1 1

BEHAVIOUR CONCEPT AT MEDICAL SCIENCES

INTEGRATION OF BEHAVIORAL SCIENCES TO MEDICINE

A. BASAK CINAR

HELLO !

MY NAME IS A. BASAK CINAR

IF YOU WOULD LIKE TO KNOW MORE ABOUT ME,

PLEASE CLICK ON MY PICTURE.”

“I am mainly interested at Behavioural Sciences at Medicine.

I have studied about “ Communication Pathways at Medicine, mainly at Oral Health Care” and “Oral Health Psychology” in common and at children specifically.”

This presentation is introduction to

“Integration of Behavioral Sciences to Medicine”

I health concept and its relation to behaviour

behaviours as dynamic patterns that can be transferred from one type to another

how to change negative health behaviours to positive ones, and communication process

holistic approach: integration of behavioural sciences to medicine

“Health is a state of complete physical, mental and social well-

being and not merely the absence of disease or infirmity.”

(http://www.who.int/about/definition/en/)

SO CAN NOT BE REFERRED TO NEGATIVELY AS THE ABSENCE OF DISEASE, ILLNESS, AND SICKNESS. RELIANCE ON A NEGATIVE DEFINITION OF HEALTH WILL PROVIDE LITTLE INFORMATION ABOUT THE HEALTH OF 80-90 PERCENT OF THE POPULATIONS. (Ann Bowling,1997)

DEPENDS ON MEDICAL AND NON-MEDICAL FACTORS

AMONG THOSE ONE FACTOR INTEGRATING AND AFFECTING EACH

BEHAVIOR

RESTORE,

MAINTAIN,IMPROVE (+) HEALTH

NON-MEDICAL DETERMINANTS OF

HEALTH

Better Worse

neutral state of healthHealth behaviours

Living-working conditions

Personal resources

Environmental factors

Health Behaviour

(http:/ / www.ahs.uwaterloo.ca/ ~hlth245/ lecture001.pdf)

X axis

Y axis

(0,0) not brushing

nonbrushing

Y axis

brushing

X axis

Figure 1: example for change at behavioural patterns on axial platform

? BEHAVIOUR ?

S

YSTEM OR UNIQUE & ALONE

If human beings are thought to be as open systems, most important factor keeping the continuity/aliveness of the system is behavioural models that are formed, as outcome of individual needs, expectations, wishes. Cognitive and emotional structure affect the forming, organisation, activation, continuity and improvement of those models and also set up the differentiation among individuals.

BEHAVIOR B

Directed to decrease inharmonity.Target goal is attractor.

BEHAVIOR A

Directed to increase inharmonity. Target goal is compeller.

BEHAVIORAL SYSTEM

“self”&self regulation

Self Centred Behavioural System

Figure 2: Behavioural System located around “self” centre

The concept of a postmodern self, states that the self is actually made up of many different selves, not just one stable self. It is multiple, adaptable and socially constructed. Then for example a woman might have family self (mother, wife, daughter,…), social relationship-self ( worker, friend, …), patient self. So self refers to the composite of ideas, feelings, and attitudes people have about themselves. (Morreale, Spitzberg, & Barge, 2002)

PLATENARY SELF

health

Child’s opinion about teeth brushing habits of his/her mother

Child’s opinion about his/her own brushing, intend to brush or not

Thoughts about the frequency of brushing

Feelings; dislike, like brushing

?

HOW TO??

X axis emotional factors

Y axis, cognitive factors ?

How to succeed communication with patient in most effective and efficient way, to achieve the most valuable outcome at health care service; patient with improved health and satisfaction that will lead patient’s compliance to health regimens at the long term.

EMOTIONAL

FACTORS

(FEELINGS,

EXPECTATIONS...)

COGNITIV

E

FACTORS

(KNOW

LEDGE,

THOUGHTS,...)

SOCIAL RELATION SELF

FAMILY SELF

PATIENT SELF

ETC.?

EMOTIONAL

FACTORS

(FEELINGS,

EXPECTATIONS...)

COGNITIVE

FACTORS

(KNOWLEDGE,

THOUGHTS,...)

SOCIAL RELATION SELF

FAMILY SELF

PATIENT

ETC.

DOCTOR SELF

PATIENT PSYCHOLOGY ( DIAGNOSIS )

INVESTIGATING DIFFERENT COMMUNICATION METHOD

ALTERNATIVESEVALUATION

CHOOSING THE SUITABLE COMMUNICATION MODEL

ARRANGING COMMUNICATION MODEL ACCORDING TO PATIENT,DESIGNING TREATMENT PLAN ON THE FRAME OF THIS MODEL

COMMUNICATION BEFORE, DURING AND AFTER TREATMENT AND FOLLOWING UP THE REACTIONS OF PATIENT

IMPROVING POSITIVE AND LEAVING OUT THE NEGATIVE COMMUNICATIVE PATTERNS WHICH ARE DETERMINED BY PATIENT’S BEHAVIORAL FEEDBACK ANALYSING THE PROBLEMS AT NEGATIVE FEEDBACK

CONTINOUS COMMUNICATION AND IMPROVEMENT OF POSITIVE HEALTH BEHAVIOURS

FOLLOW UP

PLANNING

ACTING

CONTROL

As patient’s compliance to health regimens mostly determines the success of treatment, rehabilitation, preventive measures, he/she should be taken into consideration as a system with biological-physiological subgroups and psychological processes.

