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Medical sociology.pptx

  1. Medical sociology Lijodi Brenda
  2. Health behaviour
  3. Health behaviour • Health behaviour refers to the activities people do that either maintain or improve their health or potentially harm their health. • The full set of health behaviours, then, consists of activities that promote good health (promotive, positive, protective, or preventive behaviours) and of activities that may harm their health (risky, negative, or dangerous behaviours). • It also the periodic activities we do to screen for various health problems • We learn many behaviors, including health behaviors (positive and risky behaviors alike) from our parents, friends, and other people
  4. Types of health behaviour  Health-directed behavior ◦ Observable acts that are undertaken with a specific health outcome in mind  Health-related behavior ◦ Those actions that a person does that may have health implications, but are not undertaken with a specific health objective in mind
  5. Types of health beahaviour  Preventive Health Behaviour ◦ action taken when a person wants to avoid being ill or having a problem e.g. a mother takes her child for immunisation  Illness Behaviour ◦ action taken when a person recognizes signs or symptoms that suggest a pending illness e.g. a mother gives her child cough medicine after hearing her wheeze
  6.  Sick-role Behavior ◦ action taken once an individual has been diagnosed (either self or medical diagnosis) e.g. an employee takes a vacation because he is ill, he takes treatment and obeys his doctor’s advice
  7. Models of behaviour change
  8. COGNITIVE DISSONANCE MODEL  The model holds that inconsistency is a painful or uncomfortable state  Since dissonance is psychologically uncomfortable, it will motivate an individual to reduce dissonance to achieve consonance  In addition, the individual will actively avoid situations and information that are likely to increase the dissonance
  9.  For example, if a respected role model with whom an individual identifies makes a statement or declaration with which the individual disagrees, consonance is achieved by either: ◦ (a) changing the belief, or ◦ (b) changing attitudes to the respected person.
  10. Maslow hierarchy of needs  Behaviour is motivated by a hierarchy of human needs  Explains why not everybody responds to the obviously beneficial and well-meaning interventions  Health needs may be compromised for the sake of satisfaction of low- order needs
  11. Safety needs - to feel secure and safe, out of danger Basic physiological needs - hunger, thirst and related needs Belongingness and love needs - to affiliate (follow) with others, be accepted Esteem needs - to achieve, be competent, and gain approval and recognition MASLOW’S HIERARCHY OF NEEDS Self-actualization needs - to find self-fulfilment and realise one’s own potential
  12. Health belief model • Two major factors influence the likelihood that a person will adopt a recommended preventive health action • First they must feel personally threatened by disease i.e. they must feel personally susceptible to a disease with serious or severe consequences • Second they must believe that the benefits of taking the preventive action outweigh the perceived barriers to (and/or cost of) preventive action”
  13. HEALTH BELIEF MODEL Demographic variable [age, sex, race ethnicity, etc.] Socio-psychological variables Perceived Threat of Disease “X” Perceived Susceptibility to Disease “X” Perceived Severity of Disease “X” Perceived benefits of preventive action minus Perceived barriers to preventive action Likelihood of Taking Recommended Preventive Health Action Cues To Action Mass Media Campaigns Advice from others Reminder postcard from physicilan or dentist Illness of familiy member or friend Newspaper or magazine article I N D I V I D U A L P E R C E P T IO N S M O DIFYI N G FA C T O R S L IK E L IH O O D O F A C T I O N
  14. HBM Concept Definition Perceived Susceptibility One’s opinion of chances of getting a condition Perceived Severity One’s opinion of how serious a condition and its sequelae are Perceived Benefits One’s opinion of the efficacy of the advised action to reduce risk or seriousness of impact Perceived Barriers One’s opinion of the tangible and psychological costs of the advised action Cues to Action Strategies to activate “readiness”
  15. P e r c e i v e d s u s c e p t i b i l i t y Y o u n g m a n h a s b e e n e n g a g i n g i n s e x w i t h m u l t i p l e p a r t n e r s . P e r c e i v e d S e v e r i t y Y o u n g m a n b e l i e v e s t h a t A I D S i s a d e a t h s e n t e n c e s i n c e t h e r e i s n o c u r e . P e r c e i v e d T h r e a t Y o u n g m a n b e l i e v e s t h a t h e i s a t r i s k b e c a u s e f r i e n d i s ill. C u e s t o A c t i o n R a d i o m e s s a g e s e x p l a i n i n g t h e n e e d f o r s a f e s e x . P e e r e d u c a t i o n o n s a f e s e x a n d H I V. B e n e f i t s / b a r r i e r s  C o n d o m s a r e e a s y t o u s e , o n e c a n f e e l s a f e  C o n d o m s n o t r e a d i l y a v a i l a b l e , c o s t l y D e s i r e d B e h a v i o u r Y o u n g m a n b u y s a n d u s e s c o n d o m s r e g u l a r l y. S e l f - e f f i c a c y Y o u n g m a n h a s h a d p r a c t i c e u s i n g c o n d o m s a n d f e e l s c o n f i d e n t t o u s e t h e m .
