Health Exam 1

Front 1

Health

Back 1

An interaction between biological, psychological, and social factors
-"A positive state of physical, mental, and social well-being (not simply the absence of injury or disease) that varies over time along a continuum."

Front 2

Early cultures got rid of disease by

Back 2

puncturing skull of sick people so evil spirits will leave

Front 3

Ancient Greece and Rome

Back 3

balance between four:
-earth, fire, air, water
-mind and body are not related

Front 4

Middle Ages

Back 4

illness due to sin or devil. Didn't know cause of death

Front 5

Renaissance and after

Back 5

-tools and surgery
-mind and body are separate but communicate with one another

Front 6

Biomedical model

Back 6

-all diseases or physical disorders can be explained by disturbances in physiological processes
-include injuries, infections, etc
-disease is an affliction of the body and is separate from the psychological and social processes of the mind
-don't look at stress, social support, etc

Front 7

Implications of the Biomedical Model
-Reductionistic model

Back 7

-doesn't focus on other factors that may influence health

Front 8

Implications of the Biomedical Model
-single factor model

Back 8

-only interested in biological factors

Front 9

Implications of the Biomedical Model
Mind-body dualism

Back 9

-mind and body are separate entities

Front 10

Implications of the Biomedical Mode

Back 10

emphasizes illness over health

Front 11

Lifestyle

Back 11

-Risk factors: characteristics or conditions that are associated with the development of a disease or injury
-Can be biological (genetic) or behavioral

Front 12

Personality

Back 12

a person's cognitive, affective, or behavioral tendencies that are fairly stable across time or situations

Front 13

Psychosomatic medicine

Back 13

-examines the relation between individuals' physical symptoms and emotions
-tied to medical disciplines

Front 14

Behavioral medicine

Back 14

-interdisciplinary - wide variety of disciplines
-uses conditioning to change health behavior (Classical Conditioning, Operant conditioning, Reward and Punishment)
-interventions that do not use drugs or surgery

Front 15

Health Psychology

Back 15

1) Examine the causes and correlates of illness
2) Promote and maintain health
3) Prevent and treat illness
4) Analyze and attempt to improve the health care system

Front 16

Health Psychologists:

Back 16

examine the uses of illnesses; studies ways to promote and maintain health...

Front 17

Biopsychosocial model

Back 17

-Biological, psychological, and social factors affect and are affected by a person's health
*Biological factors (genetics, physiology, physical systems)
*Psychological factors (behavior and mental processes{cognition, emotion, motivation}
*Social factors (society, community, family)

Front 18

Implications of the biopsychosocial model

Back 18

-Health and illness are cased by multiple factors and produce multiple effects.
-mind and body are interconnected
-emphasizes both health and illness
-macrolevel and microlevel processes interact to produce a state of illness

Front 19

Interaction of biopsychosocial factors: Systems Theory

Back 19

Social systems, Psychological systems, Biolgoical Systems all affect each other

Front 20

What type of model is Biopsychosocial?

Back 20

Realage: looks at all aspects of life

Front 21

Research Methods:
Theory

Back 21

a tentative explanation of why and under what circumstances certain phenomena occur
-relate information that may seem unrelated before
-often enable us to make predictions
-ex: smoking cigarettes is a cause of lung cancer

Front 22

Research Methods:
Hypothesis:

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a prediction stated as a specific, testable proposition about a phenomenon
-ex: individuals who stop smoking will have a reduced likelihood of developing lunch cancer than individuals who continue smoking

Front 23

Types of Variables:
Independent Variables:

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are studied for their potential or expected influence
ex: smoking cigarettes

Front 24

Types of Variables:
Dependent Variables:

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are assessed because their values are expected to ‘depend’ on the independent variable
ex: likelihood of developing lung cancer

Front 25

Types of Variables:
Nuisance Variables:

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have an unintentional effect on the DV
ex: family history

Front 26

Types of Variables:
Control Variables

Back 26

remain the same throughout all conditions of the experiment
ex: number of years spent smoking

Front 27

Experiments

Back 27

-Controlled studies in which researchers manipulate an independent variable to study its effect on a dependent variable