Behaviour B (e.g NONsmoking) Behaviour A (e.g

smoking)

Figure 3

nurse

doctor

patient

Figure 4: Interaction between patient, doctor, nurse

Thus will bring out control over the bright futures of tomorrow

….and many questions starting with how…..

How to analyse this subgroups- subsystems -

among the perspective of system concept.

How to find out effective communicative pathways

How to define non-medical parameters relevant to health

How to improve the quality of lives , remembering that

only healthy individuals can take the responsibility of

their own lives and the society they are living in.

Responsibility will bring out endeavour and willingness to develop the quality at every single area in society.

Even in a simple system composed of patient, doctor, nurse answers are not so easy and with one choice. First step might be to remember prevention, treatment, rehabilitation should not be based on only medical parameters.Most effective solution may lay down on the concept of integration of Behavioural Sciences to Medical Sciences.Behavioural Sciences :“INDIVIDUAL’S BEHAVIOUR WITH ITS REASONS, GOALS; CHARACTERISTICS OF BEHAVIORAL PROCESSES; AND ITS RELEVANCE TO OTHER SCIENCES ARE STUDIED”THE MAIN SCIENCES THAT FORM BEHAVIORAL

SCIENCES : •PSYCHOLOGY• SOCIOLOGY

•SOCIAL PSYCHOLOGY•ANTHROPOLOGY

Provision of health services is a process and generally patient is the most common/identified input and outcome of this system. Patient with medical or non medical problems will enter system and then leave it as satisfied or dissatisfied.This mood will turn back to system by feedback as input. Patient maintained or improved his/her (+) health, is positive feedback whereas patient with the previous health or worser health conditions are negative for the system. So how to, at least maintain, the restored (+) health state. If the process chain between input and output is the key determinant, so then it might be better to define this process .

Patient with special needs and expectations; visiting health services

Patient with positive health outcomes, satisfied and accepted the offered new health behaviour;

leaving the health services

FEEDBACKD.S

B.S

M.S

P.S & S.S .

Interaction of sciences that forms the prevention, treatment and rehabilitation processes (transformation period)

Open systems have two main components, those are input and output (reference)

input output

System composed of many subsystems

Transformation process

???????

A patient with deep caries and pain

Input

Treatment

Black box; no any other interaction

Communicative Patterns based on

Behavioural Sciences

Marketing (2.level subsystem of behavioural sciences) e.g.affective and convincing communicative patterns...

Treatment and maintenance/improvement of positive oral health care, development of oral care behaviour:::::long term success

Psychology

e.g:Patient’s beliefs, thoughts, feelings, attitudes towards oral health care

Sociology

e.g. social norms, beliefs affecting the patient’s attitudes, thoughts, living conditions, social realities, environmental factors

………….

Social Psychologye.g. how affected from friends, modelling from family

outcome

White box

T

R

A

N

S

F

O

R

M

A

T

I

O

N

P

Figure 5

                          

               

               planing

treatment

Follow-upcommunication

control

• Communication; active process at every stage of health care service.• Communicative patterns can not be standardised for all patients because all patients have different needs, feelings, attitudes, expectations

KNOWLEDGESKILLSMOTIV

ATION

KNOWLEDGESKILLS

MOTIVATIO

N

KNOWLEDGESKILLS

MOTIVATIO

NRECEIVING MESSAGE

CONSTRUCTING MEANING

RESPONDING TO MESSAGE

knowledge

motivation skills

DOCTOR

PERCEPTION

PATIENT

Figure 6: Communication between doctor and

patient

MEDICAL SCIENCES ARE MAINLY FOCUSED ON “HEALTH” OF INDIVIDUALS

NONE OF OPEN SYSTEMS CAN LIVE WITHOUT INTERACTION WITH NEIGHBOURHOOD SYSTEMS

INDIVIDUALS ARE OPEN SYSTEMS ON CONTINOUS INTERACTION WITH EXTERNAL & INTERNAL

ENVIRONMENT.

MEDICAL SCIENCES ARE ON INTERACTION WITH THE SYSTEMS AFFECTING INDIVIDUALS

SO ONLY ONE WAY; MEDICAL TREATMENT; CAN NOT BE SO EFFECTIVE AT LONG TERM.

HOLISTIC APPROACH; INTEGRATION OF BEHAVIORAL SCIENCES AND MEDICINE MIGHT BE A KEY FOR A

SOCIETY WITH HEALTHY INDIVIDULAS

HEALTHY INDIVIDUALS ARE EMPOWERED FUTURE OF A SOCIETY

THANKS FOR READING

PLEASE REMEMBER THAT I WILL BE GLAD TO HEAR

ABOUT YOUR VALUABLE COMMENTS

basak.cinar@helsinki.fi