2. What is the meaning of the terms ‘structure’ and ‘agency’ and what is their relevance for health?  Agency (individuals) – The capacity of individuals to act independently and make their own free choices.  Structure (society) – The influence of society and its structure on the choices and opportunities available.  The relationship between individuals (agency) and society (structure) is important for explaining human action  potentially explaining health behaviors

3. Define a lay belief?  People’s ‘common sense’ understanding and knowledge about health and illness. Generally rooted in people’s own experiences, not always different from medical understanding  Give an example description of someone’s lay belief.  A patient comes into the GP surgery and is worried about their cough. They report seeing the TV adds saying if you have had a cough for more than 3 weeks you should go see the doctor, and is worried about lung cancer.

4. Monica is a 75 year old lady who bases a lot of her own knowledge about COPD from previously being admitted to hospital. This is an example of a patients lay knowledge coming from “personal knowledge and experience”. List FIVE other sources of lay beliefs/knowledge. 1.Previous medical encounters  very similar to the example given here 2.Folk knowledge 3.Media & internet 4.Spiritual beliefs 5.Alternative & complementary medicine

5. List THREE reasons lay beliefs are important to doctors. 1.Helps to better understand people’s illness related behaviour 2.Gain insight into patient needs and their expectations of doctors 3.More satisfied patients and doctors

6. What is the ‘lay referral’ system?  When a patient seeks advice from others before consulting a doctor.  List the FIVE ‘triggers’ to seeking medical help 1.Temporalizing of symptomatology 2.Sanctioning 3.Interpersonal crisis 4.Interference with social or personal relations 5.Interference with vocation or physical activity

7. Why do patients delay seeking help?  Perceptions before the event eg. I am not the typical patient/victim; it won’t happen to me  I am still able to do my day to day activities so it won’t happen to me/I am well  Fear  Caring responsibilities

8. Expert Patient Programme  List FIVE benefits of the Expert Patient Programme 1.Patients conditions improve or stay stable 2.Patients will have more confidence in seeking health and social care services for them 3.Patient contribute towards improving health services 4.Patients require fewer visits to GPs and outpatient clinics  saves NHS resources 5.Patients and health professionals work together to find the best solutions

9. List FIVE potential problems with the Expert Patient Programme 1.Isn’t possible to ensure participation of all social groups 2.May intensify the exclusion and marginalisation of the most disadvantaged groups 3.More pressure placed on patient organisations 4.No corresponding strategy to challenge professional attitudes 5.Is the Expert Patient Programme just to save NHS resources?

10. Define what a health behaviour is.  Behaviours that are related to the health status of the individual.  List the THREE types of health behaviour 1.Good health behaviours eg. Sleeping 7-8 hours, exercise, healthy eating 2.Health protective behaviours eg. Attending health screening* easy way to link screening here 3.Health impairing habits eg. Smoking, drinking, eating fast food a lot etc.

11. What is the dual pathway model of health?  Two broad ways in which psychological processes can influence physical health  What is the bio-psycho-social model of health?  “Bio” = viruses, bacteria & genetics  “Psycho” = stress, behaviour, emotions, beliefs  “Social” = class, employment or income, ethnicity

12. List the FOUR determinants of health behaviour 1.Background factors 2.Stable factors 3.Social factors 4.Situational factors  What are some “background factors”?  Employment  Ethnicity  Culture  Education etc.

13. Stable factors are down to the individual & their personality; define “stable factors”  Variations between people in psychological activities that, within people, produce responses that are stable across time and context  What THREE ways do stable factors “influence appraisal”? 1.They determine if/how much an event is important 2.The provide a generalised framework for understanding and evaluating the event (threat vs. challenge) 3.They make available/suggest potential responses

14. Stable factors are split into three “types”; what are they? 1.Emotional dispositions  present 2.Generalised expectancies  future 3.Explanatory styles  past  Emotional disposition = psychological processes involved in experience & explanation; list the FIVE personality traits. 1.Openness to new experiences 2.Conscientiousness 3.Extroversion 4.Agreeableness 5.Neuroticism

15. Generalised expectancy  locus of control & self-efficacy  What does locus of control mean?  Expectation that future outcomes will be determined by factors that are either internal/self or external/powerful others/chance  List THREE things that people with an internal locus of control believe 1.They are responsible for their own health 2.Ill health can be avoided by good health behaviours/taking care of themselves 3.Ill health results from negative health behaviours eg. Eating too much fat, not exercising enough

16. Generalised expectancies  what is self-efficacy?  Belief in one’s self to organise and carry out an action, and the expectation that the action will lead to a good/desirable outcome  Explanatory styles  what are the two types? 1.Opitmism = the expectation of a positive future outcome despite current negative event. Associated with better physical health/illness recovery 2.Attributional style = causal explanation of negative events as self (internal vs. external), time (permanent or temporary?) and global situation

17. Social cognition theories  what do they mean/do?  Attempt to explain the relationship between social cognition (beliefs, attitudes and goals) and behaviour  List THREE Social Cognition Theories 1.Health belief model 2.Theory of planned behaviour 3.Transtheoretical model of change

18. Health-Belief Model

19. *MCQ; In the theory of planned behaviour, “control beliefs and self efficacy” lead to which of the following? A.Behavioural attitude B.Subjective norm C.Perceived behavioural control D.Perceived threat E.Perceived efficacy

20. Thank-you!  Any questions?  Good luck with your revision