Health psychology introduction what is health PDF

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Introduction to Health PsychologyWhat is Health Psychology- Health being a state of feeling well and not being sick. We commonly think about health in terms of an absence of (1) Objective signs that the body is not functioning properly, such as measured high blood pressure, or (2) Subjective symptom...

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Introduction to Health Psychology What is Health PsychologyHealth being a state of feeling well and not being sick. We commonly think about health in terms of an absence of (1) Objective signs that the body is not functioning properly, such as measured high blood pressure, or (2) Subjective symptoms of disease or injury, such as pain or nausea. In 1948, the World Health Organization (WHO) defined health as, “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity Health psychology is an exciting and relatively new field devoted to understanding psychological influences on how people stay healthy, why they become ill, and how they respond when they do get ill. . Thus, Health is defined as state where a person functions, physically & mentally efficiently and effectively with relative comfort & of well- being. . Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare. It plays an important role in understanding how behaviors, cognitions, and emotions impact mental and physical health. Health psychology was described by Matarazzo as ‘the aggregate of the specific educational, scientific and professional contribution of the discipline of psychology to the promotion and maintenance of health, the promotion and treatment of illness and related dysfunction’ (Matarazzo, 1980). It is the specialty area that focuses on how biology, psychology, behavior, and social factors influence health and illness. Other terms including medical psychology and behavioral medicine are sometimes used interchangeably with the term health psychology. The field of health psychology emerged in the 1970s to address the rapidly changing field of healthcare. Life expectancy was much lower then, due to lack of basic sanitation and the prevalence of infectious diseases. Health psychology is focused on promoting health as well as the prevention and treatment of disease and illness. Health psychologists also focus on understanding how people react to, cope with, and recover from illness.

Goals of Health Psychology Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare. It plays an important role in understanding how behaviors, cognitions, and emotions impact mental and physical health. Joseph Matarazzo (1982), the first president of the Health Psychology division of American Psychological Association, outlined four goals of health psychology. These goals are described below:  To study scientifically the causes or origins of specific diseases, that is, their etiology. Health psychologists are primarily interested in the psychological, behavioral, and social origins of disease. They investigate why people engage in health-compromising behaviors, such as smoking or unsafe sex.  To promote health. Health psychologists consider ways to get people to engage in healthenhancing behaviors such as exercising regularly and eating nutritious foods.  To prevent and treat illness. Health psychologists design programs to help people stop smoking, lose weight, manage stress, and minimize other risk factors for poor health. They also assist those who are already ill in their efforts to adjust to their illnesses or comply with difficult treatment regimens.

To promote public health policy and the improvement of the healthcare system, Health psychologists are very active in all facets of health education and consult frequently with government leaders who formulate public policy in an effort to improve the delivery of health care to all people. Some other major goals of health psychology are: •Understanding behavioural and contextual factors for health and illness •Preventing illness •Investigating the effects of disease •Providing critical analyses of health policies •Conducting research on prevention of and intervention in health problems •Improving doctor-patient communication •Improving adherence to medical advice •Finding treatments to manage pain. Thus, psychologists work to achieve these goals in a variety of ways to help in improving and promoting good health. 

Mind-Body Relationship For centuries, there has been a debate over the mind and body problem concerning the extent to which the mind and the body are separate (dualism) or the same thing (monism). In history, the mind-body relationship has been understood distinctly in different time periods. In the pre-renaissance period, superstition (belief that cause of physical and mental illness is evil spirits) and trephination (surgical intervention wherein a hole is drilled in the human skull for treatment of epilepsy, mental disorders) were prevalent (monistic view). Also, it saw the origin of humoral theory (Hippocrates, 460 B.C.), proposing that the body contains four fluids namely humors (black bile, yellow bile, blood and phlegm) and its imbalance in the body leads to illnesses. Greek philosophers like Plato and Galen proposed the mind/body split i.e.,mind and body as separate entities having little or no relationship. During the middle ages, religion became influential and sickness was seen as God’s punishment for evildoings. Next, in the renaissance period, Rene Descartes’ cartesian dualism became a prominent view. Descartes proposed a view of mind as an immaterial that engages in diverse activities or states such as logical reasoning, imagining, feeling (sensation), and volition. Matter (brain/body) conforms to the laws of physics in mechanistic fashion, which he believed is causally affected by the human mind and which further produces certain mental events (through pineal gland). For example, wanting for the arm to be raised causes it to be raised, yet being hit on the finger with a hammer causes the mind to feel pain. He believed that mind was separate from matter, but that it could influence matter (known as interactionism). The manner in which such an interaction could be effected remains a point of contention. With the growing emphasis on dualism, this period saw a plethora of scientific discoveries like microscopy, autopsy, surgical and pharmaceutical interventions. Furthermore, in the modern era, these discoveries laid the foundation of the “biomedical model” which proposes that all diseases or physical disorders can be explained by disturbances in physiological processes, which result from injury, biochemical imbalances, bacterial or viral infection. It assumes that disease is an affliction of the body and is separate from the psychological and social processes of the mind. This viewpoint became widely accepted during

the 19th & 20th centuries. With the rise of modern psychology, particularly Sigmund Freud's (1856–1939) early work on conversion hysteria, the biomedical viewpoint began to shift. Specific unconscious conflicts, according to Freud, can cause physical disturbances that represent repressed psychological conflicts. Adding to that, it was the psychological impact of the world wars in the form of shell shock that brought upon the view of monism again to the forefront. This then slowly gave rise to the ‘bio-psycho-social model’ standing in sharp contrast with the biomedical model. Biopsychosocial model

