Understanding Patient Behaviour Flashcards
Leventhal et al. (1985) outlined the Factors believed to predict health behaviours. list these factors
1) Social factors, such as learning, reinforcement, modelling and social norms
2) Genetics, suggesting that perhaps there was some evidence for a genetic basis for alcohol use tension and fear
3) Perceived symptoms, such as pain, breathlessness and fatigue
4) The beliefs of the patient
5) The beliefs of the health professionals
list the Risk factors for CVD (9)
1) smoking/tobacco use
2) poor diet
3) high blood cholesterol
4) high blood pressure
5) insufficient physical activity
6) overweight/obesity
7) diabetes
8) psychosocial stress
9) excess alcohol consumption
discuss the Behavioural risk factors which can be influenced in order to treat coronary heart disease
1) resuming appropriate levels of exercise
2) smoking cessation
3) weight management (body mass index [BMI]
What is the ‘lay referral system’?
1) decision to seek medical advice result of discussions with others: Family, Friends, Colleagues
2) Decision influenced by the lay referral system’s:
- Extent of ‘close knit social relations’
- Predominant values and attitudes to professional healthcare
explain when Patients consult a GP / pharmacist
when the ‘benefits’ outweigh the ‘costs’, to: alleviate symptoms, legitimise their ‘illness’, If anxious or uncertain about symptoms
outline when patients consult a pharmacist?
1) For minor ailments
2) For confirmation of health status
3) Because of pharmacists’ accessibility
4) Because they are a source of information and supplier of conventional and unorthodox treatment
5) To have a medicine dispensed
6) To receive health promotion advice and/or diagnostic testing
discuss the Factors influencing an individual’s response to illness
1) Symptom visibility and perceived importance
2) The potential for the individual’s symptom to disrupt the community
3) Symptom denial for fear of confirmation of serious disease
4) Deferring response to symptoms for competing demands (e.g. work or family commitments)
5) An assessment of the social and economic costs of responding to symptoms, against the potential health-related benefits
6) Available information, knowledge and cultural assumptions and understandings of the evaluator
7) Frequency and persistence of symptoms
8) Competing interpretations of the symptoms
discuss the psychological needs for patients who have already suffered from cardiac problems (cardiac patients)
1) concerns about the significance and impact of symptoms
2) adherence to or side effects from treatments
shock, disbelief and denial about having a cardiac problem
3) coping and engaging in everyday activities
modifying behavioural risk factors for coronary heart disease
4) changes in their relationships and interactions with other people
5) catastrophic interpretations about the impact of cardiac disease on their lives and prospects for the future
6) the re-emergence or intensification of pre-morbid psychological difficulties (e.g. past depression linked with cardiac disease)
Patients with cardiovascular disease don’t always take their medicines. discuss the issues relating to Adherence
1) Non-adherence to medications >60% of CV patients
2) The immediate discharge period is a time of high risk for non-adherence
4) Patients with high adherence rates have a significantly lower risk of cardiovascular events compared with those with low adherence rates
outline the Causes of medicationnon-adherence
1) communication barriers: poor literacy, substance abuse, mental issues, not the primary language
2) socio-economic: inadequate healthcare coverage, unemployed, cost
3) motivation: poor understanding of disease state, lack of perceived need, fear of toxicity or adverse effect
Patients with cardiovascular disease can suffer from anxiety and depression. what % of patients suffer from this and how can it be measured?
1) 30–45% of patients have at least borderline levels of anxiety or depression
2) measure using the Hospital Anxiety and Depression Scale (HADS)
3) many were reluctant to accept a diagnosis of anxiety or depression and rejected the term ‘depression’ for describing their problems
Patients behaviour should be addressed for better outcomes. outline the Lifestyle changes after an MI (recommended by NICE)
1) Changing diet
2) Alcohol consumption
3) Regular physical activity
4) Smoking cessation
5) Weight management
describe Lazarus & Folkman (1984): Stress and coping model
1) stimulus->
2) primary appraisal: threat relevant? ->
3) secondary appraisal: what can i do? what resources do i have?
4) coping behaviours: managing the cause of distress (problem focused). regulation of distress (emotion focused)
5) re- appraisal
outline Leventhal et al (1984) Common Sense Model
1) health threat -> cognitive illness representation of health threat -> coping behaviour to manage health threat -> appraisal of cognitive illness representation and coping response
2) health threat-> emotional response -> coping behaviour to manage emotional response -> appraisal of emotional response and coping response
how can pharmacists Influence a behavioural change
1) Persuasive communication and interaction
2) Appropriate follow up
3) CPD to ensure best practice
4) Adherence to best practice guidelines
5) Interventions that work: Interventions targeted at eating, physical activity, sexual behaviour
- Shorter interventions are more effective
- Targeting women and older people more effective
describe the COM-B model: for understanding behaviour
1) In this ‘behaviour system,’ capability, opportunity, and motivation interact to generate behaviour.
2) Capability- the individual’s psychological and physical capacity to engage in the activity concerned. It includes having the necessary knowledge and skills.
3) those brain processes that energize and direct behaviour, not just goals and conscious decision-making.
4) all the factors that lie outside the individual that make the behaviour possible or prompt it.
