Define health behaviour, and state the three classifications of health behaviour
Health behaviours: Behaviours related to the health status of the individual
Good health behaviours: regular exercise, healthy eating, sleeping 7-8hrs
Health protective behaviours: wearing a seat belt, attending screening and check-ups
Health impairing habits: smoking, high fat diet, alcohol abuse
Describe the four main determinants of health behaviour
Background factors: Characteristics that define the context in which people live their lives
Stable factors: Individual differences (personality) in psychological activity that are stable over time and context
Social factors: Social connections in the immediate environment
Situational factors: Appraisal of personal relevance that shape responses in a specific situation
What are stable factors?
Individual variations between people in psychological activities that produce the same (stable) responses across time and context (If the event were to happen again, the response would be the same).
Appraisal of the situation and decisions on coping mechanisms are made. Sensitivity towards a particular event is determined, the event is evaluated (e.g. threat or challenge) and a response (or potential response) is made.
What are the three broad types of individual differences?
Explanatory styles: Psychological processes involved in explaining the cause of negative events (past)
Emotional dispositions: Psychological processes involved in the experience and expression (present)
Generalised expectancies: Psychological processes involved in formulating expectations about future outcomes
Describe the five types of emotional dispositions
Openness to new experiences: Intellect and interest in culture, imaginative
Conscientious: the will to achieve, self disciplines, efficient, organised, reliable
Extroversion: outgoing, talkative, assertive and active
Agreeableness: loving, friendly, compliant, generous
Neuroticism: experience more negative emotions, anxious, tense, worried, self-pitying
Define locus of control
Expectations that future outcomes will be determined by factors that are either internal (self) or external (others, chance)
How does locus of control influence patients' attitude to health?
An internal locus of control is generally associated with more favourable outcomes, and performance of health behaviours (however this is dependent on situational factors) People with an internal locus of control believe they are responsible for their own health, illness can be avoided by taking care of themselves, and that ill health results from poor health behaviours e.g. not eating correctly or not getting enough exercise.
What is self-efficacy?
The belief in your own ability to organise and execute a course of action, and the expectation that the action will result in, or lead to a desired outcome.
Describe the two psychological processes involve in explaining the causes of negative events
Optimism: Expectation of positive future outcome, despite current negative event. In optimism there are low levels of physiological reactivity in mild/moderate levels of stress and promote active responses. Associated with better physical health, recovery and health behaviours. (Reverse for pessimism)
Attributional style: Explanations of the cause of negative events as internal (self), permanent (time i.e. inevitable), and global (situation). Outcomes are better if causes are attributed to external, unstable, specific causes rather than internal, permanent and global. Attributions made by a patient infuencecs their expectations about control of future outcomes e.g. relevance of health behaviours
What are social cognition theories?
Attempt to explain the relationship between social cognition (belief, attitudes, goals) and behaviour
Describe the features of the health-belief model
Whether an individual engages in a behaviour or not depends on the percieved threat and perceived efficacy.
Perceived threat: Patients evaluate likelihood of adverse outcome from a a particular state/condition (perceived susceptibility) and how severe the outcome is is likely to be (perceived severity
Perceived efficacy: Evaluate the benefits of behaviour and barriers to changing health behaviour. This process determines health behaviour.
Drawback: Doesn't take into account self-efficacy or social networks. Useful in understanding screening behaviours.
How can the health beliefs model be used in clinical
Need to explore the patient's perceived susceptibility, severity, benefits and barriers.
Use education for perceptions of threat and goal setting/action planning and problem solving to help overcome barriers.
Describe the theory of planned behaviour
Behaviours are result of behavioural intention which have been formed from behavioural attitude, subjective norms and perceived behavioural control.
Patients develop an attitude which turns into a behavioural intention which then manifests as a behaviour.
Behavioural attitudes are formed from behavioural beliefs - the likelihood that an action will result in a positive/negative outcome, and evaluation of consequences of that outcome
Subjective norms arise from social networks (normative beliefs) and motivation to comply with beliefs.
Perceived behavioural control is the most significant factor in forming behavioural intention. This is formed from asessing the advantages and disadvantages of the behaviour, any barriers. Failing to believe you have control means an individual is unlikely to change behaviour.
Describe the transtheoretical model
Stages of change: (useful for understanding addictive behaviours)
Precontemplation: No consideration of change
Contemplation: starting to think about change
Preparation: start to gather information
Action: engaging in good behaviour
Maintenance:good behaviour is maintained.
Relapse can occur at any stage. As an individual progresses their self efficacy increases, advantages become more apparent and temptations decrease.
Why is it important to understand the framework for determinants of health behaviour?
Different factors represent different intervention targets and therefore require different intervention strategies
What are the four main determinants of health behaviours and beliefs
Background factors: cultural norms, ethnicity, genetics
Stable factors: emotional disposition, explanatory styles
Social factors: perceived support (family, friends), subjective norm, helping relationships
Situational factors: perceived risk, motivation, emotional response, situation-specific self efficacy.
What is perceived susceptibility?
The perecption of risk the individual is at from a state/condition. Subjective
What is perceived severity?
The evaluation of how serious the consequences associated with a state or condision is. Subjective
What is perceived threat and how does it influence health behaviour?
Perceived threat is the subjective evaluation of the likelihood of adverse outcome from a a particular behaviour and how severe the outcome is is likely to be.
This can be an indication of the level of motivation an individual has to avoid a particular outcome
Define perceived benefits
The positive benefits of taking a health action to ofset a perceived threat, as understood by the patient.
This is influenced by an individual's overall health motivation
What is self-efficacy?
The belief in one's own ability to excecute a given behaviour
How can the theory of planned behaviour model be used in clinical practice?
Can be used retrospectively to analyse health behaviours, to predict and understand behaviours, and in the design of health promotion interventions.
e.g. weight gain prevention and eating behaviour, HIV prevention and condom use
Explore attitude and perceived norms to assess knowledge and motivation to comply. Then explore intention and perceived control.
Why are frameworks useful for understanding health behaviours?
Patients are influences by a combination of background, stable and social factors which provide an understanding of the current situation. Understanding (appraisal) of the situation determines behaviour in that situation.
Different intervention targets require different intervention strategies.
Describe the three main components of the Theory of Planned Behaviour
Behavioural attitude: outcome of evaluating whether or not an action is likely to promote or decrease a given outcome, and whether the outcome is to be acheived or avoided (desireable or negative consequences)
Subjective norms: refers to beliefs about what behaviours others expect and the degree to which the individual wants to comply with others’ expectations.
Perceived behavioural control: Combination of control beliefs - the external factors which inhibit or facilitate an action and self-efficacy, the indiviual's own self-confidence to excecute the action.
How can psychological factors affect health?
Directly: by leading to poor mental health and physical health
Indirectly: by leading to poor health behaviours which impact physical health
What is the biopsychosocial model?
Model that suggests biological, psychological (thoughts, emotions, and behaviors), and social factors, all interact to play a significant role in human functioning in the context of disease or illness.
State the four main determinants of health behaviour and give two examples of each
Background: Gender, Ethinicity, Genetics, Cultural norms, Chronic health status
Stable: Emotional disposition, generaliseed expectanciesm explanatory styles
Situational: perceived risk, emotional response, motivation
Social: perceived support, helping relationships