George Engel proposed the Biopsychosocial model in 1977, arguing that understanding a person’s medical condition requires consideration of not only the biological factors but also psychological and social factors. He argued that all the factors are independent and health and illness are the result of the complex interplay between them. The biological (physical) component of the model includes an individual’s genetic makeup and history of physical trauma, injuries, or infections. If the individual is involved in drug use or abuse, then the bodily effects of drugs would fall under the purview of the biological component. The body’s entire system’s (nerves, tissues, organs, etc.) efficient and effective functioning determines health and illness. The psychological (mental) component comprises of cognition, emotion, and motivation of an individual. Cognition is a mental activity that includes perceiving, learning, remembering, thinking, interpreting, believing, and problem solving. Having positive and rational cognition leads to good health and reduced illness. Emotion is a subjective experience that influences and is influenced by our thoughts, behavior, and physiology. Emotions, such as joy and affection, are positive, while others, such as anger, fear, and sadness, are negative. Emotions are linked to health as people with relatively positive emotions, for example, are less disease-prone and more likely to take good care of their health and recover quickly from illness than people with negative emotions. Lastly, motivation refers to the internal process that causes people to begin an activity, choose a course of action, and stick with it. For instance, a person who is motivated to feel and look better might begin an exercise program to reach their goals. The social component of the model includes social support systems, family relationships, and cultural beliefs. We live in a society, and it affects the health of individuals by promoting certain value systems and beliefs that are a part of one’s culture. Then, the community (town, or

neighbourhood) in which we live affects that way individuals engage in healthy behaviors, for example, residents tend to be more physically active in communities that have parks. Additionally, family plays an important role in propagating health related behaviors (Murphy & Bennett, 2004). For example, many health-related behaviors and ideas are instilled in children by their parents and siblings such as by wearing seat belts, serving and eating nutritious meals, exercising, not smoking, and so on. Therefore, it is extremely vital to understand the physical, mental, cognitive, social and spiritual components of health to gain a comprehensive understanding into health and illness.

lifestyle and disease pattern in India The already constrained public health system in India is likely to face serious challenges with a double burden of communicable and non-communicable diseases. An effective and responsive public health system needs to be in place to make health care services available for NCDs and CVDs at the primary level. In order to ameliorate caregiving, the involvement of family will be critical. Informing the people inculcate healthy habits may be an effective health promotion measure. India has some of the palpable health indicators in the world. The improvement in infant mortality rate (IMR) and maternal mortality ratio (MMR) in India are awfully slow. The recent sample registration system bulletin reveals that over the last two decades (1990-2015) IMR in India reduced from 88 to only 37 per 1000 live births. The subcontinent of India reports one of the highest MMR i.e. 167 deaths per 100,000 live births [1]. Similarly, life expectancy at birth which is considered as a summary indicator of health and well-being showed only a marginal improvement, an increase of 3 years from 65 years to 68 years during a period from 2001-2011 [2,3,4,5]. The health care delivery system of India is characterised by a massive out of pocket expenditure. Government spending on health sector in India is meagre. The public spending on the health in India is less than one percent of the GDP, much lower than many of the African countries [3, 6, 7]. A recent estimate suggests that out of pocket expenditure was nearly 846 billion rupees in 2004 which was about 3.3 percent equal to that of the GDP of the year [8]. In all, evidence suggests somewhat poor health outcomes in India. Different regions of India experience dissimilar temperature, rainfall and other geographic conditions due to considerable latitude and longitude extensions ranging from the north to south and the east to west. Across the country, there are different set of cultural beliefs and practices that have a significant bearing on the ways the population perceive health. Non-communicable diseases like cardiovascular diseases, cancer, diabetes, chronic obstructive disease, mental disorder and injuries account for about half of all deaths in India [5]. According to the global health observatory report (2012), out of 68 million total deaths globally, an estimated 38.5 million deaths occurred due to NCDs. India is doubly burdened with both communicable as well as non-communicable disease. Although CVDs and other non-communicable diseases are on the rise, communicable diseases continue to be a major public health problem in India. An incessant

