Monday, October 2, 2017

Health Psychology Principles

On Health Psychology Principles
1. Open system theory
Health Psychology deals with Health Behaviour. It is not mere therapy but the open system. As open system,
It has homeostasis, self-regulation, equilibrium/balance, autopoiesis, equifinality/common finality (vide Katz and Kahn). Earlier it is assumed that it is close system. Therefore health Psychology researchers paid attention to adherence - compliance behavior.
2. Medicine taking
Close system assumes stream lining process as if patient will act by the advice of physician. So they started researching on Adherence - compliance behavior.
Compliance suggests that the provider has set a rule and the patient is expected to follow it. According to a recent British Journal of Pharmacology article, the term compliance comes from “the Latin word complire, meaning to fill up and hence to complete an action, transaction, or process and to fulfil a promise.” The patient is promising to take their medication or cut out sugar from their diet. Adherence on the other hand comes from “the Latin word adhaerere, which means to cling to, keep close, or remain constant.” Adherence then is about committing to lifestyle changes. It is attachment or commitment to a person, cause, or belief. It involves the extent to which a patient acts in accordance with the prescribed interval and dose of a dosing regimen. It disregards self regulation behavior of patient. Sometimes patient despite of illness aggravation does not take medicine. Who will regulate patient ? Physician or patient himself ?
3. Non-compliance
Patient has expected standard of own health that affects self regulation. One asks for silent death for the same. We know euthanasia.
Despite knowing non repeated hospital visit, thalassemia patients do not make spleen operation. Once I did research on spleen operated Thalassemia patients. Thalassemia is a blood disorder passed down through families (inherited) in which the body makes an abnormal form of hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen. The disorder results in large numbers of red blood cells being destroyed, which leads to anemia. My results show high neuroticism among non-spleenectomy patient. It was published research. So some patients are afraid of operation though they understand operation will reduce repeated blood taking behavior. It is the responsibility of health Psychologist to convince the patient and guardians not by mere lecture but by demonstration.
4. Community service
Health Psychology covers community health. Once I did research under World Bank project titled IPP-VIII. I observed extent of unawarenes among down trodden about measures of population control and their resistance to change.
of population control
In Bengal, large number of people due to eye problem are going to Chennai. Why is this flow? Why do people trust on Vellore?
These are related to medical concordance.
Health Psychology researchers should probe it. Levinson et al conducted a study among physicians who had a history of previous malpractice claims and those with no previous malpractice history. They found that physicians with no previous history of malpractice claims had better communication consultation skills, using more facilitative talk such as soliciting the patient’s opinion and encouraging them to talk.
In Kolkata, medical hospitals are over crowded due to high flow from suburban and villages.
Health concordance is serious issue in pharmacy management. Due to poor concordance many useful drugs remain unutilized.
International pharmacoeconomics thrusts on Medication persistence. It is “the duration of time from initiation to discontinuation of therapy.” Patients may choose to stop a medication (i.e., nonpersist) for a variety of reasons: to avoid potential or actual adverse drug reactions; because they do not believe they need the medication or do not believe the medication is working; or even because a prescriber directed a medication change in some way (e.g., drug holiday, dosing change, drug discontinuation, samples given, etc.) .

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