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REVIEW ARTICLE

Role of in Health Care

Azad AF1, Mahmud A2

Abstract Back ground: Recent advances in psychological, medical, and physiological have led to a new way of thinking about health and illness. This conceptualization, which has been labeled the biopsychosocial model, views health and illness as the product of a combination of factors including biological characteristics (e.g., genetic predisposition), behavioral factors (e.g., lifestyle, stress, health beliefs), and social conditions (e.g., cultural influences, family relationships, ).Objectives: Create awareness about psychological support, understanding behavioral and contextual factors, preventing illness.

Introduction In the 1950s, and medicine began to are well understood by medical science. notice a new trend. Life expectancy was up Psychological factors can affect health directly because people were less likely to die of (such as stress causing the release of hormones contagious diseases. However, medical such as cortisol which damage the body over problems due to lifestyle choices were on the time) and indirectly via a person's own rise. Obesity leading to heart disease and Type II choices which can harm or diabetes. leading to heart disease and protect health (such as smoking or taking cancer. Stress leading to compromised immune exercise). take a biopsychosocial system and cardiovascular disease. So, the approach - this means that they understand biopsychosocial model was created. Providers health to be the product not only of biological now need to examine all aspects of a patient's processes (e.g. a virus, tumour, etc.) but also of life. The medical physicians treat the physical psychological processes (e.g. stress, thoughts causes. It is the psychologist's job to identify and beliefs, such as smoking and the behavioral, affective, and social exercise) and social processes (e.g. contributors to disease and medical problems. socioeconomic status, and ethnicity). Does someone smoke because it is classically By understanding and harnessing psychological conditioned? Is hypertension caused by a factors, psychologists can improve health by stress job? Will someone's prognosis for working directly with individual patients, cancer improve with coping skills, family Bio-Psycho-Social Model of Health and Illness therapy, and behavioral intervention? The Venn Diagram psychologist then has to design interventions to address the behavioral, affective, and social issues that cause and maintain these diseases. Psychological Sociological Health Psychology is the study of psychological Health and behavioral processes in health, illness and healthcare. It is concerned with understanding how psychological, behavioral and cultural Biological factors are involved in physical health and illness, in addition to the biological causes that

1. Counselor 2.GM-Medical Services, Apollo Hospitals Dhaka.

Pulse Volume 6 (1 & 2) 2013 37 REVIEW ARTICLE

The Work Setting of a Psychologist the effectiveness with which people cope with Psychologists participate in health care in a and reduce stress and pain, biopsychosocial multitude of settings including primary care connections with immune functioning, and programs, inpatient medical units, and factors in the recovery, rehabilitation, and specialized health care programs such as pain psychosocial adjustment of patients with management, rehabilitation, women's health, serious health problems. oncology, , headache management, and various other programs. They Working area for psychologist in health care also work in colleges and universities, Psychologists provide mental and behavioral corporations, and for governmental agencies. health services. Psychologists focus on prevention; address Clinical Activities health disparities; aim to reduce psychological Assessment approaches often include cognitive distress; and enhance and promote and behavioral assessment, psycho psychological wellbeing in all populations. physiological assessment, clinical interviews, Many psychologists concentrate on demographic surveys, objective and projective underserved populations, such as older , personality assessment, and various other children, the chronically ill (i.e., those with clinical and research-oriented protocols. heart disease, cancer, diabetes), and victims of Interventions often include stress management, abuse and trauma, relaxation therapies, , psycho Psychologists work with people of all ages who education about normal and patho-physiological experience disorders including processes, ways to cope with disease, and depression and anxiety; serious and enduring cognitive-behavioral and other mental illness (e.g., bipolar disorder, psychotherapeutic interventions. Healthy people schizophrenia); neurological disorders (e.g., are taught preventive health behaviors. Both Alzheimer’s disease); adjustment to physical individual and group interventions are utilized. illnesses (e.g., heart disease, diabetes); Frequently, psychology interventions focus addictive behaviors (e.g., substance abuse); upon buffering the effect of stress on health by eating disorders; behavior disorders (e.g., promoting enhanced coping or improved social Attention Deficit Hyperactivity Disorder - support utilization. ADHD); personal and family relationship Psychologists are on the leading edge of problems; and learning disabilities. research focusing on the biopsychosocial model Psychologists assist in the diagnosis and in areas such as HIV, oncology, psychosomatic treatment of patients with chronic illnesses. illness, and compliance with medical regimens, They utilize interventions such as , and the effect of , behavioral techniques, and psychological, social, and cultural factors on biofeedback to help individuals make numerous specific disease processes (e.g., behavioral changes (e.g., medication diabetes, cancer, hypertension and coronary compliance, diet, exercise) and develop coping artery disease, chronic pain, and sleep strategies (e.g., chronic pain management) to disorders). Research in psychology examines: reduce problems that are residual to the the causes and development of illness, methods patient’s illness or disorder (e.g., cardiovascular to help individuals develop healthy lifestyles to disease). They also teach patients the skills promote good health and prevent illness, the necessary to enhance physician/patient treatment people get for their medical problems, partnership by reporting changes in their

