Health Psychology Contributions to the Indian Health

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First published 2023
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ISBN: 978-1-032-28751-5 (hbk)

ISBN: 978-1-032-42105-6 (pbk)
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DOI: 10.4324/9781003360858

Typeset in Bembo
by KnowledgeWorks Global Ltd.
Dedicated to
Professor I. Ramabrahmam
The Inspiration Behind This Volume
CONTENTS

List of Figures x
List of Tables xi
Contributorsxiii
Forewordxix
Prefacexxi
Acknowledgementsxxv

PART I
Holistic Approach to Health1

1 Evidence-Based Health Care: Contributions of Health

Psychology3
Meena Hariharan

2 Health Communication as a Preface to Management of

Non-Communicable Diseases 25
Sunayana Swain

3 Health and Well-Being for All: Policy Perspectives in the

Indian Context 41
Ramya Chitrapu

4 Implementation Research for Public Health and Preventive

Health Care in India 54
B. R. Shamanna
viii Contents

PART II
Health and Well-Being of Individuals in Society 71

5 Residential Crowding and Subjective Well-Being:

Mediating Role of Helplessness73
Surendra Kumar Sia and P. S. Neethu

6 Health in the Culturally Changing Underdeveloped Adivasi

Communities86
Purnima Awasthi, Madhurima Mukherjee, and R. C. Mishra

7 Smoking and Alcohol Consumption Among Type 2

Diabetics: Health Behaviour Models-Based Investigation 98
Eslavath Rajkumar, J. Romate, R. Lakshmi,
and G. T. Kruthika

PART III
Psychosocial Factors in Cardiovascular Diseases 113

8 Psychological Necessities of Patients Electing Cardiac

Bypass Surgery: A Review and Roadmap 115
Marlyn Thomas Savio

9 Illness Perception and Adherence Behaviour in Patients

with Coronary Artery Disease 127
Arti Singh and Shikha Dixit

10 Optimizing Hypertension Management: Children as

Adherence Monitors for Adult Patients143
Sandra Roshni Monteiro

PART IV
Psychosocial Factors in Diabetes Management 157

11 Illness Perceptions and Quality of Life of Diabetic Patients:

Role of Perceived Control of Internal States159
Meera Padhy and A. Sheila Kumari Valli

12 Illness Perceptions and Diabetes Self-Management:

A Mixed-Method Approach177
Chelli Kavya
 Contents ix

PART V
Critical Care Needs and Psychological Support191

13 The Intensive Care Unit Experiences and Repercussions:

Need for Psychosocial Care193
Usha Chivukula

14 An Interpretative Phenomenological Analysis: The Unmet

Information and Supportive Care Needs of Cancer Patients206
Mahati Chittem, Matsungshila Pongener, Sravannthi Maya,
and Shweta Chawak

Index222
FIGURES

2.1 Public Health Care System in India.33

4.1 What Is Implementation Research?56
5.1 Proposed Model for the Mediating Role of Helplessness on the
Relationship Between Crowding and Well-Being.77
5.2 Structural Model for Crowding and Subjective Well-Being
Mediated by Learned Helplessness.79
8.1 Elements of the Biomedical Approach (left) and the
Biopsychosocial Approach (right) to CABG care.123
10.1 Bar Graph Representation of Percentage of Successful and
Unsuccessful Reminders of Hypertension Management
Record Booklet Documented by Children for Parameters
of Medicine, Exercise, and Diet.153
14.1 Interpretative Phenomenological Analysis Process.209
14.2 Flow Chart of the Themes.210
TABLES

1.1 Top ten causes of death in children in the age group of

5–14 years in India between 2010 and 20135
3.1 Total budgetary expenditure vis-à-vis health expenditure and
percentage of gross domestic product (GDP) at the central level
in India – a glimpse47
3.2 Health infrastructure in India – an overview (as of March 2021)48
5.1 Descriptive statistics, validity measures and correlation
coefficients of the constructs79
5.2 Standardized regression coefficient and bootstrap analysis
of the indirect model crowding and subjective well-being
through helplessness80
7.1 Association of the HBM, TPB, and SET domains with
smoking behaviour103
7.2 Association of the HBM, TPB, and SET domains with alcohol
use behaviour105
9.1 Demographic details of participants131
9.2 Multiple regression to identify predictors of various dimensions
of Adherence Behaviour Scale133
9.3 Identified themes, subthemes, and codes134
10.1 Mean (M), standard deviation (SD), and t values of
hypertension knowledge and its subscales among children
participants (N = 181) 150
10.2 Mean (M), standard deviation (SD), and t values of
hypertension knowledge and its subscale among adult
participants (N = 181) 151
10.3 Mean (M), standard deviation (SD) and t values of hypertension
compliance and its subscales among adult participants (N = 181) 151
xii Tables