Front 28

Steps for experiments

Back 28

1) Select a sample
2) Randomly assign participants to groups
3) Collect data
4) Analyze data

Front 29

Quasi-experimental studies

Back 29

Have separate groups of subjects that were not randomly assigned to groups
-ex post facto study: subjects are categorized and placed in groups on the basis of an existing variable or circumstance
-Conducted when unfeasible or unethical to randomly assign participants to groups or to manipulate the independent variables
-Results are correlational, not causal

Front 30

Single-subject designs

Back 30

-Used for demonstrating the usefulness of a new treatment method for a specific medical or psychological problem
-Results can determine the effectiveness of a treatment for a specific individual
-Results cannot be used to make inferences about an entire population
-compares behavior after an intervention with a baseline measurement of that behavior
-a baseline is a measurement of the dependent variable taken prior to the manipulation or presentation of the independent variable

Front 31

Sociocultural differences of Health

Back 31

differences in illness patterns between countries, regions, or ethnic groups result from many factors
-heredity
-environmental pollution
-economic barriers to health care
-cultural differences in people’s diets, health-related beliefs, and values

Front 32

Explanatory models for illness

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-How individuals conceptualize an illness episode
-Usually includes ethnocultual beliefs, personal and idiosyncratic beliefs, and biomedical concepts

Front 33

Folk Illnesses

Back 33

-Illnesses that are commonly recognized within a cultural group
-explanatory model (and treatments) often conflict with biomedical paradigm

Front 34

Cause of illness

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-Evil Spirits
-ancestral spirits or supernatural powers (e.g., spirits of natures, trees, and the forest)
-Related to education, exposure to information

Front 35

Treatments of illness

Back 35

-Use ‘traditional’ medicine instead of or as a supplement to treatment from formal sources
-ex: acupuncture
-prayer
-meditation
-herbs
-magic
-traditional healers (herbalists, curanderas, midwifes)

Front 36

Idioms of Distress

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-Differences in how cultures express, experiences, and cope with feelings of distress (mental health symptoms)
-somatization: the expression of distress through physical symptoms

Front 37

Culture-bound syndromes

Back 37

-mental health conditions that exist only within a specific culture
-four possible explanations
1) Distinct disorders that exist only in those cultures
2) Reflect different ways in which individuals from different cultures express mental illness
3) Reflect different ways in which the social and cultural environment interact with genes to produce disorders
4) Some combination of the above

Front 38

Nacirema

Back 38

-“Magic-ridden people”
-Ritualistic
-“Preponderantly masochistic people [who] have developed sadistic specialists”
-“An example of the extremes to which human behavior can go”

Front 39

Cultural factors to consider

Back 39

-Religion
-Acculturation

Front 40

Daniel Hauser case

Back 40

-boy with cancer
-parents ran with him to give him natural treatment
-court order to give him chemotherapy

Front 41

Acculturation

Back 41

-“The process by which an individual raised in one culture enters the social structure and institutions of another, and internalizes the prevailing attitudes and beliefs of the new culture.”

Front 42

If you have less acculturation, you have better health because:

Back 42

-not adopted health risk behaviors of US culture
-ie driving, high fat diet, sitting in front of computer
-no extended exposure to social stress and physical environmental health risks associated with being a racial/ethnic minority in the US
-protective aspects of culture

Front 43

If you have less acculturation, you have poorer health because:

Back 43

-Less effective users of the health care services
-language barriers
-use alternative medications that may be harmful to health

Front 44

Language problems

Back 44

-English language proficiency
-Related to receiving information about health conditions and understand instructions related to medication
-Use of translators
-Privacy of patient’s health information
-accuracy of the translation
-is the patient receiving good-quality information about their health?
-Patient may be less likely to ask all questions he/she has or to fully disclose information that may be important for physician to know.

Front 45

Cultural (in)sensitivity

Back 45

-Western physicians less accepting of traditional medicine
-Patients less likely to disclose traditional healing practices → physicians misdiagnose and mistreat because lack important information
-Distrust → patient less likely to adhere to prescription
-Lower quality health care

Front 46

Why understand folk illnesses?

