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Psihotogia sona/alii Tatiana TurchinA

Tema 1. PSIHOLOGIA SANATATn -DOMENJU DE STUDIU

Subiecte:

.1-pre.mis.eleapar.i~ie.i Psiholo.giei Sanata~iiObiectivesi toprca de studiu. Principii ~i paradigme de studiu

4 Scurt istoric5. Pregatirea psihologului In domeniul sanata!ii6. Relatia Psihologiei Sanatatii cu alte discipline

Resurse bibliografice:1. Enachescu C, Tratat de igiena mintala, Ed. Polirom, Iasi, 20042. Popescu Bruma S_Psihologia saniHatii, Ed. Paralela 45, 2005

1. Premisele aparitiei Psihologiei Sliniitii{ii

emld~~D].~t ica Q.Q IjJ9r Rsih9.spl'J)_~t.~£e.jllf~J~(tZ~,..1i,t_H...nlS:JH~inac1tsj._R.~lhQ!Qg,i~.~,<~~~.IL1~>_p;;ih~2~!!!~!.!ce.urmeaza In ultimele decenii 0 curba ascendenta care este similara Cllcea a nevrozelor. -.•_....-~.'"'.>..•..,....,,~J._...,~ -.--- ....~.;..;.

L~atura dintreyiata pSihicaJicea ..somatica este 0 observatie veche~ .Ideea. unitatii dintre ..psihicsi;on~~ icJi:a .fac·utloc-~lgu ros:111'(ned i~'iha~cki'~'lrll)~roilJffil'~ i~ilI~~·t;-0§ut o~s~rvatii I~·.~~!:~,1iu~J:Q$is'U6'irnTare-i~etipi:6cfiatea'airitre- tulburari lefunctionale~ileziunTle or:ganice, '-rolli! jucat de ernotie 111

tlllbllr~l:ife functionale, imporranta factorilor psihologici In tratarnentul unorboli.

,~!"IJ.i.ll}PJD.Q~J~.I~g'!tI[um~di£j!lA dom il)aconc.~J?ti~,..1.neS~,tliGis!~\g~r"~•.SQ[l§ig~mJ~zjllneadf; ..Qrg'.!:l1.dnmtcentrulJ2t1tologiei umane in rimp ce psihicul era conceputcac~va vag sau chi<:tr~rCiign()r~t~,§anatate~.iJ)oala era~ coosld'e;ai~""ca ~oliaellti-tati~.ioliledic.al~. Secons!9§raca 1)ag~juigeneiicaip~~neicauzea:tiflffi6'oli'i'avTreasau '60ali.SAnAtaie'aenl percepuildoar ea abselltaa bolii. . .. ,

_•.• " ..~",,",--,-,,_<__.,...:..•....-,,-:---.::-.:-,.-..... ,,:., ;.. ., , . _. ..... _.-_.. -_.__.... -:.. J. ::... ... ....

Mi~careaJ;>.sjb.9somaticaapare ca 0 reactie irnpotriva unei l1le~iciI1Lloca~i~Jioniste care vedea oD~all\;ll,-..............~ -~ .••.•.•••. oW. ••. __ :."" •• ~.' •••••. _. " •. :,~. ,. ,---- __ ,-:~.-- ••••.• -.' ... - •. ---'--. -, .• ~_,.._ •••• .:.;~--.--.; •.. ,,~;., .•••• r, ·.o.:·,.·:·i .••••.~ .•.-'-'"'"-- ••..••.••~~'""..,.,.··-·~

-,dar nu vedea persgan1(umana. apare ca 0 reactieIn fatiluri~i medicini ultraspecializate.~~":';';"-""-.:..~~",. '"';..;.;. ... ,..-'-' .. .~... .

li1e~iCina .Rsih6s~.~.i~~ ,,1d f.) - $..-.2~~_~~~?mplex,~,.9~c~2Q!J1~r_~",,~~<;.9QJrr~YlL()~~~et!9J~<2~i~~~.,patogeniei ~i t~rapeuticii fenomenelorpatologice, 'in care-factorii psihici joaca un rol patogenic sau slnt'I~~rapori~eu ter'a'peutica lor,-· - . . . .. ',. .

Termenul de psihosomatica a fast i_ntrodusde HEINROTH (17.73 - 1843) In l~I~c'"""'- . __ ._";,,,,--",,,",_ '""w ._:...., ' ....• C·, '-'"' •. "_;" ",-_-,_=-~",,--_,.. ..,..,.,.",".,-"""...:~ .,.•.._. •.. --.7~--- ._--:'-.-:- - .. -.-.'_.::.:::::"-~-"'-'''-:-~--'>:;'':-.~-':.. ...•...~-..• ",._- ..•.. :v,.';r,~'···.•....y ... :;. -, •

. SOMMER In 1890 introduce teflllell~Lqe psih()genie.princaresunt"9~1J~1,mi~~bolile deterlll.illa.te de,cauze pSlnice,~htiii;;p-ce"~iuto-fli)allei, Freud.)a$pers fundamenieaz~'terillenllide p:~ihoge~~;'q'-..'"'-" •.•._~_ ..:: •.•.• ~.- .. '-.----'. •. ·W'.,"::. . •.••." •• ...: ' .•....... ~..<_ ..::.;;.~;.,,_.:;;,:,.-_.-._•.~.#

. "In 1916~OMS.apubIicat unul ~inprimele defillitii.d~tes~natatii .~. definitie caredore~.sa aiba 0;;;~~p'tare~~I~~~~af~~De"fiilTfj'a,'-care-7a'-aeiel1Ii~destuj,.de'-curfnd~~un?~c~i~" pe glob, '~ra ..~rinlitoar~:~':;-:"SiI11iiiateareprezinta acea stare completa de bine din punct de veder(~"fizjc. social .ii i;pi,·ti,;al.-;r~~

•.... _.:.<_. . _::'. ,,' '\;;;.,_: .... '•. -'.', .. ,__ ·c· .;.'. .., ..• :. ' .. :._ .. : .._.-.-.:._:... . .. ,' .. :' ... ··'·::·"~"."":"-''''·:::.-·'''i·-·'·<'·X:,>-','···:·'':_::c.,.;.: ...··~..y\.-' .."':'?f;~'~;...~.<"·~ ..•."'\'"''''-

doar pur ~·isimpluabsen(abolir' ..

;Y'"Chiardaca aspectele invocate in definitie nu sunt prezente in proportie de 100% in randul populatiei,.') fiind considerata cand abstracta, cand idealista, aceasta are 0 baza de inspiratie de echilibru general,'r'con~inand valoarea spre care se tinde permanent. Totodata, s-a ararat pe buna dreptate.ca statusul numiti starea de bine este realmente influentat de factorii sociali, economici, implicit de cei culturali (R.Rascanu).

;~- ..-~~Criticele s-au indreptat spre definirea rnai clara a contextului sanatatii. Se accepta ca sanatatea trebuie

'C discutata in interrelatie cu boala si ocrotirea sanatatii, in care procesele psihice reprezinta 0 "cheie"__intima extrem de importanta, cu rezonante sociale multiple.

