are still encouraged to promote good health, but no longer by identifying diseases at an
asymptomatic stage, but by encouraging patients to change their behaviour. During
recent years there has been a shift towards self-help and health promotion, reflected by
the preoccupation with diet, smoking, exercise and self-examination. Prevention and
cure are no longer the result of professional intervention but come from the individual –
patients are becoming their own doctors.TO CONCLUDE
Screening (secondary prevention) has been developed throughout the twentieth century
as an important means to detect illness at an asymptomatic stage. Specific criteria have
been developed to facilitate the screening process and research has been carried out to
evaluate means to increase patient uptake of screening programmes. Recently, however,
there have been debates about the problems with screening. These have concerned the
ethics of screening, its cost-effectiveness and its possible psychological consequences.
Although screening programmes are still being developed and regarded as an important
facet of health, there has been a recent shift from a system of ‘doctor help’ to ‘self-help’,
which is reflected in the growing interest in health beliefs and health behaviour and the
process of health promotion.ASSUMPTIONS IN HEALTH PSYCHOLOGY
The literature on screening highlights some of the assumptions in health psychology:
1 Challenging the biomedical model. Health psychology aims to challenge the bio-
medical model. However, it often does not challenge some of the biomedical
approaches to ‘a successful outcome’. For example, although by examining the
psychological consequences of screening it is suggested that screening for its own sake? QUESTIONS
1 Screening is an essential aspect of promoting health. Discuss.
2 Discuss the factors effecting the uptake of a screening programme.
3 Screening is unethical. Discuss.
4 What are the possible psychological side effects of screening for illness?
5 Develop a research protocol designed to improve attendance for cervical
screening.FOR DISCUSSION
Consider which factors (e.g. beliefs, environmental) relate to whether you do or do
not practise breast self-examination (for women) or testicular self-examination (for
men).230 HEALTH PSYCHOLOGY