Psychology,health and health care

This article traces the development of the World Health Organization's emphasis on psychological and behavioural factors in health and notes its encouragement of recognition of these factors by member states. The article further outlines the reasons for this increasing recognition and stresses the important role of psychological and behavioural factors in the maintenance of health and prevention of illness.     

Being and feeling liked by others: How social inclusion impacts health

This study examined the effects of perceived and actual social inclusion on health across and within individuals from a network perspective. During the first semester, 75 freshmen students provided bi-weekly ratings on their perceived social inclusion and health. To capture actual social inclusion, each student nominated liked and disliked fellow students. Perceived social inclusion mediated the effect of actual social inclusion on health. Specifically, students with more ‘likes’ perceived more social inclusion and those with higher perceived inclusion reported a better health status (between-person effect). In addition, at time points, when students received more ‘likes’ they also perceived more social inclusion. They reported better health at times when they felt more included (within-person effect). Thus, the perception of social inclusion is rooted in reality and actual social inclusion has an impact on health when passing the filter of perception.     

Socio-economic health inequalities: Their origins and implications

Abstract

Evidence attests to substantial variations in health contingent on socioeconomic position. It is argued that these effects cannot be dismissed as artefact nor can they be explained, in the main, by either social selection or an unequal distribution of accepted behavioural risk factors among different social groups. The most likely explanation would seem to be social causation. However, it is continuing social and material inequality that appears most implicated; accounts which locate the effects in childhood social and material causes are far less compelling. The persistence of socioeconomic health differentials into the materially better-off social strata and the possible determining role of relative as well as absolute living standards suggest that psychological, in addition to material, variables are likely to be involved. Isolating the key psychological variables and identifying the nature of their influences will not be easy tasks, although social relations, psychological stress, uplifts, and control have emerged as possible candidates. However, psychological mediators of this sort most probably constitute surface rather than basic causes. Socio-economic inequality, it is contended, remains the basic cause, and, as such, the proper target for intervention. Psychological interventions are unlikely to yield much in the way of dividends in this context and indeed could inadvertently contribute to victim blaming.     

A survey of smoking status and cancer risk perceptions among participants attending a hospital-based head and neck screening program

Abstract

Screening for head and neck cancer is underutilized. Given that lack of knowledge of the risk factors may partially account for screening underutilization. we surveyed subjective risk and knowledge of risk factors for head and neck cancer among 124 individuals who attended a free. hospital-based head and neck cancer screening. Few participants were current smokers. Most attendees perceived their risk as similar to others of their age and sex. Personal health habits comprised almost all of the risk-decreasing factors, yet less than half of the risk-increasing factors. generated. Personal habits were less frequently endorsed than factors such as pollution and heredity. Those who mentioned a risk behavior, or a family cancer history, reported higher subjective risk. Those who mentioned a personal health habit reported lower subjective risk. Results highlight needed efforts to increase screening among high-risk individuals through targeted education messages.     

Biases in intuitive reasoning and belief in complementary and alternative medicine

Very little is known about the reasoning underlying beliefs in complementary and alternative medicine (CAM). This study examined whether CAM beliefs can be better explained with intuitive reasoning, paranormal beliefs and ontological confusions of physical, biological and mental phenomena than with 12 variables that have typically been used to explore the popularity of CAM, namely gender, education, income, age, health, desire to control treatment, satisfaction with conventional medicine and world view (unconventional, feministic, environmentalist, exotical and natural). A representative sample of Finnish people (N = 1092) participated in the study. The results showed that intuitive thinking, paranormal beliefs and ontological confusions predicted 34% of the variation in CAM beliefs, whereas the 12 other variables increased the prediction only by 4%. The results help to explain individual, cultural and situational differences in the popularity of CAM and to differentiate between CAM statements that can be scientifically examined from those that cannot.     

exploring drug users' illness representations of hiv,hepatitis b and hepatitis c using repertory grids

Abstract

Hepatitis B and C viruses are more prevalent among injecting drug users than HIV. This study explored drug users' illness representations of hepatitis B and C using repertory grid methodology. Initially, nine drug users were presented with six elements including hepatitis B and C, and HIV. Constructs were elicited via the sequential form variation of the method of triads. Elements were rated on elicited constructs using a five-point scale, and analyzed using “Flexigrid”. In a second quantitative research stage, 52 drug users were presented with six elements and supplied constructs. Results of the first stage indicated participants were able to generate constructs relating to Leventhal et al.'s (1980) features of illness representations. Most constructs, however, were causal in nature. Participants perceived hepatitis B, C and HIV similarly along the causal component. This similarity on the causal component was largely replicated in the second research stage. Participants, however, distinguished HIV from hepatitis B and C along serious, cure and timeline features. Participants did not distinguish hepatitis B from hepatitis C. The implications of these results for health promotion are discussed.     

Resolving the theory of planned behaviour's ‘expectancy-value muddle’ using dimensional salience

The theory of planned behaviour is one of the most widely used models of decision-making in the health literature. Unfortunately, the primary method for assessing the theory's belief-based expectancy-value models results in statistically uninterpretable findings, giving rise to what has become known as the ‘expectancy-value muddle’. Moreover, existing methods for resolving this muddle are associated with various conceptual or practical limitations. This study addresses these issues by identifying and evaluating a parsimonious method for resolving the expectancy-value muddle. Three hundred and nine Australian residents aged 18–24 years rated the expectancy and value of 18 beliefs about posthumous organ donation. Participants also nominated their five most salient beliefs using a dimensional salience approach. Salient beliefs were perceived as being more likely to eventuate than non-salient beliefs, indicating that salient beliefs could be used to signify the expectancy component. The expectancy-value term was therefore represented by summing the value ratings of salient beliefs, an approach that predicted attitude (adjusted R ²?=?0.21) and intention (adjusted R ²?=?0.21). These findings suggest that the dimensional salience approach is a useful method for overcoming the expectancy-value muddle in applied research settings.     

Book Review of Health and the Construction of the Individual. J. Ogden. London: Routledge, 2002. i–viii + 130 pages ISBN 0415233070

Abstract

Recent theoretical and empirical research has challenged the assumption of health psychologists employing social cognitive models that beliefs can confidently be inferred on the basis of questionnaire responses. It is charged that responses to questionnaires are a function of the intelligibility of the items, constructs and theoretical framework to survey participants. To investigate this contention, cognitions specified by Protection Motivation Theory (PMT) were measured with respect to intentions to use a condom and intentions to use dental floss. Three alternative formats of a questionnaire which varied the order of presentation of PMT items were distributed to student samples. Analyses showed that while questionnaire format did not affect the reliability of cognition measures, there was some variation in the significance and strength of correlations between PMT cognitions across formats. Individual differences in social desirability and salience of the target behaviour had small and predictable effects upon reliabilities and intercorrelations. Implications for the measurement of health beliefs and the status of questionnaire responses are outlined and suggestions are made for controlling bias associated with respondents' capacity to “read” a questionnaire.     

Attention and Memory in Children with Brain Tumors

The Rey Auditory Verbal Learning Test was utilized to examine attention, learning, and memory abilities in 42 children with cerebellar (N?=?18) and third ventricle tumors (N?=?24). Children with cerebellar tumors exhibited significant auditory attentional impairments and displayed adequate encoding and retrieval across subsequent learning and memory trials. In contrast, children with third ventricle tumors exhibited average auditory attentional abilities, but they displayed mild encoding deficits across trials 2–5. Furthermore, the third ventricle group's compromised performance on the delayed recall trial and average performance on the delayed recognition trial is suggestive of underlying retrieval deficits.