SET5A Health Psychology Unit : I - V

Transcription

1 SET5A Health Psychology Unit : I - V 1

2 UNIT I Syllabus Introduction to Health Psychology Definition of Health Psychology Why is the field of health psychology needed Models in Health Psychology Careers in health psychology 2

3 What is Health? A definition of health is offered by the World Health Organization (WHO) as, A complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity. What is Health Psychology? Health Psychology deals with the psychological and behavioral processes contributing to overall individual s well-being and health 3

4 Areas of Focus In Health Psychology Health Promotion and Maintenance Prevention and Treatment of Illness Etiology (causes) and Correlates of Health and Illness Health Policy and Health Care Service Delivery 4

5 A brief history of Health Psychology In ancient times and the middle ages there was a belief that spiritual disturbances caused disease. The development of early Greek Medicine and the advent of the Renaissance brought about a focus on physical causes for disease. Scientific advances in microscopy and human anatomy further advanced medicine. 5

6 A brief history of Health Psychology Mind body relationships Disease attributed to evil spirits and punishment from the gods Hippocrates (circa BC) Humoural theory Descartes ( ) Dualism 6

7 A brief history of Health Psychology Mind body relationships 7

8 A brief history of Health Psychology Psychoanalytic Contributions - Freud s early work on conversion hysteria: - unconscious conflicts produce physical disturbances such as glove anesthesia tremors, muscular paralysis, possible eating disorders Psychosomatic Medicine -Dunbar and Alexander - linked patterns of personality to specific illnesses - helped shape belief that bodily disorders are caused by emotional conflicts 8

9 Biomedical model Diseases and symptoms have underlying pathological cause. Reductionist 9

10 Biopsychosocial model Disease and symptoms are explained by a combination of physical, cultural, psychological and social factors. 10

11 Why do we need Health Psychology? - Changing patterns of illness Advances in technology and research: Role of Epidemiology in Health Psychology Morbidity and mortality 11

12 Why do we need Health Psychology? Cause of Death Deaths Percent of Total Deaths Diseases of the heart 710, Malignant Neoplasms 553, Cerebrovascular Diseases 167, CLRD 122, Accidents (unintentional injuries) 97, Diabetes 69, Influenza & Pneumonia 65, Alzheimer s Disease 49, Kidney Disease 37, Septicemia 31, Total 2,403,

13 Why do we need Health Psychology? Expanded health care services health care is the largest service industry in the U.S. Increased medical acceptance Health psychology research the role of theory, experiments, correlational studies, prospective designs, retrospective research 13

14 Careers in Health Psychology Careers in Practice Physicians & Nurses Social work Occupational therapy Dietetics Public health Careers in Research Public health researchers 14

15 UNIT II Health promotion and health behavior Introduction to health behavior Barriers to effective health promotion Factors influencing the practice of health behavior. 15

16 Health Promotion Overview: - the idea that good health, or wellness, is a personal and collective achievement - health promotion appears to be more successful and less costly than disease prevention

17 Health Behaviors Health Behaviors: - behaviors undertaken by people to enhance or maintain their health -health habits: - firmly established behaviors that are often performed automatically such as wearing a seatbelt, brushing one s teeth and eating a healthy diet

18 Health Behaviors

19 Factors Influencing Health Behaviors Demographic factors Values Social influence Perceived symptoms Age Personal control Personal goals/values Cognitive factors Access to the health care delivery system

20 Barriers to modifying poor health behaviors 20

21 Barriers to modifying poor health behaviors - not knowing when to intervene to change health habits - instability of health habits - health behaviors are elicited and maintained by different factors for different people 21

22 Barriers to modifying poor health behaviors Intervening with children and adolescents: -socialization: - the influence of parents as role models -using the Teachable Moment : - window of vulnerability -adolescent health behaviors influence adult health: - precautions taken in adolescence may affect disease risk after age 45 more than adult health behaviors 22

23 Barriers to modifying poor health behaviors Interventions with at-risk people: - children and adolescents are vulnerable 23

24 Barriers to modifying poor health behaviors Benefits of focusing on at-risk people: - may prevent or eliminate poor health habits - an efficient and effective use of health promotion dollars - makes it easier to identify other risk factors 24

25 Health promotion and the elderly Focus is on: - maintaining a healthy, balanced diet - developing a regular exercise regimen - taking steps to reduce accidents 25

26 Health promotion and the elderly Focus is on: - controlling alcohol consumption - eliminating smoking - reducing the inappropriate use of prescription drugs - vaccinating against influenza 26

27 Social Determinants of Health 27

28 UNIT - III Modification of health behavior Health beliefs Cognitive behavioral approaches to health behavior change Appropriate venue for health habit modification. 28

