Ce diaporama a bien été signalé.
Nous utilisons votre profil LinkedIn et vos données d’activité pour vous proposer des publicités personnalisées et pertinentes. Vous pouvez changer vos préférences de publicités à tout moment.
BEHAVIORAL
SCIENCE
Dr. Dalia El-Shafei
Lecturer, Community medicine
department, Zagazig university
How to understand humanHow to understand human
behaviorbehavior
HEALTH
PROBLEM
 May take many different components,
therefore it may be viewed in the form of.
HEALTH BELIEF
MODEL
HBM can explain:
BACKGROUND
Theorists:
(1950’s) Group of social psychologists
Trying to explain why people were not
participating in dis...
PERCEIVED
SUSCEPTIBILITY
Subjective belief that a person may acquire
a disease or enter a harmful state as a
result of a p...
PERCEIVED
SEVERITY
Belief in the extent of harm that can result
from the acquired disease or harmful state
of a particular...
PERCEIVED
BENEFITS
Belief in the advantages of the methods
suggested for reducing the risk or
seriousness of the disease o...
PERCEIVED
BARRIERS
 Concern that the new behavior will take
too much time.
 Their belief could be actual or imagined.
SELF-EFFICACY
Confidence in a
persons ability to
purse a behavior
CUES TO ACTION
To cause a force that would make
a person feel the need to take
action.
 Advice from a doctor, or friends...
1ry Prevention example for HBM
Should I get the H1N1
vaccination?
CONSTRUCTS &
APPLICATIONS
 Perceived
susceptibility
 How likely is it I
will get swine flu?
Perceived
severity
Perceiv...
CONSTRUCTS &
APPLICATIONS
 PerceivedPerceived
BarriersBarriers
 Is it available-Is it available-
what’s the cost?what’s ...
HBM IN HEART
CONDITION
Chest pain sometimes affect performance
(Perception) of risk & its seriousness
Middle aged male wit...
Perception of benefits
Realize they adopt a healthy behavior (enjoy life,
carry work & not get ill)
Perception of barriers...
STAGES OF CHANGING
HEALTH BEHAVIORExit
Maintain
safe life
Pre
contemplation
PRE CONTEMPLATION STAGE
Person has no
awareness or no
motivation for the
need to change
habits or lifestyle
CONTEMPLATION STAGE
People enter this
stage when they are
thinking about
change or have
enough motivation
to enter the cy...
COMMITMENT “PREPARATION”
STAGE
Willing to make
serious decision to
change.
ACTION STAGE
Actively begin
to change.
MAINTENANCE STAGE
People struggle to
maintain change.
RELAPSE STAGE
Early exit from the cycle due to
false belief of satisfaction.
EXIT STAGE
People are settled
into changed
behavior & can exit
the cycle from the
revolving door
ILLNESS
BEHAVIOR
ILLNESS BEHAVIOR
DEFINITION:
How the patient
ThinkThink...... Feel & ReactFeel & React
when he develop any symptom
CLINICAL TIP OF THE ICEBERG
PHENOMENON
Only MinorityMinority of
the patients visit their
physicians
MajorityMajority of
th...
 I am a patientI am a patient
 I am weakI am weak
 I need helpI need help
It is not easy to show your
weakness
Why pati...
Symptoms (Biological ProblemBiological Problem)
is notnot the only reason for
patient seeking medical help.
The Real Reason for Patient attendance
Idea
Concerns
Expectation
Effect
Feelings
IllnessDisease
++Physical
Symptoms
Comprehensive Approach
Idea
Concerns
Expectation
Effect
Feelings
Illness frameworkDisease framework
++
(McWhinney 1984
DOCTOR’ BEHAVIOR
Pts feel frustrated
doctor behalf badly against minor complaints
Pts feel doctors uninterested
Both types...
PRESENTATION OF
SYMPTOMS
Experiencing symptoms may be presented as:
1.Perceiving any change or deviation of body
functions...
VARIABLES INFLUENCE ILLNESS
BEHAVIOR
 Visibility of symptoms & signs.
 Extent to perceive as serious.
 Extent to disrup...
PATIENT
COMPLIANCE
A CHRONIC PROBLEM!!A CHRONIC PROBLEM!!
Hippocrates once wrote
that patients often lied
about taking their
medicine.
Adhere...
 Patient compliance describes the degree to which
a patient correctly follows medical advice.
 Most commonly, it refers ...
PATIENT’S COMPLIANCE
 Adherence to the advice of health care
professionals [includes]:
1. Preventive health behavior.
2. ...
PATIENT’S
INCOMPLIANCE
Almost 50% of prescribed medications
have health impacts.
Doctors may be effective with only with...
CATEGORIES OF
MEDICATION NON-
ADHERENCE
PRIMARY
NO PRESCRIPTION
SECONDARY
 INTENTIONAL
UNINTENTIONAL
53
Kira
n
Sha
rma,
...
10/22/1554
OBSTACLES TO PATIENT
COMPLIANCE
Kira
n
Sha
rma,
Assi
stan
t
Prof
esso
FACTORS ASSOCIATED
WITH ADHERENCE
 First:
Pts has to understand what they are really
asked to do.
 Second:
Pts must reme...
COMPLIANCE
AIDS
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Behavioral science
Prochain SlideShare
Chargement dans…5
×

