Health promotion from the perspective of social cognitive theory

Abstract

This article examines health promotion and disease prevention from the perspective of social cognitive theory. The areas of overlap with some of the most widely applied psychosocial models of health are identified. The models of health promotion and disease prevention have undergone several generational changes. We have shifted from trying to scare people into health, to rewarding them into health, to equipping them with self-regulatory skills to manage their health habits, to shoring up their habit changes with dependable social supports. These transformations have evolved a multifaceted approach that addresses the reciprocal interplay between self-regulatory and environmental determinants of health behavior. Social cognitive theory addresses the socio structural determinants of health as well as the personal determinants. A comprehensive approach to health promotion requires changing the practices of social systems that have widespread detrimental effects on health rather than solely changing the habits of individuals. Further progress in this field requires building new structures for health promotion, new systems for risk reduction and greater emphasis on health policy initiatives. People's beliefs in their collective efficacy to accomplish social change, therefore, play a key role in the policy and public health approach to health promotion and disease prevention.     

Differential disgust responding in people with cancer and implications for psychological wellbeing

Objectives: Evidence suggests that disgust responses, known to negatively affect psychological wellbeing, may differ in people with cancer. We performed the first quantitative investigation of three discrete types of disgust trait – disgust propensity, sensitivity and self-directed disgust – in people diagnosed with a broad range of cancers (versus cancer-free controls), and explored their associations with psychological wellbeing.

Design: In a cross-sectional survey design, 107 participants with heterogeneous cancer diagnoses, recruited from cancer charities and support groups, were matched with cancer-free controls by age and gender.

Outcome measures: Measures of the three disgust traits were taken alongside measures of anxiety and depression.

Results: Disgust sensitivity and physical self-disgust were significantly higher in the cancer than control sample, while disgust propensity and behavioural self-disgust were lower. The disgust traits had a different pattern of associations to psychological wellbeing across the two groups, with disgust sensitivity predicting depressive symptoms to a significantly greater extent in the cancer than control group.

Conclusions: People with cancer differ from matched controls in their disgust responses and these responses have significant predictive relationships with aspects of their psychological wellbeing. The results suggest that emotion-based interventions may be useful for improving psychological wellbeing in people with cancer.     

Schools and the twenty-first century labour market: perspectives on structural change

ABSTRACT

The focus of this article is the youth labour market and how changes within it have (negatively) affected the economic prospects of young Britons. It suggests ways in which schools and colleges can respond to such change in order to optimise the life chances of their students. The paper reviews the perspectives of two important groups of people well-placed to offer informed views to educationalists: policy commentators close to the political and academic debates surrounding youth employment; and, HR professionals with first-hand experience of recruitment. Synthesising perspectives, the paper highlights three key changes demanding attention: the growing complexity of the labour market; increased competition for entry level employment; and, the changing requirements of employers who increasingly seek new employees well placed to be personally effective in applying knowledge and skills in changing situations. The paper concludes by offering a framework for structuring school provision to optimise the school to work transitions of young people.     

Cyberbullying Victimization among High School and University Students in Ghana

ABSTRACT

This study sought to establish the extent of cyberbullying among students in Ghana, its consequences on the victims, and the characteristics of the victims. The study found that nearly all participants had experienced one form of cyberbullying before. Victims of cyberbullying were not very different from non-victims in psychological wellbeing. The effect of cyberbullying on psychological wellbeing was small, and no clear profile characterizing victims emerged. The present findings should be an eye-opener for Ghanaian parents, educators and health professionals and set the stage for further studies to understand the Ghanaian situation.     

The social context of Hong Kong's booming elderly home industry

Hong Kong experienced a rapid increase in private homes for elderly people in recent years. This paper examines the social background of that development. Private elderly homes thrived in a context of rising demand due to changing demographics, particularly massive emigration secondary to political instability, which created a large potential market of elderly people in need of residential care. However, entrepreneurs would not be attracted unless it is a profitable business, and much of that profit is likely derived from social security payments to elderly people. Because the amount of social security benefits is way below the level required for purchasing good quality service in the private sector, many elderly people are bound to live in very poor residential settings. The preparation of this article was supported in part by CPHK Grant No. 903089. I am grateful to Alfred Chan, Man-fuk Leung, Alice Chong, Nicky Hamid, Murray Levine, and three anonymous reviewers for their helpful comments on an earlier version of the article.     

