Health Promotion and Disease Prevention

Health promotion and disease prevention has always been in the forefront in the health care system. Focus has been always on the physical factors that contribute to the birth and progress of a disease. Very few researches and studies are carried out on the psychological factors that influence the adoption of health improving behaviors. Many psychological theories and models have been proposed to explain patient’s health behavior. The two studies that I have read and I use in my daily clinical practice are the health locus control (HLC) theory and health belief model (HBM). The study which uses HLC is on managing diabetic foot ulcers and the second study is about using HBM for weight management. Both the studies focus on factors that would lead a patient to adopt changes in his behavior to promote health. I usually come across male patients in my unit within the age group of 45 – 65years admitted with acute coronary syndrome. Their health assessment mostly reveal unhealthy lifestyles such as smoking, high cholesterol, unhealthy diet, lack of exercise and sedentary life which are all modifiable factors along with non-modifiable factors such as age, family history and gender. Rotter in 1966 proposed the HLC and the internal –external locus scale. According to Rotter internal locus of control is the belief that positive/ negative life changes are a consequence of one’s own action whereas external locus of the control is the belief that positive/ negative life events are unrelated to one’s own behavior and so are beyond one’s own control. In my daily clinical practice I use HLC to give insight to patients that unhealthy life styles are creating the negative trend in their health. Patients with high health values and high internal HLC’s request more information about the disease and are more receptive towards health education, they are more compliant with treatments and they make use of the support system.
Health belief model (HBM) was propounded by Baranowski,

References: Baranowski, T., Cullen, K., Nicklas, T., Thompson, D., & Baranowski, J. (2003). Are current health behavioral change models helpful in guiding prevention of weight gain efforts? Obesity Research, 11(10), 23-42. Daddario, D.K. (2007). A review of the use of the health belief model for weight management. Medsurg Nursing, 16 (6), 363-366. Przybylski, M. (2010). Health locus of control theory in diabetes: a worthwhile approach in managing diabetic foot ulcers? Journal of Wound Care, 19 (6), 228-233. Rotter, J.B. (1966). Generalized expectations for internal versus external control of reinforcement. Psychol Monogr. 1966; 80: 1 1-28.