Psychology & Health Practice Flashcards

Course Information and Learning Outcomes

• Module: $310$ Psychology and Health

• Course Name: Psychology of Nursing

• Instructor: Dr. Tahani Ismail Hawsawi, PhD, MMHN, BSN ($1^{\text{st}}$ Class), Dip

• Instructor Role: Assistant Professor of Mental Health Nursing and Recovery

• Duration: $40\text{-Minute}$ Lecture

• Lecture Number: $11$

• Session Date: $2026$ Session

• Scope: A comprehensive exploration of biomedical and biopsychosocial models, frameworks, health behavior theories, and their application in nursing practice.

• Slide Count: Total of $37$ slides.

Learning Outcomes

• Outcome $1.1$ (Principles & Theories): Identify mental health and health behavior models that inform health behavior. (Aligned to PLO K1).

• Outcome $1.2$ (Psychology in Care): Recognize how mental health and health behavior models affect people's healthy living.

• Outcome $1.3$ (Evidence-Based Models): Explain evidence-based mental health and health behavior models using empirical findings. Specifically:     - Health Belief Model (HBM)     - Theory of Planned Behavior (TPB)     - Transtheoretical Model (TTM)     - Self-efficacy     - Locus of control

Section $1$: Health Psychology

Definition of Health Psychology

• The study of psychological and behavioral processes in health, illness, and healthcare.

• It explores how biological, psychological, and social factors influence health and illness.

Core Objectives and Goals of Health Psychology

• Promote & Maintain Health: Encouraging positive health behaviors (e.g., exercise, nutrition, and stress management) to enhance well-being before illness occurs.

• Prevent & Treat Illness: Implementing interventions to reduce risk factors and providing psychological support alongside medical treatment for existing conditions.

• Identify Causes & Correlates: Researching how biological, psychological, and social factors combine to influence health outcomes and disease vulnerability.

• Improve Healthcare Systems: Enhancing health policy and care delivery to make systems more patient-centered, efficient, and psychologically informed.

Section $2$: Mental Health Models

Significance and Clinical Utility

• Why They Matter: They help professionals understand mental illness from different perspectives, guiding more accurate assessment, treatment, and support for each person's specific needs.

• Structuring Care: Gives clinicians a structured way to understand symptoms and choose appropriate interventions in real practice.

• Identifying Barriers: Pinpoints cognitive and emotional obstacles that prevent behavior change.

The Recovery Model

• Origins: Grew from the ex-patient and psychiatric survivor movements.

• Core Philosophy: Challenges the idea that people with mental illness should be defined only by their diagnosis or their dependency on professionals.

• Recovery Definition: Understood as a personal journey rather than simply symptom elimination.

• Key Principles:     - Self-determination and shared decision-making.     - Rights and hope.     - Peer support.     - Living a meaningful life.     - Focus on fostering resilience and social inclusion.     - Working toward self-defined life goals.

The Tidal Model

• Definition: A nursing model for mental health care that focuses on the person's own story, strengths, and experiences rather than only on illness or symptoms.

• Approach: Promoting empowering, relationship-based, person-centered care.

• Evidence-Based Support: Recent reviews and theoretical work (Barker & Buchanan-Barker, $2001$; Silva et al., $2024$; Santos et al., $2019$) show support for:     - Autonomy.     - Resilience.     - Reduced aggression.     - Stronger nurse-service user relationships in mental health settings.

Section $3$: Health Behavior Models

Theoretical Framework Foundations

• Definition: Act as a roadmap for understanding the complex motivations behind patient choices and actions.

• Clinical Utility:     - Explain Behaviors: Uncovers why individuals adopt healthy habits (e.g., exercise) or avoid care (e.g., screening).     - Guide Interventions: Provides a structured approach to design assessment tools and targeted nursing interventions.     - Predict Outcomes: Forecasts patient adherence to medication regimens and long-term treatment success.     - Identify Barriers: Pinpoints obstacles to change.

• Determinants of Health: Range from lifestyle choices to medication adherence.

Health Belief Model (HBM)

• Purpose: Predicting health behaviors based on individual beliefs.

