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49 Cards in this Set
- Front
- Back
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Health Promotion:
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general philosophy that has at its core the idea that good health, or wellness, is a personal or collective achievement.
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Top 3 preventable factors that cause nearly half the deaths in the US
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Drinking, Smoking, Unhealthy eating
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Health Behavior Definition:
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behavior undertaken by people to enhance or maintain their health
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Health Habits
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health related behaviors that are firmly established and often performed automatically without awareness.
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Health Habits and Illness (Beloc & Breslow, 1972)
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Sleeping 7 to 8 hours a night, not smoking, eating breakfast, having no more than 1 or 2 drinks a day, exercise, not eating between meals, being no more than 10% overweight.
•more health behavior led to: •fewer illnesses •more energy •less "disability" |
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Health Habits and Mortality (Breslow & Enstrom, 1980)
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28% men more likely to live longer, 43% for women
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Primary Prevention
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instilling good health habits and changing poor ones
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Strategies for primary prevention:
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•help people change problematic behavior
•keep people from developing poor habits in the first place |
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Factors that influence health behavior
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Demographics: SES, education, age
•typically health habits are good in childhood •Deteriorates in adolescence •improve again among older people |
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Values and Culture
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•Exercise
•Sexual behavior •eating habits |
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Health Locus of Control:
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•perceptions about whether or not one's health is under personal control
•control of your own health •powerful others are in control of your health •chance is a major determinant in your health |
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Social Influence:
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•Family, friends, and workplace companions can influence health behavior
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Protective Factors decrease likelihood of engaging risk behavior
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•positive models of healthy behavior
•social sanctions for non-normative behavior •social support |
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Risk Factors
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increase the likelihood of engaging in unhealthy behavior
•models of unhealthy behavior •opportunity •personal and social vulnerability |
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Self Affirmation:
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the ultimate goal of the "the self" is to protect an image of its self-integrity, morality and adequacy.
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Health Belief Model
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• Basic Concepts- Depends on two “beliefs”
o Threat/Susceptibility • Am I at risk? o Severity o Effectiveness: will this behavior reduce the threat? •Threat is a product of...general health values, beliefs about personal vulnerability, beliefs about the consequences of the health risk (severity) •effectiveness is a product of...beliefs about whether or not the behavior will reduce the threat, beliefs about the cost vs. benefits of the health behavior |
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Health Belief Model Limitations
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• Explains only a small amount of variance in health behaviors
• Very belief focused • Some components don’t lend themselves well to intervention • Beliefs don’t always translate into behavior |
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Heal
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Explains prevention behaviors well
• Provide clear avenues for intervention |
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Theory of Planned Behavior
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• Basic Concepts- Health behavior is a results of intentions which are made up of 3 components
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Theory of Planned Behavior 3 Components
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Attitudes: similar to threat, effectiveness, cost
o Subjective Norms: perception of what others think about behavior and motivation to follow them o Perceived Control/Self-efficacy: Similar to self-efficacy (can i do it?) |
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Theory of Planned Behavior Benefits
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•identifies intention as the link between attitudes and behavior
• includes social and psychological factors •provides clear avenues for intervention |
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Theory of Planned Behavior Limitations
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•does not explain long-term behaviors change well
•sometimes attitude change messages produce reactance •does not identify how to change attitudes, motivation, or self-efficacy |
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Transtheoretical Model
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Basic Concepts:
•identify themes across theories to analyze the stages and processes we go through to change behavior •different "stages" require different processes •interventions must be tailored to fit the stages |
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Transtheoretical Model
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•Precontemplation: no intention of changing behavior
•Contemplation: aware of problem; thinking about change •Preparation: intend to change; change not yet begun •Action: modifying behavior; committing time and energy |
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Transtheoretical Model Benefits
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•talks about the change process itself •provides clean intervention suggestions tailored to stage
•is generalizable to multiple bahaviors •relates to long-term change processes |
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Transtheoretical Model Limitations
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does not provide theory about specific barriers to change
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Stigma
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is the linking of social judgments about a characteristics to an individual who posses( or is believed to possess) that characteristics.