Supervising professionals involved in the psychological care of people infected with HIV/AIDS

The provision of psychological care for people with HIV/AIDS in the last decade has led to a demand for professional supervision of counsellors and other professionals who work with this patient group. While there are many similarities in the supervisory process with professionals working with patients with other medical and psychological problems, there are also unique and specific issues which stem from working with people with HIV/AIDS. Some of these are discussed in this paper. The supervisory process described relates to a systemic conceptual framework. Tasks in clinical supervision and dijiculties in supervision are highlighted. Suggestions are offered for setting up and developing supervision sessions in clinical practice.     

Perceptions of health care social workers in Ontario: challenges and facilitators to reflective practice

Background: Reflective practice in health care social work ensures that social workers provide effective and efficient services to clients as well as maintaining their mental and physical health. In this study, we aim to determine how health care social workers engage in and describe reflective practice and challenges related to their reflective practice in their work in the health care system.

Methods: We used the Reflective Dialogue Rating Scale (RDRS) developed by Marion Bogo et al. to structure qualitative face-to-face interviews with 23 health care social workers employed in a hospital in a large urban area in Ontario, Canada.

Results: Findings illustrated that all participants regularly engaged in reflective practice in order to carry out everyday social work activities, promote ethical practice, and to enhance the provision of services to their clients. The social worker participants consistently agreed that as a profession they faced challenges maintaining their knowledge of current research due to few opportunities for professional development, workload competing with educational opportunities, and a work climate that is not conducive to gaining professional development, thereby challenging reflective practice. Supportive working environments include: peer supervision, safe and private spaces to talk to colleagues, a supportive supervisor, and an overall positive organizational culture.

Discussion and conclusion: Reflective practice is a key component in health care social work. All 23 social workers stated that they used reflective techniques (such as peer supervision and debriefing) to deal with their own reactions and operated in a purposeful and intentional manner to form therapeutic relationships with clients. As such, participants stated that lifelong learning was paramount in providing quality care to clients.     

Democratisation of wellbeing: stakeholder perspectives on policy priorities for improving national wellbeing through paid employment and adult learning

Recent policy initiatives in the UK have heightened the degree to which wellbeing can be considered a political construct: The acceptance of different policy options for wellbeing depends on the extent to which those options are responsive to popular wellbeing concerns. Drawing on the views of over 400 people gathered through a variety of methods and across the UK, we outline different stakeholder views of what wellbeing is and the priorities that stakeholders believe should be addressed to improve wellbeing. We draw out the implications for reframing policy debates around wellbeing, the practice of career guidance, academic debates around identified wellbeing priorities, and the best means of developing a policy and a practice-oriented and stakeholder-responsive approach to researching wellbeing.     

Anti-Racism Strategies in Pediatric Psychology: Using STYLE Can Help Children Overcome Adverse Experiences With Police

Black children are exposed to police violence at alarming rates. Such stress impacts development and treatment of physical health problems. In the current discourse, we introduce STYLE (Self-examination, Talk about community-police relations and racism, Yield space and time to anti-racism work, Learn about how structural racism impacts child health, Evaluate policies and practices through an anti-racism lens). STYLE offers a framework through which professionals in pediatric psychology can engage in anti-racist work across contexts from clinical care to academic and advocacy settings. Pediatric psychologists have a responsibility to be on the frontline as interventionists, educators, researchers, organizers, and advocates for racial justice through anti-racism practices. The current paper introduces STYLE in clinical care, community service, training/supervision, and academic and advocacy contexts. Case examples are provided. Professionals in pediatric psychology must first focus on changing their STYLE to promote individual and infrastructural change consistent with anti-racism work.

     

Investigating the social integration and wellbeing of transgender individuals: A meta-synthesis

Introduction: There is growing literature about the experiences of social integration and wellbeing of transgender individuals. However, there has been no synthesis across this body of research. Accordingly, the aim of this review was to aggregate, interpret, and synthesize findings from qualitative studies pertaining to the social integration and wellbeing of transgender individuals.

Methods: This study synthesized findings from 18 qualitative and mixed method studies which had explored the social integration and wellbeing of transgender individuals, using Noblit and Hare's meta-ethnography method. The Critical Appraisal Skills Programme was also used to appraise the 18 included studies.

Results: Data from the included 18 individual studies ranged from moderate to strong in quality. Data analysis revealed five major themes which influenced transgender individuals' daily lives. These were gender transition and disclosing gender identity, health and self-isolation, living with stigma and discrimination: health care, leisure and work, the importance of relationships, and last, overcoming adversity: stories of what can work.