10.4 Mean (M), standard deviation (SD), and t values of mean

arterial pressure of adult participants (N = 181) 152
11.1 Correlation between demographic variables, dimensions of
illness perception, perceived control of internal states, and
dimensions of QoL (N = 150) 166
11.2 Multiple hierarchical regression analysis for demographic
variables, subscales of illness perception, and perceived control
of internal states predicting QoL (satisfaction) 167
11.3 Multiple hierarchical regression analysis for demographic
variables, subscales of illness perception, and perceived control
of internal states predicting QoL (impact) 168
11.4 Multiple hierarchical regression analysis for demographic
variables, subscales of illness perception, and perceived control
of internal states predicting QoL (social and vocational worries) 169
11.5 Multiple hierarchical regression analysis for demographic
variables, subscales of illness perception, and perceived control
of internal states predicting QoL (diabetes related worries) 170
11.6 Multiple hierarchical regression analysis for demographic
variables, subscales of illness perception, and perceived control
of internal states predicting QoL (total) 171
12.1 Demographic characteristics of participants phase II 179
12.2 Summary of simultaneous multiple regression for illness
perceptions predicting diabetes self-management 182
12.3 Themes and their sub-themes 183
12.4 Themes and their sub-themes with illustrative quotation 184
13.1 Frequencies and percentages of stressors in the ICU 197
14.1 Demographic and medical information 208
14.2 Interview topics and sample questions 209
CONTRIBUTORS

Purnima Awasthi is Professor of Psychology at the Department of Psychology,

Faculty of Social Sciences, Banaras Hindu University, Varanasi (UP), India. Her
research interest includes health psychology, cross-cultural health psychology,
social psychology, rehabilitation psychology, and positive psychology. She
is primarily interested in the study of health beliefs and practices of people
from different sections of Indian society, and their application to community
development. She has contributed scientific research papers to various journals
of national and international repute and also chapters in edited books in the
areas of health psychology and Community Development. She carried out an
Indian Council of Social Science Research project entitled ‘Understanding and
Management of Some Critical Health Problems in an Underdeveloped Kharwar
Tribal Community’. She also published books on ‘Leadership’ (2009) with
PHI, New Delhi, ‘Write Your Script: The Scientific Way’ with White Falcon
Publishing, Chandigarh, and ‘Power of Emotional Intelligence: Incredible Tool
to Become Healthy and Wealthy’ with Walnut Publications, Bhubaneswar, India.

Shweta Chawak, PhD, received her doctoral degree from the Indian Institute
of Technology Hyderabad, India. Through her PhD, she developed and tested
the feasibility of an intervention which introduced the question prompt list to
Indian cancer patients undergoing radiation therapy and their primary family
caregivers. Her research interests lie in health and medical psychology, with a
special focus on understanding and improving communication in health care
settings using a multistakeholder perspective.

Ramya Chitrapu was formerly Junior Research Fellow, Administrative

Staff College of India (ASCI), Hyderabad, India. Ms. Chitrapu is presently a
xiv Contributors

doctoral research scholar with the Department of Political Science, University

of Hyderabad, India. Her research interests include policymaking, public service
delivery, governance, and innovations in governance.

Mahati Chittem, PhD, is Associate Professor of Health and Medical Psychology

with the Department of Liberal Arts, Indian Institute of Technology Hyderabad
(IITH), India. Her research interests lie in chronic disease management (with a
special focus on cancer, endocrinology, and chronic kidney disease) and health
behaviour change (diet, exercise, and safe sex).

Usha Chivukula received a doctorate degree in Psychology from the Centre

for Health Psychology, University of Hyderabad, for her research in the area of
psychosocial care in intensive care units. Currently, she is working as a faculty at
the Centre for Health Psychology, University of Hyderabad, and has extended her
research into the areas of behavioural cardiology, community health psychology,
and child and adolescent health.

Prof. Shikha Dixit is Professor of Psychology with the Department of

Humanities and Social Sciences, Indian Institute of Technology, Kanpur,
India. She has been in the profession for the last 28 years and has contributed
significantly to areas such as health psychology and social representations.

