Psychology

The patients state of mind has been the repeated subject of scrutiny for the purpose of finding alternative curative practices. That is to say, how the patient perceives and responds to his or her situation has been related to the probability of health improvement. State of mind may be affected either by the patients assessment of his or her situation or it may be affected by external factors which cause the patient to develop an affect response. Studies have revealed that whether a patient engenders a positive or negative state of mind has a corresponding effect on a patients health and medical condition (Baker, 2007).

In the present study, state of mind will focus on the patients assessment of his or her situation, particularly that of his or her medical condition. This is to be referred to as the patients disposition. In prior studies, patients diagnosed with particular medical conditions were monitored for improvement in their particular cases. However, few studies have studied the effect of a positive disposition on the general clinical health of an individual. The purpose of the present study is to examine the effect of a persons positive disposition on the number of times that he or she requires doctor consultation and the number of times that he or she gets sick. In the succeeding sections, prior research conducted in this area of study will be reviewed in order to fully understand the variables to be examined. The review of prior research will also develop a basis for the nature of the relationship of the variables allowing an educated hypothesis as to the results of the present study.

Literature Review
In order to better understand the goal of this research and the method through which such goal may be achieved, an assessment of prior research conducted in this field must be conducted. Prior research has classified disposition into optimism and pessimism. Optimism has been consistently found to be a predictor of treatment outcome and better physical recovery (Allison, Guichard,  Gilain, 2000). This shows that optimism is able to improve chances of healing when it is present in a specific medical situation. Individuals who are admitted as patients find that their chances of improvement and discharge improving when they retain a positive outlook regarding their medical condition.

There are however fewer instances wherein optimism has been related to a study of the general or overall health of an individual, particularly one who has not been admitted for a particular diagnosed disease. Some studies which have had this focus reported that individuals who were optimistic about their health also enjoyed healthier lifestyles and were sick less often than individuals who did not have an optimistic mind set about their health.

Optimism has been identified as a coping mechanism employed by individuals found to be in highly stressful situations (Baker, 2007 Fry, 1995). Because of the positive outlook engendered in the midst of trying situations, optimists have been found to engage in behaviors directed towards the improvement of the self. Therefore, optimists have been found to resort to exercise over drinking and smoking when faced with difficulties (Baker, 2007). Optimism has also been found to boost a healthy self-esteem thereby promoting a greater awareness of physical changes and symptoms (Fry, 1995). This allows optimists to prevent developing health threats rather than ignore them.

From the above it is shown that optimism promotes a health-conscious outlook for the average individual. This allows the individual to respond to the bodys needs thereby promoting greater health. In a sense, dispositional optimism regarding health is a self-fulfilling prophecy. Optimism therefore allows for greater possibility of recovery for patients diagnosed with particular diseases. Moreover, optimism encourages a healthy lifestyle for individuals who have not been diagnosed with illness. The subsequent portions will discuss how dispositional optimism and health may be measured given that the present study seeks to study the effect of optimism in promoting not just a healthy lifestyle but the active avoidance of illness.

Measuring Dispositional Optimism
Studies have viewed disposition as a construct with two poles (Scheier  Carver, 1985). One pole being the optimism end and the other pole the pessimism end. This meant that a decrease in one would lead to the increase in the other. Thus, optimism and pessimism were viewed as being affected by the same set of factors and the absence or presence of these factors determined to which pole an individual gravitated towards.

However, studies coming after Scheier and Carvers study viewed disposition as having two separate poles. Pessimism and optimism were observed to be affected by different factors (Baker, 2007). The optimism and pessimism categories were separated although they were admitted to be related. The emergence of this new categorization of disposition did not overthrow the prior perspective. Chang, DZurilla and Maydeu-Olivares (1994) came to the conclusion that the two-scale model of optimism and pessimism reflected that optimism was the more accurate predictor of health outcomes. This meant that in the previous studies where a one-scale model was used, it was mostly optimism that revealed a change in health. The pessimism construct was not found to be a good predictor.