38 Pulse Volume 6 (1 & 2) 2013 Role of Psychologist in Health Care condition and sharing concerns, questions, and Psychological support before-after surgery treatment preferences. Most of the people have a fear about operation. Sometimes doctors need to postpone operation End of life care due to patient’s fear. Sometimes patient get This care is for attendants to cope with trauma. some wrong information from society. That When a patient become very sick and near to makes them more anxious. So psychologist can death, at that time. help to prepare patients for surgery. And after End-of-life care provides physical, mental, and emotional comfort, as well as social surgery, confusion about prognosis and accept- support, to people who are living with and dying ance of the present condition can make patients of advanced illness. depressed and anxious. Here psychologists can People who have already discussed their help the patient. wishes for end-of-life care with their loved ones feel less stress at the end of their life, and so do Rejection of treatment their families. Sometimes patients reject their treatment proce- dure. Most of the time hopelessness about life Psychological support for long standing increases possibilities of rejection. Conflict patient with family members, frustration in life, and no Sometimes this kind of patient becomes aim for living, incapability can increase possi- depressed and hopeless about recovery. They bilities of rejection. Psychologist can help to have lost their interest about life which is linked to delayed physical recovery. In this situation improve this situation in positive way. they can reject to take treatment and maintain rules. Psychologist can help them to boost up Disclosing critical diagnosis and poor prognosis: their mind and increase hope for life. In this area psychologist can help to disclose and make patient cope. Psychological support for ICU patients The environment of ICU is totally different than Typical activities of psychologists working in other ward. There we see frequent death or severe health centers condition of every patient. Every patient is being Assessing and diagnosing an individual's monitored by critical machine or equipments. For needs, abilities or behavior using a variety of they are isolated from attendants methods, including psychometric tests, inter- and they can meet at only fixed times. In this views and direct observation of behavior. circumstances patient becomes depressed and feelings of irritation can arise. Some patient can Collaborating as part of an interdisciplinary develop PTSD, stress and negative may team, working alongside other health profes- have both immediate, as well as long-term effects sionals (e.g., physicians, nurses, social workers, on ICU patients' psychological and physical occupational therapists, pharmacists and well-being, and they are linked to delayed dentists). physical recovery. Psychologist can help this Creating and monitoring appropriate kind of patient to make them understand and cope programs of treatment, including therapy, in with present condition. ICU nurses need to collaboration with other involved health profes- engage in psychological support in a systematic sionals. way, and to acknowledge the high priority of Offering therapy for difficulties relating to support interventions.

Pulse Volume 6 (1 & 2) 2013 39 REVIEW ARTICLE anxiety, depression, addictions, social/ interper- The Psychologist. 1994. 7;114-118. sonal problems, and risky behaviors. 4. Schofield, W. The role of psychology in the delivery Rehabilitating patients into the community. of health services. American Psychologist. 1969. Developing and evaluating programs for the 24(6);565-584. provision of mental & behavioral health 5. Johnston M, Weinman J & Chater A. A healthy services. contribution. The Psychologist. 2011;24(12):890- Providing consultation to other health 892. professionals and other involved staff. 6. Johnston, M. Health psychology:current trends. The Psychologist. 1994. 7:114–118. References 7. Sharman SJ, Garry M, Jacobsen JA, Loftus EF & 1. Crider AB, Goathals GR, Kavanaugh RD, Solomon, Ditto PH. False memories for end-of-life decisions. PR. (1993). Herpercollins colleg publishers. Health Psychology. 2008. 27;291–96. Psychology (4th ed), P 2-35. 8. Resnicow K, Jackson A, Blissett D, Wang T, McCa- 2. Sarafino Edward P, Smith Timothy W. Health rty F, Rahotep S & Periasamy S. Results of the Psychology: biopsychosocial interactions. 5th ed. p. 150-200. healthy body healthy spirit trial. Health Psychology. 3. Johnston, M. Current trends in Health Psychology. 2005. 24;339–48.

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