  16. Illness behaviour and illness experience
  17. ILLNESS • “Illness is a condition characterized by a deviation from a normal health state which is manifested by physical & psychological symptoms.” – Kozier.
  18. VARIABLES AFFECTING ILLNESS BEHAVIOUR 1. Internal Variables. 2. External Variables.
  19. INTERNAL VARIABLES • 1. Perception of symptoms. • 2. Nature of illness. • 3. Characteristics of person.
  20. 1. Perception of symptoms • It is the way of perceiving the symptoms of illness that influence illness
  21. If a person takes the symptoms not too seriously & takes adequate treatment, recovery will be quick, but if a person takes it very seriously , it may become life threatening or fatal for the person.
  22. Nature of illness • Nature of illness also affects illness behaviour. • As in the case of an acute illness when the person is taking treatment that will be
  23. Characteristics of a person • How a person responds to illness depends upon the adjusting, coping abilities. • He may become well adjusted to illness or may get mentally disturbed.
  24. EXTERNAL VARIABLES • 1.Visibility of symptoms. • 2.Social group. • 3.Culture & values. • 4.Economic variable. • 5.Accesibility of health care system.
  25. 1.VISIBILITY OF SYMPTOMS • The visibility of symptoms affects body image as well as behaviour. The clients with visible symptoms are more likely to seek more assistance than clients without symptoms.
  26. • E.g. A person with lip ulcer will seek medical help sooner than a person with sore throat because the lip sore has changed the physical look.
  28. 2.SOCIAL GROUP • Social group may assist the client in recognizing the threat of illness or support the denial of potential illness. • The clients responds positively to social support.
  29. 3.CULTURE & VALUES • The culture & values teach the client how to remain healthy & also how to recognize the illness.
  31. 4.ECONOMIC VARIABLE • The economic constraints may delay the treatment or may allow the client to carry out daily activities. • Studies have shown that persons of low economic status have chronic illness.
  32. 5.ACCESIBILITY OF HEALTH SERVICES. • The proximity of health services has great influence on individuals in utilizing the same.
  34. • The experience of illness of complex. The person generally passes through five stages of illness behaviour. • This pattern involves how a person seeks, finds & completes the health care.
  35. • 1.Stage I • 2.Stage II • 3.Stage III : • 4.Stage IV : • 5.Stage V : : Symptom experience. : Assumption of sick role. Medical care contact. Dependent client care. Recovery & rehabilitation.
  36. STAGE I – SYMPTOM EXPERIENCE • In the first stage, person feels that something is wrong but he is not able to diagnose the problem.
  37. • Perception of symptoms includes awareness of physical change like pain, rashes, lump. At the end of this stage , he is able to make the decision that it is a symptom of an illness.
  38. STAGE II –ASSUMPTION OF SICK ROLE • If the symptoms persist, then the client will assume sick role & seek confirmation from family & others that they are indeed sick. Then he gets excuse from normal duties & role expectations.
  39. • Assumption of sick role results in emotional changes such as withdrawal, depression, physical changes. The person may deny & delay the contact with health care system.
  40. STAGE III –MEDICAL CARE CONTACT • At this stage, the client acknowledges the illness & seeks explanation of causes, duration of illness & it’s complications. Health professional may determine whether the client is ill or not.
  41. • After knowing about illness some client seek medical treatment , but sometimes, they start denying the symptoms.
  42. STAGE IV – DEPENDENT STAGE • After accepting the diagnosis, client becomes dependent upon health care professionals to get treatment.
  43. • Here, the client accepts the care, sympathy, protection from the demands & stress of life.
