This is the Chapter 2 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch. 2: Health inequalities

Health differentials: 

Environmental and social factors influence on health

• Socio-economic status (SES): measure of social class
• Health differential: differences in health status and life expectancy across different groups

Evidence:

• Lower respiratory tract infections: infections in parts of the respiratory system. It's the most common cause of death among poverty
• Health USA: they scored badly in the WHO, because of:
  • Native Americans/inner-city poor
  • HIV
  • Cancers relating tobacco use
  • Violence

Socio-economic health inequalities:

• It is defined as health-behaviour choices, availability such choices, and the social context
• Does SES influence health, or does health influences SES?
  • Social causation model: low health causes health problems --> more predictable of SES
    • Coronary heart disease (CHD): narrowing blood vessels that supply blood and oxygen to heart --> Individuals with low SES, more than twice as likely to develop CHD
  • Social drift model: when people develop health problem --> they are unable tp maintain the workload, the levels of overtime required to maintain that standard of living.

Different health behaviours:

• Premature mortality: death before age that is normally expected (65 years) --> Behaviours of people of low SES are more health-damaging and less health-promoting than behaviours of people of high SES

Access to health care:

• USA:
  • 18%: with health insurance --> they report financial barriers that prevent them from appropriate care
  • 13%: accessed to appropriate medication
• UK: economic barriers less stark
• Coronary artery bypass grafts: surgical procedure, to improve blood flow (CHD) --> although high percentage in SES received it, poorer population remined relatively deprived of this health care
• Statins: drug to reduce cholesterol levels --> High SES are more likely to be prescribed statins

Environmental factors:

• Low SES is exposed to health damaging environments:
  • Working in dangerous settings
  • Low-quality housing --> respiratory health damaged and high levels of stress hormones
    • Atheroma: fatty deposit in intima (inner lining) artery
    • Renting: more at risk of developing CHD
      • Experience more damp
      • Earn less
      • Psychological consequences of living in differing accomodation
• Psychological pathways: illustrates the differences of exercise facilities, traffic safety, and poor environment conditions, in low SES and high SES.

Stress hypothesis:

• Childhood: family instability/overcrowding/diet/education
• Adolescence: family/exposure smoking/poor qualifications/unemployment or low-paid
• Adulthood: working conditions/financial insecurity/unemployment/control work or home life/social interactions
• Older age: occupational pension/heating system/food
• Hierarchy-health hypothesis: states that when someone is aware of their position in the

This is the Chapter 4 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch. 4: Health-protective behaviour

Adherence behaviour:

Definition and measurement:

• Compliance: behaviour which conforms with “doctors’ orders”
• Adherence: person sticks to/cooperates with/advice about medication (or lifestyle change) in a more collaborative practitioner-patient relationship --> influenced individual/environmental factors (healthcare practices)
  • 60% of drug needed daily, any less defined as non-adherence
• Concordance: agreement physician/patient as to what appropriate treatment (not describe adherence behaviour, but more the conditions in which to encourage it)

Do people adhere?

• Gather data: combine self-/other- report, with biological measurements/pill counts/electronic monitoring systems
• Adherence rate vary:
  • Treatment complexity (timing medicines/…)
  • Individual beliefs/actual illness severity

Cost of non-adherence:

• Hospital readmission
  • UK --> £200 million per year due t repeat admissions to hospital

Why not adhere:

• Patient-related factors: self-efficacy beliefs
• Condition-related factors: symptom type, perceived severity
• Treatment-related factors: number/type/timing/side-effects
• Socioeconomic factors: access to dispensing pharmacy/social isolation
• System-related factors
• Nonadherence behaviour:
  • Intentional non-adherence: “I stopped taking my pills as they made me feel sick”
  • Unintentional non-adherence: “Sometimes I forget…”
• Influences:
  • Micro level: personality
  • Macro level: cultural/political context
  • Meso level: social institutions

Healthy Diet:

• Low intake fruit/vegetables --> responsible for over 3 million deaths yearly

Fruit/vegetables

• Essentials healthy body: 5 per day
  • Vitamins
  • Folic acid
  • Antioxidants: oxidation of low-density lipoprotein (LDL/bad cholesterol) --> some chemical properties (polyphenols) of substances (red wine) inhibit process of oxidation
  • Fibre
• Meta-analysis: review/re-analysis of pre-existing quantitative datasets, combines analysis to provide large samples/high statistical power to draw reliable conclusions about specific effects
  • Vegetarians lower cancer incidence/lower rates of ischaemic heart disease: restriction of blood flow to heart

Why problem with intake?