29 Changing Health Habits Attitude change and health behavior: - educational appeals: - vivid communications - expert communicator - strong arguments at beginning and end - short, clear, direct messages - messages should state conclusions explicitly - caution with extreme messages - depending on the audience, communication should include favorable and/or non-favorable points - fear appeals - message framing

30 Changing Health Habits Self-Efficacy and Health Behaviors - the belief that you can control your behaviors Theory of Planned Behavior: - a health behavior is the direct result of a behavioral intention - benefits of the Theory of Planned Behavior - evidence for the Theory of Planned Behavior

31 Changing Health Habits Health Belief Model: whether a person practices a health behavior depends on: - perception of health threat - perception of threat reduction - support for the Health Belief Model - using the Health Belief Model to change behavior 31

32 Changing Health Habits 32

33 Transtheoretical Model of Behavior Change Stages of change: - precontemplation - contemplation - preparation - action - maintenance

34 34

35 Cognitive-Behavioral Approaches to Health Behavior Change Cognitive-Behavior Therapy (CBT) - self-monitoring - classical conditioning - operant conditioning - modeling -stimulus control 35

36 Cognitive-Behavioral Approaches to Health Behavior Change The self-control of behavior: - self-reinforcement - contingency contracting - cognitive restructuring - behavioral assignments - social skills training - motivational interviewing - meditation - relaxation training 36

37 Changing Health Behaviors Through Social Engineering Social Engineering: Modifying the environment in ways that affect people s ability to practice a particular health behavior - banning certain drugs such as heroin and cocaine - requiring vaccinations for school entry - using safety containers for medications - lowering speed limits - raising the drinking age 3- SET5A- 37 Health Psychology 37

38 Cognitive-Behavioral Approaches to Health Behavior Change Relapse: - reasons for relapse? - consequences of relapse - reducing relapse - relapse prevention - lifestyle rebalancing 38

39 Venues for Health Habit Modification - private therapist s office - health practitioner s office - family - managed care facilities - self-help groups

40 Venues for Health Habit Modification - schools - work-site interventions - community-based interventions - mass media - Telephone - The Internet

41 UNIT - IV Health enhancing behaviour Exercise Accident prevention Cancer related health behaviour Weight control 41

42 Exercise Aerobic exercise: - sustained exercise that stimulates/strengthens heart and lungs - improves body s utilization of oxygen High-intensity, long-duration and requisite high endurance: - jogging - bicycling - jumping rope - running - swimming

43 Benefits of exercise - decreased risk of chronic disease and some cancers - decreased risk of Type II diabetes in high-risk adults - accelerated wound healing - increases in cardiovascular fitness and endurance - increased longevity - how much exercise is a factor - amount of exercise vs. amount of stress is a factor - positive effects on psychological health - exercise is effective as stress management 43

44 Exercise (cont.) Determinants of regular exercise: - individual characteristics: - positive attitude, athleticism, sense of self-efficacy, social support - boys more than girls - leaner people - characteristics of the setting: - convenient - easily accessible

45 Exercise (cont.) Characteristics of interventions: - strategies: - cognitive-behavioral strategies promote adherence - relapse prevention techniques - individualized exercise programs - understanding motivation and attitudes

46 Accident Prevention Home and workplace accidents: - most common causes of death and disability among children under age 5 - have declined due to better safety precautions - number of falls among elderly likely to increase with population change Motorcycle and automobile accidents: - single greatest cause of accidental death

47 Cancer-Related Health Behaviors Mammograms - prevalence of breast cancer in this country remains high - majority detected in women over 40 - early detection through mammograms improves survival rates Convincing women to have mammograms: - breast cancer brochures, counseling, mailed materials - changing attitudes - theory of planned behavior

48 Cancer-Related Health Behaviors (cont.) Colorectal cancer: - second highest cause of cancerous deaths Colorectal cancer screening: - screening is distinctive; people learn they have polyps rather than malignancies - participation predicted by self-efficacy, perceived benefits, physician s recommendation, lack of barriers

49 Cancer-Related Health Behaviors (cont.) Skin cancer: - fourfold increase in the incidence of skin cancer over the past 30 years - melanoma incidence has risen 155% in 20 years - among the most preventable cancers Problem with sunscreen use: - tans are perceived as attractive - young adults are especially concerned with appearance Communication to adolescents and young adults is most successful when stressing gains rather than risks

50 Developing a Healthy Diet Why diet is important: - dietary factors contribute to a broad array of diseases - dietary habits have also been implicated in the development of several cancers - changing one s diet improves health

51 Developing a Healthy Diet (cont.) Resistance to modifying diet: - difficult to get people to modify their diet - problem of maintaining change - some dietary recommendations are restrictive, monotonous, expensive and hard to find/prepare - stress has a direct effect on eating - some dietary changes may alter mood and personality

52 Weight Control and Obesity Regulation of eating: - leptin and insulin are important hormones that control eating - ghrelin may explain why dieters gain their lost weight back - a malfunctioning ventromedial hypothalamus interferes with normal eating habits

