Behavioral Science Reading 1

Question 1

The WHO defines “health” as

Answer 1

a state of completely physical, social, and mental well-being

Question 2

Summarize the extension of the modern health care model and thus, the broadened role of physicians

Answer 2

Not just treatment of dz

Also prevention of disease, injury, sickness and illness and the promotion of health

Question 3

Describe how primary prevention differs from secondary prevention

Answer 3

Primary prevention - protect, promote and maintain health i.e. sanitation, exercise, healthy diet

Secondary prevention - enhances resistance or buffers the impact of risk factors i.e immunizations, health screening

Question 4

Why is the biomedical model too specific?

Answer 4

Healthcare requires a comprehensive multidisciplinary approach and should account for psychosocial-spiritual approaches

Question 5

Describe the BPSS model

Answer 5

Multiple determinants are involved in development of disease and the resultant illness
Biological, Psychological, Social, Spiritual

Question 6

Describe the Integrated Sciences Model

Answer 6

Psychosocial phenomena functionally connected to biological with common universal principles (homeostasis, stress adaptation, learning, development)
5 critical domains: bio, behavioral, cognitive, sociocultural, environmental

All psychosocial and biological phenomena are interdependent and interactive
Individuals are complex integrated system of interacting variables (stress in one domain affects all others)

Question 7

Describe the importance of integrated assessment

Answer 7

Exploration of differential and interactive contributions of bio, behavioral, cognitive, cultural and enviro risk factors
- More informative of all mechanisms and processes that contribute to a disorder (i.e. targets for tx)

Question 8

Describe the importance of multimodal treatment

Answer 8

Addresses as many contributing factors as possible, i.e. bio, behavioral, cognitive, sociocultural, enviro
- More effective especially with complexly determined health behaviors (such as smoking)

Question 9

Describe the biomedical model

Answer 9

firmly grounded in basic biologic sciences and scientific methodology

Question 10

Summarize the responsibilities of physicians

Answer 10

• inform to the best of their ability
• use authority in best interest of patient
• avoid abuse
• elicit, listen to, and address pt concerns
• respect pt decisions

Question 11

Summarize rights of physicians

Answer 11

• refse to perform any act that conflicts with personal or ethical principles (i.e. abortion ) but still make referrals

Question 12

Summarize the rights and responsibilities of patients

Answer 12

• receive complete information
• refuse treatment (certain exceptions)
• know about hospital’s conflicts of interest

Question 13

Define informed consent

Answer 13

Patient’s right to know all tx options and to decide which care is appropriate for them

Question 14

Describe the limits of confidentiality when working with patients

Answer 14

• situations where there is concern that the patient will harm themselves
• situations that involve mandatory reporting (i.e. child abuse)
• between professionals involved in pt care
• members of a teaching group

Question 15

Describe transference

Answer 15

Beliefs, expectations, and perceptions from previous relationships that influence current life experience (i.e. physician lectures diabetic about not following regimen; pt has very strict and critical parent and responds negatively to MD as if parent)

Question 16

Describe countertransference

Answer 16

Inappropriate reactions the physician has to a patient (i.e. MD views pt as “nice old lady” and is unable to ask intrusive questions)

Question 17

Summarize factors that influence patient adherence to treatment recommendations

Answer 17

• complexity of regimen
• persistence of symptoms
• frequency and quality of contact with physician
• patient beliefs

Question 18

What type of patient beliefs influence adherence to treatments?

Answer 18

illness warrants tx, tx is effective, cost is reasonable for benefits, tx is feasible

Question 19

Define rapport

Answer 19

State of mutual confidence and respect between two people

Question 20

How is rapport maximized between physician and patient (6 ways)?

Answer 20

• sensitivity to emotions
• cultural appropriateness
• establishing limits of confidentiality
• attentive listening
• observation
• touching

Question 21

Describe how a physician should respond to sadness

Answer 21

show respect, be considerate and caring, be patient

Question 22

Describe how a physician should respond to anger

Answer 22

acknowledge anger, remain calm, listen reflectively, do not take personal, encourage patient to discuss

Question 23

Describe the types of questions that should be avoided (2)

Answer 23

Compound questions - several questions asked together

Leading questions - prompt patient to give a specific response

Question 24

Describe potential sources of error in clinical decision making (8(

Answer 24

a) theoretical and personal bias
b) diagnosis by formula (fitting its into preconceived categories)
c) optimism/pessimism
d) too many hypotheses
e) oversimplification
f) reorganizing the abnormal
g) provider-patient interactions (bad attitudes, labels)
h) mistaking correlation for causation