Practise health psychology through practitioner-patient interaction, adherence, pain, stress and health promotion, applying studies, methods and debates to cases.
A professor wants to improve doctors' verbal communication with patients.
Suggest one way to improve the doctors' verbal communication with patients.
A professor wants to improve doctors' verbal communication with patients.
Suggest one way to improve the doctors' verbal communication with patients.
For the suggestion:
Award 2 marks for an outline of the way to ensure effective verbal communication.
Award 1 mark for a basic outline/identification of the way to ensure effective verbal communication.
Syllabus content:
- verbal communications with a focus on understanding medical terminology (e.g. McKinlay, 1975)
- doctor-centred (directed) and patient-centred (sharing) consultation (Key study - Savage and Armstrong, 1990)
Example:
One way would be to train the doctors to give details of both their diagnosis and treatment to their patients at the clinic.
(1) Any terminology that is used must be clearly explained in terms that the patient will understand for both the diagnosis and treatment. (1)
The doctors should adopt a doctor-centred (directed) style of consultation. (1) This is where the doctor takes an authoritarian approach and tells the patient what their diagnosis is and outlines the treatment that they should follow. (1)
Other appropriate responses should also be credited.
2
Explain why your suggestion in part (a) would be better for these patients.
Explain why your suggestion in part (a) would be better for these patients.
Award 2 marks for explanation of why suggestion would be better for patients.
Award 1 mark for a basic outline of explanation of why suggestion would be better for patients
For example:
Using simple language without medical terminology means that the patients will understand the diagnosis/treatment. (1) Therefore, when the patient uses the treatment at home they will know how to carry it out correctly (e.g. how to use medical equipment such as an inhaler). (1)
The findings of Savage and Armstrong show that patients prefer a doctor-centred (directing) style of consultation. (1) Patients reported they felt the doctor understood their problem and the quality of the explanation given were better in the doctor-centre style compared to the sharing style of consultation. (1)
Other appropriate responses should also be credited.
2
Outline why it would be better for patients. (e.g. understand what the doctor is saying, feel the doctor is professional) =1 mark
Effect of this on the patient (e.g. less anxious/embarrassed, can carry out treatment correctly ) linked to the suggestion = 1 mark
Dr Munsi is concerned that some of her elderly patients with heart disease do not take their medication every day. Dr Munsi uses the Health Belief Model to design a leaflet to reduce non
adherence in her elderly patients.
Suggest what Dr Munsi could include in her leaflet to reduce non-adherence in the elderly patients, using the Health Belief Model.
-adherence in her elderly patients.
Suggest what Dr Munsi could include in her leaflet to reduce non-adherence in the elderly patients, using the Health Belief Model.
Award 3-4 marks for a detailed answer with clear understanding of Health Belief Model linked to helping Dr Munsi reduce non-adherence.
Award 1-2 marks for a basic answer with some understanding of Health Belief Model linked to helping Dr Munsi reduce non-adherence.
Likely suggestions for leaflet:
- Outline heart disease including short and long term symptoms and outcomes (increases knowledge of the disease).
- Opening hours of clinic and pharmacy with transport links so that it is easy for the elderly patient to attend the clinic/collect their medication (reduces barriers to access).
- Typical medications for heart disease and what the medication does to improve the heart (improves perception of benefits of the medication).
- Explain the possible side effects and likelihood of experiencing these side effects (knowledge of perceived cost/negative of medication).
- Space for Dr Munsi to write the individual patient's medication and how to take it (personalised information - could increase patient satisfaction with Dr Munsi/the clinic).
- Provide leaflet in large font size so easy for elderly patients to read (specific to the demographic)
4
Needs to refer to improve adherence/reduce non-adherence to taking medication every day.
If no context max 2 marks.
Context = elderly patients and/or heart disease and/or taking medication every day.
1 or more suggestions for the leaflet is allowed.
Do not allow ideas that are linked to leading to high fear arousal. Ideas linked to low fear arousal are okay only when clearly linked to HBM.