Food preferences:

• Biological preferences/social + cultural factors
  • Parents major role patterns eating/food choices/leisure activities/rules & guidelines as to what considered appropriate behaviour
• Food Dudes: pre-/primary-school children UK --> programme draws on learning theory techniques of increased taste exposure to fruit/vegetables
  • Cartoon youth characters reinforcement by means of rewards for fruit/vegetable eating

Exercise:

• Physical inactivity: 4^th leading risk factor for global mortality
• Exercise: health-protective, reduce risk of developing -->
  • Cardiovascular/CHD
  • Type 2 diabetes mellitus
  • Osteoporosis: reduction bone density due to calcium loss
  • Obesity
  • Some forms of cancer --> colorectal/breast cancer

Recommendations:

• Adults [18-64]:

This is the Chapter 6 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch. 6: Behind changing behaviour

Development interventions:

General Health Interventions: change behaviour entire population

• PRECEDE-PROCEED model: identifies a range of psychosocial variables that could be the target of any intervention
  • Predisposing factors: knowledge/attitudes/personal preferences/existing skills and self-efficacy in relation desired behaviour
  • Enabling factors: environment facilitate behaviour changes (availability and accessibility of resources)
  • Reinforcing factors: factors reward desired behaviour change (ex: social support/economic rewards/social norms)
• Phases of implementaton:

1. Social diagnosis: planners impression health problems affect community
2. Epidemiological/behavioural/environmental diagnosis: identification and assessment health issues, and related behavioural and environmental influences
3. Educational and ecological diagnosis: determine how behaviour phase 2 can be changed --> identity predispositions and reinforcing factors
4. Administrative and policy diagnosis: program consistency with policy organization
5. Implementation of program: implementation intervention. 3 elements evaluation:
   • Process: program do as intended?
   • Impact: impact on outcome
   • Outcome: long-term effects on health

Risk behaviour changed?

• How do we increase motivation, change beliefs and attitudes, encourage people to work towards desired goals, and so on?
  • Stages of change (Prochaska and di Clemente): stage model --> pre-contemplation/contemplation/preparation/change/maintenance or relapse --> reasonably accurate predicting behaviour. Move back and forth along change continuum.

Motivational change:

• Provision of Information:
  • Novel information: does not contradict previous understandings of issues, is highly relevant to the individual, and is relatively easy to act on
  • Involve social, psychological and situational factors --> men and women found negotiation of the use of condoms, as well as their actual use, complex and embarrassing
  • Influence motivation:
    
    • negative consequences of health-damaging behaviour
    • Information about the ease of behavioural change
    • NICE guidelines for behaviour change: when quitting smoking
      
      • Outcome expectancies: Smoking causes people to die on average eight years earlier than the average
      • Personal relevance: If you were to stop smoking, you could add six years to your life, and be fitter
      • Attitude: Life is good and worth living
      • Self-efficacy: managed to quit before.
      • Descriptive norms: 30 per cent of people of your age have successfully given up smoking.
      • Subjective norm: Your wife and kids will appreciate
      • Personal/moral norms: Smoking is anti-social and you do not want your kids to start smoking
• Elaboration Likelihood Model (ELM): only individuals already interested beforehand info, will pay attention and act accordingly.
  
  • Peripheral processing: not motivated, not involved, incongruent beliefs --> maximize credibility/attractiveness message through use indirect cues/info
  • Motivated to receive argument when:
    • Congruent

This is the Chapter 9 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch.9: Symptoms experienced and interpreted

Sensation illness:

• Illness: changes in bodily sensations and functions, goes to the doctor. Includes changes in bodily functions (e.g. increased frequency of urination), emissions (such as blood in one’s ­ urine), sensations (e.g. numbness, loss of vison) and unpleasant sensations (e.g. fever, pain, nausea)
  • views about health --> prior experience of illness and their understanding of medical knowledge
• Disease: wrong organs, cells or tissues

Perception symptoms:

