Midterm Intro To Health PDF

THE HEALTH BELIEFS Learning objectives of this chapter are: 1- To introduce students to the health belief model (HBM) 2- To discuss the components of the health belief model and how they influence behavior 3- To discuss application of the health belief model to UAE population  THE HEALTH BEL...

THE HEALTH BELIEFS Learning objectives of this chapter are: 1- To introduce students to the health belief model (HBM) 2- To discuss the components of the health belief model and how they influence behavior 3- To discuss application of the health belief model to UAE population  THE HEALTH BELIEFS  Thehealth belief model (HBM)  Components of the health belief model  https://www.youtube.com/watch?v=Knedre8 Ul60  INTRODUCTION  The health belief model (HBM) is a health behavior change and psychological model developed by Irwin Rosenstock in 1966 for studying and promoting the uptake of health services.  Subsequent changes to the model were made in 1988, to accommodate the role that knowledge and perceptions play in personal responsibility.  INTRODUCTION, CONT.  The HBM has been adapted to explain and predict: https://www.youtube.com/watch?v =3ZFcYZJ8Os4  COMPONENTS OF THE HEALTH BELIEF MODEL (HBM)  Perceptionof susceptibility to disease (perceived personal vulnerability)  Perceived severity (seriousness)of disease  Perceived costs of action  Perceived benefits of action  Perceived cues to action  PERCEPTION OF SUSCEPTIBILITY VULNERABILITY)  Perceived Susceptibility: (an individual's assessment of their risk of getting the condition)  My chances of getting lung cancer  how likely do you think you will have this health issue?  PERCEIVED SEVERITY (SERIOUSNESS)  Perceived Severity: how serious a problem do you believe this health issue is?  Refers to an individual's assessment of the seriousness of the condition, and its potential consequences  E.g. lung cancer is serious PERCEIVED COSTS OF ACTION  Individual's assessment of the influences that discourage adoption of the promoted behavior  What are the potential negative aspects of doing this recommended behavior? E.g. stopping smoking will make me irritable.  PERCEIVED BENEFITS OF ACTION  Perceived Benefits: an individual's assessment of the positive consequences of adopting the behavior.  how well does the recommended behavior reduce the risk(s) associated with this health issue? PERCEIVED CUES TO ACTION  An individual's perception of the levels of susceptibility and seriousness provide the force to act. Benefits (minus barriers) provide the path of action  Cues may be internal (symptoms of breathlessness) or external (information in form of health education leaflets)  THE HBM-MEDIATING FACTORS  Demographic variables (such as age, gender, ethnicity, occupation)  Socio-psychological variables (such as social economic status, personality, coping strategies)  Health motivation (whether an individual is driven to stick to a given health goal)  Perceived control (a measure of level of self- efficacy) HEALTH BELIEFS MODEL  HEALTH BELIEF MODEL (BECKER, 1974, 1988; JANZ & BECKER, 1984) INDIVIDUAL PERCEPTIONS MODIFYING FACTORS LIKELIHOOD OF ACTION Demographic variables Perceived benefits of (age, sex, race, preventive action ethnicity, etc.) minus Sociopsychological variables Perceived barriers to preventive action Perceived Susceptability to Disease “X” Perceived Threat of Likelihood of Taking Disease “X” Recommended Perceived Seriousness Preventive Health Action (Severity) of Disease “X” Cues to Action Mass media campaigns Advice from others Reminder postcard from physician/dentist Illness of family member or friend Newspaper or magazine article THE REVISED HEALTH BELIEF MODEL  Becker Rosenstock (1987) revised the HBM and added self-efficacy to the original factors of the model  Self-Efficacy: one’s “conviction that one can successfully execute the behavior required to produce the outcomes” (Bandura, 1977).  SELF-EFFICACY (BANDURA, 1986, 2004) OUTCOME EXPECTATIONS PHYSICAL SOCIAL SELF-EVALUATIVE SELF-EFFICACY GOALS BEHAVIOR SOCIOSTRUCTURAL FACTORS FACILITATORS IMPEDIMENTS Adapted from Bandura (2004). Health Education & Behavior, 31, 143-164. Concept Definition Application Define population(s) at risk, risk levels; personalize risk based on a Perceived One's opinion of chances of getting person's features or behavior; Susceptibility a condition heighten perceived susceptibility if too low. One's opinion of how serious a Specify consequences of the risk and Perceived Severity condition and its consequences are the condition One's belief in the efficacy of the Define action to take; how, where, Perceived Benefits advised action to reduce risk or when; clarify the positive effects to be seriousness of impact expected. One's opinion of the tangible and Perceived Identify and reduce barriers through psychological costs of the advised Barriers reassurance, incentives, assistance. action Provide how-to information, promote Cues to Action Strategies to activate "readiness" awareness, reminders. Confidence in one's ability to take Provide training, guidance in Self-Efficacy action performing action.  