• promoting and maintaining health and preventing illness,
• understanding how people react to, cope with and recover from illness,
• personalizing treatments and interventions,
• improving health care systems and health policy.

Health psychology asks: What drives health-related behaviours, and how can these behaviours be changed? It also examines how emotions and beliefs are linked with these behaviours and their consequences. Health psychologists, therefore, work across many different environments and groups of people. These include patients, carers and families, individuals in the community, health care professionals, and healthcare systems and institutions. As a result, some basic concepts from the field of health psychology are relevant for anyone working with patients or promoting behavioural changes in practice.

Promoting and maintaining health and preventing illness

While the burden of chronic illness is rapidly increasing worldwide, much of this is preventable. Epidemiological research has demonstrated that primary prevention (e.g., reducing risk factors for cardiovascular disease) is more effective than secondary prevention for reducing deaths from cardiovascular disease. Health psychology has a huge contribution to make in terms of reducing risk factors for illness in populations by identifying specific behaviours (e.g., smoking, poor diet, lack of physical activity, attending medical screening) and targeting them for change.

Health psychology focuses on the psychological mechanisms (e.g., knowledge, attitudes, cognitions) and social influences that may be hindering change and leading to sustained unhealthy behaviour patterns. A better understanding of these processes helps identifying optimal ways to support people to break out of such unhealthy routines and, for example, stop smoking or increase fruit consumption. The development and use of eHealth applications has steadily increased in this area, and the delivery of behaviour change techniques via Apps and devices provides a very interesting opportunity for health psychology.

Understanding how people react to, cope with and recover from illness

Illness has psychological effects that can impact recovery. Individuals may experience stress, anxiety or depression, or struggle with what the illness may mean for their identity. Health psychologists try to better understand how to best support individuals dealing with illness, while also examining the complex links between cognitions, coping, outcomes and important health behaviours (e.g., medication adherence in different populations). Health psychologists critically consider the definition and measurement of key illness behaviours, for example: How can adherence to medication be measured? What is an ‘acceptable’ level of adherence? Theories and models are used to explain and predict illness-related behaviours and outcomes, and form the basis for designing interventions to make positive changes in behaviours. Health psychologists also try to find out how and for whom these interventions are most effective.

Personalizing treatments and interventions

We want to find out how for example a change in goal-setting or social skills may lead to better outcomes, e.g., improved self-management or generating social support; such a finding implies a mediation effect. These findings are important because it will enable us to improve our interventions since it opens the black box of the intervention and shows which ingredients effectively work and have an effect on the outcome when we are able to change them. In addition, it is also very important to know what works best for whom. Suppose a Cognitive Behavioural or Mindfulness intervention helps cancer patients to cope with the implications of the disease, we will see that some individuals do not respond to the treatment they were given. Research techniques enable us to find out whether patients with certain characteristics (like gender, age, or a personality characteristic) respond better or worse to one of these treatments. This is very helpful in determining which treatment works best for whom – a personalized treatment.

Improving health care systems and health policy

The ways in which doctors, nurses and other healthcare professionals interact with a patient can have a significant impact on the patient’s response to illness and treatment. As well as working with patients, carers and families, health psychologists may work with health care professionals. Health psychology has an important role to play in the education of healthcare professionals by promoting patient-centered care that facilitates increased self-management, allowing individuals to have control over their health and helping them make better choices. This includes examining the communication style of healthcare professionals and finding ways to better match the style with patients’ needs in order to improve healthcare outcomes. So, for example in various countries Health Psychology Departments at Academic Hospitals train medical students in the above.

Reaching out to Health Psychologists

If you are dealing in your work with issues described above and you like to be informed about the latest developments in this area, we suggest to keep an eye on our Health Psychology Practical Blog. In addition, if you need practical help, do not hesitate to get in contact with a Health Psychology Department in your own country and to see whether they can help. Could be anything from answering a quick question to collaboration in for example a health promotion project.

Via: https://practicalhealthpsychology.com/

The WHO Global recommendations on physical activity for health recommend that people aged 65+ years should do at least 150 minutes of moderate-intensity physical activity, or at least 75 minutes of vigorous-intensity physical activity, or an equivalent combination of moderate- and vigorous-intensity activity throughout the week. It also recommends that older adults perform physical activity to enhance balance and prevent falls on 3 or more days per week, and take part in muscle-strengthening activities at least twice weekly. Despite clear recommendations about the amount of physical activity associated with health gains, around one third of the world’s population is physically inactive, with older people being the most inactive. 

It’s important to note that doing something is better than nothing, even if people can’t quite manage the amount recommended by guidelines. Physical activity can include a range of activity types, from structured exercise classes, to active transport, to gardening and home maintenance. Starting small and building up the amount and intensity of activity and choosing something enjoyable are the best ways to start.  For those who are already participating in more vigorous activities such as running, rowing, or cycling, ageing is no reason to stop if a person’s health allows it. 