Sick recognition process: 1. Noticing, 2. Interpreting, 3. Planning/take action

• The attentional model of Pennebaker (1982): competition for attention between multiple internal or external cues or stimuli leads to the same physical sign or physiological change going unnoticed in some contexts but not in others.
• The cognitive–perceptual model of Cioffi (1991): processes of interpretation of physical signs and influences upon their attribution as symptoms while also acknowledging the role of selective attention

Bodily signs --> increased likelihood symptom perception:

• Bodily signs: are physical sensations that may or may not be symptoms of illness.
• Symptoms: defined as what is experienced and, as such, they are more subjective (unreliable indicators of the need for medical attention’)
  
  • Symptoms receiving attention:
    
    • Painful or disruptive: if a bodily sign has consequences for the person
    • Novel: (considered rare and serious) subjective estimates of prevalence significantly influence
      
      • (1) the perceived severity of a symptom
      • (2) whether the person will seek medical attention
    • Persistent: a bodily sign is more likely to be perceived as a symptom if it persists for longer than is considered usual
    • Pre-existing chronic disease: past or current illness experience has a strong influence upon somatisation (i.e. attention to bodily states) and increases the number of other symptoms perceived

Attentional states:

• Competition of Cues Theory: competition attention internal/external cues --> notice physical signs in some context, not notice in others
  • Stroop Task: demonstrated that previous experience with an illness can increase a person’s attentional bias --> anxiety is commonly implicated in enhanced attention to potential or actual health threats.
  • Placebo response: manifested by attentional processes --> demonstration of the power of expectation.
• Primary Attentional System (PAS): operate below the level of consciousness and acts on stored representations, such as illness schema which it automatically selects from.
  
  • Mass Psychogenic Illness: illustrates the powerful effect of anxiety on our perceptions and behaviour --> heightens a person’s attention to their own bodily signs and

This is the Chapter 11 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch.11: Stress, health and illness

Stress:

• Stimulus or event external to the individual
• Psychological transaction between the stimulus event and the cognitive and emotional characteristics of the individual
• Physical or biological reaction

Life events theory (Holmes and Rahe, 1967):

Naturally occurring life events --> unitary consequences + cumulative effects

• SRRS, Holmes and Rahe 1967: social readjustment rating scale, with values (life change units [LCU]) from 11 (minor violations of law) to 100 (maximum value was assigned to death of a spouse).
  • Social readjustment: intensity/length of time necessary to accommodate to a life event, regardless of the desirability of this event

Limitations of life events measurement:

• Retrospective assessment: ill people search for explanations for illness, which may include misattributions to past events.
• Items scale not globally appropriate --> depending on, events might not be applicable
• Items intertwined/interrelated: cancel out or enhance the effects of one another
• LCU system assumes people rank events in a similar way
• Inconsistencies reported with events rated as ‘severe’
• Life events approach: does not systematically address the many internal and external factors that may moderate the relationship event/outcomes.

Stress as a transaction:

• Psychological theories of stress: appraisal is central to whether or not an event is deemed to be a stressor or not.
  • Hans Selye (1974): physiological responses to stressful stimuli, and differentiates -->
    • ‘Eustress’: stress associated with positive feelings or healthy states
    • ‘Distress’: bad kind of stress associated with negative feelings and disturbed bodily states.
  • Cognitive Transactional Model of Stress (Lazarus and Folkman, 1984): participants exposed stressful films while monitoring self-reported stress levels and physiological arousal
    
    • Video about tribal initiation rites that included genital surgery. Intervention groups, with different introductions:
      
      • Distancing response: intellectual description of the rites from a cultural perspective --> taking a detached view  to reduce emotional activation
      • Denial response: lecture that de-emphasised the pain the ‘willing’ initiates were experiencing and emphasised the excitement they were feeling --> view that denies any negative implications of an event or stimulus
      • Emphasise perceived threat: narrative that emphasised the pain and trauma the initiates were undergoing
      • Control: no info
      • Introductions influenced the way in which the film was seen --> appraisal processes were mediating stress responses
    • Stress Lazarus: result of an interaction between:
      
      • Individual’s characteristics and appraisals
      • External or internal event (stressor) environment
      • Internal or external resources a person has available to them
      • When changing

This is the Chapter 15 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands.