9
Example:
Dr Munsi should design her leaflet about heart disease to include information on the short term and long term symptoms of the disease. (1) The health belief model suggests that knowledge about the disease increases the likelihood that patients will adhere to taking their medication as they understand the consequences of heart disease without medication. (1) She could also include the side effects of the medication and the likelihood of experiencing each side effect. (1) This would give her patients the correct knowledge of the negatives of the medication. (1) As the positive reduction in symptoms and protecting the heart in the long term is known due to the leaflet, the positives outweigh the costs and patients should decide to take the medication. (1)
Other appropriate responses should also be credited.
Explain one strength of the gate control theory of pain, from the nurture side of the debate.
Explain one strength of the gate control theory of pain, from the nurture side of the debate.
Award 2 marks for a detailed explanation of the strength in context.
Award 1 mark for a basic outline/identification of strength.
Strengths might include:
- Application to everyday life: This theory suggests that when someone experiences pain, they have some control over this perception. Techniques such as imagery and attention diversion can be learned and used to help close the gate and reduce pain.
- Free will: Pain is something that people have control over. The perception of pain is not something we are born with but something where we can exert some control through learning (nurture) techniques to reduce this pain (close the gate).
- Holistic: Gate control theory is a more holistic explanation of pain by extending specificity theory to include psychological gates. These psychological gates can be due to learning. For example, a young child will often look to their carer when they hurt themselves. The child often cries more if their carer seems concerned about their injury.
Example:
Gate control theory suggests that pain can be controlled through learning how to close the psychological gates which will reduce the perception of pain. (1) This has good applications to everyday life as patients can be taught techniques such as imagery or attention diversion to reduce their experience of pain. (1)
Other appropriate responses should also be credited.
2
Context = gate control theory of pain
Mr Sharma is a teacher in a school who is concerned that his students are not washing their hands correctly.
Suggest how Mr Sharma could use fear arousal to encourage his students to wash their hands correctly. Your answer must be ethical.
Mr Sharma is a teacher in a school who is concerned that his students are not washing their hands correctly.
Suggest how Mr Sharma could use fear arousal to encourage his students to wash their hands correctly. Your answer must be ethical.
Award 3-4 marks for a detailed answer with clear understanding of fear arousal linked to help Mr Sharma to encourage his students to wash their hands correctly.
Award 1-2 marks for a basic answer with some understanding of fear arousal with an attempt to link to help Mr Sharma to encourage his students to wash their hands correctly.
Syllabus content:
- Fear arousal: use of fear to improve health, e.g. Janis and Feshbach (1953).
Likely content:
Use minimal fear arousal - occasionally referring to the consequences of not washing hands correctly. For example, reference to how germs are passed through poor hand washing and mild illness.
Example:
Mr Sharma should demonstrate to his students how to wash their hands correctly and get them to practice with him. (1) He should use minimal fear arousal in his demonstration of hand washing. (1) He could also put up a poster in the classroom/hallways that have photographs of the procedure for hand washing as well as showing how germs can spread through poor handwashing. (1) The poster could mention that colds and the flu can be passed through poor handwashing from person to person. (1) Mr Sharma's students will feel minimal fear arousal and will be motivated to wash their hands correctly so that they do not spread germs and/or become unwell. (1)
Other appropriate responses should also be credited.
4
Idea = 1 mark e.g. film, slideshow, presentation - doesn't have to be directly linked to fear arousal.
1 mark for elaboration of this idea.
Explain one practical problem that Mr Sharma might have with implementing what you have suggested in part (a).
Award 2 marks for a detailed explanation of the practical problem in the context of implementing this suggestion with students.
Award 1 mark for a basic explanation of the practical problem.
Problems may include:
- Students may not taking it seriously.
- The habit of how the student washes their hands may be difficult to change as it is unconscious and habitual.
- Students will have experienced illnesses in the past and feel they were not very serious and so will not be motivated to change how they wash their hands.
Example:
One practical problem of using this suggestion of minimal fear arousal with Mr Sharma's students is that they already have a technique for cleaning their hands that they have been using for a number of years. (1) They have a habit of washing their hands in a certain way and the poster and demonstration with minimal fear will not be enough for them to break this habit. (1)
Other appropriate responses should also be credited.
2
No credit to ethics of what Mr Sharma does but can credit that it might lead to distress if they are unable to wash hands in the future.