ASSINGEMENT OF PSYCHOLOGY AND

SOCIOLOGY
Attitude towards illness and treatment
In psychology, attitude is a psychological construct, a mental and emotional entity that inheres
in, or characterizes a person. They are complex and are an acquired state through experiences. It
is an individual's predisposed state of mind regarding a value and it is precipitated through a
responsive expression towards oneself, a person, place, thing, or event (the attitude object) which
in turn influences the individual's thought and action.

Attitude Formation:
There are a number of factors that can influence how and why attitudes form. Here is a closer
look at how attitudes form.

Experience:
Attitudes form directly as a result of experience. They may emerge due to direct personal
experience, or they may result from observation.

Social Factors
Social roles and social norms can have a strong influence on attitudes. Social roles relate to how
people are expected to behave in a particular role or context. Social norms involve society's rules
for what behaviors are considered appropriate.

Learning
Attitudes can be learned in a variety of ways. Consider how advertisers use classical
conditioning to influence your attitude toward a particular product. In a television commercial,
you see young, beautiful people having fun on a tropical beach while enjoying a sports drink.
This attractive and appealing imagery causes you to develop a positive association with this
particular beverage.

Conditioning
Operant conditioning can also be used to influence how attitudes develop. Imagine a young man
who has just started smoking. Whenever he lights up a cigarette, people complain, chastise him,
and ask him to leave their vicinity. This negative feedback from those around him eventually
causes him to develop an unfavorable opinion of smoking and he decides to give up the habit.

Observation
Finally, people also learn attitudes by observing people around them. When someone you admire
greatly espouses a particular attitude, you are more likely to develop the same beliefs. For
example, children spend a great deal of time observing the attitudes of their parents and usually
begin to demonstrate similar outlooks.
Disease and illness
Health is “a state of complete physical, mental, and social well-being and not merely the
absence of disease and infirmity”. WHO
The Italian dictionary Devoto Oli, defines illness as “an abnormal condition of an organism
(body) caused by organic or functional impairments developing towards death, recovery, or a
new, different life condition”.
Each and every illness is clearly identifiable through specific physical tests that can identify
abnormalities in the body, organs, tissues or cells. The illness is not determined on the basis of
someone’s opinion.
A lot of people now know how to keep the health but do nothing to support it .It looks like they
have special defense mechanisms from the diseases. That the most marked level of defense from
the diseases could be in people with good health and in people with chronic diseases. The most
adequate attitude to the diseases could be in people who are on a board between health and
chronic diseases. Illness varies from society to society due to difference in socio-cultural ground.

Some Philosophy regarding Health are as follows:

* Health is a fundamental human right

* Health is the essence of productive life, and not the result of ever increasing expenditure of
medical care
* Health is inter-sectoral
* Health is an integral part of development
* Health is in central to the concept of quality of life
* Health involves international responsibility and individual state
* Health and its maintenance is a major social investment
* Health is worldwide social goal

View’s on Health
 Biomedical scientists: They stress mainly on germ theory that is they believe disease occur as a
result of microorganisms’ invasion. Their thought is rejected as it doesn’t solve some major
health problems as malnutrition, accidents mental illness

 Ecologists: They view health as a harmonious equilibrium between man and his environment.
Disease is said to be the individuals’ maladjustment to his environment.

 Sociologists: They believe health is not only biomedical phenomenon but is also influenced by
social, psychological, cultural, economical and political factors.

 Holistic View: this view is synthesis of views of all experts. This views health as a
multidimensional process involving well-being of the whole person in the context of his
environment.

Factors Influencing Health Status, Beliefs, and Practices:

o Internal factors
 o External factors

Internal factors
 Biologic dimension genetic makeup, sex, age, and developmental level all significantly
influence a person's health.
 Psychological dimension emotional factors influencing health include mind-body
interactions and self-concept.
 Cognitive dimension include lifestyle choices and spiritual and religious beliefs.
External factors
 Environment
 Standards of living
 Reflecting occupation, income, and education.
 Family and cultural beliefs
 Patterns of daily living and lifestyle to offspring( children)
 Social support networks
 Family, friends, or confidant (best friend) and job satisfaction helps people avoid illness.

The sick role

Parsons (1951) described the ‘sick role’ as the rights and responsibilities of people who are sick.
Rights include exemption from normal responsibilities, e.g. work, household or caring duties,
and not being blamed for their illness; responsibilities include a duty to want to recover, and to
seek medical assistance in doing so. It is assumed that these rights and responsibilities are
temporary and universal, and that they work together for the benefit of the patient and in the
interests of wider society.
While the sick role model can be applied well to acute or short-term diseases, e.g. flu or food
poisoning, it has considerable limitations when applied to chronic or long-term health conditions.
Firstly, it makes assumptions about illness and recovery that do not necessarily apply to chronic
conditions: it assumes that there will always be recovery from illness, and also overlooks the fact
that exemption from ‘normal’ duties is not always necessary. For example, the model was never
able to satisfactorily explain how people with chronic conditions were able (or not) to manage
both their social life and their illness. Secondly, it makes assumptions about the relationship
between doctors and patients: that patients are essentially passive and doctors always proactive,
and that medical assistance is always seen as helpful. Thirdly, it can encourage the blaming of
patients for their health conditions, particularly where there is a lifestyle component (e.g.
smoking or obesity).
Until relatively recently, this was the dominant model in describing the social aspects of living
with a chronic illness. Section 6 describes the development and application of sociological
approaches to experiences of chronic illness, which are more consistent with the shift towards
patient-centred care.