Kruthika G.T. has completed a master’s degree in Clinical and Counselling

Psychology from the Central University of Karnataka during the 2017–2019
academic year. She worked on a thesis titled ‘An association of social cognitive
domains, self-care behaviour, and glucose control’ as part of her curriculum.

Meena Hariharan is a Professor and the Founder Director of the Centre for
Health Psychology. She joined the University of Hyderabad in 1992. She has
published about 100 articles in peer-reviewed journals and four books. Her research
work in the field of health psychology covers behavioural cardiology, ICU trauma,
coping with non-communicable diseases, and resilience studies. She has supervised
five PhDs in the last 10 years and five are presently working under her. She is the
Founder President of the Association of Health Psychologists and the Chief Editor
of Indian Journal of Health Studies. She is on the editorial boards of some peer-
reviewed journals and is a member of the Board of Studies in several Universities.

Romate J. has 25 years of experience in teaching, researching, training, and

managing various administrative positions at the university level. He was
instrumental in the establishment of the Centre for Psychological Counselling at
Bangalore University (1994), the MSc Holistic Psychological Counselling in the
Department of Psychology (2000) at Bangalore University. He has also established
and been heading the Department of Psychology at the Central University of
Karnataka. He has more than 50 research papers published in reputed journals,
 Contributors xv

has attended 56 conferences and presented scientific papers, and completed

twenty research projects and eighteen academic consultancy assignments.

Chelli Kavya is currently working as Assistant Professor with the Department

of Banaras Hindu University. She has completed PhD in Psychology from
Centre for Health Psychology, University of Hyderabad. She has published
articles in various national and international journals. Her research interest is
health psychology.

R Lakshmi is a doctoral research scholar with the Department of Psychology,

Central University of Karnataka. Her doctoral research is in the field of health
psychology and focuses on health risk behaviours. She holds an ICSSR doctoral
fellowship and has worked as a Research Associate on an ICSSR sanctioned
major project. Her work has appeared in Bentham Science, Health Psychology
Research, Springer Nature, and Elsevier, among others.

Sravannthi Maya, PhD, is a psycho-oncologist and a health and counselling

psychologist. An alumnus of the Indian Institute of Technology Hyderabad
(IITH), her areas of focus are Oncology (with a specific focus on adult and
geriatric patients), Endocrinology (PCOD/PCOS and diabetes), End-of-life care,
developing coping tools for an Indian population, and death and bereavement
support. Her aim is to develop, test, and implement mental health interventions
so as to improve the overall quality of life among Indian patient populations.

Ramesh C. Mishra (DPhil, University of Allahabad) is Professor Emeritus of

Psychology at Banaras Hindu University, India. He has been a post-doctoral
Research Fellow and Shastri Research Fellow at Queen’s University, Canada,
and a visiting Professor at the Universities of Konstanz (Germany) and Geneva
(Switzerland). He has also been a Fellow-in-Residence of the Netherlands
Institute of Advanced Study, Wassenaar (The Netherlands) and a Fulbright
Scholar-in-Residence at Wittenberg University, Springfield (USA). He is the
Past President and Fellow of the National Academy of Psychology (India). His
research is focused on understanding ecological and cultural influences on human
development. He is the co-author of Ecology, Acculturation and Psychological
Adaptation: A Study of Adivasis in Bihar (SAGE) and Development of Geocentric
Spatial Language and Cognition: An Ecocultural Perspective and co-editor of
Psychology in Human and Social Development: Lessons from Diverse Cultures.

Sandra Roshni Monteiro is an Assistant Professor with the Department of

Applied Psychology, GITAM School of Humanities and Social Sciences, GITAM
(Deemed to be University), India. She was a recipient of Senior Research
Fellowship from the Indian Council of Medical Research and had qualified for
ICSSR Centrally Administered Doctoral Fellowship and UGC NET. She also
received the Gold Medal in M.Sc. (specialisation in health psychology) from
xvi Contributors

the University of Hyderabad. Her PhD research is about finding a sustainable

biopsychosocial health care solution for optimising hypertension management
by tapping onto children’s role and value as family members. Other than the
area of behavioural cardiology, she has published papers and is working in the
areas concerning childhood stress, adolescent health, positive psychology, and
occupational health.

Madhurima Mukherjee is a research scholar with the Department of

Psychology, Faculty of Social Sciences, Banaras Hindu University, Varanasi
(UP), India. Her interest lies in studying the cross-cultural adaptation and health
of ethnic minorities.

