BEHAVIORAL MEDICINE

Chapter 6
 INTRODUCTION
• Behavioural medicine is an interdisciplinary
applied science concerned with the
development and integration of behavioural
and biomedical science knowledge and
techniques related to illness and the
application of this knowledge and these
techniques to prevention, diagnosis,
treatment and rehabilitation.
 Fields involoved
• Psychology
• Sociology
• Anthropology
• Medicine
• Nursing
• Pharmacy
 4 areas covered
• Overview of theoretical basis
• Mind body connection
• Human stress response
• Placebo response
 Theoretical basis
• Can pharmacy students apply this theories.
• Health belief model(HBM)
• The purpose of this model is to explain and
predict why people make specific health
related decisions.
• The HBM predicted that individuals will take
action or not based upon:
1. Perceived susceptibility
2. Perceived severity of illness
3. Perceived benefit of taking action
4. Perceived barriers (cost)
5. Cues of action
6. Self efficacy
• HBM has been used to predict adherence to
medical regimen e.g warfarin,
benzodiazepenes
• It has also been used to predict adherence to
malarial prophylaxis
 LEARNING THEORIES AND HEALTH
BEHAVIOURS
• In order to change a behaviour, decision and individual
makes is not all that is required. External environment
in which the decision is made matters.
• Learning theorist, also emphasize on the importance of
consequences i.e rewards and punishments.
• The following learning theories relate to haelth
behaviour change:
• Operant conditioning
• Observational learning
• Self efficacy
 Operant conditioning
• Based on the argument that positive
behaviour response occurs if a person is
rewarded.
• Gradient of reinforcement- imediate rewards
are more effective than delayed rewards
 Observational learning
• Based on banduraa’s theory
• Defined as any learning that is learnt through
observing behaviours of others
• Learning manifests in a number of ways
including immitation.
• Individuals operating at various cognitive
levels respond differently to observed events
than they would respond to verbal or written
instructions
 Self efficacy

• Based on Banduraa’s
• People self regulate their action in line with their
predetermined goals.
• Most central to this theory is the idea that
people’s belief about the attainment of their
goals will influence the ability to attain their
goals.
• Has been used in the development of
intervention to improve nurse knowledge, self
efficacy and ability to perform nurse functions
 Mind Body Connection
• Belief that mind and body are connected goes
back to ancient times.
• Ancient greek and chinese conceptualized health
and disease as being due to natural causes.
• Believed that physical illness might be caused by
diseases within the blood and nervous system.
• They acknowledged one’s mind played a big role
in the outcome of the illness.
 Middle ages
• Health and illness were spiritual mediated due
to the widespread catholic churches.
• Scientific revolution changed this perspective
into the biomedical model.
• But it is criticized as it doesn’t account for
psychological and social factors that
contribute to health and illness
 Stress
• Stress and human physiology
• Biological processes interfered
• Impact of stress on pharmacists
• Pharmacy, genrally is a good job
 Placebo effect
• Placebo is a substance with no medicinal properties
that is used to treat physical or psychological
conditions.
• Placebos have been shown to have beneficial effects
on various physical and psychological disease processes
and this is due to the beliefs a pateint has whtere or
not the placebo works depends on the belief that a
patient has.
• This shows a powerful connection between mind an
body
• Suggestion- a term used to describe the process by
which a physical or mental state is created by thought.
 Medicinal interventions
• Relaxion
• meditation