Clinical health Psychology Models in Physical Health Conditions

Transcription

1 IMPARTS SEMINAR Clinical health Psychology Models in Physical Health Conditions Nicky Thomas Head of Psychological Services/Consultant Health Psychologist

2 Clinical Health Psychology Patient/family support Assessments Psychology clinics MDT clinics Ward rounds Support Group Relaxation sessions Inpatients National Level Peer Review Committee NICE CGs BPS SIG in Haematology Service support Consultation Patient literature Staff training/ education/support Inductions MDT meetings MDT seminars Research Audit/policies/protocols Service development

3 Main Health Psychology Concepts of Service Responses to Illness/ Beliefs & Representations The ways that people are affected by: Becoming ill, Receiving treatment, Adjusting to long-term illness, including pain & coping Treatment adherence. Looking at how health & health behaviour changes over life span. Patient Involvement (242 NHS Act 2006 'Duty to involve ) has been strengthened so that current legislations states: We involve service users (patients, carers) a) always when planning the provision of services b) when developing and considering proposals for changes in the way services are provided and c) when making decisions that affect the operation of those services Needs assessment-service development- Evidence based

4 Nature of Adult Health Psychology Service Normal part of MDT, not something extra; visible members; accessible service for patients and staff HP Team is diverse/established- Individual & group therapy CBT, ACT- solution focussed therapy, MI No time limit on psychology input; 6 monthly reviews; annual reviews in clinic Support groups co-facilitated by patient Neuropsychological assessment Focus on development of effective coping and self management skills & enhance well being Patients can self refer Patient representatives Encourage involvement with SCD Awareness Day, Christmas Party, Newsletter.

5 Clinical interventions Usually, interventions also address more specific health and treatment related concerns.

6 CHP -ULTIMATE GOAL Enhance perceived /personal control To facilitate /promote self management of health condition.

7 Adjustment & development through the lifespan Childhood Adolescence Early Adulthood Mid-life Living with LTC all life or Health Event [e.g. Breast Cancer Diagnosis Older adulthood

8 Main Assessments/Outcome Measures: Assess Benefit Coping Strategies Questionnaire, Revised Sickle Cell Version for Adults (CSQR; Gil, et al., 1989; Rosenstiel & Keefe, 1983; Gil et al 1989) Pain Self Efficacy Questionnaire (PSEQ; Nicholas, 1989) Short Form McGill Pain Questionnaire (SF-MPQ; Melzack, 1987). Yields sensory & affective pain W&SAS Work and social adjustment scale General Health Questionnaire 28 (GHQ 28; Goldberg & Williams, 1988). IPQ-Bref The brief Illness perceptions scale WHOQOL World Health Organisation Quality of life scale Patients satisfaction/patients experience project.

9 Clinical Health Psychology General Principles The patient is the expert in terms of their subjective experience of physical symptoms. Pain is what the patient says it is. Psychological interventions can Enhance the patients understanding & [sometimes] modify the patients experience of conditions & symptoms. Help patients cope & manage conditions Address other psychological & behavioural factors which affect the patient

10 Inequity Although there are quite a few CHPs working within physical health there is still quite a big gap in terms of CHP provision across GSTT IMPARTS is therefore very helpful in areas where there are no existing psychologists Collaboration between GSTT psychologists &IMPARTS team is key ; Presentations will highlight some excellent collaborations E.g. Lucie Knight & Mark Turner

11 THANK YOU