Back 46

-1) People who experience sick illnesses may present for care to a practitioner of biomedicine.
-2) Some folk practices and treatments may be potentially hazardous.
-3) To improve the effectiveness of communication between clinician and client

Front 47

How to become culturally sensitive?

Back 47

1) Become aware of commonly held folk beliefs in a community.
2) Increase the ability of culturally diverse clients to make choices
3) Advocate for understanding and acceptance of differing health beliefs in the health care facility and in the larger community.
4) Assess the likelihood that a particular patient or family may act on folk beliefs during a particular illness episode
-Do not assume that all people from the same cultural and subcultural group share the same belief system about health and illness
5) Negotiate between biomedicine and folk medicine
-Replace dangerous practices with alternatives that fit into the patients’ ethnocultural beliefs system
-combine folk and biomedical treatments (when it is safe)
-collaboration and consultation between healers and health care professionals

Front 48

Stress

Back 48

-the circumstance in which *transactions* leads a person to *perceive a discrepancy* between the physical and psychological *demands* of a situation and the *resources* of his or her biological, psychological, or social systems

Front 49

Example of Stress:
Demands, Resources, and Transations

Back 49

Studying for general exam
Demands:
-a lot of material
-different professors writing each question
-limited time to complete the exam

Resources:
-notes from classes
-study notes form previous students

-Transactions
-is the general exam similar to other exams I have taken in the past?
-How well did I do on those exams? Etc.

Front 50

Stress occurs when:

Back 50

Demands are greater than resources
-Demand>Resources

Front 51

Cognitive appraisals:
Primary appraisals

Back 51

assessments of the meaning of the situation of our well-being

Front 52

Cognitive appraisals:
Secondary appraisals

Back 52

assessments of the resources we have available for coping

Front 53

Stressful appraisals:
Personal factors

Back 53

-personality
-motivation
-intellectual factors
-some people may feel more challenged

Front 54

Stressful appraisals:
Situational factors

Back 54

-strong demands
-threat

Front 55

Video: Shaq's big challenge

Back 55

-Do the students perceive the event as stressful?
-What were sources of stress? What made the event more or less stressful?
-What personal and situational factors?

-he said he did it before
-hard on them
-not encouraging, makes them feel bad
-guy tells her kit can do it, tells her family has to be strong
-girl has fear and anxiety

Front 56

Biological Responses

Back 56

-Individual reactivity
-Physiological arousal
-Fight or flight response

Front 57

Biological Responses:
General Adaptation Syndrome:
Alarm Reaction

Back 57

-body is mobilized to defend against the stressor

Front 58

Biological Responses:
General Adaptation Syndrome:
Stage of Resistance

Back 58

-arousal remains high, as body tries to defend against and adapt to the stressor

Front 59

Biological Responses:
General Adaptation Syndrome:
Stage of Exhaustion

Back 59

-resources are very limited; ability to resist may collapse

Front 60

Psychosocial responses

Back 60

-Impairs cognitive functioning
-Negative emotions
-panic attacks, fear, depression, anger
-Increases positive and negative social behaviors
-angry, feel isolated

Front 61

Sources of Stress

Back 61

-Individual
-illness, conflicts, multiple decisions, too much to do
-Family
-having baby, divorce
-Society
-environmental
-pollution

Front 62

Measuring stress

Back 62

-physiological arousal
-blood pressure
-life events
-marriage
-moving
-Daily hassles
-stuff on every day basis that stress you out

Front 63

Social support

Back 63

-any kind of help, support that individual receives from another individual or network of individuals.

Front 64

4 types of Social Support

Back 64

-emotional
-compliments, making them feel important
-tangible
-instrumental
-doing things for the person
-ex: giving your aunt someone to practice with
-informational
-providing information and knowledge to the individual
-help on how to give speech
-companionship
-making individual feel like they are part of the group/social group

-individuals differ in types of social support they like to receive

Front 65

Social support can affect health:
Buffering hypothesis

Back 65

-when stress is low, it affects the health of people with low social support and high social support the same way
-when the stress is high, people with low social support have their health impacted more
-social support buffers/protect people from stress
-“Social Support is a Buffer”

Front 66

Social support can affect health:
Buffering hypothesis:
Direct effects hypothesis

Back 66

-regardless of the amount of stress, high social support people will have less negative effects than people with low social support.