Conclusion: This meta-synthesis reinforces many preconceived notions about transgender individuals. These include being at high risk of social exclusion, experiencing discrimination and stigma across many social situations, and last, being at high risk of poor wellbeing. This study also found that there is further need for studies that investigate the self-isolation of transgender individuals as well as this group's relationship and experiences with health care professionals and providers.     

The Anomalous Wellbeing of Disabled People: A Response

Disabled people frequently find themselves in situations where their quality of life and wellbeing is being measured or judged by others, whether in decisions about health care provision or assessments for social supports. Recent debates about wellbeing and how it might be assessed (through subjective and/or objective measures) have prompted a renewed focus on disabled people’s wellbeing because of its seemingly ‘anomalous’ nature; that is, whilst to external (objective) observers the wellbeing of disabled people appears poor, based on subjective assessments, people with disabilities report a good quality of life. In this paper, I examine an article by the philosopher Dan Moller in which he seeks to explain this ‘disability paradox’. Despite agreeing with his analysis that there is more to what people value than happiness, his explanation reflects some of the difficulties presented in philosophical accounts which seek to understand the lives of disabled people: this includes an analysis which fails to problematise definitions of wellbeing and who has the ‘voice’ to do the defining; which negates the multiple identities and subject positions that disabled people occupy; and which lacks recognition of the social contexts which mediate disabled people’s lives. I suggest that there is a need to incorporate disabled people’s voices into research which deepens our empirical knowledge about the relationship between impairment and wellbeing, including the social circumstances that shape disabled people’s agency.     

Educating career guidance practitioners in the twenty-first century

ABSTRACT

Rapidly changing policy contexts in England have dramatically affected the provision of career guidance, and the training and development of its practitioners. This paper takes an autoethnographic and self-reflexive approach to exploring the experience of a Senior Lecturer in Career Guidance who manages a centre that offers the Qualification in Career Guidance (QCG), and the Level 6 Diploma in Career Guidance and Development. Key questions are considered, such as: the effects of policy context on the type of qualification and curriculum offered, and their differences; the challenges of engaging learners in theoretical concepts and reflective approaches; and the tensions between ‘training’ practitioners and ‘educating’ them to develop a strong core of professionalism. The paper also considers the extent to which the learners develop as ‘knowledgeable social actors’.     

Meeting the advocacy needs of people who have been abused by health and social care practitioners

The Prevention of Professional Abuse Network (POPAN) is the first national organization within the UK to address the problem of the abuse of clients and patients by health and social care providers. POPAN has a small staff group of eight people and a larger network of advisers, supporters and allies; its activities include campaigning, training, consultancy, and the provision of information, advice and advocacy. Jennie Williams is a clinical psychologist and trustee of POPAN, she has supported the development of the organization since the early 1990s; Jo Nash was the main person involved in the development and provision of the advocacy service between September 1997 to January 2000. This is the edited version of a taped and transcribed interview that took place in 1999. Jo Nash is uniquely placed to provide information of significance to anyone using or providing health and social care services. Her work as an advocate has given her a very particular insight into the challenges faced by those seeking redress for professional abuse, and she has first hand experience of providing advocacy to people who are vulnerable and reluctant to trust anyone offering help. In this interview Jo Nash directs attention to the considerable limitations in current complaints systems, practices and procedures, and offers comment on the implications for change. Her work with POPAN provides continual reminders of the importance of prevention, and she identifies a number of ways in which action can be taken to prevent health and social care practitioners abusing their patients and clients. Copyright © 2001 John Wiley & Sons, Ltd.     

Stress mindset in athletes: Investigating the relationships between beliefs,challenge and threat with psychological wellbeing

ObjectiveStress is omnipresent in daily life and can be acutely experienced by athletes due to additional circumstances such as deselection and injury. Trait beliefs athletes have about the stress they experience as well as the cognitive appraisals of this stress may be important in determining psychological wellbeing. The present study aimed to investigate the relationships between stress mindset, irrational beliefs, cognitive appraisals and psychological wellbeing in athletes using path analysis. Broadly speaking, it was hypothesised that stress mindset would relate negatively to depressive symptoms and positively to vitality through appraisals (i.e., challenge and threat), while irrational beliefs would relate to positively to depressive symptoms and negatively to vitality through appraisals.Methods415 athletes (227 females, Mage = 33.86 years, SD = 17.73) completed an online questionnaire pack assessing stress mindset, irrational beliefs, challenge and threat appraisals, depressive symptoms, and vitality. Using path analysis, the tested hypothesised model demonstrated an excellent fit to the data.ResultsFindings demonstrate that the relationships between stress mindset, irrational beliefs and psychological wellbeing is linked by direct and indirect effects of challenge and threat in athletes. Stress mindset was positively associated with challenge and negatively associated with threat, whilst self-depreciation and awfulizing demonstrated significant positive associations with threat. Self-depreciation was found to significantly relate to stress mindset, challenge, threat and depressive symptoms to a greater extent than the other types of irrational beliefs.ConclusionsFindings suggest practitioners should be aware of the role that stress mindset and other irrational beliefs have in potentially influencing athlete psychological wellbeing.     

