HealthPsyc1 Flashcards
What is health?
WHO (1948) definition of health as a:
“State of complete physical, mental and social well-being…not merely the absence of disease or infirmity”
• Bircher (2005) defines health as
“a dynamic state of well-being characterised by a physical and mental potential, which satisfies the demands of life commensurate with age, culture, and personal responsibility”
• Indigenous Australian people define health as
“not just the physical well-being of the individual but refers to the social, emotional, spiritual and cultural well-being of the whole community. This is a whole of life view and includes the cyclical concept of life-death life”
No one single definition- complex multifaceted concept extending beyond biological aspects of individual functioning
• Biomedical model of illness
- Symptoms of illness considered to have underlying pathology
- Removal of pathology»_space; restored health
- May be mechanistic, too reductionist- ignores the fact that different people respond in different ways to illness because of differences (e.g. personality, social support, cultural beliefs).
• Biopsychosocial model of illness
- Psychological and social factors can add to biological or biomedical explanations and understanding of health and illness
- Diseases and symptoms can be explained by a combination of physical, social, cultural, and psychological factors
- Employed in health psychology, allied health professionals, and increasingly in medicine
Health psychology
Health psychology is an interdisciplinary field concerned with the application of psychological knowledge and techniques to health, illness, and health care.
• Devoted to understanding psychological influences on how people:
• Stay healthy
• Why they become ill
• How they respond if they do become ill
Health enhancing behaviours
Healthy eating • Exercise • Safe sex • Screening • Vaccination
Health Risk Behaviours
- Sedentary lifestyle
- Smoking
- Alcohol
- Salt consumption
- Fat consumption
Why are we looking at models of health behaviour?
Theoretical models have been proposed and tested in terms of their ability to explain and predict why people engage in health risk or health enhancing behaviours.
- Why do individuals smoke? What factors predict whether or not someone engages in smoking?
- The models we will describe have identified many modifiable influences upon health behaviour that offer potential targets for health intervention- promotion and education
- Using models of health behaviour- we can design interventions to address the modifiable influences on a behaviour such as smoking (e.g. overcoming barriers, highlighting benefits, increasing confidence to quit).
- We want to underpin our research and interventions with evidence based theory
Transtheoretical model
Stage model of behaviour change- individuals can be at ‘discrete ordered stages’, each one denoting a greater inclination to change
• Transtheoretical model (Prochaska, 1979 Prochaska and DiClemente, 1984) provides a framework for explaining how behaviour change occurs as individuals move through stages of motivational readiness
• Makes 2 broad assumptions:
• People move through stages of change
• Processes involved at each stage differ
Transtheoretical Model 5/7 Stages of Change
Precontemplation
• Has no intention of taking action within the next 6 months
- Contemplation
- Intends to take action within the next 6 months.
- Preparation
- Intends to take action within the next 30 days and has taken some steps in this direction.
- Action
- Has changed overt behaviour for less than 6 months
- Maintenance
- Has changed overt behaviour for more than 6 months.
- Termination
- Behaviour change has been maintained for an adequate time for the person to feel no temptation to lapse
- Relapse
- Where a person lapses into their former behavioural pattern and returns to a previous stage (common, can occur at any stage)
Transtheoretical Model Implications
The model is not linear
• People can enter and exit at any point and some people may repeat a stage several times
- It implies that different interventions are appropriate at different stages of health behaviour change
- Implications for interventions»_space; little point in trying to show how to achieve change if in precontemplation; that type of intervention may be more beneficial if individual in planning or action stage
Transtheoretical model- tailoring intervention
Implies that different interventions are appropriate at different stages of health behaviour change
- Precontemplation
- Individuals more likely to be using denial, may report lower self efficacy and more barriers to change
- Contemplation
- More likely to seek information and may report reduced barriers and increased benefits- although may still underestimate their susceptibility
- Preparation
- People start to set their goals and priorities, and some will make concrete plans. Motivation and self efficacy are crucial if action is to be elicited
- Action
- Realistic goal setting is crucial if action is to be maintained. Use of social support is important to receive reinforcement of change
- Maintenance
- Can be enhanced by self monitoring and reinforcement
Transtheoretical model- criticisms
- An individual may be in several stages of change at one time (Budd & Rollnick, 1996 heavy drinking study)
- Perhaps too much focus on motivation and intention- past behaviour is a more powerful predictor of future behaviour (Sutton, 1996)
- Participants stage of change may not be predictive of success of intervention (Carlson et al., 2003 smoking intervention study)
- Doesn’t consider social aspects of health behaviour, severity of illness/disease/outcome, characteristics of the individual
The Health Belief Model (HBM)
The HBM is a social cognitive model that attempts to
explain and predict health behaviours
• This is done by focusing on the attitudes and beliefs of individuals
• The HBM was first developed in the 1950s by social
psychologists Hochbaum, Rosenstock and Kegels
• Since then, the HBM has been adapted to explore a variety of long- and short-term health behaviours
Four Main Factors of HBM
According to the model, a person’s readiness to take a health action (e.g. quit smoking, start exercising, practice safe sex) is determined by four main factors:
- Perceived severity or seriousness of the disease: I believe coronary heart disease is a serious illness contributed to by being overweight
- Perceived susceptibility of the disease: I believe I am susceptible to heart disease because I am overweight
- Perceived benefits of the health action: If I lose weight my health will improve, my risk of heart disease will decrease, and I’ll feel good
- Perceived barriers to performing the action: Finding the time to exercise and eat well in my current lifestyle will be difficult and possibly more expensive
The Health Belief Model: Revisions/Extensions
- Becker and Mainman (1975) included general health motivation as a 5th factor.
- Revisions of the theory (Becker and Rosenstock, 1984) have also included further factors in the HBM
- Demographic variables
- Psychosocial variables
- Cues to action has been added as an additional explanatory variable (e.g. the recent advertisement on TV about the health risks of obesity worried me)
