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Behavioral science

Human behavior

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Behavioral science

  1. 1. BEHAVIORAL SCIENCE Dr. Dalia El-Shafei Assistant professor, Community Medicine Department, Zagazig University
  2. 2. How to understand human behavior? Anthropology ‫االنسان‬ ‫علم‬ Sociology ‫االجتماع‬ ‫علم‬ Psychology ‫النفس‬ ‫علم‬
  3. 3. Aim Health Promotion Understand social context of health & disease Improving doctor-patient interaction
  4. 4. HEALTH PROBLEM Risk factor • Before disease actually occurs Screening • After occurrence of disease but before symptoms appear C/P • Symptom & Signs of a disease Complication • Consequence of the disease
  6. 6. HBM can explain: • People's perception. • Behavior towards it [susceptible]. Illness • Severity. • Seriousness. Realize • Demographic & psychological V. • Perception of benefits & barriers. Health Motivation
  7. 7. BACKGROUND Theorists:  (1950’s) Group of social psychologists  Trying to explain why people were not participating in disease detection programs. (TB Screening)
  8. 8. HBM Perceived Susceptibilit y Perceived Severity Perceived Benefits Perceived Barriers Cues to action Self-efficacy
  9. 9. PERCEIVED SUSCEPTIBILITY Subjective belief that a person may acquire a disease or enter a harmful state as a result of a particular disease.
  10. 10. PERCEIVED SEVERITY Belief in the extent of harm that can result from the acquired disease or harmful state of a particular behavior. SEVERE (death)
  11. 11. PERCEIVED BENEFITS Belief in the advantages of the methods suggested for reducing the risk or seriousness of the disease of harmful state from a particular behavior.
  12. 12. PERCEIVED BARRIERS  Concern that the new behavior will take too much time.  Their belief could be actual or imagined.
  13. 13. SELF-EFFICACY Confidence in a persons ability to purse a behavior
  14. 14. CUES TO ACTION To cause a force that would make a person feel the need to take action.  Advice from a doctor, or friends or propaganda
  15. 15. 1ry Prevention example for HBM Should I get the H1N1 vaccination?
  16. 16. CONSTRUCTS & APPLICATIONS  Perceived susceptibility  How likely is it I will get swine flu? Perceived severity Perceived benefits How bad would it be if I did? What do I gain by getting the shot?
  17. 17. CONSTRUCTS & APPLICATIONS  Perceived Barriers  Is it available- what’s the cost? Cues to Action Self Efficacy Posters, Emails, commercials I am confident I can be healthy
  18. 18. HBM IN HEART CONDITION Chest pain sometimes affect performance (Perception) of risk & its seriousness Middle aged male with stressful life Changing risky behavior Demographic & social variables Motivating health behavior
  19. 19. Perception of benefits Realize they adopt a healthy behavior (enjoy life, carry work & not get ill) Perception of barriers A friend or a doctor warned him that he is at increasing risk to become ill Cues for Action Work commitments reduce time for sports social events & fast food eating
  20. 20. STAGES OF CHANGING HEALTH BEHAVIOR Action Maintenance Relapse Contemplation Commitment Exit Maintain safe life Pre-contemplation
  21. 21. PRE CONTEMPLATION STAGE Person has no awareness or no motivation for the need to change habits or lifestyle
  22. 22. CONTEMPLATION STAGE People enter this stage when they are thinking about change or have enough motivation to enter the cycle.
  23. 23. COMMITMENT “PREPARATION” STAGE Willing to make serious decision to change.
  24. 24. ACTION STAGE Actively begin to change.
  25. 25. MAINTENANCE STAGE People struggle to maintain change.
  26. 26. RELAPSE STAGE Early exit from the cycle due to false belief of satisfaction.
  27. 27. EXIT STAGE People are settled into changed behavior & can exit the cycle from the revolving door
  29. 29. ILLNESS BEHAVIOR DEFINITION: How the patient Think ... Feel & React when he develop any symptom
  30. 30. React Doing nothing Self treatment Consulting Feel Worried or angry Blaming himself Blaming others Think Is it self-limiting? Is it serious? Is it very serious? Patient has symptom (Pain … Disfigurement …malfunction )
  31. 31. Only Minorityof the patients visit their physicians Majorityof the patients are in the community The Tip of The Iceberg
  32. 32. • I am a patient • I am weak • I need help It is not easy to show your weakness Why patients may deny their Illness?
  33. 33. PRESENTATION OF SYMPTOMS Evaluation of symptoms that require further action (illness behavior). Explore seriousness through Severity Familiarity of symptoms Duration of frequency Interpretation of ill health symptom. Perceiving any change or deviation of body functions.
  34. 34. VARIABLES INFLUENCE ILLNESS BEHAVIOR Visibility of symptoms & signs. Extent to perceive as serious. Extent to disrupt normal life. Persistence & frequency. Personal tolerance. Available knowledge & cultural assumptions towards symptoms. Needs to denial or compete with illness. Interpretation of symptoms (stigma). Understanding of health providers. Availability of suitable health service.
  36. 36. A CHRONIC PROBLEM!! Hippocrates once wrote that patients often lied about taking their medicine. Adherence to medication was a big problem then, and still is today. Hippocrates of Cos (ca. 460 BC – ca. 370 BC) Greek: Ἱπποκράτης
  37. 37. PATIENT COMPLIANCE (ADHERENCE OR CAPACITANCE)  Patient compliance describes the degree to which a patient correctly follows medical advice.  Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions
  38. 38. PATIENT’S COMPLIANCE Adherence to the advice of health care professionals Preventive health behavior Keeping medical appointments Self care actions Taking medications as directed
  39. 39. PATIENT’S INCOMPLIANCE  Almost 50% of prescribed medications have health impacts.  Doctors may be effective with only with 55-60% of pts.  Pts may become ill due to non adherence. 10-25% of hospital admission due to non adherence
  41. 41. FACTORS ASSOCIATED WITH ADHERENCE 1st • Pts has to understand what they are really asked to do. 2nd • Pts must remember what they are told. 3rd • Pts must be satisfied with the doctor & consultation.