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| Pixabay credit Miguel A.Padrinan |
For most people, health is staying well & getting over illnesses. This approach explains the lack of pro-activeness in taking charge of one's own health, by practicing health-promoting-behaviours, such as exercise, meditation, eating right, avoidance of substances tobacco, alcohol etc.
The field of Health Psychology is devoted to understanding these psychological & behavioural influences on how people stay healthy, why they become ill & how they respond when they do get ill. Before we dwell into it further, let's look at how WHO (World Health Organisation) defines health.
Health is a state of complete physical, mental & social well-being & not merely the absence of disease or infirmity. WHO presents a bio-psycho-social model of health, i.e. body, mind (psychological) & social influences all put together determines health & illness. This puts the field of Health Psychology, at the very core of healthcare management principles. Let's now explore the practical implications & importance of Health Psychology, in healthcare.
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Changing patterns of illness
Until the 20th century, the major causes of illness & deaths used to be Acute Disorders (Infectious diseases like influenza & pneumonia, tuberculosis, gastroenteritis, plague, cholera, malaria etc). Acute disorders are short-term illness, often the result of a viral, bacterial or protozoal infection & usually amenable to cure.
In the 21st century, the major causes of morbidity & mortality has shifted from acute disorders to Chronic Illness (diseases of the heart, cancer, stroke, diabetes, alzheimer's etc). Chronic illnesses are slowly developing diseases with which people live for a long time. Often, these illnesses cannot be cured, but rather managed by medical interventions & lifestyle alterations.
Psychological & social dimensions are the causal factors, for several chronic illness. For e.g. personal health habits, such as diet & smoking, are implicated in the development of heart disease & cancer. Health psychology explores these causes & develops ways to modify them.
Secondly, because people live with chronic diseases for many years, psychological issues may arise in them with deteriorating quality of life. The chronically ill needs help to cope & adjust psychological & socially to their changing health state.
This changing pattern of diseases & illness in the 21st century, makes a strong case for Health Psychology as a preventive measure & as a vital adjunct in therapy & treatment strategies.
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| Pixabay credit Basil M K |
Health promotion
The role of behavioral factors is very evident in the development of preventable disorders (e.g. lung cancer, cardiovascular diseases, alcohol & other drug abuse, & vehicular accidents).
It is estimated that nearly half the deaths in the United States are caused by preventable factors, with smoking, obesity & drinking being the top three.
This has been true for the past 10 years, the only change being that obesity & lack of exercise are about to overtake tobacco as the most preventable causes of death in the United States. - CDC (Centers for Disease Control & Prevention), 2004.
Cancer deaths alone could be reduced by 50% simply by getting people to reduce smoking, eat more fruits & vegetables, boost their physical activity & obtain early screening for breast & cervical cancer. - Center for the Advancement of Health, 2003.
Thus, successful modification of health behaviours, will reduce morbidity, mortality & expand the number of years during which a person can enjoy life free from complications of chronic diseases.
Health behaviours & Health habits
Health behaviours help people to enhance & maintain their health.
Poor health behaviours are implicated in illness & if not checked, can easily become poor health habits.
A health habit is a health-related behaviour that is firmly established & often performed automatically, without awareness. These habits usually develop in childhood & begin to stabilize by pre-teens. Brushing one's teeth, eating a healthy diet, limited screen time are examples of such behaviours. It is important to establish good health behaviours & to eliminate poor ones early in life.
Examples of good health habits:
- Sleeping 7 to 8 hours a night
- Not smoking
- Eating breakfast each day
- Avoidance of regular drinking or binge drinking
- Regular exercise
- Eating healthy food
- Not eating between meals
- Being no more than 10% overweight
Exercise:
A mere daily 30 minutes of aerobic exercise (e.g. jogging, bicycling, swimming) can decrease the risk of chronic diseases (cardiovascular diseases), some cancers including breast cancer, obesity & negative moods. It increases immune system functions, strength & efficiency of heart, slow-wave sleep & longevity.
Accident prevention:
The single largest cause of accidental death is motorcycle & car accidents. Safety habits like driving within speed limits, wearing seat belts, wearing helmets, cyclist/motorist making oneself visible through reflective or fluorescent clothing, not riding/driving under the influence of alcohol, avoiding mobile phones while driving, can substantially reduce the risk of road accidents.
Cancer-related health behaviour:
Preventive screening for cancer can help diagnose malignancy at an early stage, increasing the chance of cure. BSE (Breast self-examination), Mammograms, TSE (Testicular self-examination), Colorectal cancer screening can facilitate early diagnosis of cancer, in it's early stages.
Healthy diet:
Consumption of unhealthy diet has lead to dramatic rise in obesity in several developed countries.
Dietary factors have been implicated in a broad array of diseases & risks for diseases.
