Numerous biological,
psychological, social, cultural, individual and developmental models are
associated with the progression of health consciousness, functional dependency,
health-related behaviours and health status (Germov, 2014). Health status is a
complex state that should be the overview in a holistic manner. Mental heath
lth practitioners and professionals have developed theories and models to
elaborate on the relationship between health-conscious, health-related
behaviour and functional dependency concerning the developmental course and
consequences (Barkley, 2009).
Models
This section provides a critical overview of theoretical model,
i.e. Biopsychosocial Model,
Transtheoretical model and Health Belief Model. These models better
explained the aetiology as well as the relationship of the variable to provide
in-depth information about the health status.
Bio-psychosocial model
Biopsychosocial model
signifies the biological, psychological and social aspects of health-related
behaviours, functional dependency and health consciousness. According to the
biological model, the people inherit healthy health habits from their parents
in heredity (Smith, 2002). Some studies suggest that those parents who maintain
their positive health-related behaviour, increases the likeliness that their
children will also develop healthy health habits.
According to some other
studies temperament also found to be associated with health-related behaviours,
e.g. a few people have the natural or biological instinct towards performing
the particular action such as a few children display pleasure and perceptual
sensitivity in particular task or play.
While the other people manifest surgency control, fear, and frustration
in similar circumstances. Similarly, according to the biological model, some
people develop preventative health-related behaviour in their childhood due to
temperamental attributes that further leads to well-maintained health status in
older age. In contrast, some people develop health risk behaviours due to
temperamental characteristics that lead to functional dependency and lack of
health consciousness among people in their older age (Stineman, & Streim,
2010).
The social model
highlights all the social determinants that are associated with health status
in positive and negative ways. A sedentary lifestyle is one the most
significant aspect of health-related behaviour, as the modern civilisation has
made the human life massively mechanical (Van de Velde, Eijkelkamp, Peersman,
& De Vriendt, 2016). People do not practice physical activity rather they
prefer indoor activities and remain seated for several hours that adversely
affected their health status (Smith, 2002). Secondly, health literacy is very
uncommon in underdeveloped countries; people are not fully aware of their
health status and proper dietary plan to follow.
As a result, they suffer
from poor health status and functional dependency even in late adulthood. The
people do not consult doctors and miss or skip the appointments due to health
illiteracy (Borrell-Carrió, Suchman, & Epstein, 2004). For them, a regular
examination is extraordinary and unnecessary for human health. Another aspect
of health literacy is that people do not understand the medical terminologies
and recall the medicine name by their colour shape and size instead of reading
labels (Stineman, & Streim, 2010). These signs have been found to be common
even among literate and young people as well.
Furthermore, these health behaviours become rigid and inflexible in
older age. The incomplete information on medical forms also indicates their
negative health-related behaviours. Poor socioeconomic status also contributes
to the development of risky health behaviour as the primary motive of such
people revolves around basic need, i.e. diet and shelter. For them, education,
health literacy, and preventive health behaviours become a secondary motive. As
a result, they do not focus on such health-promoting behaviours(Stineman, &
Streim, 2010). Other multiple social aspects affect the health status among the
elderly population. The belief, prejudice, discrimination and social standards
play a significant role in the development of risky health behaviour.
The psychological aspects
are critical and most alarming for the mental and physical health status of the
elderly population. It covers the negative approach towards life including
self-esteem, self-concept, negative thinking, schema and cognitive distortion
that promote the risky health behaviours among people due to lack of health
consciousness that further leads the functional dependency among the elderly
population.
Transtheoratical Model
Prochaska and Diclemnate (2005) develop Transtheoretical Model for
behaviour modification cornering the health-related choices(Van Leer, Hapner, & Connor, 2008). According to Prochaska
and Diclemnate behaviour, change or behaviour modification is a complex
phenomenon and cannot be changed abruptly (Van Leer, Hapner, & Connor, 2008). The behaviour may change
following a series of step including pre-contemplation, preparation,
contemplation, maintenance and termination (Nidecker, DiClemente, Bennett,
& Bellack, 2008). The successful completion of one stage to another needs
consistent supervision and intervention (Huang et al., 2015). Although the
transitional model is fundamental in the behaviour change process, it also
indicates some drawbacks it ignores the significance of social support and
social set up (Mahmoodabab, Mohammadi, & Abad, 2013).
Health Belief Model
Health Belief Model is the widely used model comprehensively
explained the health-related behaviours for a diverse health-related problem
such as poor health status, functional dependency, lack of health
consciousness, mental and physical illness as well (Zare, Ghodsbin, Jahanbin, Ariafar, Keshavarzi, & Izadi, 2016). The
belief may be positive or negative that formulates the particular
health-related behaviour, for example, the belief of getting positive
consequences performing positive behaviours may lead to positive health-related
behaviours. In contrast, belief about neutral consequences leads to health risk
behaviours (Masoudiyekta et al., 2018).
The interpretation of
actual events and realistic approach towards comprehending the cause and effect
relationship between events also contribute to developing preventative and
risky health behaviours (Jones et al., 2015). The perceived severity, perceived
susceptibility, perceived barriers and perceived benefits are the key
constructs of the health belief model. These construct direct or shape the
health-related behaviours among elderly peoples.
Theories
This section provides a critical overview of Theories of Health,
i.e. Theory of Planned Behaviors, Functional Theory and Conflict Theory.