Falls are also a common issue in older age, with around 1 in 3 people aged 65 + falling each year. Falls often have lasting, devastating consequences for an older person and their family, and can result in an older person moving into residential aged care. Falls are not inevitable, and can be prevented with regular exercise that challenges balance, such as tandem walking or repeated sit-to-stand exercises.

Older people face particular barriers to being more physically active – these can be financial, physical, social or practical. Some older adults find electronic gadgets that track daily physical activity useful for reminding and motivating them to be more active. 

Some people require a more supported approach to stay on track and reach their physical activity goals. Health coaching is a person-centred approach that commonly includes motivational interviewing techniques and solution-focused goal setting as strategies for promoting behaviour change. A recent systematic review of the effect of health coaching on physical activity among people aged 60+ demonstrated significant improvements in physical activity with this approach.

Goal setting is another strategy that promotes physical activity behaviour change. Goals encourage people to create a sense of urgency and motivation to invest time and energy to make the desired change. To maximise effectiveness, goals should be self-directed and meet S.M.A.R.T  criteria: Specific, Measurable, Attainable, Relevant and Timely.

The social benefits of physical activity participation are often particularly important to older people. There are many options for people who prefer to exercise in organised groups. Many local councils organise free walking groups – these are a way of keeping active in a fun and sociable way. Or for a bit more of a challenge, Parkrun is a free, weekly 5km timed running (or walking) event in more than 1,700 locations across the globe.

At any age the message around physical activity is simple- be as active as you can, in as many ways as possible, as often as you can. Doing something is better than doing nothing, and every little bit counts towards better health.

Via: https://practicalhealthpsychology.com/

Missed breaks have a range of negative consequences – from the practical discomfort of being unable to go to the toilet and the lack of opportunity to eat healthily to the feelings of demoralisation and dissatisfaction and cognitive changes that lengthy work periods with inadequate breaks can produce.

The cognitive changes that occur when working for lengthy periods without a break are one of the key arguments in support of regular breaks. We are all familiar with the experience of feeling tired and drained at the end of a long working day, struggling to make decisions or unable to concentrate on the task in front of us. This drop in cognitive performance is entirely natural, and reflects the fact that human cognition is simply not designed to focus continuously on the same task for long periods of time. In fact, in cognitive terms, fatigue is an adaptive signal – a sign that we have spent too long ‘on task’ and need to take a break before mistakes start to be made.

More than a century ago, the negative effects of working continuously without a break were clear.  In one of the most heroic examples, Tsuro Arai, the first Japanese woman ever to earn a PhD, forced herself to complete a work task that required concentration (solving complex multiplication problems) continuously for 12-hours over several consecutive days without rest. Unsurprisingly, as time on task increased, her performance became slower and less accurate; demonstrating empirically for the first time that optimal cognitive performance cannot be maintained over 12 hour periods without a break. Despite this, modern healthcare workers often spend this kind of period working without adequate rest breaks. A landmark study of  around 400 nurses over more than 5,000 shifts showed that in line with Arai’s experiment, nurses who worked more than 12 hours at a time (around 40% of sampled shifts) made significantly more errors.

In addition to errors related to slips of attention and memory, there is a growing body of evidence suggesting that decision making changes predictably over lengthy periods of work -a phenomenon referred to as ‘decision fatigue’. As people make more and more consecutive decisions without a break, they start to progressively shift towards decisions that are in some way cognitively easier (e.g., going along with the default option, passing a decision on to someone else, or using rules of thumb or shortcuts). In healthcare, we see clear evidence of this over working shifts. For example, GPs are more likely to prescribe unnecessary antibiotics towards the end of clinics and nurses become progressively more likely to refer patients on to other healthcare professionals as time since last break increases. The last example raises a key point. Cognitively, it is not the overall amount of work that is the problem –it is the amount of work completed without a break. In other words, it is the timing and presence (or absence) of breaks within the work period, rather than overall workload which is critical in maintaining optimal cognitive functioning over time.

Ensuring that healthcare staff take rest breaks in a busy health service is of course easier said than done. But here, the evidence is clear: any break is better than none and regular breaks should be considered an essential and non-negotiable part of the working day. Even when there is no time to take a proper break, the evidence suggests that taking a couple of minutes to step away from your task, stretch and breathe deeply is beneficial. ‘Microbreaks’, breaks of a few minutes’ duration, appear to be enough during demanding activities to mitigate some of the negative effects of long periods of unbroken work. Studies show for example that surgeons who take regular, brief microbreaks during operations (of 90 seconds to 5 minutes) report; better physical and mental performance, reduced stress, and fewer intraoperative events. Importantly, the operations which included these microbreaks took no longer than standard operations, suggesting that the breaks ‘pay for themselves’ by counteracting normal reductions in speed and efficiency over time.

In short, breaks are an essential part of the working day for healthcare (and other!) workers.

Via: https://practicalhealthpsychology.com/