• Individual Perceptions:     - Perceived Susceptibility: Belief about the chances of getting a condition.     - Perceived Severity: Belief about the seriousness of a condition and its consequences.

• Modifying Factors:     - Perceived Threat: Cognitive assessment of health risk.     - Cues to Action: Triggers to activate readiness (e.g., symptoms, media, advice).

• Cost/Benefit Analysis:     - Benefits vs. Barriers: Weighing effectiveness against costs or obstacles.

• Self-Efficacy: Confidence in one's ability to take action.

• Outcome: The likelihood of behavior.

Theory of Planned Behavior (TPB)

• Purpose: Determining behavioral intention and action.

• Core Determinants:     - Attitudes toward Behavior: Positive or negative evaluation of performing the behavior.     - Subjective Norms: Perceived social pressure to perform or not perform the behavior.     - Perceived Behavioral Control: Perceived ease or difficulty of performing the behavior (Self-Efficacy).

• Intermediate Point: Behavioral Intention (Readiness to perform; the immediate antecedent of behavior).

• Outcome: Behavior (Observable Action).

Transtheoretical Model (TTM): Stages of Change

• $1$. Precontemplation: No intention of changing.

• $2$. Contemplation: Thinking about changing.

• $3$. Preparation: Getting ready to change.

• $4$. Action: Actively doing the behavior change.

• $5$. Maintenance: Sticking with the change over time.

• Relapse: Falling back into old behaviors (a part of the cycle).

Self-Efficacy Theory (Bandura)

• Definition: The belief in one's capability to organize and execute actions.

• Factors Affecting Self-Efficacy:     - Mastery Experiences: Success builds robust belief in personal efficacy; currently the most influential source.     - Vicarious Experiences: Seeing people similar to oneself succeed through sustained effort raises observer beliefs.     - Verbal Persuasion: Receiving verbal encouragement from others helps overcome self-doubt.     - Physiological States: Moods, emotional states, stress levels, and physical reactions impact self-efficacy judgments.

Locus of Control (Rotter)

• Internal Locus of Control:     - Belief: "I control the outcome."     - Source: Personal actions, behaviors, and choices determine results.     - Adherence: Greater adherence; likely to engage in preventive care and seek information proactively.     - Mindset: ACTIVE; "I make things happen!"; Passion and hard work; control over life direction.

• External Locus of Control:     - Belief: "Fate controls the outcome."     - Source: Outcomes attributed to chance, fate, God, or powerful others (e.g., doctors).     - Adherence: Lower perceived control; may lead to passivity, helplessness, or poor treatment adherence.     - Mindset: PASSIVE; "Things happen to me."; "Why bother trying?"; Luck and religion control the future.

Health Decision-Making and Personality

Health Decision-Making Overview

• Complexity: The final choice is rarely linear; it results from processing interacting variables within the clinical encounter.

• Influencing Factors:     - Cognitive Factors: Risk perception, health literacy, beliefs.     - Emotional Factors: Fear, anxiety, stress, motivation.     - Social Influences: Family, peers, cultural norms.     - Environmental Context: Access, resources, logistics.     - Past Experiences: Previous care, trust, trauma.

Personality and Health Traits

• Type A Behavior Pattern: Competitive, impatient, time-urgent, and hostile; driven by intense ambition and easily angered.

• Conscientiousness: Organized, disciplined, responsible, and plan-oriented; shows self-control and goal-directed behavior.

• Neuroticism: Tendency toward negative emotions like anxiety, depression, and vulnerability to stress.

• Optimism: General expectation that good things will happen; uses active coping strategies.

• Pessimism / Fatalism: Expectation of negative outcomes; tendency to attribute failure to internal, stable causes.

• Hardiness & Resilience: Viewing change as a challenge, maintaining a commitment to activities, and possessing a sense of control.

Section $4$: Behavior Change Interventions

Strategies for Nursing Practice

• Goal Setting: Establishing SMART objectives (Specific, Measurable, Achievable, Relevant, Time-bound).

• Action Planning: Creating detailed "If-Then" plans specifying when, where, and how to perform the behavior.

• Self-Monitoring: Systematic observation and recording of target behaviors via logs, apps, or wearables.