CHAPTER 3 HEALTH BEHAVIORS OUTLINE  What is wellness?  What is health behaviors?  Attribution: The patient assigns reasons for his/her health/illness  Inconsistency in health behavior  Psychological patterns and health  Personal control and health  Stages of Change  https://www.youtube.com/watch?v=ZJ1SntT6lg4  DEFINITIONS  What is wellness  Wellness is an active process of becoming aware of and making choices toward a more successful existence  https://www.youtube.com/watch?v=tDzQ dRvLAfM  DEFINITIONS, CONT.  Preventative health behavior: “any activity undertaken by a person believing himself to be healthy for the purposes of: increasing health, preventing disease or detecting it at an asymptomatic stage” (Kasl & Cobb, 1966)  DEFINITIONS, CONT. Illness: a condition of pronounced deviation from the normal healthy state How does someone make the decision that s(he) is ill?  Illness is subjective HEALTH BEHAVIORS  Wemay act to  Wemay avoid ill promote health by: health by:  Engaging in  Not smoking wellness activities  Wearing seatbelts  Getting enough and crash helmets sleep  Washing our hands  Eating a balanced and brushing our diet teeth HEALTH BEHAVIOR  Illnesses are influenced by lifestyle factors such as diet, alcohol intake, smoking, and exercise  If we want to increase our chances of remaining healthy, we may be able to adopt healthy behavior into our lifestyle  This would mean a balanced diet, exercising, drinking in moderation, and not smoking  Do advise people on healthy behaviors?  chiropractor (A person whose job is to treat disease by pressing a person's joints, specially those in the back) HEALTH BEHAVIOR  We tend to practice some health habits but not others  Health behavior is not always rational or logical  People are not consistent in their health habits  People often postpone health behaviors  Why? ATTRIBUTION  Some people will attribute their state of health to living a healthy lifestyle  However, is it true that if we lead a healthy lifestyle then we will remain healthy? PSYCHOLOGICAL FACTORS AND HEALTH Predispositions to think, feel, and act in particular ways – personality (Type A Behavior Pattern?) PSYCHOLOGICAL FACTORS AND HEALTH  Highly stressed people may be perceived as being at risk for heart attacks  1950s cardiologists Friedman and Rosenman first described TABP  Certain personality characteristics have been associated with risk for heart attacks PSYCHOLOGICAL FACTORS AND HEALTH  Type A Behavior Pattern: Highly competitive Sense of time urgency Achievement striving Impatient with delays Try to do several things at once Chronically aroused *chronic hostility, anger, aggression, basic distrust of others PSYCHOLOGICAL FACTORS AND HEALTH Hostility and chronic heart disease  255 medical students filled out a measure of hostility  30 years later their health status was assessed  Results: Fivefold increase in CHD incidence among those physicians with the higher hostility scores  Number of deaths – 6 times greater among those with the most hostility (Barefoot et al, 1983) PERSONAL CONTROL MODELS  People differ in their views about their health  Locus of control – Some people see it as something over which they have a great deal of control and others may be content to leave the control of their health in the hands of health professionals  Personal control is made up of a person’s beliefs about how well he or she can bring about good events or avoid bad events PERSONAL CONTROL MODELS Peoplewith a high level of personal control are more likely to:  have a healthy lifestyle  seek and follow a health professional’s advice when ill PERSONAL CONTROL MODELS  Locus of Control  On one end of the scale, people believe that they are responsible for their own destiny and can control their own behavior and therefore their health (internal locus of control)  At the other end of the scale, people believe that their lives are controlled by external events beyond their control, such as powerful others or fate (external locus of control)  Which locus of control type would you like to see in your offices? PERSONAL CONTROL MODELS Individuals with higher internal locus of control tend to:  Cope better with life’s crises  Have more social support that buffers them against illness  Have a more competent immune system  Report feeling more positive emotion PERSONAL CONTROL MODELS  Which type of patient (internal or external locus of control) do you expect to see in your office?  