Health Psychology- (B) Patient Practioner Relationship

Measuring Adherence To Medical Advice

Cluss and Epstein (1985) suggest the following methods to measure Adherence to medical advice:

1. Self report: Asking patients how adherent they have been to their prescribed health regime.
2. Therapeutic Outcome: Is the patient getting better? It can be attributed to adherence to regime  on his/her part.
3. Health worker estimates: Asking doctor about their estimates on their patients' adherence.
4. Pill and bottle counts: Checking the patients medicine cabinets and medicine bottles for how frequently they have been used.
5. Mechanical methods: Devices to measure how much medicine has been removed from bottles.
6. Biochemical tests: Blood tests or urine tests may reveal how adherent the patient has been to their health regimen.

Study: Chung and Naya (2000) Measuring adherence using track caps:

They performed their study on patients from London. To measure adherence track caps were used. The track cap recorded the time and date of the usage of the bottle. In this case, the patients had to take their medicines twice. Adherence rates were found to be high among the patients.

 

Health Psychology: (A)Patient Practioner Relationship

(A)PATIENT PRACTIONER INTERPERSONAL SKILLS

• Argyle (1975) suggests that non-verbal communication is 4 times as effective and powerful as verbal communication. Non-verbal communication can be used to assist speech, become a replacement for speech, to signal attitudes or emotional states.
• Non-verbal communication plays an important role in in patient practitioner relationship. Dressing sense is powerful way to communicate non-verbally.

Study:McKinstry and Wang (1991)

They showed pictures of doctors to patients attending surgeries. The pictures were of the same male and female doctors either dressed formally (traditional white coat over suit or shirt) or informally (jeans and open-necked shirt, pink trousers, gold earrings etc) The patients were asked how happy they would be to see each doctor and how much confidence they would have in each one of them. The formally dressed doctors got higher preference rating than informally dressed doctors. This was particularly the case when the patients were elderly or professional class.

 

Study: Dimatteo and DiNicola(1982)

They argue that failures in medical communication exist due to a lack of basic courtesy on the part of practitioners such as saying "hello" and "goodbye", telling patients where to hang their coats etcetera.

They say that even though such actions may take a few minutes of the practitioner's time, they will appear warm and supportive to the patient and therefore will aid the treatment process.

Two styles adopted by practitioners

1. Doctor Centered: Doctor leads the discussion. Prescribes treatment while the patient is the passive recipient of the treatment.
2. Patient Centered: Doctor listens to the patient. Encourages the patient to participate in his/her own treatment decisions. In this case the patient is active recipient of treatment.

 

 

 

 

Environmental psychology-Architecture(f)

Community environmental design

Community environmental design differs from urban renewal in that it allows the current residents of a neighborhood to make their input  into the redesign or new development of an area.

Two Studies Of Community Environmental Designs:

1) Al-Kodmany (1999)-Chicago Pilsen Neighborhood

The residents used GIS( Geographical Information System) satellite in addition to a graphic designer to aid community environmental design. GIS allowed the planners, community leaders and designers to view the spatial layout of the neighborhood. The graphic designer amalgamated the ideas of the residents to form a shared vision.

2) Kose (2000)

He reported how Japan(which has one of the most aged societies in the world) has responded to its elderly population. The key concept of housing projects in Japan since 1987  has been to design for all ages. Kose believes that people should be able to age in their dwellings. In the U.K a different point of view is adopted. Once people can no longer live in their own houses, they usually enter shelter homes.

 

Environmental psychology- Architecture(e)

Contribution to design by psychologists

1) Windows and illumination

Ulrich (1984) examined the impact that windows had within the hospitals. 

Participants were 46 patients(30 females and 16 males) in surgical wards in a Pennsylvanian hospital. Patients were aged between 20 and 69. Patients had undergone a specific gall bladder operation known as cholecystectomy.

The sample was divided into two groups. One with window views of trees, other with window views of brick walls.

Results: Those with window views of trees spent less time in hospital compared to patients with window views of brick walls.

2)Privacy

Sundstrom et al. (1994) acknowledges that privacy is important in the workplace. Following a survey of 2000 workers it was discovered that auditory privacy should be an important consideration while building a workplace. As 54% of the respondents said that they were bothered by the noise at work.