Dietary modifications are critical for people at risk or who have been diagnosed with chronic diseases such as coronary artery disease, hypertension, diabetes & cancers (colon, stomach, pancreas & breast).
Eating right, improves one's health. Maintaining a proper diet & getting enough exercise jointly contributes to weight & obesity control. A diet high in fiber, fruits, vegetables, whole grains, peas & beans & low in refined grains, red meat, is recommended for good health benefits (it gives protection against obesity, cardiovascular diseases & lowers risk for several cancers).
Health-compromising behaviours:
Substance abuse & dependence, Alcoholism & Smoking.
Adolescence is a vulnerable age, for health-compromising behaviours to set in. However, several other health problems, such as obesity can also begin in early childhood & alcoholism can be a special risks for older adults.
Many of these behaviours are heavily tied to the peer culture, as children learn from & imitate the peers. Wanting to be attractive to others becomes very important in adolescence, leading to development of eating disorders, consumption of alcohol, tobacco & drugs.
Several health-compromising behaviours are linked to self-presentation process - an effort to appear sophisticated, cool & savvy, in the peer group.
Many of these behaviours are initiated because they are pleasurable, provides excitement & thrill & it enhances one's ability to cope with stressful situations. However, over a period, these behaviours can become a risk factor for a major chronic disease or lead to dependence/addiction.
Stress
Life events which are negative, uncontrollable, ambiguous & overloaded, leads to stress.
Stress is a negative emotional experience accompanied by biochemical, physiological, cognitive & behavioral changes. Stress is the consequence of a person's inability to meet the demands of the environment. In other words, stress is determined by person-environment fit.
When a person feels well-equipped to deal with a difficult situation, they may feel little stress & instead experience a sense of challenge. On the contrary, when a person feels ill-equipped to deal with a difficult situation, will feel stressed out.
Long-term stress brings about undesirable physiological changes.
Stress can also affect health via behaviours - first, by influencing health habits directly & second, by interfering with treatment compliance.
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| Source: Baum, 1994 |
Therefore, the impact of any potential stressful event is significantly influenced by how a person copes with it.
Personality & coping
Personality of an individual determines how he or she will cope with the event.
Neuroticism: Certain people are predisposed by their personality for a pervasive negative mood marked by anxiety, depression & hostility. They tend to express distress, discomfort, dissatisfaction & have poor health. In other words, the chronic negative state of mind has a bearing on one's physiology (illness being psychosomatic in nature, i.e. mind affects the body).
Coping skills is how a person deploys their thoughts & behaviours to effectively manage the demands of the stressful situations. It is a conscious act by the person over a period of time for dealing with the stress.
Internal resources for coping:
Positive emotional states are associated with better mental & physical health.
Optimism - An optimistic nature can lead people to cope more effectively with stress & thereby reduce their risk for illness.
Psychological control - Self-belief that one can determine one's own behaviour, influence one's environment & bring about desired outcomes; helps one to cope with stress effectively, results in good health & emotional well-being.
Self-esteem, self-confidence, conscientiousness are important determinants for effectively coping with stress.
Resilience is characterised by the ability to bounce back from negative emotional experiences & to adapt to the changing demands of stressful experiences. Sources of resilience are positive life events, positive emotions, opportunities for rest, relaxation & renewal, purposeful living, development of quality relationships.
Coping style is a general propensity to deal with stressful events in a particular way. Various people use different strategies like avoidant (minimising) coping, approach (confrontative, vigilant) coping, problem-focused coping (involves attempts to do something constructive about the stressful conditions) & emotion-focused coping (involves efforts to regulate emotions experienced because of the stressful event).
External resources for coping:
External resources include time, money, education, a decent job, friends, family, standard of living & presence of positive life events. Individuals who have more external resources, cope better with stressful situations.
Social support is a vital protective psycho-social resource.Social support can come from parents, spouse, partner, relatives, friends, social & community contacts. People with high levels of social support experience less stress & they cope with the stressful situation better.
Coping interventions - not everyone is able to cope with stress successfully on their own. Hence coping interventions help them to acquire coping skills so that they become empowered to effectively deal with stress. Mindfulness training, Disclosure (Counseling), Coping effectiveness trainings (specific coping strategies to deal with specific stressors), Avoiding negative self-talk & engaging in positive self-talk, Acquiring skills, Goal setting, Cognitive-behavioural techniques, Relaxation training & Stress management, are various examples of coping interventional methods.
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One can shift from reactive approach of treating illness with just medication, to a responsive approach of taking charge of one's own health by developing health behaviours, by changing health compromising behaviours, by enhancing one's psychological (mind) faculty & by enriching his or her social relationships.
As the old adage goes, Prevention is always better than Cure.
It's time, to become conscious & self-aware of our Health Psychology (attitude, thoughts, behaviour & habits) & to take back the control of our health, into our own hands.