Front 67

Personal Control

Back 67

-how much a person can control there outcome to have positive outcomes and avoid negative outcomes
--people who feel they have less personal control generally have more negative health outcomes as a result of stress

Front 68

Personal Control:
Behavioral Control

Back 68

-how much they feel like their behaviors can control the situation
-how much they think they can act to minimize pressures

Front 69

Personal Control:
Cognitive Control

Back 69

-how much they think they can control how they perceive the situation

Front 70

Learned Helplessness

Back 70

-Low personal control → learned helplessness
-Apathy or inactivity
-Result of repeated experiences with unavoidable stress

1. Internal-external
a. External – something to do with the situation
b. Internal – directed at one person
2. Stable-unstable
a. Something that happens all the time? Or does it happen every once in a while
3. Global-specific
a. Across many situations and circumstances, or just happening once?

Front 71

Jack and Jill example of Learned Helplessness

Back 71

Jack and Jill example – Jill wont go out with Jack
Internal – his personality
External – she has something else to do
Stable – will she always say no
Unstable – one time she says yes
Global – whenever he asks, any kind of date
Specific – only one kind of date

Front 72

Self-efficacy

Back 72

The belief that we can succeed at a specific activity we want to do
1) Must believe that behavior will lead to a favorable outcome
2) We can perform the behavior properly

Front 73

Behavioral Patterns:
Type A

Back 73

-Competitive
-Time urgent
-**Angry**

Front 74

Behavioral Patterns:
Type B

Back 74

-Relaxed
-Easygoing
-Patient
-don’t react as strongly to stressors

Front 75

Behavioral Patterns:
Type C

Back 75

-Appeasing
-Compliant
-beyond being relaxed….just there.
-body reacts negatively. Don’t even try to fight cancer. Symptoms affect them more.

Front 76

Stress and Illness:
Diathesis-stress model

Back 76

-Diathesis: predisposition to a disorder
-Stress

Front 77

Two routes that influence Illness:
1) Behavior

Back 77

1) Behavior
a. Increase
i. Diatary fat
ii. Tobacco use
iii. Alcohol use
iv. Accidents
b. Decrease
i. Dietary fruits and vegatibles
ii. Exercise
iii. sleep

Front 78

Two routes that influence illness:
2) Physiology

Back 78

a. Increase
i. Blood pressure
ii. Unfaborable lipids in blood
iii. Activated platelets in blood
iv. Clotting factors in blood
v. Stress hormones (catecholamines, corticosteroids)
b. Decrease
i. Immune functions

Front 79

3 reasons Individuals differ in their susceptibility to the effects of stress

Back 79

-Social support
-Perceived personal control
-Behavior types

Front 80

Coping

Back 80

the process by which people try to manage the perceived discrepancy between the demands and resources they appraise in a stressful situation

Front 81

Functions of coping:

Back 81

-Problem-focused (reduce demands of stressful situation or expand resources for dealing with it)
-Emotion-focused (control emotional response to stress)

Front 82

Stress Management

Back 82

any program of behavioral and cognitive methods that is designed to reduce psychological and physical reactions to stress

Front 83

Top 10 School Stress Relievers for Students

Back 83

1) Power naps
2) Visualizations
3) Exercise
4) Breathing exercises
5) Progressive muscle relaxation
6) Music
7) Staying organized
8) Eat right
9) Self-hypnosis
10) Positive thinking and affirmations

Front 84

Health Behavior

Back 84

any activity people perform to maintain or improve their health

Front 85

Health Behavior:
Well Behavior

Back 85

preventative

Front 86

Health Behavior:
Symptom-based behavior

Back 86

-what you do when you have symptoms of the illness
-ie. Cold symptoms, you think you have the flu. Not sure.