·~!lif~~~ti.~~i;..~ij;i<··., •• <j"'lI'}~.i<!ifili!,!j;jI-i;i:'i:';+';'H-1i~~~<;t!i!iii_~j;<;$~ljn.r~#~.,~'-~iL,*li'_J1fi.,!j~J,,*~;{j:;ict~~

III. Odat~ ..s;w,4~zyoltarea cercetarilor medicale, CLlIllar f tehnici chirurgica!e rnoderne, imunizarea,rata decesullli~~a'-;:e(Hls~rs-a accentuat prevenirea ~f!QLhil'bol~~vi~ranleni;ltatoare cfe-vT~i-=Dar-bom~

:ff9il,~e"cuil1arfi"6'C;Hie- aeiniil1i' cancei:;"coll1'p}icati ile d~torate consurnului de substan~e:,cQ'2K~i. fieTIl'ascendell~a incepand Cll a doua jurnatate a sec. XX. Enurneram cativa dintre factorii ,;laj2r!.S:<lr~'au condus la aparitia si dezvoltarea unei noi rarnuri psihologice: " , .. -"""'"

I .. 1i~cu.ng.~~~~,JllJl'~9LmQg~tHl~!,\"Zt2XD.~Q.t¥~4'~,~BUS~[~~t§,i, ...!r<lt~r~JLg9!'i!~[",(practic un nu~arfoarte limitat de boli sunt astazi vindecate de medicina clinica; este adevarat ca multe dintre bolisunt rnult mai bine diagnosticate ~i controlate dedit acum 'cateva decenii).

2 ...•pin ob~~rXiHii~'npirice s-ac:qllst~tat- in sec. XI)(~2Q%din n~ort~I,iJ'l,~~.,s.~ic;l~tgI"~",~ll$J]JJ.LQ,~;pana 111anii 8QII1 SUA prevalenta infectiilor acute asa catuberCuI9Z;il,g~iR.a> RQj~r...~,'s'~.allJ1,~lD

···tilllP ce rnorbiditatea si rnortalitatea pri,l'aIte tulburari aucresc,ut -:- b2il~>3~£~2.~~scu~"'(BCV), cancer, accidente cerebrovasculare, accidente rutiere, SrDA, alcoolismul, consum de

drogurr"" .. '.. " . . . '. - ...

3 ... MQ4iJic.areasen~nitic:~tiva a cauzelorjnortalitatii ~i.morbiditatii (peste 50% din cauzele de,."., ..""' ~.... ''''.. .0<...... '.' ""_ ,, .. _._.. -~_o _~.,~_ ~rnortalitate ~i rnorbiditate se datoreaza unor factori care pot f preveniti, dintre care amintim:

'" ._,,-- -._-.-' -. .." -".- .. -.' . :;;-,';--. -"'( ... -.-.-~._Iil~'!~~#~"""''''''"'"'''''''~i'i~~'~!;;P;~.¥rtlii!llOli!;,~~~;".j;;!'!~i<\<f'·'';l!1''1I1iliri~;~.\~"irlliliJ,t'~il .• iio1ii~~i"t·"!j:'#.f'tiI~h~h~'"'.~iill. ·~"H,.';·:,.",,,,..., ""'<'1".'- .~.r~~~'r_-.."....,) .

2 i

Psihologia SCllliilii!ii Tatiana Turchina

•

Etapele dezvoltarii domeniului:

1.";JtL1277,, .la,c()11ferint?l.din Yale ,sonsacratamed,icilliic0rTlPortilme,ntaliste,., expertii ..in asistenta-:~~,~~:i~~p[~e~i.~p·re discutie probleme curenie~TvHtoa;~.·pe·bizi~i~c~fii·I(;~a.fosTpr6pu·s~·difi:nm?medlclnlloef)avlorlste:

"Medicina. Behaviorista .....e.\·teuncoI11P interdisciplinar preocupat de dezvoltarea ~'i integrarea.~}'tiinreTOrcO;:lJJ~~~glijc!Jiop1.~ciicale. cuno:~ti~{elq<~i r.C!.hf}kdorreleval1te. sa~atiitii ~'i bolii sicip71careQ--ace:ftOrcuno.~tin(.e.)'i tehnici in vederea prevenriei. diagnosticarii, t~atamentull!J "~'ireaiJllitiirli.· ;',':""""". .' ",' . , '~'-'-<~.,

.."J:,a,acei:l~!t,~ollt~.r,i.~!~,a, fost lansata Revista de Medicine Behaviorists.

Altediscipline caepiderniologia ~i sociologia medicala au avut mult de oferit acestui domeniu.

MBera preocuRat~lllai rnultde lansarea de sirnpozioane, conferinte, lucrari stiintificeIndomepiu,~·~~e·dcsp~ra·li~ti· .. -:

n. In urma unor reflectii devenea clar ca Medicine Behaviorista era un do men iuce nu'!vea suficient

~~Il~~Jf~i?1~~~~ii~~:~*~~~~~~~P~~;~~~j~~~f~rnotiv, s:-aprgpuso alta specializare In Medicina Behaviorists numWi$anatatea Comportamentala .

• __ " -. - ','.-.-:.,' • "--,' - - •••••.• J ~" "._' •• , ••. ;::,,:.-.:7';;;-oco:;--.-,.... _." ' , -' ..... , -. •

~~1/!/a(~Q,,c J:~'l!!£J:Jfj;:.Jff,,,tJ./;q(iJ~~le,,.W.I, S£(C!l£?~.~~,!"~,Cf,{{,\FjJ2U,':!P,.C~c!~5{!~;f!LJ2rgJ!.w.y/lr{Ljj19,\R&L}il!J£fjjJjj,&..~J!!!PJJ£~:,g£ilt!E!f;/L.,i.'1c1ivicluqlci ina.E!fEC!~ec~"'"£lfr1;pyin((!{gr. .}:i tehnicilor diy(:., ,):£!ilJlacomportamentala si biomedicald pentru nieruinerea sanatiuii si prevenirea bolii si disfunctiilor prinfiriJniovc::ea variate/or activitati individuale." . . ,

§~Q~tat~a Coplpqrtalllentala~i-a orientat activitatea preventiva rnai mult pe teren. In reZl',~~tE,~~,observat ca s-auprodus schimbari ill societate:

"e~e.rG.i!.iifizice.

111iincarea$~rata ~i bogata In colesterol a fost inlaturata de pe masamultorfarnilii

dicta, diminuarea fumatuluiN:B informaua Illata dill articol editat ill 1980

Psihotogia sillla/alii Tanana Turchina

comportamente de rise, precum furnatul, consumul crescut de alcool, alimentatie~~~-';',"""",,~, ,. ',' ',_ ~.y.,~.:.,.".,;..--:<-:.:"'~" .': .... "'-:~~.~.t;,.'-.. "'.~ ,", .' .• -"., ,._._"_....,-'.._._~.-_._"...•;..._~..;...;.."'"'_.'~~:.:_.::c_~'"'-,_..~-.'.~'<r,.

necor~splrnzatoare:saiac~e. mediu poluar). ., -. . .'

