BEHAVIOUR CONCEPT AT MEDICAL SCIENCES INTEGRATION OF BEHAVIORAL SCIENCES TO MEDICINE

1. BEHAVIOUR CONCEPT AT MEDICAL SCIENCESINTEGRATION OF BEHAVIORAL SCIENCES TO MEDICINE A. BASAK CINAR 1

2. 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.”

3. 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

4. "for a healty and bright future..."

5. “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)

6. RESTORE, MAINTAIN, IMPROVE (+) HEALTH DEPENDS ON MEDICAL AND NON-MEDICAL FACTORS AMONG THOSE ONE FACTOR INTEGRATING AND AFFECTING EACH BEHAVIOR

7. maintenance of health improvement of health restoration of health Health Behaviour NON-MEDICAL DETERMINANTS OF HEALTH Personal resources Living-working conditions Better Worse neutral state of health Health behaviours Environmental factors

8. Figure 1: example for change at behavioural patterns on axial platform brushing nonbrushing Y axis Y axis (0,0) not brushing X axis X axis

9. ? BEHAVIOUR ?SYSTEM 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.

10. BEHAVIORAL SYSTEM Figure 2: Behavioural System located around “self” centre Self Centred Behavioural System BEHAVIOR B Directed to decrease inharmonity. Target goal is attractor. BEHAVIOR A Directed to increase inharmonity. Target goal is compeller. “self”& self regulation

11. The concept of apostmodern 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)

12. PLATENARY SELF Child’s opinion about teeth brushing habits of his/her mother Feelings; dislike, like brushing health Child’s opinion about his/her own brushing, intend to brush or not Thoughts about the frequency of brushing

13. ? Y axis, cognitive factors ? X axis emotional factors HOW TO??

14. SOCIAL RELATION SELF EMOTIONAL FACTORS (FEELINGS, EXPECTATIONS...) PATIENT FAMILY SELF COGNITIVE FACTORS (KNOWLEDGE, THOUGHTS,...) ETC. 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. SOCIAL RELATION SELF PATIENT SELF DOCTOR SELF FAMILY SELF COGNITIVE FACTORS (KNOWLEDGE, THOUGHTS,...) EMOTIONAL FACTORS (FEELINGS, EXPECTATIONS...) ? ETC.

15. PATIENT PSYCHOLOGY ( DIAGNOSIS ) INVESTIGATING DIFFERENT COMMUNICATION METHOD ALTERNATIVES EVALUATION CHOOSING THE SUITABLE COMMUNICATION MODEL CONTINOUS COMMUNICATION AND IMPROVEMENT OF POSITIVE HEALTH BEHAVIOURS ARRANGING COMMUNICATION MODEL ACCORDING TO PATIENT,DESIGNING TREATMENT PLAN ON THE FRAME OF THIS MODEL IMPROVING POSITIVE AND LEAVING OUT THE NEGATIVE COMMUNICATIVE PATTERNS WHICH ARE DETERMINED BY PATIENT’S BEHAVIORAL FEEDBACK ANALYSING THE PROBLEMS AT NEGATIVE FEEDBACK FOLLOW UP PLANNING COMMUNICATION BEFORE, DURING AND AFTER TREATMENT AND FOLLOWING UP THE REACTIONS OF PATIENT ACTING CONTROL

16. 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. Figure 3 Behaviour B (e.g NONsmoking) Behaviour A (e.g smoking)

17. Figure 4: Interaction between patient, doctor, nurse nurse doctor patient

18. 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. Thus will bring out control over the brightfutures of tomorrow ….and many questions starting with how…..

19. 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

20. 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 .

21. Open systems have two main components, those are input and output (reference) D.S B.S P.S & S.S . M.S FEEDBACK System composed of many subsystems input output Transformation process ??????? Patient withpositive health outcomes, satisfied and accepted the offered new health behaviour; leaving thehealth services Patient with special needs and expectations; visiting health services Interaction of sciences that forms the prevention, treatment and rehabilitation processes (transformation period)

22. Figure 5 A patient with deep caries and pain Communicative Patterns based on Behavioural Sciences Input T R A N S F O R M A T I O N P Social Psychology e.g. how affected from friends, modelling from family 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 …………. White box Black box;no any other interaction 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 outcome Treatment

23. 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 planing Follow-up communication treatment control

24. knowledge P E R C E P T I O N motivation skills DOCTOR Figure 6: Communication between doctor and patient KNOWLEDGE MOTIVATION SKILLS KNOWLEDGE RECEIVING MESSAGE SKILLS MOTIVATION CONSTRUCTING MEANING KNOWLEDGE SKILLS MOTIVATION RESPONDING TO MESSAGE PATIENT

25. 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

27. THANKS FOR READING PLEASE REMEMBER THAT I WILL BE GLAD TO HEAR ABOUT YOUR VALUABLE COMMENTS basak.cinar@helsinki.fi