Health Psychology

1. Health Psychology

2. Requirements • Definitions, causes and factors affecting accidents • Personality and accident proneness • Reducing accidents and promoting safety behaviours

3. Background definitions • ACCIDENT • An event without apparent cause, unexpected, unintentional, mishap. • ATTRIBUTIONS • Who/what is to blame. Fundamental attribution errors • HUMAN ERROR • Omission, commission, timing, sequence • PEOPLE APPROACH (ERRORS) • People at fault • SYSTEM APPROACH (ERRORS) • System set-up but not always followed • SELECTVE ATTENTION/COGNITIVE OVERLOAD • Too many things on our mind at one time • DESKILLING • Irony of automation. People are still left to do the difficult tasks which cannot be automated easily • EQUIPMENT DESIGN • e.g. wearing rings while playing sport. Or pressing the wrong control because it looks the same

4. Background personality • ACCIDENT-PRONE • A person approach explanation. Satisfies the name and blame option. Nobody is really accident prone though. • REPEATERS • Probably a result of some norm compliance • ABUSE • Of alcohol and substances impair our judgements • SLEEP DEPRIVATION • Make more errors, need longer to perform • TYPE A BEHAVIOUR • Lead to more risky situations by their nature to rush/compete • INTROVERT/EXTROVERT • Introverts less likely to ask for help so expose themselves to greater personal risk. BUT extroverts are impulsive and found to be a feature of car accidents.

5. Background reducing accidents • STRESS REDUCTION • In the workplace leads to fewer lost days through illness. More fluids leads to better mental faculties. • ATTITUDE/ MEDIA CAMPAIGN • Media changes our attitudes but not necessarily our behaviour. Chip pan fires were reduced b giving advice what to do rather than just consequences of not doing. • SLEEPY DRIVER • Advice needs to be useful – but some is only short term in effect • MOBILE PHONES • We wander in our lane and vary road speed. Multitasking is difficult. Deriver education, legislation, employer education. • UNDERSTANDING INSTRUCTIONS • Not everyone is given the same message by icons and signs. Literacy in black communities is low. Medical symbols need to be redesigned.

6. 3 Short Summaries • Accidents are a major cause of injury and death in th UK. Accidents have multiple causes and the explanation we choose to give affects what we do to prevent future hazardous events. If we consider the medical accident at QMC, perhaps cognitive overload and equipment design were two features that contributed to the fatal mistake. The systems explanation probably provides the most useful approach, but the more popular explanation is to blame the individual. • The person approach to accidents is satisfying but flawed. It has not been possible to identify an accident-prone type of person, but there is some evidence abut the characteristics and behaviour patterns that make people more likely to have accidents or make errors. • Preventing accidents is easier said than done. Attempts to improve the safety of the environment and to improve good practise at work can help to reduce the frequency of damaging errors.

7. Study 1 • Lysens • Who • 1989 • Accident-prone and over-use-prone athletes • Correlation & longitudinal, 185 1st yr PE students (118m+67f) 17-19y, one university – all follow same exercise programme. Informed consent • What • Medical, existing injuries recorded and recovered. Physical and psychological profiles. Definition of injury & reinjury established and classified • Results • 185 people sustained 315 injuries (137 acute, 178 overuse). 4.72 injueries/student/1000 hours. Absence longer in females than males. Generally acute injuries occur in short people with good upper body strength and functional strength who lack caution. Overuse injuries are implied by tall endomorphs with little static strength but great explosive strength, low muscle flexibility, large Q-angled neurotics.

8. Study 2 • Raiche • Who • 2000 • Older adults and falling • Testing the validity of the Tinetti balance. 225 people over 75y randomly selected from electoral roll. Informed consent. • What • Longitudinal correlation between Tinetti score and number of falls. Tinetti measures balance and gait. Lower score more likely to fall. Trained nurse administered. In own home. Calendar given, recorded falls. Telephoned monthly. • Results • Mean score on Tinetti 33.8 (/40). 23.6% fell at least once and all scored below 33 on scale. 120/225 scored 36 or less and had greater than 30% risk of falling. • Tinetti scale therefore tested for predictive validity and found to be valid.