4. Pro~<::ntlll mare a consultatiilor medicale (intre 30-50%) care nu sunt cauzate de patologie de•.__o,..:·~-- "",,-c- __~.,_. ._ ", ,_", .. " .• ;.-,-.' __ --. __ , _ :_ ••••.••• ¥_, __ :_~_.'-'- _~ ...•••••=--_'-.'_''''-"~.-_ .. _. .._" _".," ....• ' .•. ,."...:, .. :.__..•~"" __ .,,,,~"_~_

organcI'"de 'simptorne soinatice functionale, Cll substrat psihologic (migrene, obosea/a,'..'tafiica!1j'ie"~'~,~S)' ' "' ..~~~

5.. ~",~J.tI,LLQlareal tratamentelo! ,flledicale (tarile dezvoltate cheltuiesc 12-15% g}~,Jll~.•~__~iLq~~I~IMtP.;E~[~:f~rjTrTk~~(fif'a-fe)~···-·· ~,.,- ..X·

6.-1.!!Je~Gs~C[~.sCJ!L.Duq()i!Lpentru prevenirea imbolnavirilor darsipentru promovarea~~natatii, astarii de bine ~i a ca-litatiivietii.' '< •••.• .,-- .-~- ..

tI''1:-'.~.

7. c Marurizarea stiintelor psiho-comportamentale ~i sociale care au oferit modelesanatati: ~i bolii. ··""""f>·,,,.,.'

teorii ale

Din acest mqtiv dyyjl}~,fQ.~rt~"c;lill:ca multe boli cronice P.ot f prevenite sau celputin l11an;ilgerizl!!~,mllj,,".:, ,',,';"", ""'; : .. :. --'-"-'-_-'" .•., ' .. , ',>.' ',' .: ..,': ...• ':,.,..;, .•' ••...•.• ,. "." .,..•. ""''''''"''.:-:_~. ';'::'''''''~~~-'~<O".,'".'''''.-''''--...'._'.''.''',.'(~~ •

",J?'!!)~MPJ,il)"JBqSt!fiC:'lJea cOl11pQrt<;il1)en tul u i.,.,Stu d iile denotac-~.ai)i:?8·i'TIati~" 350. ,OQg;;J!~~(t.~~~~~JS~'l!,~,c;'~'}!:li9~,c::9rdar fi putut fi. preveniteIn fieciie'''an, pxi'ljn,s~ta.re~.tlii}]'!tuI4C,l\He~,g9,QlR,Ql]lJJl~n!fcontrolabile cum ar f Iipsa exercitiilor fizice si dieta saraca la fel contribuie la debutul unor boJi

_'.~":'._.•,".~_••..~~~ ---"-"':'= ..~'..' ''; _."", 1 "-,;"",:;:",:.,' ,:,;..;:, .. , ", .. ..-'"'.""",.'-"~~ ••. " •.•• ,.''''~~._ ••••• ~.'--i.1

Croll Ice.

d~siJ19Jpgi.i....:i~11~latiL,~l!i~entificat ca nu doar comportarnentul are uJlimpact asup:a /:)gJj.h.,,~L.~iatitudinile ~i factorii soda fl.· ..' --'. '. . -

,DUI2~,J?~r~!]£"lX!~tltor. autori in aceaJle~ioada_.p,~j.~.?_~~E;.i~,ay"~!L~,S~>!!fj~m~!Ef,er.i~Dltl!l~~~C(J1ll ortamentutui.ul)J.a/J. in special comp. individual. si avea o. baza ~tiintifica binestabilita, uf sup6rt

·7cl~catj'o;;-I;;'~iillt'iol)~1 de a incepe inleaiat contributii In ps}h6Iogi;siil~.~.t~fii·,· " '., '"

r~i~L9~~~S:.I~~i..,QMS .JLsiDl~jLo~yoia sa det!lleasca"promovarecl stinatiuii" ca tiind, "uYlproce;s''\ complex ..in. care individul are posihililalea":~ir :;,e·d;/zi~ol;;t'F.\;a~,Fcontroleze si sa-.~-lpef/eclioneze..• l;,:O;-;;i(I"~~:qYldl{fle",Diver~ispeciali~tia'li lacu.t'·~fort~EL,n91):u;;-;ai pentru definirea conceptlllu,ipe.

sanatate (inteles in mod di ferit in culturi ~i tradlti i diverse ).dar~Cpentruideritificarea acelur~-seide': factori care. .influenteaza balan!H. sanatate-boala.i Pornind"'gelaJn~elegerea aprofundaTf a, , comportamentelor pro-sanatate, dar ~i afactorilOi' car~ Inclin~'"bala;;Ja" spre boala sallspres~nat'ite.a

.', ~sinatatii ca stilde viata, speciali~tii au deIimitat unalt dOll1eniu.NoJ'J_qO!n~QL~JIJ.,£~.retreb~ie-recepta~a\ <,:;~iIlhlra prevenfiei" bolilor este psihologia sariatatii~ . . . . . . .' . "''-'"'''',""C''C''''',,*~,_,.·. ","." .. , , ',' . . "".','.' -".:.,.:,:,,;,:.,:,.,-, .. ,..

.f~~QlQg.if! ....,S..~..n.*L~li,L.~c~t~g·pi~Sip Iinar~t~JiyJ~_\~ar~~I~rnl.~n,~ I,a,r,(}~t...iI~!r:(}.9...~~.P~p9}lpri.n1 a,5!~5&J11;.,,~!1yJ1977 de psihqlpgul american Joseph Mat~.razzo (psiholog'de origine italii:.ln~):~

..., •.••.••••• ',,;.•_ ; .•. ,._,., .. , .• : .._', ••.. _, •.._.:, .... _ .. ' ,,_. ••.•. '_:_, .. "',' ', •.•• '.' , .. ,_ ,"-. .. -'.",,'" .,' ' •• c. .,,-- • ",... .. • ' •. '••.•.••••• ~ .•• ~

..Esteun.c(?t/}plex.de contributii stiiruifice. profesionale si eQlfcqf:i9Yialea/e disciplineide m:llU)[Q$lf.C1f.•. \fIJIJ11/. (j~a [JJ:9l11O,V(~) i me11( ir/(! .'.silluil ale a.J!-':~),,~;11F.C.{~:~{1;(~t.~lnl~YltlllQ(?,({{er,':ideJl(ifJr;f.1!'~£$/2reIqJgj,ar..elj~ologice si diagnostice ai ,wlnala(.ii ,>Fbolii. anahza ,>'i imbunilla(lrea politicilor de l!:.romovare a. sandtata" . . '. .. , ..... ~",~"-'''~''~~~'''-

Conform acestei definitii psihologia sanatatii jlTIglicanu d()~r,practica_.cEl1i~a,.da.r ~Ll!1YMllrea,cerceiar~I:l·$(adn:linist!~area'-Mai mu It dedit, aceasi'a" se;nnH,ca cuprinderea-'t~turo~' ~[ere'lor' psTh-;!og~j