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Stigma is a social phenomenon
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•stigma exists only within a social context
•Society uses stigma to define characteristics of people that are socially desirable or socially devalued •Stigma is often linked to moral values •Social evaluation leads to stereotypes •Stigma results in a change in social identity •this change is discrediting in nature •Stigma reduces the individual from a whole, "normal" person to a tainted, discounted one. •while stigma is interpersonal, the experience of stigma is intrapersonal |
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Types of Stigma
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•Abominations of the body: physical or visible changes to the body
•Blemishes of individual character: specific behaviors i.e hester prynne of scarlett letter •Tribal stigma: stigma of a particular group (religion) |
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Four Mechanisms through which stigmatization can occur
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1. Negative treatment and discriminatin
2. Anticipation of Future Discrimination 3. Expectancy confirmation 4. Automatic Activation 5. Identity threat |
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Negative treatment and discrimination
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Interpersonal
i. Experiences vary in form and severity • Institutional i. Stigma affects individuals though societal systems |
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Anticipation of Future Discrimination
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•Negative psychological consequences
•Change behaviors to conceal or reduce the visibility of their stigma |
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Expectancy confirmation
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• Self-fulfilling prophecies (stigmatizer)
i. We act in ways that elicit confirmation by others of our beliefs or attributions about them |
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Automatic Activation
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•stereotype threat
i. Pressure and anxiety experienced by memebers of a sterotyped group when they fear being seen through the lens of stereotype • Stereotype consistent behavior (stigmatizee) |
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Identity Threat
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•Attributional ambiguity
i. Consequence of other mechanisms ii. Describes how interpersonal stigma becomes internalized |
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Consequences of Stigma
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•Psychological well-being: stigmatized individuals are at greater risk for depression, anxiety, loneliness, low self esteem.
•experiences of discrimination are related to negative affect and lower overall psychological well-being. •Physical Health: stigmatized individuals are at greater risk for physical health problems. •self reported ill health •self reported number physical health symptoms •sick days •greater risk of prostate cancer and breast cancer, infant mortality and shorter life expectancies. •activation of psychological stress response •increased blood pressure and hypertension •stroke, heart attack •Increased cortisol •depression •development and progression of chronic diseases •Chronic stress •depressed immune system •Institutional discrimination •overexposure to unhealthy physical environments •less access to preventive care and healthful resources •Substandard medical care •Behavior •suicidality •interpersonal |
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Illness as Stigma
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•abominations of the body
•blemishes of individual character •Tribal stigmas |
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Adherence to Treatment
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•The extent to which a patient's behavior matches with his or her practitioner's advice
•Studies suggest adherence to medical regimen's ranges from 15-93% |
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Models of Patient Provider Relationship (Szasz & Hollender, 1956)
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• Activity-Passivity
• Guidance-Cooperation • Mutual Participation |
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Activity-Passivity
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•Doctor is seen as an actor (does something to patient), patient is seen as a recipient (unable to respond)
•Patient does not contribute to the interaction •Surgery, emergency procedure, antibiotics |
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Guidance-Cooperation
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•Patient has feelings, but does not question doctor
• Power is granted to doctor by seeking help •Treatment of acute illness, post-op care |
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Mutual Participation
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•The doctor (assistant) helps patient help himself, he patient is in partnership with expert
•Treatment proceeds in interaction and requires feedback |
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Models of Patient-Provider Communication (Emanuel & Emanuel, 1992)
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•Paternalistic
•Informative •Interpretative •Deliberative |
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Paternalistic
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Provider Role: Patient's Guardian
Provider Obligation: Promote patient well being Patient Role: Adherent and grateful Patient Autonomy: Limited to assent |
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Informative
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Provider Role: Technical Expert
Provider Obligation: Provide relevant information Patient Role: Listener and evaluator Patient Autonomy: Choice of and control over care |
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Interpretative
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Provider Role: Elucidator
Provider Obligation: Assist patient in decision Patient Role: Listener Patient Autonomy: Choice of and control over care |
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Deliberative
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Provider Role: Educator
Provider Obligation: Provide relevant information Patient Role: Open to development Patient Autonomy: Choice of and control over care |
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"It's How He Said It."
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•Audtiotaped 114 conversations (malpractice/not)
•10 second clips from 1st and last minutes •intonation, pitch, speed and rhythm •rated on how...warm, concerned, dominant, sympatheic •Surgeons whose voices were rated as (•higher in dominance •lower in concern)....were more likely to have been sued for malpractice |
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Barriers to Patient-Provider Communication
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• Inattentiveness
•Dr not paying much attention •Audiotaped office visits (Beckman & Frankel, 1984) •23% of doctors allowed patients to finish concerns before beginning diagnosis •69% interrupted after 18-22 seconds • Use of jargon: •Used to impress patients •Due to training •Keeps patients from asking too many questions • Language, •19% of U.S population speaks a language other than english at home • Impersonalization: Dr. just sees a patient as a patient not |