53 Weight Control and Obesity Obesity in childhood: - approximately 37% of children are overweight or obese - genes contribute to risk of obesity - sedentary lifestyles - early eating habits contribute to obesity Obesity in older age: - one in four people older than 50 is obese - counseling older adults to adopt a healthy diet and increase exercise is essential

54 Weight Control and Obesity Treatment of obesity (cont.): - Cognitive Behavior Theory: multimodal approach: - screening - self-monitoring - controlling over-eating - adding exercise - controlling self-talk - stress management - social support - relapse prevention

55 Eating Disorders Anorexia Nervosa: - an obsessive disorder amounting to selfstarvation - dieting and exercising to the point that body weight is grossly below optimum level Bulimia: - an eating syndrome characterized by alternating cycles of binge eating and purging through such techniques as vomiting, laxative abuse, extreme dieting and drug or alcohol abuse

56 Rest, Renewal, Savoring - rest and renewal help reduce stress and restore personal balance - savoring the positive aspects of life may also have health benefits - intuition, rather than a strong body of research, guides our thinking about restorative processes

57 UNIT V Health compromising behaviour Alcoholism and problem drinking Smoking

58 Characteristics of Health- Compromising Behaviors Many of these behaviors share a window of vulnerability in adolescence: - drinking to excess - smoking - using illicit drugs - having unsafe sex - using risk-taking behaviors

59 Substance Dependence Physical dependence: - body adjusts to substance and incorporates its use into normal functioning of the body s tissues Tolerance: - larger doses needed to produce same effects Craving: - conditioning process is involved so that environmental cues trigger intense desire

60 Substance Dependence (cont.) Addiction: - person has become physically or psychologically dependent on a substance following use over a period of time Withdrawal: - unpleasant symptoms, both physical and psychological, that people experience when they stop using a substance on which they have become dependent

61 Alcoholism and Problem Drinking Alcoholism: - physical addition to alcohol - withdrawal symptoms when abstaining from alcohol - high tolerance for alcohol - little ability to control drinking Problem drinking: - may not have all symptoms listed above, but do have substantial social, psychological and medical problems resulting from alcohol

62 Alcoholism and Problem Drinking Treatment programs: - self-help groups such as AA (Alcoholics Anonymous) - inpatient/outpatient programs: - detoxification - short-term, inpatient therapy - continuing outpatient treatment

63 Alcoholism and Problem Drinking (cont.) Treatment programs (cont.): - cognitive-behavioral treatments: - self-monitoring - contingency contracting - motivational enhancement - medications - stress management techniques - family therapy and group counseling - relapse prevention

64 Alcoholism and Problem Drinking Evaluation of alcohol treatment programs: - success involves environmental factors, outpatient services, family/social support - minimal interventions: - can make a dent in drinking-related problems - social engineering - banning alcohol advertising - raising the legal drinking age - strictly penalizing drunk driving

65 Alcoholism and Problem Drinking Preventive approaches to alcohol abuse: - appealing to adolescents to avoid drinking - social engineering programs Drinking and driving: - pressure state and local governments for tougher alcohol control measures - hosts/hostesses/friends intervening to recognize those too drunk to drive - need for stiffer penalties - designated drivers

66 Smoking - single greatest cause of preventable death - in the U.S., accounts for about 1 in 5 deaths - increases the risk of many diseases and disorders - smokers are generally less health-conscious than non-smokers - dangers not confined to the smoker; hazards of secondhand smoke - may lower cognitive performance in adolescents

67 Smoking Synergistic effects of smoking: - smoking enhances the impact of other risk factors in compromising health: - smoking and stress can interact in dangerous ways - weight and smoking can interact to increase mortality - smokers engage in less physical activity - smoking is considered a potential cause of depression, especially among youth - smoking is related to an increase in anxiety among adolescents

68 Smoking Interventions to reduce smoking: - changing attitudes toward smoking - the therapeutic approach to the smoking problem: - Nicotine replacement therapy - multimodal interventions - social support and stress management - interventions with adolescents - maintenance - relapse prevention - evaluation of interventions

69 Smoking Brief interventions: - work-site - commercial programs and self-help - public health approach Smoking prevention: - advantages of smoking prevention programs: and - potentially effective, cost-effective easily implemented - social influence interventions: - modeling - McGuire s behavioral inoculation

70 Smoking Evaluation of social influence programs: - can reduce smoking rates for as long as 4 years The life-skills training approach: - encourage self-esteem and coping enhancement as well as social skills in adolescents - has shown success in the reduction of smoking onset over time

71 Smoking Social engineering and smoking: - liability litigation - regulation of access of tobacco by the Food and Drug Administration - heavy taxation - restricting smoking to particular places - the perils of secondhand smoke