptive - older people may see it as normal and less disruptive

57
Q

What is identity work?

A

Illness becomes person’s identity

- they think about who they are and how others view them and their illness

58
Q

What is stigma? Goffman

A

Difference between how others view someone and their actual social identity.

59
Q

What is the effect of stigma?

A
  • Can cut down a person and discredit their social identity
60
Q

Define discreditable stigma

A
  • Illness that is not visible

- eg HIV or mental health

61
Q

Define discredited stigma

A

Visible illness that is well known - sees them apart

Eg disability, known suicide attempt

62
Q

Describe enacted stigma

A

A negative experience (prejudice, disadvantage) as a consequence of a condition

63
Q

Describe felt stigma

A

Individuals embarrassment/shame associated with the condition

64
Q

Give 4 social + economic factors that impact health

A
  • life expectancy
  • infant deaths
  • Morbidity
  • disability
65
Q

What is the inverse care law?

A

→ the more you need it, the less available it is

Availablity of good medical care tends to vary inversely with the need of the population

66
Q

Give an example of where the inverse care law is applied.

A
  • > in areas with the most death and sickness
  • GPS have more work and less support
  • hospital doctors have larger caseloads with less staff
67
Q

How can we measure health?

A
  • self report data (surveys and census data)

- mortality and life expectancy

68
Q

What is the relationship between deprivation and ill health?

A
  • Strong association

- more deprived a person is, larger proportion of life spent in ill health, more likely they will die at a younger age

69
Q

What 4 possible explanations of health inequalities are listed in the black report (1980)?

A
  • Artefact
  • social selection
  • behavioural cultural
  • materialist
70
Q

What is the artefact explanation?

A

Health inequalities are due to how we collect statistics

  • concerns about data quality
  • concerns about methods of measurement
71
Q

What is a limitation of artefact explanation?

A

Assumes any problems with data collection have led to an underestimation of inequalities

72
Q

What is the social selection explanation?

A

Being sick moves you down the social status ladder, your health status determines your social position
→ sick people move down social hierarchy and healthy people move up

73
Q

What is a limitation of the social selection explanation?

A

It doesn’t account for people who are born into alower status, as they are more likely to have poorer health.

74
Q

What is the behavioural cultural explanation?

A

Ill health is due to peoples choices I decisions on their own health

75
Q

What is a limitation of the benavioural explanation?

A

→ choices can only be made based on availability of options, but lower classes has limited options
→ behavioursare outcomes of social processes not just individual choices

76
Q

What is one materialist explanation?

A

Inequalities are due to differential access to material resources eg housing and choices

77
Q

What is a limitation of the materialist explanation?

A

Further research is needed to know routes through which material deprivation causes ill health

78
Q

What is the psychosocial explanation?

A

Health is influenced more by differences in incomes than the actual income
Inequalities are a problem of social status

79
Q

What are limitations of psychosocial explanation?

A
  • stress impacts health differently

- stressors are distributed on a social gradient

80
Q

What is income distribution explanation?

A

Countries with great income inequalities - greater health inequalities
- income equality → social evaluative threat → stress → poor health

81
Q

What 4 things can be done to reduce inequalities?

A
  • Strengthening individuals
  • strengthening communities
  • improving living and working conditions
  • promoting healthy macro policies
82
Q

Define inequality

A

When things are different (not equal)

83
Q

Define inequity

A

Inequalities are unfair and avoidable

84
Q

Describe how more deprived groups access healthcare

A
  • Higher rates of gp + emergency use

- lower rates of preventative service use

85
Q

How do more deprived groups view health

A

-normalize ill health
_manage health as a series of crises
- lack resources and cultural alignment

86
Q

What are the limitations of current inequities in health care?

A

Difficult to interpret current evidence as it fails to include inclividud’s that don’t access healthcare
_ doesn’t include different aspects of social disaducuntage

87
Q

What factors are associated with inequalities in health?

A

Ethnicity
Gender
Age
Disability

Homelessness

88
Q

Describe health in males?

A

Higher mortality rates

More suicide and violent deaths

89
Q

Describe the health in females? Higher lif

A

Higher life expectancy
Higher reported poor mental health
Higher rates of disability

90
Q

How does ethnicity impact health?

A
  • culture and beliefs
91
Q

List 4 factors that affect health and illness

A

Social class
Ethnicity
Gender
Deprivation

92
Q

Why is obesity seen as a disease?

A

People will take it more seriously

93
Q

Define obesity

A

An abnormal or excessive fat accumulation that presents a risk to neaten

94
Q

What is BMI

A

Crude population measure of obesity, based on the idea of standard measurements of diseases - ratio of height - weight

95
Q

Limitation of BMI

A

Crude at an individual level

96
Q

What other lifestyle factors affect obesity

A

Smoking
Alcohol consumption
Diet, fruit and vegetable consumption
Exercise

97
Q

What is the relationship between BMI and mortality?

A
  • Those with increased BMW nave increased mortality

Higher BMW - higher risk of many conditions

98
Q

List 5 diseases associated with obesity

A 
(both communicable + non -communicable diseases)
Asthma
Heart disease
Sleep apnea
Cancer 
Type 2 diabetes
99
Q

What are the effects of obesity in terms of cost?

A

Loss of income due to days off from work

Costs of dealing with obesity management and treatment

100
Q

How does society impact obesity?

A

Societal influences can influence food + what is available based on income and drive

101
Q

What is involved in weight loss?

