Positive psychological constructs

Attempts to identify the major components of quality of life are not new. It is a continuously evolving field. Celano et al. (2020) conducted a research study with 45 patients with heart failure and the efficacy of a positive psychology-based intervention to increase health behaviors. They found the use of positive psychology exercises and motivational interviewing lead to improvements in well-being and health behavior outcomes.

The following section includes a brief overview of the psychology movements that attempted to describe what constitutes quality of life, how they apply to patients at risk for heart failure and those who have heart failure, and the tools used to measure quality of life.

Most of the measurements for quality of life in health care for cardiovascular patients have been developed for patients experiencing heart failure, stages C & D. Recently the Center for Positive Psychology has been researching not only quality of life components for patients with HF, but also using the tenets of PP that help prevent the development of HF described in Stages A and B.

Positive psychological constructs

The humanistic psychology movement, which started in the 1960s, challenged the then somewhat deterministic vision of people presented by psychoanalysts and behaviorists. Abraham Maslow introduced to us insights into human needs. We were shown that humans have needs that occur in a hierarchy with the most basic needs being secured before we can move up the ladder to acquisition of higher needs. The original five needs are: 1) physiologic , 2) safety, 3) belonging, 4) esteem, and 5) self-actualization.

An expanded pyramid of human needs shown on the right has three additional levels of human needs that include: a cognitive need for knowledge and understanding, an aesthetic need for beauty and art, and the 8th level of human need is fulfilled when the individual transcends self through advancing the self-actualization of others.

Carl Rogers (1961, 1967), another humanistic psychologist, was in general agreement with Maslow’s assumptions. He described the need people have for an emotional environment that is real or genuine, offers acceptance (being seen with unconditional positive regard), and empathy (listened to and understood). These characteristics were important for the attainment of the self-actualization as Maslow described.

Important for those of us in health care are Roger’s descriptions of self-image. His belief was that people with high self-worth, positively regarded by others, treated with affection, and valued, have confidence and face the challenges of life successfully. He describes our tendency to have an ideal self-image that we attempt to closely match our actual self-image. Incongruence occurs when our vision of ourselves is different from what is occurring because of our choices or external events. If our ideal image is to be physically strong and we no longer can walk up a flight of stairs, our self-image is tarnished.

Carl Rogers advocates for client focused therapy which reinforced a person’s self-image by enabling them to be self-directed. Other humanistic theorists and researchers have followed. Carol Ryff has described well-being as consisting of six components: self-acceptance (positive evaluation of oneself and one's life), personal growth, purpose in life, positive relations with others, environmental mastery (the capacity to effectively manage one's life and the surrounding environment) and autonomy (Ryff, 1995).

Positive Psychology

One of the founding fathers of positive psychology is Chris Peterson, author of A Primer in Positive Psychology. According to Peterson, "Positive psychology is the scientific study about what goes right in life, from birth to death, and all stops in between. What is good about life is as genuine as what is bad and deserves equal attention by psychologists (Peterson, 2006, p. 4)."

Positive psychology integrates strengths, values and hopes with symptoms, weaknesses, and regrets. The therapeutic approach when using positive psychology is to not deny weaknesses or symptoms, but to amplify positive resources in patients like positive emotions, character strengths, meaning, positive relationships, and internally motivated achievements.

More recently, Dr. Howard Seligman from the University of Pennsylvania further established the field of Positive Psychology. This scientific field of study is based on the belief people want to lead meaningful and fulfilling lives as well as a desire to be the best they can be. He and his colleagues have identified five components of happiness and well-being: positive emotion, engagement, relationships, meaning, and accomplishment (Seligman, 2011). Several researchers have found realization of these components is related to lower rates of depression and higher life satisfaction (Bertisch et al., 2014).

Check out the Positive Psychology website for more information and free quizzes. https://positivepsychology.com/