Psychology Applied to Optometry
Course Syllabus
1.
2.
3.
4.
5.
6.
Psychology and visual health
Non-version communication
The visual exam
Performance of the visual exam
Giving bad news
Difficult patients and managing complaints
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
STRUCTURE OF THE THEME:
1. The psychology of health
2. The prevention of illness
3. Biomedical model and
biopsychosocial model
4. Psychological and social aspects
relative to vision
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
1. psychology of health
HEALTH AND ILLNESS:
•
•
OMS (1964): state of complete
physical, mental, and social wellbeing. It is not merely the
absence of illness or ailment.
ILLNESS: Deviation from the
state of good health
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
• Behavior when ill: the global response of the
individual to illness.
• Illness has a different meaning for every
individual which can affect its evolution and
even its appearance.
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
PSYCHOLOGY OF HEALTH:
• Field of psychology that interrelates the physical and
behavioral aspects of health and illness
• Establishes recommendations for the interaction between
healthcare professional and patient
• Tries to clarify and explain why certain damaging behaviors,
such as smoking, continue
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
Basic suppositions of the Psychology of Health
•
•
•
•
Certain behaviors increase the risk of contracting certain
illnesses (behavior is a risk factor)
The modification of certain behavior can reduce the
probability of contracting certain illnesses
Behavior can be changed relatively easily
Psychological interventions can be performed effectively
with a favorable cost-benefit analysis
THEME 1: PSYCHOLOGICAL AND VISUAL HEALTH
2. The prevention of illness
PREVENTION:
•
•
•
PRIMARY: behavioral strategies to prevent the appearance of
illnesses still absent
SECONDARY: strategies to eliminate or control existing
problems before they worsen
TERTIARY: strategies to reduce the probability of relapse in
already treated conditions
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
3. Biomedical model and biopsychosocial model
a) BIOMEDICAL MODEL: physiological and physical aspects of
illnesses
–
–
–
–
–
–
–
–
Pathologist
Reductionist
Curative
Mind-body division
Biological diagnosis
“Segmented” patient
External treatment of patient
Distant doctor-patient relationship
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
b) Biopsychosocial (Engels, 1977)
•
•
The line between health and
illness is unclear
Doctors strive to maintain good
health
PARADIGMS OF THE TWO MODELS
BIOMEDICAL MODEL
BIOPSYCHOSOCIAL MODEL
Avoid illness and postpone death
Promote health and improve the quality of life
Prevent illness
Reduce risk factors. Promote healthy lifestyles
Act on causes
Act on risk factors
Only healthcare professionals and technicians
intervene
Other sectors of the professional “community”
intervene
Multidiscipline
Transdicipline
Team work is desireable
Teamwork is unavoidable
Diverse professional sectors and social
participation are desireable
Diverse professional sectors and social
participation are the base of the model
Doctor-patient relationship is adjective
Doctor-patient relationship is fundamental
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
EXAMPLE: treatement of a child with short-sightedness
BIOMEDICAL
MODEL
BIOPSYCHOSOCIAL
MODEL
THEME 1: PSYCHOLOGICAL AND VISUAL HEALTH
BIOMEDICAL MODEL:
• Cuantification of the refractive state
• Eye exam
• Advice on the most adequate glasses and lenses for
the case
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
BIOPSYCHOSOCIAL MODEL:
In addition to the previous tests:
– Knowledge of the child’s behavioral guidelines in the
familiy environment and at school
• Posture while reading or writing
• Illumination
• Whether the child has learning disabilities or
relationship problems with friends or classmates
– Explain the usefulness of following a program of visual
therapy
– Direct the patient to other relevant professionals
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
4. Psychological and social aspects relative to vision
• Psychology: present in many university programs directed
towards the science of health
• In optometry, psychology is important for:
–
–
–
–
Optometrist-patient relationship
Successful termination of treatment
Patient anxiety
Special groups: dislexic children, the elderly, people with intellectual
or aural disabilities
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
• Vision: coordinates the other senses
• An important source of emotional expression
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
• Vision: coordinates the other senses
• An important source of emotional expression
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
• Disconcertion upon failure of visual information
• Glasses or contact lenses: alterations to self-image
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
IMPLICATIONS FOR THE OPTOMETRIST:
• Stereotypes of those who wear glasses:
– More intelligent
– More honest
– Less attractive (especially women)
• First time they realize they need glasses: rejection,
disability
• Farsightedness: resistance
• Children with glasses: beware!
THEME 1: PSYCHOLOGY AND VISUAL HEALTH
• Poor vision, elderly people (visual degeneration).
Potential recourse
• Stereotypical blind person: solitary, destitute,
dependent, depressed. Sudden loss of vision results in
depression in 5-15% of cases
Be careful with certain
behaviors in front of blind
people!