~~p,li~a1~"s~~~iliiji~i bolij.· . ',.' -'".," - d,._ . ~"---~~-.-~

Aceasta definitielncearcasa puna in echilibru:.", ..." S istern uJdeocrotire_Asa,f!~ta~i i .}i

Sistemul depQlitic:Lp.~J1~I]j i~natate.Trebuie de rnentionat, ca definitia a fost adoptata de APA si de catre Societatea Psihologica Britanica,dar si de alte organizatii similare stiintifice ~i profesionale de pe glob. Ea este folositaca definitieoficiala a psihologiei sanatatii, devenind "standardul de aur" pentru definirea domeniului.,PsihologiaSanij,tatij,_.~,~t~_(;on.si9~rl:lta'1 fi..o discjpli,I1,~."hi~!i.9.a",(;'!.ry,.({Qln!?iIl~.JLt?L~~£tiva §~.socio-umane {psihologie,sociologie,antropologle)cuc-ea a stiintelor nat~~ral~~(medicina clinica,

"<. -,

3

Temele abordate.1 . ". Rol'dIf~Sl9 rilq.rR§ittQ!8,gifL' Jl,gt,l1~za ~ie vgLIJJl£t~'lli1~dg~r~a,P91ii..)n S.~I1~t~,te~.~,ir~c.u£SI~,k~·2. Rolul factori,I,QJ-.cGQJllRQrtaITt~citalilns'anTtate~iboata. . C ,._c", --" C cc",_,,,,, c3. Rollilfactori tOLSO(;j~J[i;ls~n~iit~II90~lr-·" -~»,-.,4. Simptolnele s.o!J1<:llL\,:.~IDabseIJJap~toI9gi~i"5. Stan~ade boalii.l;gIUJlQ!1an]entulsi,rolul de, b2In~y.6. Aspecte psihologice in bol] secifice:

_'."'_ - .. :_ ~ ••••..":-="',.,..;,:..,,,"" ~ ~. .,.......,...,..•.••__ J....,...7. lnt.~~ve(lJii.R~.iQ2,12J~j£S,J;!l.,kQi!la.,8. Programe.d~ preventies] proll,lova~e a san~.t.~lU.c"

'I;J.-""-i:t.:~.~~:JLO.-·;c.;.:..,j~"",;';:·~;;.:;'::;:,:·i:"·"_"'--···'·'··'''·'·J., .... ,.:" ..... :." ":,,,.,"..•.: ....-;..... :-.... :,'.. ',.. •

't"'-'i'!j,;!,i~r: i,,' .'I~~!,,~t0:i. . . . ;":~.i: ,,'7.,1- '.,,~::~qj'$:;'~:-, ;,';!:;j."'i!-I'-:! ,"i.' .\~~;~:-:!~~ ·,.;!~5f1WK~"".1-t:t~!j~'fHF7;t.o",~'··.··,.·. ···;":3Hf;jH ••·;!i~'·~··:n(h·' ·.H~~,li;1j~~;!.l~irf~~~Hr; ..~!·:

PJi)W/ogiu .willli/ti!ii Tatiana Turchil1l1

; f

sanatatepublica, inllJn()logiC).il Sintetic putem defini Psihologia SaniWitii ca fiind domeniulinte;.dTscipf,~a;ce'iprica"cu,lo~ti~tele si tehnicile psihologice in domeniul sanatiitii ~i bolii.

2. Obiective si topica de studiu

"p.~.i"~()!ogi,~",~~DA~~lii§~oc~pa.de anali.za caracteristicilormediul~is()cial in general. ca~,i .qe aceeaprivTn(r'diferi~~le sfere ale mediului social (relatii,veciil~iate:conditiide mimca) cepot avectetectenegative saupo~itive directe sau indirecte asupra starii de sanatate, pe tot parcursul vieti]. '~~>-"~

'.. Efcctele mediului<!.supra .starii de sanatate apartin unui subiect care actioneaza ~i.reactioneaza, deaceea'J?sfTiOlog!-asafl-a1it1(~]Ze?~fstlidililfactorilor psihoi()gkiGar~joacfllnrol primordial in aRcifu~~oj§r:.ii,11.ll£!: t~\'2~.~Y:5?1u ti~.(lC.e.s(o;r,~t".)=;:xista.f4~?-£~5.:1!!/!~~.e,IL,WJ:>.lfactol:ide me.dll~~i so~io-~ell1ografici) carepOl legalize sau proteja individui ~I gYl(~E!~i!lIlLf.FI.I,l(eJ1!£i>[, (stil de viata. trasaturi patogene) carecorespund personalitatilor mai mult sau mai putin vulncrabile.

Prinlr~ anlecsdel)te;It:,~xterne,se iau in consideratie evenimentele de viata aversive,generat{)are destres,

4~~~~!l!.S£.~gS}11£!'~,jl}t~mLsllnt analizate stilurile de viata cu risc, trasarurile parogene (an~ietatea,,depre?ia._n~l,~r()_~!~iSI)lUI).. .rrasaturi le sanogene (rabdarea. C(:)11tro I,"6ptiril isiriu L'eficien~a c11'ers'6ffa-Ja)(S~Brumar _.-' , . _.

~~?.1i.cjl.1£L~~~'.1~(l1Jaj<;>recarecupri~~:. ~s ~1~~~og?.~_,_~~~!!lL,~-< .I. £l?~~S£~De~.!]}int~:S9rp..'; domen i~~c.~.se. axeazap~, in:p.Q'1~mt'!:.1J!:!lt~ttL,o?'.l}.~~t~~}'oL~•.S!L~~~~c,

boala. moarte, insllficiente.-- --,,--...--~- ,.I'."'.-::c.·· ,.:....::...c.;.~.:".".;>.:.,"<.;">.>.~.,•... :.'.-. ·c··..... :",; ... ,., ...,... ': ::: ...•: ...••.

2. ~jJJ.SJax.c,ILPos'!.I]~iIE~LsA,2..$mrt::i:\ ..ps i.hologi.sa....,S.ll!,ll~~.U},9SBr~?i~.JL~I1\it::,we~.,.pot,q.!!SJ~~ic,~t~,~5Jt~,jmJlJl~~j,alt~ procesebiologice. cearindic~.9inlinual:~11.ingrijjrij,sanatatii..

3. "!l'S;~~,(£Q,,~~,~HJ.!~~~jtUor··~·.p?ih()1,<;>gii,~~~!l§~!fIi::£I§il?~~~.:~.sanatatea...sisperanja C"i:\E~?"o~~J::'fJ1.t·._Rr~vinimbolnavirea. t:;xi$tamulteQqli Hpn}s.f£~JWJjIJiffic::~,bj~~..•' ..

4. ,Qp.timism ut,e d at itudine opt irnis~a s i com g~~!~~l)~S~l~,.r~l~tjsm':l!~~,,~~e,st.lJj.~.-cQJJ_d,!t19.!len"Z~JJgj~e., d irecta.,spre.re~uperarf(.mai buna di n boala~tJ!le.l11iflerea san~t~Jii...