Does chiropractic care encourage a patient to have an internal or an external locus of control? HEALTH BEHAVIOR People are not consistent in their health habits  They make resolutions but fail to keep them, or they postpone attempts at giving up smoking or losing weight  Why? LOCUS OF CONTROL  https://www.youtube.com/watch?v=0mKDhwk4a_ g  Locus of control  https://www.youtube.com/watch?v=Q0guTERGP K0  Locus of Control: Quick Coping Skill for Anxiety  CHAPTER FOUR Illness Cognitions and Representations  Schezophrenia  https://www.youtube.com/watch?v=hDroA6eawsE Abdullah 9/16/2024  Illness Cognitions and Representations  Illness cognition:  “a patient’s own implicit common sense beliefs about their illness” (Leventhal et al. 1980, 1997)  Knowledge about disease, meaning of illness, beliefs about illness……..  Illness representations / schemas: organized conceptions of illness. Abdullah 9/16/2024  Illness Cognitions and Representations  Acquired through personal experience, family and friends, contacts with health care system, mass media  Provide patients with a framework or schema for  Understanding their illness  Coping with their illness  Telling them what to look out for if they are becoming ill Abdullah 9/16/2024  Illness Representations Five dimensions of illness representations: 1. IDENTITY Label given to the illness and the symptoms experienced Beliefs about associated symptoms Disease prototype 2. PERCEIVED CAUSE OF ILLNESS Biological, psychological, behavioral Cultural influences Internal versus external locus of control Abdullah 9/16/2024  Illness Representations 3. TIME LINE Beliefs about the duration of illness Acute Chronic Cyclic 4. CONSEQUENCES beliefs about the impact of illness on their life (physical, emotional, social consequences) beliefs about treatments that result Abdullah 9/16/2024  Illness Representations 5. CURABILTY & CONTROLLABILITY Can the illness be treated? How? Extent to which the outcome is controllable by self or external factors Who can control the outcome of the illness (patients themselves, doctors, fate….) ? Abdullah 9/16/2024  Self-Regulatory Model of Illness Cognitions  Developed by Leventhal et al. (1980, 1997) to explain how illness cognitions affect coping strategies  Basis for model:  Humans develop problem solving techniques when normal state is altered (i.e. when health turns for the worse)  Motivated to re-establish state of normality and equilibrium  Three processes (interpretation, coping, appraisal) that interrelate in an on-going and dynamic manner Abdullah 9/16/2024  Self-Regulatory Model Representation of health threat - identity - cause - consequences - time line - cure/control Stage 1: Interpretation - symptom perception Stage 2:Coping Stage3:Appraisal - social message - approach coping - Was my coping -> deviation from norm - avoidance coping strategy effective? Emotional response to health threat - fear - anxiety - depression Abdullah 9/16/2024  Stage 1: Interpretation ⚫ Initial confrontation with the illness ⚫ An individual may be aware of illness either from symptom perception or social messages ⚫ Symptom perception, e.g. I have a pain in my chest ⚫ Social messages may take the form of doctor’s diagnosis, lab test result, or messages from lay referral system Abdullah 9/16/2024  Stage 1: Interpretation  Individual differences in symptom perception, e.g. attentional differences, neuroticism, mood, expectations, situational factors  Interpretation activates illness representation in attempt to give meaning to the problem Abdullah 9/16/2024  Stage 2: Coping ⚫ Consideration and application of different coping strategies ⚫ Coping with illness as well as emotional reactions to illness ⚫ Can be broadly categorized into: ⚫ Approach coping ⚫ E.g. Consulting a doctor, adhering to treatment, rest, lifestyle change, seeking information, seeking support from others ⚫ Avoidance coping ⚫ E.g. Denial, wishful thinking Abdullah 9/16/2024  Stage 3: Appraisal  Evaluating if the coping efforts are effective  If not effective, reconsider coping strategies Abdullah 9/16/2024 Chronic Illness and The Self-Regulatory Model of Illness Cognitions  The model is useful in understanding and/or predicting:  Emotional reactions to illness  Coping with illness  Adherence with treatment and lifestyle changes  Outcomes of illness Abdullah 