Kaptein Ad A
Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands.
Health Psychol Behav Med. 2023 Jan 27;11(1):2170379. doi: 10.1080/21642850.2023.2170379. eCollection 2023.
Psychology as applied to health and illness has a relatively short history. Nevertheless, that history shows a rapid development of the theoretical models that guide the field over the past 60 years. Core theoretical approaches are concisely reviewed, in the context of Kaplan's paper 'Behavior as the central outcome in health care' (1990), which is used as a model to examine the extent to which these approaches embrace Kaplan's notions.
Empirical studies from the health psychology domain are used, which demonstrate the gains in terms of quality of life and behavioural outcomes in patients with (chronic) somatic diseases. Over a period of some 60 years, theoretical models and core concepts in psychology as applied to health and illness have evolved from psychosomatic views to neuropsychology, quality of life, patient education, self-management, illness perceptions, patient-reported outcome measures (PROMs), shared decision-making (SDM) and health humanities (HH). The more recent models (SDM, HH) appear to align to a considerable degree with adopting 'behavior as the central outcome an outcome in health care'; shared decision-making and health humanities focus on encouraging patients to make sense of and give meaning to their illness in order to attain optimal psychosocial adjustment.
In addition to 'behavior as the central outcome in health care', a new definition of the concept of health (i.e. 'the ability to adapt and to self-manage' - Huber et al., 2011) seems to favour patients, healthcare providers, society, and health psychology. Incorporating this concept into medical care may be viewed as a challenge for health psychologists - and as a source of continual struggle with strong biomedical forces.
应用于健康与疾病领域的心理学历史相对较短。然而，这段历史表明，在过去60年里，指导该领域的理论模型发展迅速。在卡普兰1990年发表的《行为作为医疗保健的核心结果》这篇论文的背景下，对核心理论方法进行了简要回顾，该论文被用作一个模型，以检验这些方法在多大程度上包含了卡普兰的观点。
运用了健康心理学领域的实证研究，这些研究证明了（慢性）躯体疾病患者在生活质量和行为结果方面的改善。在大约60年的时间里，应用于健康与疾病领域的心理学理论模型和核心概念已从心身观发展到神经心理学、生活质量、患者教育、自我管理、疾病认知、患者报告结局测量（PROMs）、共同决策（SDM）和健康人文学科（HH）。较新的模型（SDM、HH）在很大程度上似乎与将“行为作为医疗保健的核心结果”相一致；共同决策和健康人文学科专注于鼓励患者理解并赋予其疾病意义，以实现最佳的心理社会适应。
除了“行为作为医疗保健的核心结果”之外，健康的新概念（即“适应和自我管理的能力”——胡贝尔等人，2011年）似乎对患者、医疗服务提供者、社会和健康心理学都有利。将这一概念纳入医疗护理可能被视为健康心理学家面临的一项挑战——也是与强大的生物医学力量持续斗争的根源。