5. Sup()r~lI:Lsocial - un subiect central in studiilepsil}Qlogilor~~~~,t~tLi"...

. Qbieclivele PsiflOlogiei Sanatatii sunt:~ ,,~!·g!!!QXf!.ce;a,..sanalatii,.1/ Men t iJJ~.e.a-.saJ]atatii.

.•. f""" .• ··'·~"""'''',,''''<.,,·~··-·· .

@ Educart.:gpentrll ~i:jn~tat~~.,,;;""O".,_,.,...,.".~..,." .;~..-':.-; .•. ••. •.. .. . ..: ..,..... ,...,

il Prevcnirea imbolnavirilcr.••.•• ~~..:.. '-';;: ..•..•;:-...•-: ••...:.C<"".: ~ .. ~.•. : . '_... .. ..... ,

1/ , Ident.ificareafacrori lor cogll.iliv,J".(~lllQ ti.Q!1ali~C.91llp(~rlam~'!t.<!JL~i.•¥?£i~I..!wS~!,[,9.1-in et' olo!!ia'. evolu.tla.bol ilor acut_(!_~icronice'" . '. .

e )ntelegere e~peri~~!eiboliiAsistarea bolnavului pentru 0 mai buna adaptare Ia boala, t~(;\t~~eDui .PJQ,<::~c!~I_Lnledic~

il Alneliorarea ingrijirii medicate ~i al sistemuluimedical,

4

l'sihologio,wil1lilli!ij Tntiana Turchinii

Dome.!'Jile Ps.ihoIOgicL~~[!~Wjic, __ .·' tl '-PSihoI8~i~s~n~t~tiipu9Iice (preclinice)

- ··.pr~\f~l1ti~i~1901nayirilor- ~p·fo.ij)()y'~rfa:'saniit~tii ...

-edtlca.~~'~pe6txl' saniit'atee psih?lo~iasa,(i~ta,tii,clinise

" .: "~slsta;ea"bolna~~luiacllt. c~nsing,'eab~lnav~I~1 cr;~lic

.:pre'g~n:r~a6pIClavull' i pentr~rp~ocedUI'i ch iI'llrg icaIe.",.psi.h2c~rdi()logie. 'r,· . .

..J'.S il)o~'lc()1e'gie ..-,psil)Qn~lIrQinll1noJ9gie."

psihonellroe.nd()crin()l()gie.

3. Principi ~'iparadigme de studiu

C'·ln~',:j)i/:l('.de.Vuciill,~,,'gpl(setivq{1ISP?ill()logiei SalJ~t~JU:~-,- 'r·'_··;'-·~,§,~E~~Iit~~.•~:i~()&i~:·~~,:u~~qe.t~rmini.sm111Ulti'pI~I:.biol()&i~,.psill01()gic;..,~.i.,so9iC\I.

;I·¢)(isi~'TQter&ctiYl1icomplexe.iQtreso,nati~.~ieSItij~:· .Cl .Ab.?':9.~re1)()lisJiF~",(g1Qll]laL~r2e..rsoaneis~rlKto:lse.~i/sall bolnaye~ ,·6b(),·a~Te .si?J~p1.ic;a.-;~.:~c;()logi~a a, .stari i de sanatate ~,L.89{1J~(g~,~~2£l.n.4,,g';,~!I2;~,"SQUlH,nllfbJe,

societate, In~.<.lJ.IJfizic,vnivers).'·· . . .

Par0tiigtlle(J}erspec(ive.des/u4iu ,yi de interventie uti Iizate In Psihologi~ Sa.rrat~tii:,.il . .C(:,,!~!?()ttament ah;i!:2iLID~£!£E!L~'~~"qmp9.'ot?m~.ntalijn"J11~Jltine;rea,~~Jl~.t~.ti,.L,~,~1l:ri.~£9ll.lip~ntru

111}bolnavirii;apJ,iqt[t!apriocipiil()r,erapiei conlportam.ental~illdelnersuJapljGati..v);il~('(;8f7it(~,g.{r;()JlIIJ(lstQrilor cognitivi 111mentinerea sanatatiisauriscuilli pentru Illlboln~yirii;

'-'apTiGal:~aprin~ipiiIo~tel'apiei cognitive1n dernersul aplicativ): .0> . psihofl::;iol(l~ictl Cil1t~rac;liuncadintre somatic~ipsihic Inrnentinerea ..sanatatii.s~uriscuilli

vi;~~;i":~if'llb?clnayirii;d~plicarea principii lor psihofiziologiei in deme,~s~jap(ic~iiv) ... ,,,.. ,,, ...,,.-""Cl:~:()f7Stl'l!(:tivistii( rolul factori lor socia Ii si cui tural] inconstnlcJi~?enJniJi.cgliiIQrleg<!!~S~Jlatat\'; ..

~b()alii.tratament); .. . ." '

., ,f.~~QIQg(f:{':~I~t!,~,gintr~iDqiyid ...~.i....u()iyers);

., S:'qlnunitarii(rollllgrl!plIll.lideapartenenta);.~, Gl(:ulturalii (roIIJlqiferentelorStIlturaleil}.O}entil1er~&1~~.~D.atatii);

Gl Qe,zvolliirii (roluletapelor de dezyoltare din ciciulvielU);@ fe.nlinisld (rolul genului social In vlllnerabilitatea/r·f:zisten~I:II~.b2a!A)'

4. Scurf istoric

_.Epo~a tirnRIJIie (de piat@}d.~Q~ti:~··et~~~-L:Qi'f~pFtea9i~v9Jl.!11Ji.indusa de factorii ...spirituali; ..bo..lnavuI.em...pqsed~t,A~.Qi~!XQttrat~.'ll:~ii.r·r.eraAel1aJl:lI~~pir'~4~1~,..~f:•.•recurgf:t,l-:':la s(!SritiFii.(bo.lnayul.:f(l.PJ,t§JoJr"url,loc,aAluR-it-peot.rJlca?iavollifsapiraseascac; •.pul}. .... . .....'.

'.'~~,~~~~Jl~ilQn~£m.t:,.~Jv,tr~,.iQ:~<lq~ mecIisi!l~...naturist~, ideea tal iSl11antl.IHi...~ia ~lmIJ:t~J.QJ·

perioada antichitatii

5

..,,.'