Ch.15: Impact and outcomes of illness: families/informal caregivers

Family Affair:

• Informal carers: untrained family members or friends, no clearly defined limits to their role
  • Positive effects of training caregivers in providing --> reduced caregiver burden, reduced anxiety and depression, and improved QoL for both the caregivers and their patients

Expectancies of care:

Gendered expectancies:

Societal expectation of caring being a ‘natural’ role for women, who are ‘expected’ to find family-oriented roles fulfilling, even in the absence of financial reward

• Caring becomes stressful -->  is judged as ‘going beyond the call of duty’ --> importance of identifying caregiver role expectations and their perceived spousal obligations

Culture:

• Filial piety: obligations of respecting, supporting and taking care of older family members.
  • Collectivism: belief and value systems including familism and filial responsibility or piety
  • South Asian cultures --> expectancies tend to fall on female family members
  • China --> filial obligation first extends to the eldest son, if married, his spouse.

Willingness to care:

• Caregiver well-being --> relationship caregiver and recipient from intrinsic motivations (principles) to care, as opposed to extrinsic motivations (guilt)
• Ethnic minority caregivers: emphasis on familism and filial responsibility, sense of reciprocity for former parental care and support, but also out of emotional attachment
  
  • African-American/Hispanic/Asian-American/British-Asian
• Rohr and Lang (2014): willingness to care in relation to the gains or losses anticipated from the role
• Prosocial behaviour: love, empathy, trust and altruism. Presence of the hormone oxytocin (acts as a neurotransmitter in the brain appears to reduce autonomic stress responses and associated with affiliative social behaviour) --> influence on our behaviour --> willingness to care differ in oxytocin levels.
• Caregivers may not have options other than to provide care --> demanding role seen as inescapable

Family systems:

• Stages in a continuum of adaptation (McCubbin and Patterson, 1982):

1. Stage of resistance: deny or avoid the reality
2. Stage of restructuring: acknowledge reality and start to reorganise their lives around
3. Stage of consolidation: newly adopted roles may have to become permanent

• Family-Systems Illness model (Rolland, 2012): more systemic, biopsychosocial approach to illness must acknowledge:
  • Illness and its likely characteristics over time
  • Those involved in family unit as they can ‘in turn influence the course of an illness and the wellbeing of an affected person’
  • Family goal: understanding of how they, as a family, function together and separately, with any gendered and cultural norms and expectations

This is the Chapter 17 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands.

Ch.17: Health and quality of life

Coping chronic illness:

• Therapeutic approaches:
  • Providing relevant information
    • Types of info:
      • Nature of a disease and/or its treatment
      • How to cope with disease and/or its treatment
      • Change behaviour in order to reduce risk of disease progression
    • Educational programmes: help people to manage a disease or reduce risk of further disease --> sense of control over their illness
  • Stress management training
    
    • Problem solving: prevent or minimise external problems
    • Cognitive restructuring: to identify and challenge stress-provoking thoughts
    • Relaxation: to reduce the physiological arousal that forms part of the stress response.
  • Written emotional expression: writing technique write about upsetting incidents

Mindfulness:

• Mindfulness-based stress reduction (MBSR): studies of the effectiveness --> patients coping better with their symptoms, improved overall well-being and quality of life, as well as improved health status

Social support:

Men who had experienced a radical prostatectomy benefited  from meeting with a fellow patient once a week to discuss any concerns they had and coping strategies they could use

• Group cohesiveness
• Information exchange
• Feelings of being in the same situation.
• Hope, catharsis and altruism

Managing Illness:

Info provision:

• Web-based health information sites provided by the American Heart Association: personalised report of ‘scientifically accurate’ treatment options, a list of questions to ask their doctor

Self-management training:

• Social cognition theory: teaching how to manage their illness in a way that maximises control over their symptoms and quality of life --> increased confidence and continued application of new skills
  • Structured progressive: ensures success at each stage before progression
• ‘One size fits all’ approach: tailored programmes that provide a number of modules that participants can select according to their particular needs
• ‘Intensified functional insulin therapy’: intervention involve educational component --> how factors such as additional exercise and eating meals (varying levels of carbohydrate) influence their blood sugar levels
• Heart Manual: programmes that have translated key elements of the self-management process into written or computer-based form

Stress management training:

• Episodes of angina: triggered by emotional as well as by physical stresses --> such interventions reduce the frequency of angina
  • Performed better on a standardised exercise known as a treadmill test: of cardiovascular fitness, gradually increase the level of exercise on a treadmill while having their heart monitored

Social and family support: