“Lifestyle Behavior and Heart Disease”
Educating the client on the physiological and psychological effects that lifestyle has on the individual is an important element of adherence in health regimes specially for cardiac arrest patients (Okonski, 2003). Factors such as the clients’ perspective on time orientation, health locus of control and the processes and significance of change will essentially determine the adherence of cardiovascular patients on their treatment. The most basic in this treatment is the patients’ lifestyle. The objective of this article is to focus on lifestyle as an important factor in heart disease prevention and control. Factors such as the patients’ health locus of control, change perception and time orientation shall be used as the contextual basis of the analysis and evaluation.
A heart attack is a powerfully disruptive and traumatic event that can require patients to reconstruct their lives in view of the emotional, behavioral, and social demands involved in the treatment and recovery process (Ben-Sira & Eliezer, 1990). Emotional demands include the fear of another unpredictable, and possibly life-threatening, attack (Croog & Levine, 1982); the fear that needed medical help will not be available in time ( Wiklund & Sanne, 1984); and the loss of control of certain aspects of one’s life (BenSira & Eliezer, 1990). Behavioral demands include following a medical regimen, changing smoking or dietary habits, and potential restrictions in the areas of daily living and occupation. In addition, changes in social relationships and recreational activities are often necessary.
Creating an internal locus of control contributes to the goal of the client changing his or her lifestyle into one that values health and wellness of the body and the spirit, as is consistent with wellness models. In order for clients to maintain exercise in their lives, their goals must be intrinsically motivated. High internal locus of control has been associated with an increased likelihood of healthier behavior. In addition, exercise has been associated with the strength of internal beliefs that leads to high levels of motivation (Steptoe & Wardle, 2001).
The Multidimensional Health Locus of Control Scale (MHLCS; Wallston et al., 1978) measures three dimensions of a respondent’s perception of control over his or her health, including the extent to which the respondent sees LOC residing internally, with powerful others, or in chance.
Several studies have provided indications of the positive effects of patients’ perceptions of control over the course and outcome of serious illnesses such as heart disease (Affleck, Tennen, Croog, & Levine, 1987; Ben-Sira & Eliezer, 1990). Whereas early formulations of the importance of perceived control focused on the direct effects of control beliefs, researchers have more recently begun to examine patient perceptions of control in interaction with situational variables, such as illness severity, chronicity, and overall life stress (Fowers, 1994). Results of these studies have indicated that situational variables are important moderators of the effects of perceived control and psychological adjustment to illness. Perceived control over recovery from cardiac illness and its possible reoccurrence has also been seen as important to the adjustment of cardiac patients (Affleck, Tennen, Croog & Levine, 1987; Ben-Sira & Eliezer, 1990; Krantz, 1980).
Time perspective on the other hand is the mind’s way of parsing the flow of human experience into zones of past, present and future. In an optimally balanced time perspective, these components blend and flexibly engage, depending on a situation’s demands and needs and values (Zimbardo, 2002). Orientation to time on the other hand takes into consideration the futuristic perspective of a person. For health care patients for instance, this is vital because it will in essence determine their present values and their expectations on their health situation.
The structure of Transtheoretical Model acknowledges the importance of a developmental perspective of change, rather than for example a theoretical approach that mainly focuses on personality characteristics or behaviors as predictors of change. TTM was developed to bind various aspects of counseling without detaching practice from theory; the “separation” of theory from actual practice is often inherent in other models related to eclecticism (Ginter, 1996).
TTM also incorporates an understanding of the “natural” dynamic tendencies that individuals show regarding self-change. Specifically, it incorporates what researchers have uncovered about how some individuals, with problems commonly seen in therapy, accomplish necessary changes without therapy (Sobell, Cunningham, & Sobell, 1996; Tucker, 1995; Watson & Sher, 1998). The constructors of TTM have capitalized on these natural dynamics, and this incorporation has influenced their investigations (DiClemente et al., 1991; Prochaska & DiClemente, 1983). This type of formulation and development of the model is reflective of the scientist-practitioner tradition in that it was developed from an empirically derived model of change.
Prochaska and DiClemente (1984, 1992) and Prochaska et al. (1992) discovered that the process of self-reevaluation tends to be most prevalent for individuals when attempting to change with or without therapy interventions. Rational-emotive behavior therapy, cognitive therapy, transactional analysis, and existential therapy are leading therapies that have been identified as fitting most appropriately with the respective process of TTM at the contemplation stage (Prochaska & DiClemente, 1992).
Individuals engage in or attempt an array of solutions to modify problematic thinking, deficiencies in functioning, problem behaviors, and health problems tends to resort to therapeutic processes (Petrocelli, 2002). The processes of lifestyle change can be identified as the ways in which individuals attempt to change with or without therapy.
References
Affleck G., Tennen H., Croog S., & Levine S. ( 1987). Causal attribution, perceived control, and recovery from a heart attack. Journal of Social and Clinical Psychology, 5, 339-355.
Ben-Sira Z., & Eliezer R. ( 1990). The structure of readjustment after heart attack. Social Science and Medicine, 30, 523-536.
Croog S., & Levine S. ( 1982). Life after a heart attack: Social and psychological factors eight year later. New York: Human Sciences Press.
DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991). The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology, 59, 295-304.
Fowers, B. (1994) Perceived Control, Illness Status Stress, and Adjustment to Cardiac Illness. Journal of Psychology, Vol. 128.
Ginter, E. J. (1996). Three pillars of mental health counseling–watch in what you step. Journal of Mental Health Counseling, 18, 99-107.
Krantz D. S. ( 1980). Cognitive processes and recovery from heart attack: A review and theoretical analysis. Journal of Human Stress, 12, 27-38.
Okonski, V. (2003) Exercise as a counseling intervention. Journal of Mental Health Counseling, Vol. 25.
Petrocelli, J. (2002) Processes and stages of change: counseling with the transtheoretical model of change. Journal of Counseling and Development, Vol. 80.
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.
Prochaska, J. O., & DiClemente, C. C. (1984). The transtheoretical approach: Crossing the traditional boundaries of therapy. Homewood, IL: Dow-Jones-Irwin.
Prochaska, J. O., & DiClemente, C. C. (1992). The transtheoretical approach. In J. C. Norcross & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 300-334). New York: Basic Books.
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114.
Sobell, L. C., Cunningham, J. A., & Sobell, M. B. (1996). Recovery from alcohol problems with and without treatment: Prevalence in two population surveys. Journal of Public Health, 86, 966-972.
Steptoe, A., & Wardle, J. (2001). Locus of control and health behavior revisited: A multivariate analysis of young adults from 18 countries. British Journal of Psychology, 92, 659-673.
Tucker, J. A. (1995). Predictors of help-seeking and the temporal relationship of help to recovery among treated and untreated recovered problem drinkers. Addiction, 90, 805-809.
Wallston K. A., Wallston B. S., & DeVellis R. ( 1978). Development of the Multidimensional Health Locus of Control Scales. Health Education Monographs, 6(2), 160-170.
Watson, A. L., & Sher, K. J. (1998). Resolution of alcohol problems without treatment: Methodological issues and future directions of natural recovery research. Clinical Psychology: Science and Practice, 5, 1-18.
Wiklund I., & Sanne A. ( 1984). Emotional reaction, health preoccupation and sexual activity two months after a myocardial infarction. Scandinavian Journal of Rehabilitation Medicine, 46, 47-56.
Zimbardo, P. (2002) Time to take our time; looking to the future is important–and very American–but living in the present is vital. Psychology Today, Vol. 35.
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