Pxih%gill .\'i'inlilfi{ii Tanana Turchiml

Izvoare ~SUprilU11~Lorielltaripe care astazi 0 numim psihosomarica pot f IntalnHefll l1le9j~jD~Greciei'alltice. fnTe~lileietorur~l"pioi1eruI' 1l1edici,ii"= llrp6ClrAT~-'::'·Q()~fuleaz~fapt~fGi..pe,i!ru~-~=:Cun"oa~t~· ...~~--=-~.....,..,.:.. ..~.~,;.,;..~~'i»= ..•...~y~. .... '." '_.' •.:.. .-:.~..:.-- ~- .• - . ~ "f'-<",~o::;._,_,_~, _'::';:,.)p;;:';; ... :;;;";"(:'i;~:,~-.. .c.-:--,~•.•..-,.;., .•• "~-"'~-"~3.'-""';;'"'""""--~'r<.r.:' x'c'_~

.fP!]?1:!L<2Ll~~~~.s.s.lW!!II?J;!l';~!:UL~~Je!E~Ql~ie sa a-ven15~P9~t!nte q~~PJ~~lQtit\i!~l~~cauze ~o!:1n.veOerearealizar,ii-:j.'i'ii'YJ6ilaIlLetLologiccomplet. Hipocrate preconiza' necesitate(j~ul)oa~teYii"con§t~me,

i"~' :;,;1f:.8~i~"""~~~ ..•..-.,·,:,?:;>"- • ..,.,.··,·",;.:~··,,:-.t.:·,;~,~:,:-~-;-..~. :-.':'.::: :...••.": -:-:i{":;':,;,,<:,:,_;,~:,,:.~,;, .•.• , .•:.•.••. ' __ .....: ..••• --'-- .••••a.:.:...;;.,,;_.:;;':-:;;..~ .••.,_,.•..•.•••.... --.-----""- .•-"'-'~."~---,~.~.~,. ••.•••~ •. "~ •.• ,, .••.•.. :--~~.;.~.;.-- •.-~.-, •... ;. '. "-' '<-,- --..':~..~~,: ...•. >'::;---" _. _,•.••.

•. a.'!L~ja(J.r~~~i~~r!L,R§Illice~pr~syn.l.~ianle,di uI~i fizic .~isoc ial a l.b?1navul,ui-.H ,ipqcra,te"prive$fe'fiziclIl'~ipsihicul'c,a'~u;;-,itaie:',I3oalaest~' indlls~-d'tull dezechibru al celor 4 tilnori.dill Organls~l'Ts'ahge,'hna'

Cneagrit,bilagalb~;l(tiegl1l~) carela'nlndu,lsauslmt induse de stai'ieI1l6tion-ale~""'" ." _- .."".'~'~-,,' -' :,. " .:," ":" . '. -,,", ." -. ",,, .... ,.;.' ,;,~.... ".' . -".-

CLAUDIUS GALEN-:- medic grec. care a pus bazele medicinii europene a demonstrat corelatia intre. ~o~~t1mf31lzica'-'~itendintefe~om u lui,'Pentru e I su nefur~I'spi ritii IsunfsCfa-~en~Yrupu1nt'txisia-linslaTe1. rational la nivel de cr~ier ce reprezintacentrual senZatiSL·EXlst<raolJ~rsUl5s·uf1ete~lr~.H<i~~re:'~iflulB.e:ntru. fcmci ~i unu] pentrub.jrQati- Subsufletu] nlasculi'I~-este'·I(;~alizatlgl1.ivelurilli;llTi,subslJi~t~;1 fel;lin~lfiind iocalizat la nivelulficatlli~f._···--·-~-='""· .._- .." .

,In .Iinii. geDer,~Je.sep?ateafirll1a, ca antishitatea a recunoscut unit~tea sornato __p~jhic~~rompvat,o'7;1'~dTcY~K'T~0T~tlc~,;gropalista.ill'care d'atei"eps'ihorogi ce-coil"stitt:iTal'JhF'il;e;'te~'se~tG Ie.•ln~70ea··etl.·.opatogenetlca.·.§·i'ol:jentareaterapeutiCa:"fIl'a'il'sar;i'[)TLr"Ci:i'loa'te'~i'lled,cT;;"a'anilchTiijit'a'Liiil1infi1:l'a

'," . --:' '... .- ... ', '. , .••.. -..,.:::.--... ,:... " '<:.";i"·,'/.;,:;,,,,,.;,:·,,,,~j,,",:;·,,,, __,·,,,-.,·,,~;.r,; __,-",""' __" .~...........,._"¥,,,,- .............•_-..o---"""·-~-<-o....;,.,:"::;';:i<';;';';;';"-"~;(M<"'> '~">""'·~-_"i"·~"·~i:,'-_ ••.•~.,.-,-..-,....,..:o.,~~".••."'~".'" .•.. ,

~~n,~L,de7-voltani.m~t~.r.i~!.ist7.~s,~~,P9!'!t~.s.9.!1~J:irera.ca illlp()rtal~~a..I~gat':'E.i,I,()r,p~iI~i.S~E,8!:t~~.~t~~tr~s.ltQ9~s.utaIn peri<?agel~(;ivilizatie,ilJabi.lo,I1.t;ne".grecesti ~i,romaiie, desi natura acestor.rel~!iiaJ().st)llte,.r.Pr~tata,-diferit, Ill,functie de variabilele culturale.· ..,. .

....•-- .,-::,--::---~--.--,-"---.,---,,,-,,-.-, '- - ...:.'. ""., .•... _. -~---:.

.E;.vulJ]lcdiu~~~llMJ:~j,ljgi,,!p.ediunu perrnite qet~§area un~0r..,L9~19V~5~J29a!~Jl.E~H':l~£t~d£jJ~"ho~<?,mat!~a.!?q?!.~t~SJ<::P_t:;l,t~R~I!~.g.c:.~21)~ecintaa pacatului. iar~iur¢!:<::a~,;Ilt;de~psa,epidemiile sl~tpeqeRse cotective

"p~ntrllpikatele savaqite. Medicul vindeca bolnavulprin tortl.'.~L·-·- .~...,.---,-., ..-...__- C:. --. ,.,:',. "': ,'.' -, -' '. '''''',:"",,',,-.,,''. ,..', '. .~,'.',"J'-"" ','--- "----..••.••.•.~ ,;,...-:."., ~

p,erio,!.pa renasteri i

.!:ranspar iq,ei-:; su.D.etulparaseste trupul dupa moarte. Boala este priyita ca 0 perturbate a ~I,nuior~all ~i11113intre?ului~or~.· - .

..~,,-,--:

,~erspectiva dualists a lui DESCARTES ( I596-1650) desp(}rt~,m.inre(t de trup, In Di~:f/!:!:L.ap,lpra~le!odelsi, apoi, ihMedto{iiiapare renurnita fraza, ,.gdndesc. deciexist'\princart:~esugereazii sLarca

••..:gand;1:€a~i¢9)},~tli{lt(lg~ndirii sint substraturile reale ale fiint~i.J5.£~~~ttR'Iv,~~'i<i;jSFrei~ii~.~:I~_tiJ<\leseparata compl~t.~e c?rp, asrfel ca ,.ll!,Crul_.~~I~~~2r'.:}~!Il"s~,pal:~.t95dE~l?,~.I,I,1~~~.l~c!t!£!::,

In sec.XVII SYDENHAM indeamna medicii spre a' distinge natura psihica sau organics a uneiafectiuni, ilustrata clinic prin sirnptome asemanatoare. EI a reactualizat etiologia psihogena a diverselorafecti un i cunoscute, introducand III med icina ceea ce autori i moderni nurnesc "psihologism".

ldeile lui Sydenham sunt dezvoltate de Baglivi, care subliniaza rolul ernotiilor ce nu sunt numai unconcomitent al tulburarilor somatice, ci si cauza lor directa. intrucat dupa cum afirma -"este un adevar

! i.' evident pentru tot i ell () mare parte din boli isi trag originea sau sunt alimentate de grijile care apasii\" pe umeriifiecaruia. "L_ .. ,

Miscarea psihosomatica,<F~anz~Iexan?er (1891,-1964) - a incercat sa actua liz:ez~~e?'·i!l(:l.~.!.,t';~~!,d,J?~?£~.[~J"£,£Q,~~~~.'

"dili urma transforrnari in psihologiaum~na. Acestia au identiticat,caagresiunilereprezentative au 0. ,~eosebita importanta asupra cauzelor afectiunilor psihosomatice. -AI~x;~(j~'~-de' asernen'ea"pune ac~~t, pe ..illegerea 6rgal1lillli~;- ....'. "" .--~-.- .._ ..-. so . un conflict specific genereaza un sistem specific vulnerabil

'0 ~SOillanZaI'eacoraii~~tuI~,decl,,;ge 'irIVl'rt'~tea"u'ileT'~elllnifi~~'iiiIn 'acesf sens, pelltri:t"cr soil1atlzarea "conflictului s~s~ realize~e intr-un mod .Jnteligibil'' este alesorganul care prin simptomatologia sa sugereaza contlictul psihic. Organul ales ca .victima" este

t~ '0

•

6

Tatiana TlIrchin~

organul sacrificat, care va servi drept sediu al manifestarilor clinice, este acela care poate exprima citmai sugestiv esenta conflictului psihic.Teoria lui Alexander a fast criticata, considerate ca un rnodel rnecanicist.

Helen Flanders Dunbar (1902-1959), inca In 1935 a fost prima care a folosit termenul de::psinosoinatic'f\~ln iilnb~l""e.ngl~z~. Doctor Inm-ediClna~-pura)ar·~:S:t»aTafpsinaniiTiza"Triilntede·ceraeat-

L •.;.....,.' ~ __ ,~._ •. .-c"' . ,"' ...',- ... ~ _ ,',_, ". __, __ ~__._,,~;;..:..:...... ..........., ••_ ..~_"'--""''''''':....... . ~~'"'

doilea razboi mondi.?1 la Viena si la Berlin, .adica acunoscut doetrinaortoodox3:]rslfianaiifica alui S.freud, dar ~'i doctrinefe ,:~-refiC"e';aJelujC. Jung~i- A:-fX-dter. ~De"aceea;::g~h~aiJ~il"ia~:n~i~eroarte'eC1iCfic~;t$,-respi;~ge 11LII11erO'as~tez~ale ps-ihanali~e i';:~ lasice" ..J9tu~i, ad 111ite Ill~~~-~~;P;rt~~t~

:";';':;,' •• ;....O:···,.:''''¥.;_i •••••'•••;~' ..••.••••'''"~\v·.·"'''';.;_,<·.:-~' .."'·.',.,.~,''''-,.'''~":,;:_:,: ..,;'',':,_'.,.",;:;,,',\,, .. :,'' ..~.•.• .;., :-', ..,~.....'.:,..,,"':'.,.;': "'"',: .. :.'~:_. __ . '_'.. ,',' '.:.,' ''':::'''~~''-'-''':'''' ·'.-'C•..•. ~."- .•••:' '·.-.-.-.._,--i~:,·'~""'--':.·~~i;.,;.;,-.·;~<:i!· .... '. ,~",;":,*",~;..,.~,;<;",._~,,",,,--,

a,c'lcnllllentelor trarte inlllieac9pil~r:ie~pe care I~ eQnsiderad~cisivep~ntrjJdezvortal:ea~cara~terlJlui $i~ fimd~n~~r9L'~~u,. il~=qlll pprtal~i ~n~,~,I"~},~l9j~.~cl~,~0~Jl~lL9c~."~1~~i~Jlji\1~ili.aJ,..soS iilJ) iBE§!~~iQILa1. EstecetCcalllOdul In care un subiect rcactioneaza la 0 ernotie .actuala' depinde intr-o oarecare masura $iq~_tt;e<cutYI,~_~u.de sensibilizarea sa afectiva, de faptul ca a suferit sau nu traume afe:stiye in treeut.

v.: -., ..•.•. ~ .... __ ,-'''.'' _ ... , _ .. _-.__ . '_"_".,_, __,_ ' •... , c',' . . _, . __...• ~_ ..•..•• ~·7;:··-;.:.~::~:C:. ~.. :..-~- .._.,.._.: --···-:.v...:.:.:;,:;~~·."...,

lnroarsa In SUA, Dunbarexarnineaza bolnavi somatici oili'tr-ol1ia-re"-cliilica; caurand la suferinzi deaceeasi afectiune, caracteristici afective comune. moduri sirnilare de a reactiona la stirnulii din mediulexterior, capabi Ii sa dea nastere unor reacti i emotionale. Ea demonstrcaza ca bolnavii, suferind de_~~ea~ a tee tiune au un r~rotil a I pc rsonal itali i COI11Un. C lr-ajlli()I:urmctoaeiorwsl~lils'fice:-'ctrceteaz'ap~rs.<?n~Jrt~teaoolfla VI ioi- -ar~rf~~hea fecTili'n,'sOI!l~t}c~-:~G'~~I:~e,~t(},,,,,a~~htmii'"flll~prorlrarpersonamam~"pentru fi;cm:e-"'gTT~"~m~~bQ1T-so;;~at'iC-c:~"c~~.,,-'"<,.,-' "'.-," '-·-.'.-_;"'.7,,~r"'-"'''":';'-:'-''S;=E"$'6~4"~*- ••.. - '- ,,J

. "'-Cil~toate:a(;~~tea:multe profiluri de personalitate dcscrise de Dunbar $i de elevii sai sunr foarteasemanatoare intre ele ~i apoi ce profil de personalitate are acel bolnav care sufera de diabet ~i inacelasi timp este hipertensiv?

