LEARNING THEORIES RELATED TO HEALTH CARE PRACTICE

• George Engel • A psychiatrist at the University of Rochester • Introduced the Biopsychosocial model or BPS in 1977 • He advocate the new medical model to explain health and disease. • Guided the researches on health behavior models like the social cognitive models of Bandura’s Self efficacy and health Belief model.
• Biopsychosocial Model • Is an approach that states that human experience of health or illness is greatly affected or determined by the interplay or interrelatedness
• Biological- Concerned with the functioning of the different organ systems of the body and its coping or adapting mechanisms like immunity level, genetic susceptibility or predisposition o Seeks to explain the cause of illness or disease as a result of the breakdown in the physical or environmental functioning of the body
• Psychological is thePerceptions, thoughts, emotions, attitude and behaviors o Deals with how the individual perceives the health threat and the state of emotional control, discipline and motivation to stay healthy
• Social factors- it is the Socioeconomic status, cultural beliefs and practices, poverty, technology, environmental influences and conditions. o Concerned with the individual’s perception of his/her ability to deal with the health threat or health problems and the a barriers posed by the society or the environment towards the attainment of health and healthy lifestyle.( in line with Bandura’s social cognitive theory dealing with self efficacy)
• SELF-EFFICACY AND HEALTH BELIEF MODEL: BANDURA
• Pender’s health promotion theory- Nola J. Pender
• Banduras self efficacy theory- Albert Bandura
• Becker’s health Belief Model
• Green’s PRECEDE-PROCEED Model
• Health Promotion Theory by Pender• Developed in 1987 and revised by Pender in 1996 to increase the utility of its predictions and interventions. • Widely used in the field of nursing • Emphasizes actualizing health potential and increasing the level of well-being using approach behaviors rather than avoidance of disease.
• Social Cognitive theory • Emphasizes that cognition plays a critical role in people’s capability to construct reality, self-regulate, encode information and perform behaviors.
• Self –efficacy • Is the single most important aspect of th sense of self that determines one’s effort to change behavior according to Bandura. • Equated with self confidence in one’s ability to successfully perform a specific type of action
• Direct reinforcement ▪ Supplied directly to the person
• Vicarious ▪ Participant observes someone else being reinforced for behaving in an appropriate or inappropriate manner ▪ Also called social modeling or observational learning
• Self management ▪ Involves record keeping to the participant of her/his behavior ▪ When the behavior is performed correctly, the person would reinforce or reward herself/himself ▪ Construct of self control is applied
• Behavioral capability: Refers to the knowledge and skills necessary to do behavior which influences actions ▪ Must know what the behavior are and how to perform them ▪ Needs Clear instructions or training
• Expectations ▪ Refers to the ability of humans to think and to expect certain results in certain situations
• Expectancies ▪ Are the values such as chest x-rays for tuberculosis screening that people place on an expected outcome. ▪ The more highly valued the expected outcome, the more likely the person will perform the needed behavior to yield that outcome.
• Efficacy expectations ▪ Are feelings of competency
• Outcome expectations ▪ If a person believes that the outcome of the behavior (reinforcement) is not great or good enough in terms of benefits, he/she may not attempt the behavior inspite of the feeling of competency or efficacy expectations.
• . Health Belief Model: One of the 1st models originally introduced by a group of psychologists in 1950’s to find out why people refused to use available preventive services such as chest xrays for tuberculosis screening and immunization for influenza.
• Perceived susceptibility • Person’s opinion of the chances of getting a certain condition • People will not change their health behaviors unless they believe that they are at risk. • Those who does not think that they are at risk of acquiring HIV from unprotected intercourse are unlikely to use a condom
• Perceived severity • Person’s opinion of how serious the condition is • The probability that a person will change his/her health behaviors to avoid a consequence depends on how serious he or she considers the consequence to be.
• Perceived benefits • Person’s opinion of the effectiveness of some advised action to reduce the risk of seriousness of the impact • It's difficult to convince people to change a behavior if there isn't something in it for them
• Perceived barriers • Person’s opinion of the concrete and psychological cost of this advised action • One of the major reasons people don't change their health behaviors is that they think that doing so is going to be hard. Sometimes it's not just a matter of physical difficulty, but social difficulty as well. Changing your health behaviors can cost effort, money, and time
• Self efficacy • Person’s confidence in her ability to successfully perform an action
• PRECEDE stands for: P – Predisposing o R – Reinforcing o E – Enabling o C – constructs in o E – educational o D – Diagnosis and o E – evaluation
• PROCEED stands for: P – policy o R – Regulatory o O – Organizationnal o C- Constructs in o E – Educational and o E – Environmental o D – Developmen