  44. STAGE V – RECOVERY & REHABILITATION • This is the stage when the symptoms of illness get subsiding. The person starts regaining original health status.
  45. • In case of chronic illness, final stage involves an adjustment to a prolonged reduction in health & functioning.
  47. • An emotion is a bodily state which involves feelings that may be consciously or unconsciously motivated.
  48. • How the emotions are expressed or experienced depends upon person's basic personality, perception, situation & also extent of support.
  49. • By knowing the emotional responses to illness, nurse can anticipate different reactions & can encourage the client & family to express the feelings in a constructive way.
  51. 1. Fear. 2. Over dependence & feeling of helplessness. 3. Anxiety. 4. Hope. 5. Anger & hostility.
  52. 1.FEAR • Fear is an emotional response characterized by expectation of harm or unpleasantness. • Normally, the body reacts by attempting to avoid or withdraw from threat.
  53. • Patient with fear expresses it freely but, few explanations from the nurse can alleviate the fear readily, on the other hand some are reluctant to express fears.
  54. 2.OVER DEPENDENCE • During the period of illness, the dependence & feelings of helplessness usually increase up to the point they may be harmful for the client.
  55. • Nurse can observe the over dependency in patient & can assist the client to decrease it in a manner compatible with patient’s capabilities.
  56. 3.ANXIETY • Illness results in anxiety, & in anxious patients, insight is lacking. Anxiety leads to insomnia, diarrhoea, shift in Bp, fatigue & inadequate coping with disease condition.
  57. • The nurse should have proper knowledge about anxiety level of the clients & should know the interventions to reduce anxiety.
  58. 4.HOPE • Mostly people hope for the best & expect a long & healthy life. Physical & emotional equilibrium gets disturbed & even death may occur if a person gives up the will to live.
  59. 5.ANGER & HOSTILITY • Anger is an emotion characteristically associated with frustrations & struggling with an unpleasant situation.
  60. • It is commonly seen when the goal is blocked or cannot be achieved, or the respect for self has lowered.
  61. • Hostility is an unfriendliness that is associated with a desire for aggression. Sarcasm, abusive remarks are the expression of hostility.
  62. • The over demanding, unreasonable aggressive & argumentative patients may express their hostility through their behaviour.
  63. • Nurse should have complete knowledge about all these emotions, so that she can help the client to adjust / adapt to the situation
  65. 1.Impact of illness on client. 2.Impact of illness on client & family.
  66. 1.BEHAVIOURAL & EMOTIONAL CHANGES • Individual’s reaction towards illness depends on his attitude, nature of illness & reaction of others to it. Short term illness causes few behavioural changes in the functioning of the client & the family.
  67. • Life threatening or severe illness leads to more extensive behavioural changes such as anxiety, shock, denial, anger & withdrawal. • The nurse develops interventions to assist the client & family in coping with the stress.
  68. 2.IMPACT ON FAMILY ROLES • During illness, role of the client & the family members get disturbed, may be for shorter or for long period.
  69. • An individual & a family adjust easily to short term changes. E.g., A mother of two children with common cold continues to go to the work.
  70. • Long term changes require an adjustment process. The client & his family requires counseling & guidance to assist them in coping with role changes.
  71. 3.IMPACT ON BODY IMAGE • The reaction of a client & family members to illness & subsequent change in body image depends on the following :
  72. • 1.The type of changes. • 2.Their adaptive capacity. • 3.The rate at which changes take place.
  73. • 4. Supportive services available. • 5.The client responds to illness as in the way of shock, withdrawal, acceptance & rehabilitation.
  74. 4.IMPACT ON SELF CONCEPT • Self concept means individual mental image of themselves, like how they view their strengths & weakness in all aspects of their life.
  75. • The impact of illness on self concept is not easily observed, but when the concept gets affected, the person will no longer meet the expectations of family leading to anxiety, frustration & conflict.
  76. • While providing care, nurse must be able to observe changes in client's & family member’s self concept & then help them to adjust with the situation.
  77. 5.IMPACT ON FAMILY DYNAMICS • Family dynamics is a process by which a family functions, makes decision, gives support to an individual member & copes with every day changes & challenges.
  78. • Due to the illness impact on client, it leads to changes in the family dynamics. Nursing interventions should be devoted towards client as well as family members.