In the study conducted by Fry (1995) wherein the construct of optimism was studied as a moderator of health outcome, the one-scale model of Scheier and Carver was still used. The studys goal was to assess the moderating effects of coping strategies used by females to handle stress in the work environment on their health. The results of the study supported the theory that the one-scale model of Scheier and Carver could accurately measure the degree of a persons optimism. The findings of the study supported the hypothesis that optimism helped working women to cope with their stress thereby providing moderating and maintaining health.

In Bakers study (2007), the Scheier and Carver model for measuring optimism was also used. The two-dimensional model was also used to ensure the reliability of the study results. The study revealed that the one- and two-dimensional models reflected similar effects between the relationship of optimism and health. Thus, either of the two models could have been used to reach the goals of the study. Bakers study (2007) attempted to find out the effect of dispositional optimism on the long-term health of individuals. Optimism was found to be related to health behavior. It was concluded that optimism has a direct effect on daily health experiences of individuals because of its capacity to decrease the stress experienced when handling day-to-day activities.

The above-mentioned studies show that the one-dimensional model of measuring optimism is still being used in current studies and that it is reliable. The study conducted by Mroczek, Spiro, Aldwin, Ozer and Bosse (1993) concluded that the essential factor in establishing the relationship between optimism or pessimism and health was the presence or absence of trait negative affectivity. They found that the absence of negative affect rendered irrelevant the patients degree of optimism or pessimism as regards the quality and improvement of his or her health.

These studies show that Scheier and Carvers model of measuring optimism is a reliable model to utilize in the current study. First, it has been shown to result in the same statistical findings as the two-dimensional model. Second, the measurement takes into consideration the presence of negative affect thereby ensuring the condition for the relationship between optimism and health. Finally, the nature of the studies wherein this measurement was used focused on general health questions, in contrast with the majority of studies which focus on specific medical conditions. Therefore, this measurement would be a good predictor of optimism and will be applied in the current study.

Measuring Health Outcomes
The second aspect of the present study focuses on the health outcomes which result because of the level of optimism espoused by the individual. Previous studies will reveal what particular predictors of health were measured by researchers in order to ascertain the improvement or degradation of health. Fry (1995) utilized a health self-report measure wherein participants were asked to indicate the variety of physical symptoms that they experienced. These symptoms were tied up with several physical illnesses.

Baker (2007) held a more general perspective in her assessment of health outcome. The number of hassles experienced by participants, their reported global health status index, their URI symptoms, and their probability of drinking, smoking, and exercising were all taken into consideration. Unlike Fry, Baker not only measured the symptoms of particular illnesses but she also measured the tendency of participants to engage in health-promoting and health-debilitating activities. Baker was thus concerned with the overall health of the individual and not simply their tendency to develop sicknesses and illnesses.

A study conducted by Allison, Guichard, and Gilain (2000) used dispositional optimism to predict the health-related quality of life of patients diagnosed with upper aerodigestive tract cancer. The one-dimensional model of the optimism measurement was employed in the study. The researchers used socio-demographic data and clinical data to assess the level of health-related quality of life of the patients. They concluded that higher levels of optimism improved the health-related quality of life of patients. Given the specificity of the health issues studied, it was appropriate for the researchers to use clinical records to ascertain the health quality of the participants.

The present study doesnt focus on any one illness but is concerned with the capacity of the patient to avoid disease and illness as a result of the levels of optimism experienced. The study will therefore access clinical records in a general way in that the number of visits participants made to hospitals or clinics will be tallied. The number of times that the participants have reported feeling ill will also be tallied. The frequency of engaging in health-promoting activities, such as exercise and the like, will also be tallied. These measurements will reflect how an optimistic disposition affects the clinical health of individuals.

Optimism has been shown to be a predictor of enhanced recovery for patients. It has also been shown to promote engaging in health-promoting activities. Given these findings, it is hypothesized that the present results will show that optimism not only promotes a healthier lifestyle but that it also results in a decreased frequency of illness. Therefore, it is hypothesized that high levels of optimism will result in fewer numbers of clinical records and hospital visits while resulting in greater frequency of exercise and other health-promoting activities.