 

Environmental psychology- Architecture (d)

Urban renewal and building design

Urban renewal is an attempt to rejuvenate areas of town that have become rundown. Porteus (1997) defined Urban renewal as an integrated set of steps taken to maintain and upgrade the environmental, economic and social health of an area.

1. Architectural Determinism:Is the view point that built environments directly shapes the ehaviour of people in it.
2. Architectural Possibilism :Major determinant of our behavior is the individual. A building is what we make of it.
3. Architectural Probabilism: Architecture determines the behavior of people to a certain extent but is modifiable by them.

Designing effective study environments- Stone N.J (2001)

Aim: To find out how a person's ability to study is affected by setting( open plan or private), color(white, blue or red) and type of task( reading or mathematics)

Sample:144 students

Method: Each of the students was assigned to one of the twelve combinations of above three categories.

Results:

• Participants most satisfied with their performance in white private room
• For the private room the color red bought the most positive mood
• Participants performed significantly worse if surroundings were red. They performed better in white surroundings.

Conclusion: Color and setting had an effect on the type of task performed.

Environmental Psychology- Architecture(c)

Effects Of Urban Living On Social Behavior

Study by Milgram (1997): Friendliness

Undergraduates approached strangers on streets in both urban and rural areas. They extended their hands in friendly manner. Only 38.5% of the city dwellers reciprocated compared to 66% of the rural dwellers.

 

 

Study by Levine et al.(1994): Helping behavior investigated in 36 U.S cities:

 

Participants: A large sample, from 36 U.S cities.

Method: 6 different measures of helping investigated

1. Dropped pen: A pen was dropped deliberately  by an experimenter, who kept on walking ahead.
2. Hurt Leg: An experimenter walking with a limp and a leg brace dropped a pile of magazines.
3. Change for a quarter: The experimenter requests oncoming pedestrians for change.
4. Helping a blind person cross street: Experimenter wearing dark glasses and carrying a cane, waited for assistance to cross the road.
5. Lost letter: Percentage of dropped letters( which were addressed and stamped) compared with the percentage of letters that were eventually returned.

     6.United Way contributions: Per capita contributions to United Way calculated from 1990 records.

conclusion(result): Greater population density was found to be associated with LESS helping gestures. ( It maybe because of the fear for increasing crime rate in urban areas rather than an innate tendency to help less in urban dwellers)

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Environmental Psychology-Architecture(b)

Effect of Urban Living On Health
The effects on urban living on health are inconclusive as yat. Where some studies manage to demonstrate the negative effects of urban living, other studies give evidence for vice versa.
1.Fisher et.al: Study on the effects of urban living on eating behavior:
Method: Administering questionnaires
Aim: To examine potential differences  between the eating behaviors of urban and sub-urban dwellers.

PARTICIPANTS: Approximately 270 sub-urban females,390 uban females and 280 urban males

 

Result:(Conclusion)

1. Urban dwellers more likely to be overweight, when they perceive themselves not to be
2. Suburban dwellers perceiving themselves overweight when they are not
3. Higher self esteem in urban dwellers, particularly males

A level Psychology

Hello Psychology Lovers!!
This Blog is currently under construction. First of all complete summarized resources for A2 level Environmental and Health Psychology will be uploaded. So viewers, have patience. In time you will be able to use this blog as a reference point while you're studying Psychology. I'm hoping that you will find the resource material helpful :D

Environmental psychology- Architecture(a)

THEORIES
Four theories that examine effects of Urban living on health and Social behavior:

1. Adaptation level theory: This theory states that any stimuli that are intense, complex or novel lead to either a positive effect or a negative effect. People who find urban life too complex or intense eventually adapt over time.(for e.g. by finding relatively peaceful and secluded places in that very urban area)
2. Behavior constraint theory: People who live in urban areas consider their behavior to be constrained someway compared to people living in rural areas. Crime on roads, experience and expectation  of finding the shopping mall crowded may lead a person to believe that they are  deprived of the freedom to behave the way they wish.
3. Environmental Stress Theory: Specific stimuli in urban areas have negative effects on our lives. For e.g. crowding and noise have been found to be detrimental to our health by researchers.
4. Overload Theory: This theory suggests that people in urban environments are faced with many stimuli, not all of which can be dealt with. For e.g. many people being around, noise, trying to find parking space in a jammed parking lot and so forth. This overload, if continued can lead to exhaustion and illness.