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Sayyed Mohsen Fatemi

Health Psychology Chapter Summaries Chapter 1 -- Introduction Until recently psychologists have dealt almost exclusively with the mind. In recent decades, psychological principles have been applied to the arena of health. The definition of health is important to defining health psychology. Health is a complete state of physical, mental and social well-being; it is not simply the absence of illness or disease. Health psychologists are devoted to promoting health, preventing illness, and identifying correlates and predictors of health, illness and dysfunction It has long been believed that emotions and mental status interact with physical health. Hippocrates wrote about the physicians demeanour as it affects the patients will to live. Osler instructed medical students to listen to the patient to find the proper diagnosis The focus of this book is primarily on individuals in the context of health, illness and the experience of medical care. There are many intricacies associated with research, particularly in health psychology. Human beings are vastly complex and issues related to healthcare, healthcare systems, and healthcare delivery are multifaceted True experiments [randomized clinical trial] enable researchers to determine causality, but are difficult, sometimes impossible, to carry out. Correlational studies provide valuable insights, but cannot establish causal relationships Prospective studies are preferable to retrospective studies because the latter are affected by biases in the ways in which people remember events Longitudinal studies are usually preferable to cross-sectional studies because they enable us to distinguish patterns of change over time from cohort effects Laboratory studies occur in controlled settings and allow confounding variables to be eliminated, but realism may be sacrificed. Field studies provide more natural responses, but extraneous influences are difficult to control Random assignment: a method of sorting participants into experimental versus control group, uses random methods so that each participant has an equal chance of being chosen for wither group covary: to correlate, to relate in a specified and predictable way cross-lagged correlation: an assessment of the degree of association between two variables, one of which is viewed as a lagged value of the outcome variable state dependent memory: the tendency of people to remember most easily the events of the past connected with the emotional state they feel as they report age cohort: a group of people born at the same time who thus share similar experience Health psychologists work in various settings as consultants on medical teams, as therapists, contributing to public health promotion programs, and as researchers. Many graduate programs in health psychology exist, but not all health psychologists were formally trained in such programs The 20th century is probably the only period in history in which the predominant medical opinion has emphasized a focus on the body and has neglected the mind as a factor in health. During most of recorded history, illness has been attributed to magical and unknowable phenomena such as sinful thoughts, possession by evil spirits, and the will of vengeful gods. Western medicine originated in ancient Greece during the time of greatest intellectual development. Hippocrates built the earliest foundation for rational medicine Galen is considered by many to be the greatest figure in ancient medicine because he based diagnosis on anatomy and physiology In the 15th century, the Renaissance brought intellectualism and rationalism to the realm of medicine prognosis: the forecast of the course of a disease diagnosis: the identification of disease using signs and symptoms dialysis: a process of mechanically filtering toxic byproducts from the blood auscultation: the process of listening for sounds within the human body palpation: the application of the fingers with light pressure to the surface of the body to determine the consistency of parts beneath in physical diagnosis Around 1990, medicine began to be transformed into a clinical science. Most of the great strides in medicine have taken place in even more recent years. During the time of greatest advances in the technical aspects of medicine, it has been easy to forget the human side Intense focus on the technical side of medicine has prevented a clear distinction between disease and illness. Disease is the collection of physical findings and symptoms that form a definable disease entity. Illness may or may not involve definable diseases, but illness upsets the optimal functioning of the individual. the whole patient may be ignored in an effort to focus on his or her disease general practitioners Psychological factors are entwined with physical phenomena. The connection is manifested in many ways presented throughout this book. Psychological factors are as important as physical ones in understanding the etiology [cause of disease] of a disease or in carrying out its treatment. There is a delicate interplay between mind and body in the realm of illness Holistic approaches to healthcare incorporate the mind-body connection and combine Western technology with non-Western traditions. hospice monistic germ theory: illness is caused by micro-organisms conversion hysteria: the phenomenon in which it is believed that unconscious psychological anxiety is transformed into physical sympotoms In the mid-20th century, Dunbar and Alexander paved the way for the field of psychosomatic medicine linking personality characteristics to specific physical illnesses Dunbar and Alexander deviated from Freudian ideas regarding some diseases as converted from unconscious psychological anxiety. They proposed specific disease-psychology relationships and a physiological mechanism by which personality and illness might be linked Type A Personality: links between this personality and coronary heart disease/disease prone; characterized by negative emotions such as depression, hostility and anxiety Type B Personality meta-analysis: Behavioural medicine emerged in the 1970s as a distinct discipline with the goal of applying behavioural science principles to the maintenance of physical health and the prevention of disease Because of medical advances, Western society is largely free of many of the diseases of precious centuries; now chronic diseases are of concern. Medical care needs have changed, and there has been a shift in focus from purely biomedical to biopsychosocial frameworks biomedical model: a model that assumes that illness can be fully accounted for by a persons deviations from the norm on measurable biological variables biopsychosocial model: a model that requires that psychological and social factors be included in any attempt to understand symptoms and the experience of illness Chapter 2 -- The Process of Medical Care The goal of this chapter is to examine in detail what occurs when patients consult physicians and other medical professions and other medical professionals for the diagnosis and treatment of illness. It focuses on the verbal communication Communication results in both subjective and objective outcomes. Different points of view, or philosophies, underlie effective and ineffective practitioner-patient communicationThe four premises of medical care that are relevant to our analysis are: Doctors treat patients, not diseases. The body has the last word. All medical care flows through the relationship between physician and patient. The spoken language is the most important tool. communication diagnosis Words are extremely powerful tools in medicine; they establish the reality of suffering. Because of their power, the utterance of words in the medical encounter is a very serious enterprise. Through the process of communication, practitioner and patient attempt to gain a common understanding of the patients illness. A practitioners and /or a patients poor communication skills can cause problems in their relationship. A physician may give a patient very little opportunity to participate in his or her own care either because the physician lacks communication skills or believes that patient participation is not valuable and not worth the trouble Sometimes these two reasons reciprocally affect another Communication uncovers hidden premises. A modern medicine becomes dominated by technology, some medical professionals tend to give attention to practitioner-patient dialogue. premises: an assumption on which an argument is based subcutaneous : under the skin malignant: cancerous There are three basic models of the physician-patient relationship: The Active-Passive Model occurs when the patient is unable, because of his or her medical condition, to participate in care and make personal medical decisions The Guidance-Cooperation Model occurs when the physician takes the bulk of responsibility for diagnosis and treatment The Mutual Participation Model involves physician and patient making joint decisions about every aspect of care Other model variations define 4 or 5 basic categories. Common to all of them are variations of patient involvement in their care One important issue in the physician-patient relationship is conflict. Conflict ma
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