9/16/2024  Chronic Illness  Characteristics:  Long in duration  Long-term consequences  Usually involves multiple causes, including health habits  Cannot be fully cured; can only be managed  As many as 50% of population has some chronic condition  Cancer, heart diseases, diabetes, hypertension, arthritis, stroke……… Abdullah 9/16/2024  Challenges  Change in perception of self  Worries concerning the illness and one’s life Abdullah 9/16/2024  Chronic Illness  Emotional reactions to chronic illness Shock and Denial Anxiety Depression Abdullah 9/16/2024  Chronic Illness  Illness as crisis  Unexpected appearance of illness  Unclear and ambiguous information about illness and the course of illness  Need to make quick decisions (on treatment, telling others, taking time off work)  Little experience with illness (limited past history) Abdullah 9/16/2024  Coping Strategies for Chronic Illness  Similar to coping strategies for other stressful events in life except that chronically ill patients use less active coping methods:  Social support and direct problem-solving  “I talked to someone to find our more about the situation”  Distancing  I didn’t let it get to me”  Cognitive escape / avoidance  “I wished that the situation would go away”  Behavioral escape / avoidance  “Avoiding the situation by eating, drinking, sleeping etc” Abdullah 9/16/2024 Chronic Illness and The Self-Regulatory Model of Illness Cognitions  The Self-Regulatory Model has been found to be useful in understanding and/or predicting:  Adherence with treatment and lifestyle changes  Brewer et al. (2002): belief that illness has serious consequences was related to medication adherence, and belief that illness is stable, asymptomatic, and with serious consequences was related to actual cholesterol control among patients with hypercholesterolaemia Abdullah 9/16/2024 Chronic Illness and The Self-Regulatory Model of Illness Cognitions  Outcomes of illness  Johnston et al. (1999): perceived control predicted recovery among stroke patients at one and six months after discharge from hospital  Petrie et al. (1996): Longitudinal study of 143 first-time MI patients aged 65 or below for 12 months following admission to hospital  Belief that the illness had less serious consequences and would last a shorter time (at baseline) predicted return to work at six weeks  Belief that the illness could be controlled or cured predicted attendance at rehabilitation classes Abdullah 9/16/2024  CHAPTER FIVE - 1 Stress, illness and coping 9/29/2024 Dr. Abdalla  Stress, illness and coping 9/29/2024 Dr. Abdalla  Content What is stress Three Views of Stress 1. Stress as a stimulus 2. Stress as a response 3. Stress as an interaction Major sources of Stress Factors Affecting Stress Appraisal 9/29/2024 Dr. Abdalla  What is Stress https://www.youtube.com/watch?v=Nrt_amb 8_y0 Stress is mental and physical condition that occurs when a person must adjust or adapt to the environment. Major stressors vs. routine hassles Major:Cumulative nature of stress. Hassles: Cognitive appraisals. 9/29/2024 Dr. Abdalla  Three Views of Stress 1. Stress as a stimulus (stressors): focus on the environment. 2. Stress as a response (distress): reaction to stress. 3. Stress as an interaction: relationship between person and the environment. 9/29/2024 Dr. Abdalla  Stressors (as stimulus) Examples: War Overcrowding Deadlines Dense traffic Marital conflict, and Work stress. 9/29/2024 Dr. Abdalla  Acute vs. Chronic Stress Acute stress Sudden, typically short-lived, threatening event (e.g., robbery, giving a speech). Chronic stress Ongoing environmental demand (e.g., marital conflict, work stress, personality). https://www.youtube.com/watch?v=vLV4WsKlYhA https://www.youtube.com/watch?v=WuyPuH9ojCE 9/29/2024 Dr. Abdalla  Stress as a response Selye’s General Adaptation Syndrome (1956, 1976, 1985) Series of bodily reactions to prolonged stress, occurs in three stages. 1. Stage of Alarm Reaction: Body resources are mobilized to cope with threat (stress). 2. Stage of Resistance: Body adjusts to stress but at a high physical cost; resistance to other stressors is lowered. 3. Stage of Exhaustion: Body’s resources are drained and stress hormones are depleted (exhausted), possibly resulting in psychosomatic disease or complete collapse. 