Front 87

Health Behavior:
Sick-role behavior

Back 87

-things you do when you’re sick
-ex: stay home, drink orange juice

Front 88

Illness prevention

Back 88

-Behavioral influence
-eating right
-Environmental measures
-safe place to walk
-Preventive medical efforts
-drilling for cavities to prevent tooth decay. Prescription meds. Etc.
-your behavior

Front 89

Types of Prevention

Back 89

-Primary: avoiding illness
-Secondary: identifying and treating illness
-Tertiary: containing or slowing the illness
-surgery

Front 90

General factors in health-related behavior

Back 90

-Learning
-Social, personality, and emotional factors
-(learn in the textbook)
-Perception and cognition
-(learn in the textbook)

Front 91

Learning

Back 91

-Reinforcement – increase behavior
-Punishment – decrease behavior
-Extinction – behavior ends because no consequences

Front 92

Positive reinforcement or positive punishment

Back 92

Giving something (positive)

Front 93

Negative reinforcement or negative punishment

Back 93

Taking away something (negative)

Front 94

Theories of Health Behavior

Back 94

-Beliefs/Intentions
-Health belief model
-Theory of planned behavior
-stages of change
-social cognitive theory
-Motivation/Emotion
-Motivated reasoning
-Conflict theory

Front 95

Health Belief Model

Back 95

-Perceived threat motivated people to take action
-Beliefs about potential behaviors determine the specific action plan
-Susceptibility
-Severity
-Benefits
-Costs
-Self-efficacy
-Cues to action

Front 96

Theory of Planned Behavior

Back 96

-Social norms
-attitudes
-perceived behavioral control
-intentions

Front 97

Stages of Change Model

Back 97

-1) Precontemplation
-2) Contemplation
-3) Preparation
-4) Action
-5) Maintenance
-6) Termination

Front 98

-Health care systems use secondary and tertiary prevention strategies

Back 98

-related to biomedical model
-tertiary: slow down progression of health conditions

Front 99

What options do you have for health care?

Back 99

doctor's office, clinic, infirmary, hospital

Front 100

What are benefits and costs associated with each alternative?

Back 100

-hope to get better
-a lot, you need insurance for it. Without insurance, you may not get help
-long lines, lots of waiting

Front 101

US Health Care System:
Government insurance programs

Back 101

-Medicare (younger people with disabilities, elderly 65+)
-Medicaid (low income people, low income families with children)

Front 102

Managed Care:
Health Maintenance Organization (HMO)

Back 102

-flat monthly rate
-only providers in network
-place restrictions on who can see

Front 103

Managed Care:
Preferred provider organization

Back 103

-reimbursed for visiting providers outside the network

Front 104

Perceiving Symptoms

Back 104

-individual differences
-competing environmental stimuli
-psychosocial influences
*placebos (sometimes people expect to have symptoms, even if they won't)
*medical student's disease - students learn about something, perceiving they have the symptoms themselves.
-mass psychogenic illness

Front 105

Responding to Symptoms

Back 105

-commonsense model
-illness identity
-define what it is
-causes and underlying pathology
-any biological or psychological changes
-time line
-consequence
-Lay referral network

Front 106

Health Belief Model

Back 106

-how threatening the illness is
-perceived benefits and costs

Front 107

Treatment delay

Back 107

-1) Appraisal delay
-decide whether they are sick. If no, they delay treatment.
-2) Illness delay
-I’m sick, but do I need care or treatment? If no, they delayed treatment. Ex: Cold or Flu?
-3) Utilization delay
-Is it worth paying that money and taking time off from work?

Front 108

Complementary and Alternative Medicine (CAM)

Back 108

-Complementary
-used with conventional methods
-ex: Drink 7UP and go to doctor
-Alternative
-Used as a substitute for conventional methods
-ex: Drink 7UP

Front 109

5 Types of CAM

Back 109

1) Body/mind therapies
2)Biologically based therapies
3) Manipulative and body-based methods
4) Energy therapies
5) Alternative Medical Systems

Front 110

5 Types of CAM:
Body/mind therapies

Back 110

a. Mind can play role in body’s physical health
b. Hypnosis
c. Biofeedback
d. Mind and body are related

Front 111

5 Types of CAM:
Biologically based therapies

Back 111

a. “natural products”
b. fish oil
c. probiotics

Front 112

5 Types of CAM:
Manipulative and body-based methods

Back 112

a. Manipulate different aspects of your body
b. Chiropractors (manipulate joints to increase range of motion)
c. Massages (manipulate muscles)