Theory of Planned Behavior
Ajzen (1985) proposed the theory of planned behaviours that stressed upon the intention to perform a particular behaviour. According to this model, the intention of an individual plays a vital role in developing any habit or healthy behaviours. The other key determinants of this behaviour refer to the subjective norm, behaviour intention, attitudes, and perceived behaviour control.Functional Theory
The functional theoretical model explains an extensive framework
that underpins the society as a multifaceted system whose element coordinate
collectively to support solidity or stability. These system overviews the
society as a macro-level approach and covers both aspects, i.e. social
structure and social functions (Stineman, & Streim, 2010). The
functionalist theory stresses the role of effective medical care and Health
Status for a productive life and appropriate behaviour for performing social
functions or actions. Illness refers to the inability or lack of capability to
execute roles particularly in society, and societal stability deteriorates if
the number of people is sick. The sick people cannot perform their roles. As a
result encounter “poor return” to society (Van de Velde, Eijkelkamp, Peersman,
& De Vriendt, 2016).
Similarly, the
availability of poor medical care or limited access to health care facilities
is also alarming for the society, as ill people face trouble in health
recovery; furthermore, such issues pose a danger to healthy people (Germov,
2014). The functional theory discourages the role of society towards ill people
and suggests following the multiple expectations (sick role) to consider an
individual legitimately sick. First, the sick people should not be labialized
or discriminate for having the health issue (Stineman, & Streim, 2010). For
example, if the victim of obesity intake more food, he receives the least
sympathy as compared to those obese people who follow the balanced diet plan.
Likewise, a drunk driver death causes less sympathy than sober driver accident
death. Secondly, sick people labelled as Maligning instead of legitimately ill
if they prolonged their symptoms and pretended to be unwell for a long period
(Borrell-Carrió, Suchman, & Epstein, 2004).
Third, it is obligatory
for sick people to get confirmation of his/her illness from the physician
otherwise he/she has no right to pretend sick. Physicians also play an
imperative role in the diagnoses, prognosis and treatment of illness (Van de
Velde, Eijkelkamp, Peersman, & De Vriendt, 2016). To achieve an optimal
level of health status, the collaboration between physician and patient is
significant, such as a patient ought to authentically and appropriately answer
the physician’s question regarding medical examination and follow the
prescription as well (Germov, 2014).
The functional theorist
enlightens that why sick people behaved in particular modes; and the literature
reveals the cause and effect relationship between stimulus and response of
behaviours. According to qualitative and quantitative data, the people prolong their
medical or psychological symptoms to avoid the responsibility for their actions
and obligation. A longitudinal intervention based study has been conducted on
the major depressive patient the patient received a proper treatment plan, but
she got relapses each time after recovery and consciously or consistently found
to indulge in prolonging the symptoms of her mental illness. The findings of
the study indicated that being a patient with Major Depressive Disorder escape
her from all the roles and responsibility (Borrell-Carrió, Suchman, &
Epstein, 2004). Literature also suggests that those people account for more
psychopathology that has committed criminal or immoral acts and justify their
sins or crime by highlighting the signs of insanity for their defence.
Conflict Theory
Conflict theory addresses the
economic and political aspects that create social disparities such as
inequalities, discriminations, prejudice, radicalisation, conflicts and
fundamental disorientation (Germov, 2014). The economic and political
disparities in class produce disproportion and unfairness regarding ethnicity,
social class, race, socioeconomic status, gender and the people build up rigid
stigmas and inadequate reaction chains in response to such discriminatory
behaviours that reproduced physical and mental health issues.
Literature recommended
that apparently, the disadvantaged social backgrounds of people are the cause
of mental and physical illness and disadvantaged background oriented people are
more vulnerable to acquire mental and physical illness. Furthermore, once they
become sick, inadequate and insufficient health care system and lack of
accessibility to health care facility makes the recovery of the patient more
difficult (Germov, 2014). The conflict theory highlights the contradiction
between social and medical theory. The medical model prognosis diagnoses all
human problems and illness as medical problems, and disregard the psychosocial
etiological factors of health and illness (Stineman, & Streim, 2010). For
example, Attention Deficit/Hyperactivity Disorder used to be diagnosed and
treated following the medical model by the physicians. In the last few decades,
the physician used to prescribe a drug Ritalin to diminish the hyperactive
symptoms of the child, as the ADHD simply used to take as a hyperactivity
disorder. The doctors and manufactures of Ritalin ignored the possible social
roots causes of their Hyper Active behaviour such as schools environment,
teacher-child relationship, inadequate parenting, and gender discrimination
(Van de Velde, Eijkelkamp, Peersman, & De Vriendt, 2016). According to a
qualitative study, the boys manifest more hyperactive symptoms as compared to
girls. Furthermore, the socio-cultural theory overview of the cultural and social
factors significantly associated with ADHD are maternal illiteracy, maternal
depression, premature marriages, and preeclampsia during pregnancy.
Another significant
example of social conflict theory illustrates the people behaviour towards
medical models (Borrell-Carrió, Suchman, & Epstein, 2004). The patients of
eating disorder consult physicians and doctors for their problem instead of a
psychiatrist, psychologist, or other health-care practitioners. Although the
management of Eating Disorder is purely psychosocial, counselling oriented but
the physician and the people consider it as a medical disease. According to
Germov (2014), the chief cause of Eating Disorders is the national and
international standards of beauty that have adversely affected the health
status of the people. The social standards had made the human health status in
danger, and there are the needs to psycho educate people about health and
illness.