• Reinforcement & Prompts: Using cues to trigger behavior and rewards (internal or external) to strengthen the habit loop.

• Social Support: Leveraging family, friends, or groups for emotional encouragement and practical assistance.

• Environmental Nudges: Modifying the physical context to make the healthy choice the easy, default choice.

Summary and Key Takeaways

Comparison of Health Models

• Biomedical Model: Focuses on physiological pathology and cure; the patient remains passive.

• Biopsychosocial Model: Integrates bio-psycho-social factors; provides holistic care; the patient is an active partner.

Behavior Theories Summary

• Frameworks: HBM, TPB, and TTM predict behavior via beliefs, attitudes, norms, readiness, and self-efficacy.

• Intervention Use: These are key to designing effective nursing interventions.

The Human Factor in Summary

• Personality Traits: Conscientiousness and optimism promote health; neuroticism and hostility increase risk.

• Stress and Coping: Chronic stress impacts immunity and disease progression; resilience/hardiness buffer negative effects.

• Decision Making: Influenced by cognitive factors (literacy), emotional factors (fear), and social factors (cultural norms).

Recommendations for Nursing Practice

• Adopt holistic assessment using the Biopsychosocial (BPS) model.

• Tailor education to the patient's specific stage of change.

• Build patient self-efficacy and agency.

Questions & Discussion

Reflection Prompts

• Model Application: "Think of a recent patient encounter. Which model (Biomedical or Biopsychosocial) best explains the approach taken, and how did it impact the outcome?"

• Communication Strategy: "How would you adapt your communication style for a patient in the Precontemplation stage versus one in the Action stage?"

• Building Self-Efficacy: "Identify one specific moment in a clinical interaction where you could actively build a patient's self-efficacy. What specific words would you use?"

References

Key Textbooks

• El-Hay, M. A. A. ($2019$). Understanding psychology for medicine and nursing ($1^{\text{st}}$ ed.). Taylor & Francis.

• McFarlane, J. M., Shi, A. L., Ramoo, D., & Yousef, T. ($2024$). Introduction to psychology: Moving towards diversity and inclusion (S. Hutchinson & C. B. Eady, Eds.). BCcampus.

• Spielman, R. M., Jenkins, W. J., & Lovett, M. D. ($2020$). Psychology 2e. OpenStax.

• Stangor, C. ($2015$). Introduction to psychology ($1^{\text{st}}$ Canadian ed.). University of Minnesota Libraries Publishing.

Key Theoretical Sources

• Ajzen, I. ($1991$). The theory of planned behavior. Organizational Behavior and Human Decision Processes, $50(2)$, $179\text{--}211$.

• Bandura, A. ($1977$). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, $84(2)$, $191\text{--}215$.

• Barker, P., & Buchanan-Barker, P. ($2001$). The Tidal Model: Developing an empowering, person-centred approach to psychiatric and mental health nursing. Journal of Psychiatric and Mental Health Nursing, $8(6)$, $713\text{--}719$.

• Engel, G. L. ($1977$). The need for a new medical model: A challenge for biomedicine. Science, $196(4286)$, $129\text{--}136$.

• Moreno-Poyato, A. R., et al. ($2024$). Implementation of the recovery model and its outcomes in patients with severe mental disorders.

• Priebe, S., Kelley, R., Omer, S., & Golden, E. ($2023$). The alliance in mental health care: Conceptualization, evidence and practical implications. Frontiers in Psychiatry, $14$, $1055956$.

• Prochaska, J. O., & DiClemente, C. C. ($1983$). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, $51(3)$, $390\text{--}395$.

• Rosenstock, I. M. ($1966$). Why people use health services. Milbank Memorial Fund Quarterly, $44(3)$, $94\text{--}127$.

• Santos, A. M., et al. ($2019$). Nursing care in mental health based on the Tidal Model: An integrative review.

• Silva, R. P., et al. ($2024$). Tidal Model in light of complexity: Contributions to clinical nursing care in mental health.

• Slade, M., et al. ($2014$). Implementing recovery-oriented practices in mental health systems. World Psychiatry, $13(1)$, $15\text{--}21$.

• Som$360$ ($2020$). The recovery model, a paradigm shift in the approach to mental health.