Front 113

5 Types of CAM:
Energy Therapies

Back 113

a. Practioner/healer places hands on point of injury and their energy is supposed to heal the injury

Front 114

5 Types of CAM:
Alternative Medical Systems

Back 114

a. Own ideas of causes of illnesses and how to treat them
b. Homeopathy
c. Individuals believe that having small doses of the negative substance will protect you from the illness

Front 115

CAM usage

Back 115

-Commonly used
-Most popular are body/mind therapies and biologically-based therapies

Related to coping
-Primary control – less likely to use CAM
-Secondary control – more likely to use CAM

Front 116

Hypochondriacs

Back 116

-Excessive worry about health
-“Cyberchrondia” – too much information online, some is not valid

Front 117

Patient-practitioner interaction:
Setting:

Back 117

-uncomfortable setting
-can’t explain themselves
-uncomfortable questions
-phyician does not have a lot of time to ask questions
-may not answer questions completely
-can contribute to negative interactions

Front 118

Patient-practitioner interaction:
Change in Health Care

Back 118

-from private physician to HMOs
-need satisfied customers so patients will keep coming back to see them
-private physicians: people feel like they are more cared about, private interest in wellbeing of patient
-HMO – insurance program
-negative interactions: waiting for approval, not feeling cared about

Front 119

Provider's behavior that leads to faulty communication

Back 119

-provider:
-not listening
-not asking right questions
-not getting correct information from patients
-cannot treat health condition
-medical jargon
-doesn’t allow patient to understand
-Simplistic explanations
-do not help patients with behavior
-Depersonalization of the patient
-thinks of individual as an object
-Assumptions about patient
-about family history
-ex, sexual orientation

Front 120

Provider's behavior in interactions:
Doctor-centered:

Back 120

-close-ended questions
-yes or no, closes conversation
-highly controlled
-physician is in control. Chooses the questions. Chooses what they try to treat
-focused on initial problem presented

Front 121

Provider's behavior in interactions:
Patient-centered:

Back 121

-open-ended questions
-“where does it hurt”
-no medical jargon
-allow clients to participate
-what kind of treatment they would like
-what behavior they would engage in

Front 122

Patient's behavior that leads to faulty communication

Back 122

-anxiety
-explaining symptoms
-ability
-emphasize/downplay
-ex hypochondriac
-focus on pain and symptoms
-lack of participation

Front 123

Need provider-patient interaction. Why?

Back 123

-no feedback to the provider
-what is the outcome? better? not better? worse? died?
-is the patient satisfied?

Front 124

Outcomes of faulty communication

Back 124

-dissatisfaction
-malpractice litigation
-(Non)adherence

Front 125

Adherence

Back 125

*The degree to which patients carry out the behaviors and treatments their providers recommend
-not exercising enough
-About 40% of patients fail to adhere closely to treatment
-how often you take your meds
-May occur for different types of medical advice and in different ways

Front 126

Measuring adherence

Back 126

-Self-report
-practitioner report
-pill counting
-count number of pills left
-medication-recording disper
-Biochemical tests

Front 127

Treatment factors

Back 127

-Lifestyle changes
-Complexity of treatment
-duration
-how long treatment should last
-side effects
-side effects can make people not as willing
-expense

Front 128

Patient factors

Back 128

-health belief model
-if benefits outway the costs and
-if health condition is severe
-more likely to adhere to treatment
-rational nonadherence
-change their own treatment
-ie, 1 pill is just as effective as 3 pills
-self-efficacy
-social support
-helps to have someone to remind you

Front 129

Provider factors

Back 129

-Instructions are not clear and explicit
-said to take pill with breakfast. Meant to say take it in the morning
-not enough time explaining treatment
-short amount of time they have with each patient
-Medical jargon
-Doctor-centered

Front 130

Improving adherence

Back 130

-related to health condition and treatment
-provider
-explain the regimen
-make sure patient understands it
-patient
-tailoring the treatment
-instead of “when you eat breakfast” use “before you brush your teeth”
-prompts and reminders
-calendar or cell phone
-self-monitoring
-behavioral contracting