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Person-centered Health Promotion in Chronic Disease
1Wallace Renard Professor of Psychiatry, Genetics, & Psychology, Washington University in St. Louis, USA.
None:
Health promotion must be person-centered, not organ- or disease-centered, in order to be effective because physical, mental, social, and spiritual aspects of human functioning are inextricably intertwined. Chronic medical disorders, such as heart disease, chronic obstructive pulmonary disease, diabetes, cancer, asthma, and arthritis, are strongly associated with immature personality, emotional instability, and social dysfunction. All indicators of physical, mental, and social well-being are strongly related to the level of maturity and integration of personality, so personality is a useful focus for the promotion of well-being. Assessment of personality also facilitates the awareness of the clinician and the patient about the patient's strengths, weaknesses, and goals, thereby contributing to an effective therapeutic alliance. Health, well-being, resilience, and recovery of function all involve increasing levels of the character traits of Self-directedness, Cooperativeness, and Self-transcendence. Person-centered programs that enhance self-regulation of functioning to achieve personally valued goals improve compliance with medical treatment and quality of life in people with chronic disease. Effective therapeutic approaches to health promotion activate a complex adaptive system of feedback interactions among functioning, plasticity, and virtuous ways of thinking and acting. The probability of personality change can be predicted by high levels of Self-transcendence, which give rise to an outlook of unity and connectedness, particularly when combined with the temperament traits of high Novelty Seeking and high Persistence. In summary, person-centered psychobiological treatments that facilitate the development of well-being and personality development are crucial in the prevention, treatment, and rehabilitation of chronic medical diseases.
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