Social and Behavioural aspects of Pharmacy Practice Fall 2012-13

Pharmacists have to deal with many social and behavioral issues in their daily work either directly or indirectly. It is also important for a pharmacist to know about illness behavior and medical treatment.

Behavioural sciences A science or branch of learning, as psychology( علم النفس )or sociology ( علم الإجتماع) , that derives its concepts from observation of the behavior of living organisms It involves the systematic analysis and investigation of human/animal behaviour It is associated with the decision process and communication strategies, the activities and the interactions of the pharmacist with the surrounding

The behavior of a pharmacist is important in preventing and treating many diseases. Pharmacists serve as an essential link to patients in health care management Pharmacists can help patients choose lifestyles that are safe and achievable eg: obesity-involves self monitoring of diet and exercise, increase patient awareness, determine patient compliance, patient motivation

Social sciences A branch of science that deals with the study of human society and of individual relationships in and to society provide a perceptive framework to study the processes of a social system through impacts of social organisation on structural adjustment of the individual and of groups. include sociology, economics, history, public health, anthropology ( علم الانسان ) and political sciences.

studies the human aspects of the world, explains individual actions(pharmacist and physician) as related to the society in the relation to health and illness-meet needs of patient. Pharmacist-physician, pharmacist patient- prevent and treat diseases

Community pharmacists are the professionals who can interact with patients friendly –therapy success Pharmacist will receive more respect and appreciation from the society by solving drug related problems. Patients depends on pharmacist for solving health problems- should have the time and knowledge

Psychology scientific study of human or other animal mental functions and behaviors. Psychological knowledge helps in the assessment and treatment of mental health problems It helps understanding patterns of behavior, thought, and emotion in individuals, commonly referred to as personality eg:behavior of children, old age, mental patients It also explains the understanding of patient’s response to illness and treatment

HEALTH,ILLNESS AND DISEASE Sociological health is any state in which individual capacity is maximized Psychological successful progression through various stages of development. Medical absence of disease/maintenance of physiological parameters within normal WHO(1948) Health is defined as “the state of complete physical,mental and social wellbeing” People spend money to maintain health or to return to a healthy state.

Illness feeling of being unwell. any behaviour taken by an individual who feels ill to relieve it. Patients behavior to illness differs: may ignore the symptoms It is dangerous-cancer; certain diseases are self limiting; chronic symptoms must not be ignored(cough, pain, bleeding) consult with family Not a proper way of treating diseases; prefer medicinal herbs

consult with friends Mostly observed in sexually transmitted diseases Self medication Around 50%; some may use old drugs stored at home which may be expired or not of choice; majority depends on pharmacist for non prescription drugs visit family doctor/GP May not be specialized; misuse of antibiotics and vitamins occur turn to medical care system Hospitals may be government or private; outpatient or inpatient

Many social and psychological factors are involved which decides on the type of illness behaviour taken by the individual Factors which affect illness behaviour are socio economic status, nature of symptoms, age, gender, ethnicity, education, family structure and social networks. It could also be related to health care coverage and insurance

SOCIAL EFFECTS OF DISEASE abnormal medical condition affecting the body-signs and symptoms SOCIAL EFFECTS OF DISEASE

In olden days, disease was attributed to a variety of spiritual or mechanical forces. Interpreted as a punishment by God for sinful behavior or the result of an imbalance of body elements During the nineteenth century, discovered microorganisms as cause of infectious disease and identified that mind and body were independent.

SOCIOENVIRONMENTAL MODEL States that the risk conditions which evolve from the social and physical environments in which we live has a direct influence on health. Health is also affected by the physiological ,psychosocial and behavioural risk factors. In order to promote health of the population, the basic needs of one’s life needs to be controlled.

HEALTH STATUS Risk conditions Physiological risk factors Behavioural risk factors Psychosocial risk factors HEALTH STATUS

Physiological risk factors Behavioural risk factors Risk conditions Physiological risk factors Behavioural risk factors Psychosocial risk factors Poverty Hypertension Smoking Isolation Low education / occupational status Immune disorders Poor diet Lack of social support Stressful work Diabetes No exercise Low self-esteem Polluted environment Genetic factors Alcohol Self –blame Discrimination Hypercholesterolemia Low perceived power and control Low political power Hopelessness Large gaps in income Poor housing Inadequate access to healthy food

Social support Marital status has an influence on psychological states and lifestyles Married tend to be happier and more satisfied with life than unmarried. They are less likely to be socially isolated and have more social bonds. Studies have proved that people (with disabilities) who are having few social contacts were more likely to deteriorate than people with high levels of contact with others. Social support refers to practical assistance, financial help, psychological support and providing information and advice.

Life events Stressful life has a negative impact on health. Lead to disturbances in the control of diseases like diabetes Cause duodenal ulcers and appendicitis Women are more prone to develop depression, due to various factors Life stress was an important component of functional disorders

Physical environments in which people work also damages health Lack of freedom to make decisions at work(stressful and demanding) leads to behavioral risks(smoking),physiological risks(high BP) and affects health outcomes(heart disease) Unemployment Have a negative effect on health Become chronic and affects the existence of individual Experience more illness(increased blood pressure etc..) and increased mortality

Biological pathways Environmental circumstances (stressors) causes physiological and psychological changes in the body. Stress-outcome depression-changes in the body-cause disease directly/make the individual more prone to disease. Social support and psychological factors such as personality characteristics also affect health outcome Behavioural responses to stressors- damages health.