Behavioral science

Community medicine

  • Soyez le premier à commenter

Behavioral science

  1. 1. BEHAVIORAL SCIENCE Dr. Dalia El-Shafei Lecturer, Community medicine department, Zagazig university
  2. 2. How to understand humanHow to understand human behaviorbehavior
  3. 3. HEALTH PROBLEM  May take many different components, therefore it may be viewed in the form of.
  4. 4. HEALTH BELIEF MODEL
  5. 5. HBM can explain:
  6. 6. BACKGROUND Theorists: (1950’s) Group of social psychologists Trying to explain why people were not participating in disease detection programs. (TB Screening) Theorists: (1950’s) Group of social psychologists Trying to explain why people were not participating in disease detection programs. (TB Screening)
  7. 7. PERCEIVED SUSCEPTIBILITY Subjective belief that a person may acquire a disease or enter a harmful state as a result of a particular disease.
  8. 8. PERCEIVED SEVERITY Belief in the extent of harm that can result from the acquired disease or harmful state of a particular behavior. SEVERE (death)
  9. 9. 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.
  10. 10. PERCEIVED BARRIERS  Concern that the new behavior will take too much time.  Their belief could be actual or imagined.
  11. 11. SELF-EFFICACY Confidence in a persons ability to purse a behavior
  12. 12. 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
  13. 13. 1ry Prevention example for HBM Should I get the H1N1 vaccination?
  14. 14. 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?
  15. 15. CONSTRUCTS & APPLICATIONS  PerceivedPerceived BarriersBarriers  Is it available-Is it available- what’s the cost?what’s the cost? Cues to Action Self Efficacy Posters, Emails,Posters, Emails, commercialscommercials I am confident II am confident I can be healthycan be healthy
  16. 16. 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
  17. 17. 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
  18. 18. STAGES OF CHANGING HEALTH BEHAVIORExit Maintain safe life Pre contemplation
  19. 19. PRE CONTEMPLATION STAGE Person has no awareness or no motivation for the need to change habits or lifestyle
  20. 20. CONTEMPLATION STAGE People enter this stage when they are thinking about change or have enough motivation to enter the cycle.
  21. 21. COMMITMENT “PREPARATION” STAGE Willing to make serious decision to change.
  22. 22. ACTION STAGE Actively begin to change.
  23. 23. MAINTENANCE STAGE People struggle to maintain change.
  24. 24. RELAPSE STAGE Early exit from the cycle due to false belief of satisfaction.
  25. 25. EXIT STAGE People are settled into changed behavior & can exit the cycle from the revolving door
  26. 26. ILLNESS BEHAVIOR
  27. 27. ILLNESS BEHAVIOR DEFINITION: How the patient ThinkThink...... Feel & ReactFeel & React when he develop any symptom
  28. 28. CLINICAL TIP OF THE ICEBERG PHENOMENON Only MinorityMinority of the patients visit their physicians MajorityMajority of the patients are in the community The Tip of The Iceberg
  29. 29.  I am a patientI am a patient  I am weakI am weak  I need helpI need help It is not easy to show your weakness Why patients may deny their Illness?
  30. 30. Symptoms (Biological ProblemBiological Problem) is notnot the only reason for patient seeking medical help.
  31. 31. The Real Reason for Patient attendance Idea Concerns Expectation Effect Feelings IllnessDisease ++Physical Symptoms
  32. 32. Comprehensive Approach Idea Concerns Expectation Effect Feelings Illness frameworkDisease framework ++ (McWhinney 1984
  33. 33. DOCTOR’ BEHAVIOR Pts feel frustrated doctor behalf badly against minor complaints Pts feel doctors uninterested Both types of feelings influence subsequent consulting behavior & medical ttt adherence & health.
  34. 34. PRESENTATION OF SYMPTOMS Experiencing symptoms may be presented as: 1.Perceiving any change or deviation of body functions. 2.Interpretation of ill health symptom. 3.Explore seriousness through Severity. Familiarity of symptoms. Duration of frequency. 4.Evaluation of symptoms that require further action (illness behavior).
  35. 35. 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. PATIENT COMPLIANCE
  37. 37. A CHRONIC PROBLEM!!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: πποκράτηςἹ
  38. 38.  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 PATIENT COMPLIANCE (ADHERENCE OR CAPACITANCE)
  39. 39. PATIENT’S COMPLIANCE  Adherence to the advice of health care professionals [includes]: 1. Preventive health behavior. 2. Keeping medical appointments 3. Self care actions. 4. Taking medications as directed.
  40. 40. 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. CATEGORIES OF MEDICATION NON- ADHERENCE PRIMARY NO PRESCRIPTION SECONDARY  INTENTIONAL UNINTENTIONAL 53 Kira n Sha rma, Assi stan t Prof esso
  42. 42. 10/22/1554
  43. 43. OBSTACLES TO PATIENT COMPLIANCE Kira n Sha rma, Assi stan t Prof esso
  44. 44. FACTORS ASSOCIATED WITH ADHERENCE  First: Pts has to understand what they are really asked to do.  Second: Pts must remember what they are told.  Third: Pts must be satisfied with the doctor & consultation.
  45. 45. COMPLIANCE AIDS

×