Dominika Kwasnicka, SWPS University, Poland and University of Melbourne, Australia
Det ultimative mål med sundhedsfremmende tiltag er at skabe længerevarende forandring og sundhedsprofessionelle kan hjælpe patienterne til at forbedre deres helbred og bibeholde adfærdsændringer. Vi ved at det er svært at påbegynde en adfærdsændring og endnu sværere at holde ved den på længere sigt. Et af de store spørgsmål, inden for sundhedspsykologi, er, hvorfor det er så svært at holde ved.
By Thomas L. Webb, Department of Psychology, The University of Sheffield, the UK
How are you getting on with your goal to reduce the amount of sugar that you eat and lose 10kg? Chances are that you don’t really know – or even want to know. In situations like these, people tend to behave like ostriches and bury their heads in the sand, intentionally avoiding or rejecting information that would help them to monitor their goal progress. Research on this “ostrich problem” suggests that people often do not keep track of their progress (e.g., step on weighing scales, read the packets of food that they buy), in part, because doing so can make them feel bad about themselves – e.g., they realise that they weigh more than hoped and that they still consume too much sugar. However, theory and evidence suggest that keeping track of progress helps people to identify discrepancies between their current and desired states that warrant action. The implication is that avoiding monitoring makes it difficult to identify the need to act and the most appropriate way to do so. The ostrich problem therefore represents an opportunity for healthcare professionals (and others) to help people to monitor their progress and capitalise on the benefits of so doing. Perhaps not surprisingly then, we found good evidence that prompting people to monitor their progress helps people to achieve goals across a range of domains.
By Shane Timmons, Economic and Social Research Institute, Ireland
Governments worldwide have mobilised to try to control the spread of the novel coronavirus, but the behaviour of individuals will be vital to their success. We – the Behavioural Research Unit at the Economic and Social Research Institute in Dublin – are working with Ireland’s Department of Health to inform their response to the COVID-19 pandemic. As part of this work, we’ve reviewed over 100 scientific papers and have begun testing ways to best communicate with the public, with lessons relevant for health psychology practitioners. In our review, we focus on literature relevant for three areas that have formed the basis for public health messaging in multiple countries: hand hygiene, face touching and isolation. We also address broader literatures on how to motivate helpful behaviour and communicate effectively in a crisis.
By Nadia Garnefski and Vivian Kraaij, Department of Clinical Psychology, Leiden University, The Netherlands
“Rob has just heard that he has HIV (negative event). He thinks that he is the one to blame for this (self-blame) and he avoids seeing his friends (withdrawal). The situation makes him sad. When sitting at home, he cannot stop thinking about his feelings (rumination) and believes that what has happened to him is a complete disaster (catastrophizing). Because he feels sad, he has little energy. As a result, he withdraws even more. This makes him even sadder. In this way, Rob is drawn into a downward spiral.”
Peter Harris and Ian Hadden, The Self-Affirmation Research Group, School of Psychology, University of Sussex, UK
Have you ever been reluctant to face up to something you’d rather ignore? Maybe your fondness for something bad for you that you eat too often or your tendency to avoid health check-ups? Well, you’re not alone. Most of us think we are generally quite sensible and competent people. So, being told that something we do is not really sensible or competent can be quite challenging. As a result, we can be pretty skilled at resisting messages we’d prefer not to hear.
By Winifred Gebhardt, Leiden University, The Netherlands
About nine years ago, I became a vegetarian overnight. In a novel I was reading, the main character explained how he could not eat anything “in which at some time a heart had been beating”. Like a thunderbolt these few words sunk in. I realized that this was exactly how I felt. I stopped eating meat and fish instantly, and I have not had any problem sticking to this new diet ever since. The new behavior perfectly fitted the “person I am”.
Conversely, in the past I used to jog regularly and could easily run seven kilometers. However, I never regarded myself as a “sporty person”, and whenever a barrier occurred such as being ill, I lapsed into being a couch potato. I now no longer try to “be sporty” but do try to walk whenever I can during the day. I consider myself an “active person”.
By Marie Johnston and Derek Johnston, University of Aberdeen, Scotland
Practitioners frequently want the answer to a problem which concerns one person, one health care team, one hospital or one region etc. For example, it may be important to know how often an obese man snacks, when and where he snacks and if stress makes it worse. Or you may wish to find out how often members of the healthcare team omit hand hygiene, if it is worse when they are under-staffed and if ward adverts improve it. Or you may be investigating sources of clinical errors to check if they are more common on some wards or for some grades of staff. Or, at a policy level, it might be valuable to investigate whether a new regulation, such as a smoking ban in public places has affected smoking rates.
You might try to answer these questions by asking people what they think or remember but it would be better to ask or observe at the critical times and places to avoid problems of bias and forgetting. Recent technological advances such as digital monitoring using smartphones make it easier to track what is going on in real time and an n-of-1 study might allow you to answer your question.
N-of-1 studies are possible when the problem can be assessed repeatedly to look at change over time. Then one can describe the problem and examine whether it is better or worse under some conditions. Or one may introduce a new intervention or treatment and assess whether it is having the proposed effect.
The simplest evaluation of the data collected is the observation of trends on a graph as in the illustrations below. This is an essential step in any n-of-1 analysis and can be sufficient. Additionally, there are methods of statistical analyses for n-of-1 studies. More complex methods continue to be developed (e.g., methods for assessing dynamic change ).
Af Anne Tiedemann, The University of Sydney, Australien
“Mangel på aktivitet ødelægger ethvert menneskes gode helbred, mens bevægelse og systematisk fysisk aktivitet bevarer og beskytter det”… Plato, 400 f.Kr.
Det har længe været velkendt, at fysisk aktivitet, som en fast vane, er vigtig for både helbred og velvære. Sundhedskampagner er imidlertid ofte målrettet børn og unge, og har mindre fokus på vigtigheden af fysisk aktivitet blandt ældre på 65 år og over. Dog er det netop i alderdommen særligt vigtigt at gøre fysisk aktivitet til en del af ens hverdag.
Af Jane Ogden, University of Surrey, UK
Vægt er et kildent emne at omtale i en konsultation. Nogle patienter kan være trætte af at høre ordene “du burde tabe dig” hver gang de besøger klinikken: uanset om de er kommet på grund af ondt i halsen, en screening for livmoderhalskræft eller potentielle hjerteproblemer. De har måske oplevet hele deres liv at føle sig stigmatiseret af folk fra sundhedsvæsnet og tænker, at det eneste folk nogensinde ser er deres størrelse. Mens det for nogle forholder sig således, kan andre, som aldrig har anset deres vægt som et problem, blive fornærmede eller overraskede hvis emnet bliver taget op. Nogle mennesker vil måske simpelthen ikke høre beskeden, ignorerer hvad end der bliver sagt og tænker for eksempel ’hvad ved du – du er tynd / fed / for ung / for gammel’ eller ’videnskab tager altid fejl.’ Samtalen om vægtproblemer kræver derfor grundige overvejelser af ’hvornår’, ’hvordan’ og ’hvad’ der skal siges til en overvægtig person.
Af Ralf Schwarzer, Berlins Frie Universitet, Tyskland og SWPS Universitet for Samfundsvidenskab og Humaniora, Polen
At ændre ens adfærd er ofte ønskværdigt men svært at føre ud i livet. At stoppe med at ryge, spise sundt og følge en træningsplan kræver alt sammen motivation, en kontinuerlig indsats og generel vedholdenhed. Mens mange psykologiske faktorer har en indflydelse på adfærdsændringer, er self-efficacy blandt de vigtigste.