Various Model of Health

Health and illness is complex and dynamic. A model is theoretical way of understanding a
complex phenomenon. Health models help to understand client’s health behaviors and belief so
that effective health care can be provided. Health models helps nurses to understand the
relationship between health of the client and various variables affecting it such as nutrition, life
style, health practice etc. Model represents various ways of approaching complex wishes.
Models of health and illness contain a combination of biological characteristics behavioral
factors and social conditions.
Some of the models of health are as follows:
 Health – illness continuum model
 High level wellness model
 Agent – host environment model
 Health belief model
 Holistic health model
 Health promotion model

HEALTH – ILLNESS CONTINUUM MODEL

 Measure person’s perceived level of wellness

 Health and illness/disease opposite ends of a health continuum
 Move back and forth (forward) within this continuum day by day
 Wide ranges of health or illness
 Health and illness can be viewed as the opposite ends of a health continuum
 From high level of health a person’s condition can move through good health -- normal
health -- poor health -- extremely poor health -- to death.
 People move back and forth within this continuum day by day.
 How people perceive themselves and how others see them in terms of health and illness
will also affect their placement on the continuum.

Characteristics of Health-Illness Continuum Model

 At any time any person’s health status holds a place on certain point between two ends of
health-illness continuum.
  Any point on the health-illness continuum is a synthetically representation of various
aspects of individual in physiology, psychology and society.

Nurses Responsibilities
 To help the client to identify their place on the health-continuum
 To assist the clients to adopt some measures in order to reach a well state of health

Importance of social learning in health

Social learning theory is the concept of learning from other people through observation,
questions, collaboration, and knowledge sharing. Social learning is happening all around us.
Nurses can apply learning theories at the individual, group, and community levels to understand
and teach new material and tasks, solve problems, change unhealthy habits, build constructive
relationships, manage emotions, and develop effective behavior
Theories used for patient teaching include:
 Health Belief Model
 Self-efficacy theory
 Locus of control theory
 Cognitive dissonance theory
 Diffusion theory
 Stress and coping theory and
 Adult learning theory

HEALTH BELIEF MODEL (HBM)

The health belief model (HBM) is a social psychological health behavior change model
developed to explain and predict health-related behaviors, particularly in regard to the uptake of
health services. The HBM was developed in the 1950s by social psychologists at the U.S. Public
Health Service and remains one of the best known and most widely used theories in health
behavior research. The HBM suggests that people's beliefs about health problems, perceived
benefits of action and barriers to action and self-efficacy explain engagement (or lack of
engagement) in health-promoting behavior. A stimulus, or cue to action, must also be present in
order to trigger the health-promoting behavior
The HBM has been used for intervening with health screening, illness, sick role and
precautionary behaviors.

It acknowledge the patient`s values and attitudes towards health behavior

Self efficacy theory
Self-efficacy refers to an individual's belief in his or her capacity to execute behaviors necessary
to produce specific performance attainments (Bandura, 1977, 1986, 1997). Self-efficacy reflects
confidence in the ability to exert control over one's own motivation, behavior, and social
environment.
Self-efficacy influences the effort one puts forth to change risk behavior and the persistence to
continue striving despite barriers and setbacks that may undermine motivation. Self-efficacy is
directly related to health behavior, but it also affects health behaviors indirectly through its
impact on goals.

Social learning Theory

Built on understanding of interaction of the individual and his/her environment.
Taken as a whole, it provides insight into approaches to improve individual’s knowledge and
skills to act to improve their health.
It explicitly identifies the importance of social norms and cues, and environmental; influences on
health behavior.
Social learning theory can be applied by teachers of resident physicians or medical school
students in a clinical setting to maximize teaching opportunities from informal, unplanned, and
opportunistic situations to formal and planned lessons.
Social learning theory is based partially on behaviorist principles; the self-regulation and control
that the individual exerts in the process of acquiring knowledge and changing behavior are
considered more critical and are more reflective of cognitive principles.

Socio-cultural theory
Assumes learning to be a social process where learning happens in a social context. The learner
is involved in apprenticeship in the community practice or as a full member in the community.
Learning is in relationship between people and environment. An increasing amount of medical
education occurs in workplace contexts; hence, this learning theory can be an appropriate
explanation in this setting.
Overall, the importance of social learning in health is enlisted below:
 Social learning is important because life (and work) is social. Social learning helps
replicate the realities that learners are likely to face when they are required to make actual
decisions and solve actual problems in the workplace.
 Social learning also helps to improve communication, improves collaboration between
individuals.
 To understand patient and family behaviors, trauma and loss, palliative care and issues of
terminally ill patient.
 It is importance to understand the behaviors of others people and to identify the
psychosocial problems of the patient.
 Social learning theory can be applied by teachers of resident physicians or medical school
students in a clinical setting to maximize teaching opportunities from informal,
unplanned, and opportunistic situations to formal and planned lessons.
 Social learning theory is based partially on behaviorist principles; the self-regulation and
control that the individual exerts in the process of acquiring knowledge and changing
behavior are considered more critical and are more reflective of cognitive principles.
 Nurses can apply learning theories at the individual, group, and community levels to
understand and teach new material and tasks, solve problems, change unhealthy habits,
build constructive relationships, manage emotions, and develop effective behavior.

Prepared by: Sandhya Sharma and Bipana Surkhali, roll no 20 and 23