increase in the communicable disease, CVDs, NCDs has overburdened the already inadequate health systems in India. Studies reveal that the infectious diseases, rapid rising of CVDs and NCDs are attributed mainly due to change in intake of food pattern, urban sprawl lifestyle, poverty, poor quality water supply and unhygienic environment, pollution, etc. However, the risk of such diseases among the population with different background characteristics is a relatively lesser known fact. Particularly, the socio-economic determinants contributing to the health condition of a population hold significant relevance to inform policy and programme better. The morbidity pattern of a population is considered as a proxy measure to understand their health status . Measures of self-reported morbidity are directly linked to the health status of any given population. However, limited studies explored the pattern of morbidity across the major states in India using nationally representative large-scale survey data. On the other hand, little information is available about the changing pattern of morbidity prevalence in India from a recent population-based survey. Characteristics of Health Behaviour Health behaviour Health behavior refers to actions that an individual engages in that affect their health either positively or negatively. Health behaviour are the overt behavioral patterns, actions and habits that relate to health maintenance, to health restoration and to health improvement’ (Gochman, 1997, p. 3). A useful broad definition would include any activity undertaken for the purpose of preventing or detecting disease or for improving health and well-being. A variety of behaviours fall within such a definition including medical service usage (e.g. physician visits, vaccination, screening), compliance with medical regimens (e.g. dietary, diabetic, anti hypertensive regimens), and self-directed health behaviours (e.g. diet, exercise, smoking). These can be simple personal choices like hand washing or more complex situations like choosing a place to live that has healthy living conditions. illness behaviour The study of illness behavior, in contrast to health behavior, is concerned with the way people monitor their bodies, define and interpret bodily indications, make decisions about needed treatment, and use informal and formal sources of care (Mechanic 1986, 1995). Like other behavior, illness behavior is learned through socialization in families and peer groups and through exposure to the mass media and education. There is great diversity of attitudes, beliefs, knowledge, and behavior, all of which affect the definitions of problematic symptoms, the meanings and causal attributions that explain them, socially anticipated responses, and the definition of appropriate remedies and sources of care. Motivation and learning affect the initial recognition of symptoms, reactions to pain, the extent of stoicism and hypochondriasis, and the readiness to seek release from work, school, and other obligations and to seek help (Mechanic 1978). Sick role behaviour The sick role is a concept arising from the work of the important American sociologist Talcott Parsons (1902–1979). Parsons was a structural functionalist who argued that social practices should be seen in terms of their function in maintaining order or structure in society. Thus Parsons was concerned with understanding how the sick person related to the whole social

system, and what the person's function is in that system. Ultimately, the sick role and sick-role behavior could be seen as the logical extension of illness behavior to complete integration into the medical care system. Parsons' argument is that sick-role behavior accepts the symptomatology and diagnosis of the established medical care system, and thus allows the individual to take on behaviors compliant with the expectations of the medical system. Basically, Parsons defined the "sick role" as having four chief characteristics. First, the sick person is freed or exempt from carrying out normal social roles. The more severe the illness, the more one is freed from normal social roles. Second, people in the sick role are not directly responsible for their plight. Third, the sick person needs to try to get well. The sick role is regarded as a temporary stage of deviance that should not be prolonged if at all possible. Finally, in the sick role the sick person or patient must seek competent help and cooperate with medical care to get well. Theories of Health Behaviour Protective motivational theory- Deeksha Protection motivation theory (PMT) was originally created to help understand individual human responses to fear appeals. Protection motivation theory proposes that people protect themselves based on two factors: threat appraisal and coping appraisal. Threat appraisal assesses the severity of the situation and examines how serious the situation is, while coping appraisal is how one responds to the situation. Threat appraisal consists of the perceived severity of a threatening event and the perceived probability of the occurrence, or vulnerability. Coping appraisal consists of perceived response efficacy, or an individual's expectation that carrying out the recommended action will remove the threat, and perceived self efficacy, or the belief in one's ability to execute the recommended courses of action successfully. PMT is one model that explains why people engage in unhealthy practices and offers suggestions for changing those behaviors. It is educational and motivational. Primary prevention: taking measures to combat the risk of developing a health problem.(e.g., controlling weight to prevent high blood pressure). Secondary prevention: taking steps to prevent a condition from becoming worse. (e.g., remembering to take daily medication to control blood pressure).

Theory of reasoned action

The theory of reasoned action (TRA or ToRA) aims to explain the relationship between attitudes and behaviors within human action. It is mainly used to predict how individuals will behave based on their pre-existing attitudes and behavioral intentions. An individual's decision to engage in a particular behavior is based on the outcomes the individual expects will come as a result of performing the behavior. Developed by Martin Fishbein and Icek Ajzen in 1967, the theory derived from previous research in social psychology, persuasion

models, and attitude theories. Fishbein's theories suggested a relationship between attitude and behaviors (the A-B relationship). However, critics estimated that attitude theories were not proving to be good indicators of human behavior.The TRA was later revised and expanded by the two theorists in the following decades to overcome any discrepancies in the A-B relationship with the theory of planned behavior (TPB) and reasoned action approach (RAA). The theory is also used in communication discourse as a theory of understanding. The primary purpose of the TRA is to understand an individual's voluntary behavior by examining the underlying basic motivation to perform an action TRA states that a person's intention to perform a behavior is the main predictor of whether or not they actually perform that behavior. Additionally, the normative component (i.e. social norms surrounding the act) also contributes to whether or not the person will actually perform the behavior. According to the theory, intention to perform a certain behavior precedes the actual behavior.This intention is known as behavioral intention and comes as a result of a belief that performing the behavior will lead to a specific outcome. Behavioral intention is important...