A

Achieving an energy restriction that you can live with

About diet in the short term but exercise is needed to maintain weight loss

102
Q

What factors affect the maintenance of weight loss?

A

Personal choice
Social + environmental factors
Training and support
May return to habitual behaviour

103
Q

What are societies views on weight?

A

Ideal body types for men and women with pressures to conform to ideal body image
Society focuses on losing weight but focus should be on improving health

104
Q

What effect does weight stigma have on practice?

A

Negative impact as it can be a barrier for people with larger weight accessing health

105
Q

What are health related behaviours?

A

Anything that may promote good health or lead to illness (positive and negative outcomes)

106
Q

Why are models of health behaviour useful?

A
  • can predict behaviour given a set of circumstances

- influence behaviour to promote good health

107
Q

What are the 2 learning theories?

A

Classical conditioning

Operant conditioning

108
Q

What are the 2 social cognition models?

A

Health beliefs model

Incory of planned model

109
Q

What are 2 integrative models?

A

Trans theoretical model

Prime theory

110
Q

How can classical conditioning be applied to humans?

A

Pairing between an environmental cue and ur can explain cravings as the mind makes expectations based on previous experiences leg. Smelling food at restaurant and being hungry)
- link to drugs alcohol trigger benaviour

111
Q

How can benaviour be changed according to classical conditioning?
Explain in terms of an example

A

Break unconscious response to stimulus
Avoid cues or change stimulus pairings
→ aversion therapy in alcohol misuse - pair alcohol with an unpleasant response e.g, nausea
Meds

112
Q

How can operant conditioning be applied to humans?

A

Shape behaviour through reinforcement

  • punish negative health behaviours
  • reward positive health behaviours

Motivational incentives

113
Q

What are the limitations of learning theories?

A
  • doesn’t explain withdrawal and long term consequences
  • doesn’t account for cognitive factors
  • no social context
114
Q

How can social learning theory be applied in health

A

Role models may carry outharmfull benaviours, those that view them as remodels will do the same

115
Q

What is cognitive dissonance theory?

Apply to health

A

People feel discomfort when their actions are inconsistent with their beliefs
- changing benuciours reduces discomfort

→ health promotion = provides info that may cause mental discomfort leading to change

116
Q

What is the health belief model?

A

Assumes that health bencuiour is based on a desire to avoid illness and that a specific health action will prevent /cure illness

117
Q

What are the 6 parts to the health belief model

A 
Perceived susceptibility / severity
Perceived benefits/barriers
Cut to action
Modifying factors
(percieved threat)
Like good of changing behaviour
118
Q

What is the theory of planned behaviour?

A

Sociocognitive constructs that mediate patients intention to carry out behaviour

  • attitudes
  • subjective norms
  • perceived benavioural control, belief on their capacity to engage with benaviour
119
Q

What does the updated theory of planned behaviour model include?

A

Past benaviour - meaning data in real world behaviour could be explained more, acts as a good indicator of future behaviour

120
Q

What are the limitations Of social cognition models?

A
  • assumes people make rationdidecisions before carrying out benaviour
  • don’t include emotional influences
  • don’t incorporate moral norms
  • focus on change but not how to change
121
Q

What is the trans theoretical model 3.

A

Aka stages of change model

-represents the stages a person has to go through to change benaviour

122
Q

What are integrated models?

A

Integrate more contextual and environmental factors

123
Q

What are the stages of the trans theoretical model

A 
Precontemplation
Contemplation
Preparation
Action
Maintenance -> stable lifestyle if change is embedded)
Relapse
124
Q

What other factors influence the the transtneorerical model?

A
  • Decisional balance (pros vs cons of change)
  • confidence
  • temptation
125
Q

What are the strengths of the trans theoretica model?

A

Recognises the different stages of change and interventions that can be used
Includes relapse

126
Q

What are the limitations of the trans theoretical model?

A
  • stages may not be followed in the exact order
  • steps may be skipped
  • doesn’t explain relapse
127
Q

What are the 4 assumptions that prime theory makes about motivation and health?

A
  1. Need to understand moment to moment control of behaviour
  2. Motivation-al system has plasticity I can be modified)
  3. Self idenityy is important to benaviour
  4. Determine motivational system so we can remodel it
128
Q

What are the 5 main factors of prime theory?

A 
Plans
Responses
Impulses
Motives
Evaluations
129
Q

What is a limitation of prime theory?

A
  • lack of evidence of its efficacy in planning in long term
130
Q

What are the 3 parts of the com- B model of behaviour?

A 
Capability= physical and psychological
Oppurtunity= physical and social
Motivation= reflective and automatic

Each factor influences eachother and behaviour, and behaviour also influences behaviour

131
Q

What is the behaviour change wheel?

A

Based on the com - B model with sources of benaviour, intervention functions, policy functions
Motivation - enablement, training, coercion
Capability - modelling, restrictions, environmental restructuring
Opportunity -education, persuasion,incertivization

132
Q

What is nudge theory?

A

Small behaviour manageable interventions that have a wider impact

  • based on assumption that 80% behaviour is automatic
  • cues in environment unconsciously shape choices
133
Q

What is intrapersonal stigma?

A

A person’s attitudes to their own condition

134
Q

What is self stigmatization?

A

Process in which person with mental health diagnosis becomes aware of public stigma

135
Q

What is interpersonal stigma?

A

Stigma a person faces from other people

136
Q

What is structural stigma?

A

Stigma that people face from institutions

All TP1 and Some TP2 (11 decks)

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