Gratitude reception and physical health: Examining the mediating role of satisfaction with patient care in a sample of acute care nurses

ABSTRACT

Literature examining well-being benefits of gratitude experiences is currently thriving in psychological science. However, evidence of the physical health benefits of gratitude remains limited. Research and theory in affective science suggests an indirect relationship between gratitude and physical health. This study examines how receiving expressions of gratitude predicts physical health outcomes in a sample of acute care nurses over time. Registered nurses (N = 146) practicing in Oregon completed weekly surveys over 12 consecutive weeks describing their positive and negative events, health, and work-related experiences. Multilevel mediation models revealed that being thanked more often at work was positively related to a nurse’s satisfaction with the care they provided within that week, which subsequently predicted sleep quality, sleep adequacy, headaches, and attempts to eat healthy. These findings contribute to literature demonstrating the health benefits of gratitude by indicating that benefactors may experience improvements in subjective physical health through positive domain-relative satisfaction.     

Evaluating health care work settings: A holistic conceptual framework

Abstract

After offering a systems perspective that considers a diversity of job-related and personal factors, we discuss the determinants and impacts of health care work climates and how staff morale and performance can influence the treatment milieu and quality of patient care. We also describe the physical features, organizational structure and policies, and suprapersonal and task factors that help to shape health care work climates. We then review research on the connections between work climate and staff morale and performance, the interplay of work climate factors, and the role of personal factors in these relationships. Finally, we orovide some ideas about how to improve health care work settings and focus on some promising new research directions.     

Does Needs Satisfaction Matter for Psychological and Subjective Wellbeing in Developing Countries: A Mixed-Methods Illustration from Bangladesh and Thailand

The paper uses qualitative and quantitative data collected by the Wellbeing in Developing Countries ESRC research group in Bangladesh and Thailand to explore the extent to which objective need deprivation predicts subjective and psychological wellbeing, controlling for location, socio-economic status, and gender. The regression analysis is triangulated with qualitative analysis of three illustrative case studies to explore why people experiencing great need deprivation nevertheless report high subjective and psychological wellbeing and propose factors that might support their resilience. The paper reports perhaps unsurprisingly that need deprivation was lower in Thailand than Bangladesh, and subjective and psychological wellbeing higher, with the exception of life satisfaction which was higher in Bangladesh. While goal attainment was significantly associated with affect and life satisfaction in both countries, in Thailand life satisfaction and goal attainment were negatively correlated (−.334), so the more goals respondents felt they had attained, the less satisfied they were. These apparent anomalies are explored further using data from the case studies. The findings confirm that although measures of subjective and psychological wellbeing are correlated, they are not substitutable. For example, subjective wellbeing, especially positive affect, is more influenced by need deprivation than psychological wellbeing, while psychological wellbeing is more influenced by demographic factors, especially in Thailand. Finally, the paper discusses whether the distinct relationships of subjective and psychological wellbeing with need deprivation and income have any implications for policymakers.     

Ensuring an independent future for young people with special educational needs and disabilities (SEND): a critical examination of the impact of education,health and care plans in England

This article examines the implications of the new education, health and care (EHC) planning process for career professionals in England. The new process comes in the wake of a succession of legislation relating to young people with special educational needs and disabilities (SEND) in England. There is much to recommend the new process as it represents a shift to a more holistic and person-centred approach. However, there are four main criticisms which can be made of the new process: (1) the policy has an excessive focus on paid work as an outcome which is unrealistic (for some young people); (2) the resourcing in local authorities is too limited to successfully operationalise the policy; (3) there is a lack of clarity about the professional base delivering EHC planning (especially in relation to the career elements); and (4) the policy is too narrowly targeted. While the new legislation offers some major opportunities, realising these will be difficult. In this paper, questions are raised about the resources required to deliver these services; the responsibilities relevant to such services; and the role and scope of these services in supporting the transitions of vulnerable young people into learning and work in an environment where universal careers provision has been substantially diminished.