Behavioural Science for dentists Flashcards
What is the scientist practitioner model ?
integration of clinics and research so they can dictate each other
using methods to test out different interventions
What is the medical model of care ?
dominant
diagnosis and treatment of the focus disease
signs and symptoms are resolved with treatment
What is teh biopsychosocial model ?
patient recovery is due to a number of factors not just medical
social, biological and psychological factors
What are social factors in the biopsychosocial model ?
family cultural habits beliefs finance/social class
What are psychological factors in the biopsychosocial model ?
thoughts
nehaviours
attitudes
beliefs
What are biological factors in the biopsychosocial model ?
medication
infection etc
What is the relevance of behavioural science ?
differences in communication style can dictate complaints, dentlal anxiety and behaviour
What are the comp;ications with fearful people ?
likely to have poor oral health
no show
treatment with sedation which is expensive and rsiky and does not solve the problem
What is self efficacy ?
a persons confidence in their ability to carry out a behaviour
What is the implementation intention theory ?
likelihood of a person performing a behaviour is increased by making an implicit behaviour plan
What is exhibited in burnout ?
exhaustion-emotional and physical
combination of environemtnal and internal stressors
negative attitude to job, low self esteem etc
What are the 4 challenges leading to burnout ?
dealing with anxious patients
making complex decsions
difficult postures
time pressures
What is fear ?
an emotion now
danger and urge to fight or escape
physical response is fight or flight
What is anxiety ?
an emotion
associated with anticipation of danger
in the future
urge to avoid
What is pain ?
unpleasant sensroy experience assocaited wit actual or potential tisseu damage
can be increased by distress
What is behaviour learning theory ?
classic conditioning
2 things that always occur together become linked
pavlovs dogs
the dentist and unpleasant feelings are linked
What is a stimulus ?
exerts a particular response
What is a neutral stimulus ?
something that has no effect goes to becoming a conditioned stimulus
What is generalisation ?
conditioned response can be triggered by other similar stimuli
What are the dental implications of classic condtioning ?
patients may react with fear to the features of the dental environment
elements may resemble past abuse
What is operant conditioning ?
behaviour and emotions are foten linked
are we reinforcing appraoch behaviour or avoidance behaviour
behaviour is shaped by what happens imemdiately after
What is positive reinforcement ?
a behaviour is followed by a rewarding outcome
eg. getting canfy for getting an A
What is negative reinforcement ?
behaviour is followed by cessation of an unwanted experience
eg. eat brocolli and i will stop shoutung at you
What is punishment ?
a behaviour followed by an unwanted experience
What is extinction ?
a behaviour is followed by no rewarding outcome and eventually stops
What does stopping reinforcement lead to ?
fast exticntion
What is the cognitive model ?
thinking thoughts more likely to feel it
thinking anxious thoughts you are more likely to feel it
What are the implications of escape ?
if they escape then they have no idea if the worst would have happened or not
What is vicarious leaning ?
learning through the experiences of someone else
eg, observations, hearing, picking up
eg. siblings in the room
What does the 5 areas model do ?
splits up our experience into thoughts, behaviors, emotional feelings and physical - they are linked
How can we apply the 5 areas model ?
by making 1 or 2 small changes over time
little changes over time make a big difference
How does dental fear come about ?
traumatic dental experiences
pain
vicarious experience
What is the cycle of dental fear ?
dental fear leads to delayed visiting
dental problems
symptom driven treatment
What is the fight or flight response ?
triggered by potential danger cortisol and adrenaline release fast breathing and HR hot and sweaty fumbling and nausea
How can we minimise fear ?
paying attention to factors that present as a conditioned stimulus
What is systematic desensitisation ?
fear can be treated by exposure to factors that present as conditioned stimuli - patient sees nothing wrong and fear reduces
What are cognitive principles ?
help patients understand what is happening in theri treatment
ask and address concerns
normalise reactions
What are recommendations for mild forms of anxiety ?
general anxiety reducing style
acknowledge anxiety
assure patient nothing will happen against will
distraction and relaxation
What are recommendations for specific phobia ?
construct a hierarchy and work through each level with patient tolerance
What are recommendations for high treatment needs ?
IV or General sedation
but the patient wont progress with ther fear
How can we address psychosocial aspects ?
keep calm
signalling
let them know it is due to fight/flight response
breathe 7 in 11 out
How can we address social aspects ?
treat with respect and without judgement
What can pain be influenced by ?
situation interpersonal factors previous experience temperament response
How can we address pain ?
anxiety management principles
What are behaviour changes that dental professonals are intersted in ?
cleaning teeth
attending routine check up
diet and smoking
general health
What is the assumed model of communication ?
we give accurate information about the risk and impact of current behaviour
patient understands and this leads to appropriate behaviour change
What is required for change ?
an intetntion
What does intention depend on ?
whether we are confident
What happens after intetnion ?
we need the ability to translate into new behaviours
What does the self efficacy theory state ?
a change in behaviour is predicted by the ability of the person to carry out the behaviour
How can we change confidence ?
experience
observations
persuasion
feeling good after
What can affect intention ?
attitude
subjective norm
normal beliefs
What is the intention behaviour gap ?
we intend something doesnt always lead to behaviour
What are 2 stages of changing ?
motivational phase- leads to intetnion and wanting to change
volitional phase- going ahead and doing it
What is volitional phase affected by ?
maintenance of self efficacy
What are the stages of the change model ?
pre contemplation contemplation planning action maintenance
What is motivational interviewing ?
to motivate someone
develop a guiding style
ask about pros and cons
allow consultation to be patient led
How to design an intervention phase ?
define problems
target behaviours
specify the behaviour
identify what needs to change
What are the factors of the behaviour change wheel ?
capability - physical
motivation - do they think its important
opportunity - provide opportunities
What is behaviour learning theory ?
behaviour is affected by stimuli and reinforcement
What is classical conditioning ?
a stimuli can become conditioned to produce a particular response
What is the difference between operant and classical conditioning ?
operant conditioning states that behaviours are performed based on what happens after that behaviour
classical conditioning states that behaviour is determiend by stimuli that have been conditioned to produce a certain response
