Application of psychological theories at the Queens Hospital

Abstract
This report analyses the application of psychological theories at the Queens Hospital where I was on placement as a Health Care Assistant. Health psychology takes into consideration the context of individuals’ lives, beliefs, behaviours and other risk factors in order to achieve the desired objectives, which in this case is to provide the best ways of attending to the patients. The hospital uses the biopsychosocial model, psychoanalytical and the task oriented approaches in offering psychological care to the patients. All the three approaches emphasise the idea of ensuring that the patient is the centre of all actions in order to engage them as much as possible in the treatment process.
Introduction

Picano (2009, p. 44) suggests that in the past the medical practitioners regarded psychology and other social sciences as unimportant soft sciences in the medical profession. However this notion slowly changed as scholars started linking psychology to the well being of both physical and mental health. This paper explores the linkage between psychological theory and practice at the Queens Hospital. I worked as a health care assistant and was a vital part of the team that supported the medical staff and patients in wards and departments throughout the hospital. I had direct links to both the patients and the medical staff and as such I was able to observe the interactions between the patients and other medical staff. As the first point of contact for many patients and members of the public, healthcare assistants need to be well-presented and confident with good interpersonal skills. Some of the tasks are unpleasant and needs flexibility to able to help patients with their personal care without getting embarrassed and making sure they are comfortable. Achieving this requires application of psychological theories into practice in order to be able to offer the best care to the patients in medical settings.
Psychological theories
Segal & Hersen (2010, p. 47) define psychology as the study of human behavior, emotions and thought processes. Psychological theories if well applied contribute greatly to understanding other people and developing functional relationships. Robins (2007, p. 28) suggests that health psychology is the application of these psychological theories and research in the promotion of evidenced based health. Nevid (2009, p. 33) claims that health psychology takes into consideration the context of individuals’ lives, beliefs, behaviours and other risk factors in order to achieve the desired objectives, which in this case is to provide the best ways of attending to the patients. It is for this reason that it is important for all healthcare personnel to have some psychological knowledge so that they can know how to attend to the patients in the best possible way.
The patients come from varied social and cultural backgrounds valuing certain behaviours and beliefs over others. Walker (2007, p. 36) claims that this may place more risk or less risk of illness than the others. In this case therefore, some sociological knowledge is equally essential to the healthcare practitioners. In the same way, some knowledge of biomedical sciences is critical in the comprehension of the link between physiological and psychological process (Hefferon & Boniwell, 2011, p. 67). Therefore, psychology complements these other disciplines in making important contributions to the well being of the patients. Psychology is important to health and social care because health care professionals spend most of their time interacting with the patients. An important aspect of their job is to encourage and promote the well being of the patients and those around them. Before going further into the discussion, it is important to first define the meaning of health in order to be able to bring out the importance of psychology to the discipline clearly.
Irwin & Rippe, (2008, p. 18) define health as a state of complete social, physical and mental well being and not just the absence of infirmity or disease. This is an important goal to health care professionals working in health and social care and it is the reason why they need the knowledge and skills to help them work toward their achievement. Psychological theories and research contributes to the improvement of health and social care through appreciation of other people’s feelings in order to offer them individualised care. Patterson & Lipschitz (2008, p. 44) claim that health care is among the most complicated services because it faces the challenge of client diversity and need variability. Patients come to the hospital with different needs caused by many different diseases; some of them adhere to the requirements of behavioural change while others don’t. In addition to this, some patients do not even finish taking the prescribed drugs which makes the treatment process more difficult for the doctors and nurses. In addition to this it also faces huge pressure from other factors because the whole process occurs around beds and wards. The health care professionals operate in an abstract world and are faced by both psychological and social forces guiding them from the point of admitting the patients to administration of treatment. They attend to patients with different psychological needs and as such must be well equipped with psychological theories in order to attend to them in the best possible ways.
Patterson & Lipschitz (2008, p. 24) assert that while all health care issues have their own controversies and debates, at times moments of transient consensus often occur. This stems from the fact that the role of patients in medical settings have gradually changed along environmental and social lines in the western society over the years. The major changes include aspects like consistent erosion of the previously perceived omnipotence of physicians, increase acceleration of information exchange, and increased awareness of the rights of the patients. Greenberg (2007, p. 22) suggests that the prevalent situation in most hospitals today is the partnership model that is acceptable to both the providers and the patients. These patients no longer play passive roles as recipients of medical procedures but are actively involved in deciding the clinical decisions affecting them. Ninivaggi (2010, p. 17) asserts that this new arrangement raises ethical issues in the determination of best interests and delegation of authority to the relevant personnel to pursue them. Psychology seeks to understand and explain why people behave in certain ways both as individuals and in groups. It does not only seek to understand and predict behaviour but also looks into ways of changing them in order to improve the quality of life. This is closely linked to what the medical practitioners do as they also seek to understand the behaviour of the patients, treat them and then direct them on healthy living practices.
Medical practitioners often employ psychological theories in the dispensation of their duties because medical care has its foundations in psychology, sociology and biology (Marini, Glover-Graf, & Millington, 2012, p. 30). Theory provides the medical personnel with the framework and goals for assessment, diagnosis and intervention. For instance the nurses working at the hospital focused on the aspects of care that are holistic in nature for more effective judgment of different patient situations and conditions. The goals of care helped the nurses by providing a checklist by which the services that they provide are measured against. In deed Walker (2007, p. 65) says that theory is an effective tool that renders practice more efficient through comparing the outcomes against the set goals and then providing mechanisms for rectifying problems as soon as they are detected.