S. Pregiitirea psihologului in domeniul siiniitii{ii

I. Cunosiirue teoreticefundamentale:I. LdcpsihoIog.ia sanatatii ~i alte ramuri ale psihol<?Eieiip. sociala, clinica, psihQtcra,J;lit;.,...ctc,);

: "';"~""''''''''', "..' '"""";'-' _'_"_"'.~"""",.,_".,~••..,.,,,,..:,,...:,,.,",,,......,...,...•~~,,~,,,,".••~-,,,," ---. ~"""""""""""""""",,,,~,, ,,_;<".t"'~"'--'~

1.2. dinilltediscipline (ex.il'le'aicina preventiva, rnedicina comunitara, sanatate publica.soc i0 log ie. a 11tr;QP~iogTe) ."~~--'"~--~---~'-----"--- --'-_, .w,,·~. ~_·,o-

II Ahililliilfu'1dan~(!J!!ale j~~nln/.~,l l.lrnunca.preclinica si clinica',

cornunicareevaluare

- "diagnosticarcproiectare de programc populationale de interventieiiiiplernentarea programelor poplii~i~ionale deinterventieeonsiliere ~i psihoterapie

".i.nteryentii individuale ~ide:"grnp11.2.;;,Jnuneade.eer~etare11.3. activitat! de instfuiJe,alltr~llc;\.n~~i. s_lJP-~.ryi~'.lLe11.4. activitati de management

6. Reltuia Psihologlei Siilllltii{ii ell alte discipline

*~ih?-Ipgi~.· s~naJ~.tii ..njlldun.d9nl~n}1I inter~iscipli.n~r uti 1 izea:a. ~i P~I~~ ..I(l·,9isp?zit}~.,S.M~~Q,~ttnl~.,~jtehnici din/pentru mat multe ramun ale pSlhologlel.Totodata, datonta caracterului relativ nou al

'---c- __-_. _. --,_"-: .• _ .••.. ',-,," '.' ~ .••...•• - ..•• '-·'~"-:-·'·7'·;":":_".,.~<",=,,"''--:--''''·''"'C;~''''_'''''~'~·~'>'>:'''''~''-

disciplinei, mai persista"f,OJlfu:z:ii In diversi termeni relationati ...•. .,;..-". • • ---'-".0 -,_ ~.-..o-."y:;;,,+ ';:. ,.;.,::":~~··.- __o_,.•,--,-••••._~

~..• ' . ,..,:.'

'7

Psi/w/ogia .winiilii!ii Tanana Turchinii

~ Psihologia clinica - dit~r~Jlta lntre cele doua discipline consta In faptul ca psihol~,gia cll~ic_a-.vi'Zdiia 'mai ales tulburarile ernotionale si boala mentala, in timp ce psihologia sal~atatii se'foc;alizeaza pe stares global a . de sanatate. r2.t\.!J,J~ctodlor. psiho-sociali 111' e!i2Jqgi~",~~!iisomatice (boala cardio-vasculara, cancer. SIDA).~_reactia~i!cjaptarea ~i recuperarea din, boala

. somaticaacuta (ex. infarct miocardic) sau cronic:3. (ex. colo'n'~i;1iabii)," C6ncep'iele~~r~teo;lnedezvoltate de psihologia clinica (teoriile "anxiet~tii. deR~~,si~L..J~'lbur~r.il~L".~t~.Jl~A:~..QJlaI~tate,

.diagnosticul clinic)}Hnt deosebit de relevant~ pentru psihologia sanatatii.

Ii Psihoterapia ~i Consilierea ofera psihologiei sana@ii cunostinte si tehnice. de lucru cu:Patientii, cum slll}tceleprivitoareia relatioiiarea psif:iolog~ pacient, modalita:rid~nlodiflc:,,!~~_acognitiilor nerealiste. a stai-ii eiilof;oi1ale--negafive'sau ale comportamentelor defic:jtax~·-- '.' ""',". .','. . . .'. ---------_. .

Q} Psihologie medicala este un termen care acoperea panaaculll. trei deccni] oqL.~Q.a,"12~u:t~",,gLQdom en iu I psihol()¥i ~i..~a.~~t~JiL~I~~;~JJS11~L!~,,~g~.~!2L~~1~L""P.Hli.Q...,vctiJi,zat In ..LI,Iti.mE..~.~~i..8f1~2J'}Ja<ca~actsn'llli,~~u.X~s.ti:ictiv~"Psihologia,., fJ1edicala se focalizapreponderent pe relatia medic _.

- pa'2.ieiit sipe adaptarea bol;lavului la mediul spitalicesc~istareade boala.

e Psihosomatica c.ontllreazaun dorneniu interdisciplilHlX, situat la gran ita dintre llle9icill~LG.U.ni.ca'iOU..*'"" ' .••.. :- -c· ....." ~:":'~~~;~':'''''''''~''''''~';'~''''''''''''-'';''''''''''';':'':'--''; ,;.;"~,,,,~.:.,.-.c..__,'.-:__".-" ,.' ."'" .,. ' .• ,,' ..';:, - •..., .•~.... '" -·'-:",·.C'<"':';':, ~':o:::.:'"""_':_'-'_~:"_~.• c.", ""'"",;" " ..... c..-',.: :~~,;"'.;".:. ~J",""",_~_=""".~"~"" ,."",.'<-- "",.

~I. psiilo1ogie car~ .~,t~Cllt Sariera panajn 1:inij60: Datorita faptului ca'inodelele sale expl icativesi teh'llici]~ deinte,:~en'ii~';'~'baz~~"p~~po";d'~re,~i pe paradigms psihanalitica, astazi termenuleste tot mai putin utilizat. ~~J1.ij~4lwJJ£;9j,si.u.1..c...QnW9xt1:ln1~!JJ.<!.lb.l?,~ihpLQgiasanatatii. sau. celde consultarie de legarura (consultation liason) au 'I~at In mare Ill'as~r~ '-'iocuTCerl~i'<' de:-ps~~5lliilii~Hc~r " __'~"""C>;~~"'·~·Y· .

e Medicine bahavioristd este un termen care de multe ori e~te considerat sinonim cu.celde. ~;~fhologia ·'sallatAti-i. Decele n~~i multe o';i:"p'FeteF,nraoop~n~~~;~ '~_T,t'enll((11 .'s~l~"'·'artuT-.~~te

-==~-,,,,,,:,,-_.,",,,,,,,,,,,,",,,,,,,,,,,,,;,'_;_. ,~,;"";.-~.. :'-;"-"~"'--.-.C:.: -. ." __, . . '•. ' -., -:_ ·.·;:;~'i'7'-'·=·.''7-~-,,?,,·''.·-·.:-:.~r:-- -. .--,..- .....,...••~ 'r-- *'~~~~~~ __.._<:L~~.rf.1~)natade domcniul din dfre'provin specialistii care ll utili~e~za, psihologiesag mt:diciila,

._, .... . . .,·-.c··'··.. . __ ,." ".-.~,~~ __=, .Totusi, consideramutila precizarea unor difererrte. Scopului prinlordial al medicine]comportamentale cste integrarea stiintelor cornportamentale cu cele medicale: de asemenca,medicine comportarnentala acorda prioritate utilizarii tehnicilor comportamentale in medicinaclinica fata de preventia imbolnavirilor si promovarea sanatatii. JJ:!..psihologia sanatatii ierarhiaobiectivelor este .,u~or diferita: ..asa cum am ara,ta,k,.oJ?L~.<;;JjXHL.,,£':iJ.i!2!]:@r~~~~iB][e,!<sanatatii ~i prevenirea imbolnavirilor: asist?re.9_p{:r~()iine:iin starede boala este un obiectiv ce

,~fecllrge din eel' enlllitat anterior. . .,-- -.-~ -,.~ ..--,.- -.-,-----~~.~~.~--

: '.j.

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