Health Psychology

PHIL THIRKELL

Lay Beliefs

What are Lay Beliefs?• Common-sense understanding and knowledge about health/illness• Rooted in their own experience• Aren’t necessarily wrong

Where do patients get lay beliefs from?

• Personal knowledge • Media/Internet

• Previous medical encounters • Spiritual beliefs

• Folk knowledge • Alternative/Complimentary medicine

Lay Beliefs Why might taking into account a patient’s lay beliefs be beneficial?

• Help to understand illness related behaviour

•Understand their needs

•Understand their expectations

•Patient satisfaction

•Doctor satisfaction

What triggers a patient to access healthcare?

•Sanctioning (my wife told me to come and see you…)

•Temporalising of Symptomatology (if my leg hasn’t got better by next week I’ll go to the GP…)

•Interfering with vocational activity (my constant headaches mean I can’t concentrate at work…)

•Interfering with social activity/relationship (I can’t play football anymore because my knee hurts so much…)

•Interpersonal crisis (my brother’s just had a heart attack, so think I should do something about my chest pain…)

Health Behaviour vs. Illness Behaviour

Health Behaviour◦ Behaviours related to the health status of an individual

◦ Sleep, exercise, attending screening, smoking, alcohol etc.

Illness Behaviour• Behaviours a patient engages in once they believe they are ill• e.g. seeking help, changing habits etc.

Dual Pathway Model – how psychological factors affect health

Psychological Factors

e.g. stress

Health Outcome

e.g. hypertension

Behaviour

e.g. smoking

direct pathway

indirect pathway

BioPsychoSocial ModelBIO

• Bacteria• Viruses• Genetics• Other illness

PSYCHO

• Behaviour• Emotions• Beliefs• Stress

SOCIAL

• Employment• Housing• Class• Ethnicity

Determinants of Health Behaviour

Background – e.g. ethnicity, culture, education etc.

Stable (personality type)

Social – e.g. social cues (you look terrible today), social support (high = perceived healthier)

Situational – e.g. if bored you’re more likely to notice symptoms, publicly visible symptoms

Emotional disposition – O.C.E.A.N.Expectancies – LOCUS OF CONTROL

Explanatory style – OPTIMIST/PESSIMIST

Stable Factors – Emotional Disposition

OCEAN◦ Openness – curious, willing to accept new ideas

◦ Conscientiousness – discipline, organisation etc.

◦ Extroversion – enthusiastic, actively seeks information/help

◦ Agreeableness – sympathetic, appreciative etc.

◦ Neuroticism – anxious, tense, self-pitying

Stable Factors – Generalised Expectancies

Locus of Control – how much control they have over future events

• Internal – more favourable outcomes. They believe:• Responsible for their own health• Illness can be avoided by good health behaviours• Ill health is from poor health behaviours

• External – opposite of all the above

Self – Efficacy• Belief that they can carry out an action which will lead to a good outcome

Stable Factors – Explanatory Style

Optimism/Pessimism

A patient’s expectation of the future despite a current bad situation

Attributional Style

•Self – internal/external

•Time – permanent/temporary

•Situation – global/specific

Models of HealthMedical Social Interactional

Health state is biological fact Health state is socially constructed

Biological causes to illness Ill health caused by social factors e.g. wheelchair ramps

Causes identified using diagnosis with signs + symptoms

Causes identified through beliefs and interpretation

Medical knowledge is all with doctors

Knowledge isn’t exclusionary - it has historical, cultural, social

context

Disease oriented and concerned with pathology

Holistic – taking into account people’s lives and experiences