health psychology option

biomedical model of health

• health is the absence of disease

• the most dominant model used, assumes problems are based on your bio functioning, so it is fixed with bio solutions

• basically says that ur health is only determined by viruses or genes or your systems abnormalities

• to alleviate ur stuff, they use drugs! they usually js interfere with neurotransmitters to fix you (ex: antidepressos)

health depends on serveal things > determinants

biopsychosocial model of health

• invented when ppl started questioning the biomedical model

• integrates bio, psych, social/envi factors suggesting that health is caused by an intersection of these factors

• more hollistic understanding of well being, encourages health pros to be more rational and informed in the psychosocial aspects of the patient

svenberg et al

aim: capture messages and themes in the words of somalian refugees currently residing in sweden, interviewed abt their health

sample: 13ppl, 5W8M, purposive sampling, all participants lived in swede for 10 years at least and lived in a major city, but were born in somalia

procedure: conducted semi structured and causal 1.5 hour long interviews to gather info about their health, were in the presence of friends and family, translated for 3/15 of them. began with “cld u tell us how u feel abt ur health” and then followed up for the rest and explored themes related to their health after living in sweden. recorded and transcribed, reread many times to determine themes and narratives

findings: participants found feeling of isolation, longing for their homeland, pain, discirmination, family good and bad, religion, connected to their life experiences

conclusion: their thoughts and beliefs abt health were connected to their social context bc they lived outside of somalia, nd it could become physical symptoms

svenberg SWOT!

strengths

• Super rich data bc qualitative

• Validity high because it was a causal interview and not a lab experiment

• purposivE sample, all participants relevant to the aim

• traNscribed verbatim

weaknesses

• small sample, generalizaBility not a main goal

• intErmediary translator bias

• social desiRability either to interviewer or friends/family

• not trianGulated

• thematic analysis is based on subjective opinion by researcher

xiao et al

aim: explore application of BPS approach in healthcare, aimed to get info to promote that approach

study 1: one on one w 30 med staff + 16 patient focus group

study 2: 13105 med staff in hangzhou surveyed abt status quo on BPS

finding 1: staff did not want ppl to express their emotions, patients believed staff didnt want them to report their emotions

finding 2: only 37.5% of staff actl gaf about psychosoc status, and this was biased more to females and psychiatric ppls. significant gaps in training regarding psychosocial factors in patient care.

concl: yes BPS been around long but its still not used! ppl care more abt physical symptoms and not psychsoc status, training shld be implemented to fix this. patients shld also set better expectations

xiao SW!

strengths

• method triangulation, qualitative + quantitative

• in depth answers through interviews and focus groups

• large sample size

• both staff and patients

weaknesses

• bias response in surveys and all, self reported

• generalizability beyond china

• limited sample in study 1

biomed sw

strengths

• focus on bio causes, can give more in depth treatment to that, making it faster and easier

• there are advancments in medtech and pharama

• clear and structured

• can easily help acute diseases where bio = primary cause

weaknesses

• reductionist, ignores psychosoc factors

• focus on treatment over prevention and holistic care

• overreliance on medicaiton

• may not be suitable for chronic diseases

• not patient centered

BPS SW

strengths

• considerd all factors, b p and s!

• holistic view, more personalized care for patient

• emphasis on prevention and lifestyle change

• helps manage chronic illness and confitions

• engages more w patient, patient centered treatment

weaknesses

• difficult to implement in medicine, too many factors to consider

• requires cross departmental involvement

• certain conditions do not need the hollistic view

• psychosoc cannot be objective

• lack of a standardized response to patient care

determinants of health

• social, econ, envi, personal factors that cld affect health and well being

• can be social or personal

• 5 determinants- soc, phys, health, bio, behavior

• risk factors r things that makes someone more likely to get sick relative to others, protective is the opposite

peroud 2014

environment/genetic risk factors

aim: how inheriting ur parents ptsd cld be explained by transmission of epigenetic shiz like the status of the glucocortoid receptor gene, modulator of stress hormone

sample: 25 tutsi widows exposed to trauma (rwanda genocide) in their 2nd and 3rd trimester + the offsprings, then 25 tutsi women who were abroad + the offsprings

procedure: ptsd 17 item checklist of severity adminstered by a psychologist + beck depression inventory, self report ques for depression. also blood samples

findings: those exposed had higher ptsd and depression, correlation between nr3c1 activation status in mothers + children due to exposure to envi stress

conclusion: activating the gene is associated w changes in the hpa, aka connection btwn nervous/enfocrine system so it affects cortisol. abnormal activity = ptsd/depression and the mechanism explain the inheritance

peroud SW

strengths

• explores bio mechanisms for ptsd

• natural experiment investigating real world trauma event

• control group

• psych measures + biological measures

weaknesses

• small sample size w limited generalizability

• confounding variables w socioeconomic status or parenting style not controlled

• correlation does not equal causation

• ethical conssdierations

fischer et al

individual behavior risk factors

aim: effect of stress beliefs on physical health

sample: 216 students of umarburg (germany) predominantly rich females

procedure: 2 questionnaires on stress beliefs/levels: screening scale for the assessment of chronic stress (sscs) and beliefs about stress scale (bass). data gathered at the start of summer term (april) and end of it (september)

findings: neg stress beliefs = more health problems > addtl inc in stress during exams. APPRAISAL, stress = bad higher levls of stress = physical symptoms

conclusion: if u think stress is bad, u will have bad health when u have stress

fischer SW

strengths

• longitudinal, data collected twice

• questionnaires are standardized and reliable

• informed consent, approved by ethics commiteee

• practical and relevant to world for stress management

weaknesses

• majority rich female, limited generalizability

• stress levels/symptoms self reported, bias/inaccuracy

• no objective data for health

• does not show causation

• context