9. Study 3 • Sherry • Who • 2003 • Accidents and support in the trucking industry • Correlation: stress, supervisor support, personal attributes and accidents • 55 long-distance drivers. Consent. • What • Variables measured using likert scales. Accidents measures using 3 questions (how many injuries in 4 y, how many collisions, how many traffic tickets) All question embedded in a large questionnaire. • Results • Significant relationship between stress & injuries, personal attributes & injuries, supervisor support & number of tickets. No relationship between stress & collisions, personal attributes & collisions. Personal variable and injury showed a correlation between few injuries and low score on distractibility.

10. Study 4 • Gofin • Who • 2004 • Motor ability and child accidents • 2057 children gr3-6. 8 schools (Israel). Informed consent (parents). Natural experiment. • What • Gender and grade from school records. Questionnaire sent home but too few returned. Questionnaire in class on perceived health, Physical activity, handedness, sensation seeking. PE teachers (std protocol) anthropomorphic data + motor ability (agility, balance, reaction time) Injuries on school premises (needing medical treatment or reduced activity) measured by teacher incentives for compliance. Cause of accident, nature, severity, circumstances. Over 1 year. • Results • 73 (3.9%) injured. 9 injured twice. 82 injuries. More male than female, more 6gr than 3gr. Cuts/scrapes common but 5 fractures. Mostly falls or blows on playground, field, PE. Anthropomorphic features not implicated. • Contrary to hypothesis – those with better ability to balance suffered more injuries than those with lower balance. Agile children suffered more injuries. Maybe they take more risks.

11. Study 5 • SWOV • Who • 1997 • Principal causes of accidents for cyclists • Victims of cycling accidents, Amsterdam, stratified random sample. 3 groups – injury while riding, injury while stationary, passenger. All taken to hospital. • What • Questionnaire • Results • 53% fell while riding, 29% collided cyclist, 24% collide object. 7% cycle defect, 28% own behaviour, 27% other road user, 14% road, 24% other causes. 8% admit cycle needs better maintenance, 30% those riding without lights thought it could be avoided if they put their lights on. 4% wearing helmets & fewer head injury but rode faster. Passengers 73% feet caught, 70% no wheel cover, 20% poor seats • Unsafe behaviours cause accidents rather than unsafe system. Recommendations – improve road surface, wear helmets, wheel covers/cycle seats better, legal requirements.

12. Study 6 • Haight • Who • 2001 • Review article accident proneness • What • 3 causes of road accidents • factors internal to driver • factors related to road • purely random factors • Results • Accident proneness is a search for a scapegoat • [Personal note – this study is not useful to learn – it is far too vague]

13. General Review • Validity • Lysens – profiles developed have predictive validity for that group also face and construct validity. But as not checked against other things measuring the same variable we can’t say they have concurrent validity. • Gofin – predictive validity but not construct validity since hypothesis cancelled out. • Sherry – predictive validity as measurement can predict • Raiche – predictive validity • Ethics • Informed consent, confidentiality, protection • Informed consent in all studies. • Gofin allows some identification of the children involved (grade 3-6 and school identifiable) • Protection none of the participants put at extra risk . All injuries occurred as a result of day-to-day activities. • Sampling • Raiche – random sample – generalisable. • Gofin – restricted cluster sample but offset by large size. • Sherry – very small sample • Lysens – generalise to young sports students but not sportspeople in general (wide ranging activities) • Methodology • Correlations (Lysens, Raiche, Sherry) mean we know nothing about causes of injuries – just an increased risk other factors play a part. • Gofin – experiment so cause and effect can be inferred.

14. Questions • Describe one study of causes of accidents (6) • Discuss the problems of researching causes of accidents (10) • Describe one study of personality and accident proneness (6) • Discuss the validity of the concept of accident proneness (10) • Describe what psychologists have discovered about accidents • Discuss the psychological evidence on accidents • Suggest a psychological intervention that would be helpful in reducing accidents from the use of tea cosies in the home. Give reasons for your answer.