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 Model BIO 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 Health MedicalSocialInteractional Health state is biological factHealth state is socially constructed Biological causes to illnessIll 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