9/29/2024 Dr. Abdalla  Stress as a response, Cont. Selye’s General Adaptation Syndrome (1956, 1976, 1985) Alarm Resistance Exhaustion Reaction Arousal Limited Perceived Fight or high as Physical Stressor flight body tries resources; defend resistance and adapt. to disease collapses; death 9/29/2024 Dr. Abdalla  Figure 10.3: Organ Systems Involved in the GAS 9/29/2024 Dr. Abdalla Psychophyiological model of the stress response 9/29/2024 Dr. Abdalla  Stress as a response physiological model of the stress response 9/29/2024 Dr. Abdalla  Cognitive Model of Stress Lazarus & Folkman Primary appraisal: Is there a potential threat? Outcome – Is it irrelevant, positive, or stressful? If stressful, evaluate further: o Harm-loss – amount of damage already caused. o Threat – expectation for future harm. o Challenge – opportunity to achieve growth, etc. Secondary appraisal: Do I have the resources to deal effectively with this challenge or stressor?- If not, then distress. 9/29/2024 Dr. Abdalla  Cognitive Model of Stress Lazarus & Folkman, Cont. 9/29/2024 Dr. Abdalla  Cognitive Model of Stress Lazarus & Folkman https://www.youtube.com/watch?v=a8FEMH CRowM Lazarus & Folkman Transactional model of stress & coping 9/29/2024 Dr. Abdalla  Cognitive Model of Stress Lazarus & Folkman Low High High Stress Resources Demands High Threat High High/low Moderate Resources demands Stress Low Threat Low Low High Stress Resources demands Low Threat High Low Low or no Resources demands stress 9/29/2024 Dr. Abdalla  Major sources of Stress Frustration: blocked goal Conflict: incompatible motivations - Approach- approach - Approach - avoidance - Avoidance - avoidance Change: having to adapt - Social Readjustment - Life Change Pressure: Perform/conform 9/29/2024 Dr. Abdalla  Major sources of Stress https://www.youtube.com/watch?v=ALiCToVg24g https://www.youtube.com/watch?v=XxhuvNV-ync Stress and Coping 9/29/2024 Dr. Abdalla  Personal Factors Affecting Stress Appraisal ❑Intellectual ❑Motivational ❑Personality ❑Beliefs 9/29/2024 Dr. Abdalla  Situational Factors Affecting Stress Appraisals Strong demands Imminent Life transition Timing Ambiguity – role or harm ambiguity Desirability, and Controllability - Behavioral control - perform an action - Cognitive control - using a mental strategy. 9/29/2024 Dr. Abdalla  Job Strain – Role of control Demands High Low High Control Low STRAIN 9/29/2024 Dr. Abdalla  Job Stress - Other aspects Physical environment Poor interpersonal relationships Perceived inadequate recognition or advancement Unemployment (even anticipated) Role conflict, and High responsibility for others. 9/29/2024 Dr. Abdalla Fig. 15.2. Stress is the product of an interchange between a person and the environment. 9/29/2024 Dr. Abdalla  Biopsychosocial Aspect of Stress How stress affects health - Via behavior - Via physiology See the video: How Stress Affects Your Brain - http://www.youtube.com/watch?v=prG3NI__Bf4 9/29/2024 Dr. Abdalla  Psychophysiological model of the stress response 9/29/2024 Dr. Abdalla  Behavioural Aspects Increased alcohol intake Smoking Increased caffeine Poor diet, and Inattention leading to carelessness. 9/29/2024 Dr. Abdalla  Physiological Aspects 1. Cardiovascular reactivity – increased blood pressure, platelets, lipids (cholesterol). 2. Endocrine reactivity – increased catecholamines and corticosteroids. 3. Immune reactivity – increased hormones impairs immune function. 9/29/2024 Dr. Abdalla  Psychophysiological Disorders 1. Digestive system – e.g., ulcers, irritable bowel syndrome 2. Respiratory system – e.g., asthma 3. Cardiovascular system – e.g., hypertension, lipid disorders(altered levels of blood lipids, e.g. elevated levels of blood cholesterol), heart attack, angina 9/29/2024 Dr. Abdalla  Stress-Illness Relationship Illness Preexisting Physiological physiological & psychological or psychological wear and tear vulnerability Illness precursors, symptoms Behavioural Exposure changes & to stress Coping efforts Illness behaviour 9/29/2024 Dr. Abdalla  Stress and the Cardiovascular System Repeated exposure to stress linked to cardiovascular problems - Especially for those who display strong physical reactions to stressors. Physical reactions depend partly on one’s personality. https://www.youtube.com/watch?v=qRaGx02cLtQ The Relationship Between Stress and Cardiovascular Disease 9/29/2024 Dr. Abdalla  The Relationship Between Stress and Cardiovascular Disease The video talks about multimodality imaging, which aims to assess the activated parts of the brain while having some stressful things going around, it also relate this to the ability of having cardiovascular diseases. In addition to the amygdala which is a partin the brain responsible for the emotions, senses from all around the body.  Stress & Heart disease https://www.youtube.com/watch?v=hsrrOeQ kgno The Impact Of Stress On Your Heart. 2mins https://www.youtube.com/watch?v=ZhGzU0C hv1g Reversing heart disease. 10mins 9/29/2024 Dr. Abdalla