Neethu P. S. is currently working as an Assistant Professor with the Department

of Sports Psychology, Central University of Rajasthan. She has completed PhD
in Applied Psychology from Pondicherry University. Her core areas of research
include environmental psychology, sports psychology, and health and well-being.
She has published articles in various national and international journals and also
edited a book published by an international publisher. She is the recipient of Prof.
Deepak Bhatt Award and Dr. Barbara Hanfstingal Inspa award.

Meera Padhy received her PhD from Utkal University in 1996. She was a
recipient of UGC JRF fellowship during her PhD. She has been associated
with the Centre for Health Psychology, University of Hyderabad, India, since
2007. She has published extensively on health psychology, developmental
psychology, and occupational psychology in national and international
journals of repute as well as presented in many conferences. Her work has been
recognised with awards like the best Health Psychologist, IPERA, in 2013 and
the best paper presenter award in the 52nd and 21st International Conference
of the Indian Academy of Applied Psychology in 2017. Her research interests
include behavioural diabetology, occupational health, social support, leisure,
and well-being.

Matsungshila Pongener, MSc, is a PhD scholar with the Department of

Liberal Arts, Indian Institute of Technology Hyderabad (IITH), India. Her PhD
is focused on cervical cancer related lay understandings with interdisciplinary
approaches from medical anthropology and public health. Her interests also lie
in bringing together a confluence of making mental health more accessible to the
general population with widespread awareness and affordability.

Eslavath Rajkumar is an Assistant Professor with the Central University of

Karnataka’s Department of Psychology in India. Currently, he is also Affiliate
Assistant Professor with the University of Washington’s School of Social Work,
USA. Since 2014, he has been working in the field of health psychology,
health risk behaviours among tribal and rural population, behaviour change
 Contributors xvii

interventions, social cognition, and rural health education. His notable works
have been published in prestigious journals such as Nature Portfolio, Sage,
Elsevier, Springer Nature, Frontiers, Hindawi, Taylor and Francis, and Bentham
Science publishers. He is also a project director and co-director for DST-Satyam,
ICSSR-funded, major projects.

Marlyn Thomas Savio currently works as a Behavioural Scientist for wellness

& resiliency in TaskUs, a multinational business service provider and digital
innovation company. Previously, she worked in clinical and teaching roles
in health care and academia. Her research interests include interventions for
chronic and terminal illnesses, occupational well-being, and phenomenology.
She received the Prof. Anima Sen award for excellence in research (2017), Gold
Medal in PhD (2017), and Prof. Deepak Bhat award for best paper presentation
(2013). Her contribution to the peer review process of journals was appreciated
by Elsevier (2018). She is a chartered psychologist (CPsychol), registered with the
British Psychological Society.

B. R. Shamanna is a medical doctor by training with postgraduate degrees in

community medicine, maternal & child health, social & preventive medicine,
community eye health, and medical law & ethics. He served as a PHC Medical
Officer at the beginning of his career and then was instrumental in setting up
two WHO Collaborative Centres for Prevention of Blindness in Madurai, Tamil
Nadu, and Hyderabad, Telangana. He has been Visiting Faculty in the Master’s
program at the London School of Hygiene and Tropical Medicine since 2002 and
also has been certified as a Public Health Leader by the NIH supported project of
Emory University, Atlanta, Georgia, USA. He has developed the Public Health
portfolio at the University of Hyderabad.

Surendra Kumar Sia is presently working as a Professor with the Department

of Applied Psychology, Pondicherry University. He has done his MA, MPhil,
and PhD in Psychology from the University of Delhi. Prof. Sia has more
than 17 years of teaching and research experience and successfully supervised
nine PhD scholars and two MPhil students. To his credit he has more than
30 research publications in journals of national and international repute like
South Asian Journal of Human Resource Management, Benchmarking: An
International Journal, Asia-Pacific Journal of Management Research and
Innovation, Global Business Review, Management and Labour Studies,
Vision: The Journal of Business Perspectives, Journal of Indian Academy
of Applied Psychology, Indian Journal of Industrial Relations, and Social
Science International. His areas of interest include organisational behaviour,
environmental psychology, and psychology of the elderly.

Dr. Arti Singh is Assistant Professor of Psychology with the Jindal School of
Psychology and Counselling, O. P. Jindal Global University, Sonipat, Haryana,