Application of psychological theories at the hospital
As a health care assistant I was many times faced with the challenge of choosing the appropriate theory or set of theories to apply in any given circumstances. This was not an easy decision because I realised that selection of only one theory in a certain circumstance would have placed restrictions on practice and probably led to inefficiencies. It is for this reason that I relied heavily on theory adoption where I took a theory and then altered it to suit the situation where I was applying it and in other cases I had to use it alongside another one. I learned that most of the patients were going through intense stress as a result of their illnesses. Some of the patients adjusted well to their new conditions whereas others developed some form of psychological disorders secondary to their physical diseases especially for those that were unable to do basic things like going to the toilet and bathing. In addition to this, some patients also showed physical symptoms for which there is no significant medical explanations and most of them were as a result of unrecognised psychological problems.
I was able to learn from the nurses and other hospital staff as I realised that they were applying psychological theories in dealing with the stressed patients. They used the biopsychosocial model to explain to me the reasons why the patients were stressed. This was a very resourceful tool in the assessment of psychological stress among the patients in the hospital. The model included both environmental parameters and personal processes of perception and being able to cope with the different stress factors at the hospital. Greenberg (2007, p. 30) claims that the effects of stress have a positive correlation to coping. Coping in this case as defined by the Lazarus theory is constantly changing both cognitive and behavioural efforts to manage the existent taxing demands of the internal or external environment (Pickren & Rutherford, 2010, p. 52). The doctors and nurses encouraged dialogue with the patients because they considered it an important aspect in the management of psychological and psychiatric elements of physical ill health. Greenberg (2009, p. 67) suggests that this relationship is beneficial to both the medical team and the patients. It is very important for patients particularly for those with serious physical and psychological problems to have a more personal relationship with the nurses and doctors in order to create and sustain a therapeutic relationship for better health care delivery (Sitzman & Eichelberger, 2011, p. 94). This will be helpful for the health care personnel to identify the patients that need psychological treatment in good time and offer immediate attention to help them cope with the mental problems. The doctor patient relationship is explained by two other approaches which are the psychoanalytical and the task oriented approaches (Bekerian & Levey 2012, p. 31). All the approaches emphasise the idea of ensuring that the patient is the centre of all actions in order to engage them as much as possible in the treatment process. Greenberg (2007, p. 32) says that these approaches demand that for an effective treatment to be achieved there has to be an efficient partnership and information sharing between the patients and the doctors. Nevid (2012, p. 89) says that the information has to flow both ways in order to improve the clinical outcomes through cognitive (knowledge), behavioural (adherence to advice) and affective (satisfaction). Indeed the application of psychological theories at the hospital was beyond what I had imagined it will be at first. I observed that the patients were mostly able to recall more information when they were satisfied. The non cooperative patients seemed to remember less information and the hospital staff in most cases had to offer them specialised care. Good communication was also maintained among the clinicians to ensure that the information flowing to the patients was consistent in order to eliminate any possibility of conflicting information reaching the patients. This was important because any conflicting information would have left the patients wondering who to believe and this would have even made things worse for them.
Conclusion
Application of psychological theories in medical settings is an important aspect of the treatment process because the patients need to be attended to psychology as well. As indicated in the paper some patients find it difficult to cope with their new conditions in the hospital and go to the extent of developing mental disorders as a result. This is the reason why the hospital made use of psychological theories in understanding their behaviour and condition in order to be able to attend to them efficiently. This is a big lesson that I learned from my placement at the Queens Hospital and I will apply it once I start working in the hospital. I am now aware of the fact that ignoring the psychological needs of the patients places them at an increased risk of developing psychological disorders and as such will always apply psychological theories in communicating with them in order to know how they feel and the best possible ways of attending to them.
References
Bekerian, D. A., & Levey, A. B. (2012). Applied psychology: Putting theory into practice. Oxford: Oxford University Press.
Greenberg, T. M. C. (2007). The psychological impact of acute and chronic illness: A practical guide for primary care physicians. New York: Springer.
Greenberg, T. M. C. (2009). Psychodynamic perspectives on aging and illness. Dordrech: Springer.
Hefferon, K., & Boniwell, I. (2011). Positive psychology: Theory, research and applications. Maidenhead, Berkshire, England: Open University Press.
Irwin, R. S., & Rippe, J. M. (2008). Irwin and Rippe’s intensive care medicine. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Marini, I., Glover-Graf, N. M., & Millington, M. J. (2012). Psychosocial aspects of disability: Insider perspectives and counseling strategies. New York: Springer Pub.
Nevid, J. S. (2009). Psychology: Concepts and applications. Boston: Houghton Mifflin Co.
Nevid, J. S. (2012). Essentials of psychology: Concepts and applications. Belmont, CA: Wadsworth, Cengage Learning.
Ninivaggi, F. J. (2010). Envy theory: Perspectives on the psychology of envy. Lanham: Rowman & Littlefield Publishers.
Patterson, J. A., & Lipschitz, I. N. (2008). Psychological counseling research focus. New York: Nova Science Publishers.
Picano, E. (2009). Stress echocardiography: [CD-ROM included]. Berlin: Springer.
Pickren, W. E., & Rutherford, A. (2010). A history of modern psychology in context. Hoboken, N.J: John Wiley.
Robins, R. W. (2007). Handbook of research methods in personality psychology. New York: Guilford.
Segal, D. L., & Hersen, M. (2010). Diagnostic interviewing. New York: Springer.
Sitzman, K., & Eichelberger, L. W. (2011). Understanding the work of nurse theorists: A creative beginning. Sudbury, Mass: Jones and Bartlett Publishers.
Walker, J. (2007). Psychology for nurses and the caring professions. Maidenhead, Berkshire: Open University Press