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LEC 1, Introduction to Behavioral Sciences

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21 views19 pages

LEC 1, Introduction to Behavioral Sciences

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ameenachachar9
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By AQSA KALHORO

Lecturer IPH, PUMHSW


SBA
Introduction
1.Behavioral science is a branch of social science that
derives its concepts from observation of the behavior of
living organisms.
2. Broadly defined, behavioral science is the study of
human habits, actions, and intentions.
3.Combining knowledge of sociology, psychology and
anthropology with strong observation, research, and
communication skills, a behavioral scientist works with
communities and individuals examining behavior and
decision-making.
Behavioral science has three domains:

1. Psychology
2. Sociology
3. Anthropology
Psychology –
Psychology is the scientific study of the human mind and
its functions.
-Psychology is the scientific study of the mind and
behavior.
-Psychology is focused to individual person.
Sociology
Sociology is the study of the development, structure, and
functioning of human society.
It is focused to a group of people belonging to a society.
Sociology is the scientific study of society, including
patterns of social relationships, social interaction, and
culture.
Anthropology
Anthropology is the study of what makes us human.
Anthropology is the study of people throughout the
world, their evolutionary history, how they behave, adapt
to different environments, communicate and socialize
with one another.
The study of anthropology is concerned both with the
biological features that make us human (such as
physiology, genetic makeup, nutritional history and
evolution) and with social aspects (such as language,
culture, politics, family and religion).
Behavioral Sciences and their
importance in health
• Another major influence on human behavior is the role played by the
family, the society or the community.
• The study of sociology as one of the behavioral sciences help the
doctor to understand the influence of society and its various units and
institutions on the processes of health and how they can change to
cause disease.
• The role of family, gender issues, social classes, socioeconomic
circumstances, housing, employment, social supports and social
policies in maintaining health or causing disease is studied in this
domain
BIOPSYCHOSOCIAL MODEL
• The Biopsychosocial model was first conceptualised by George
Engel in 1977, suggesting that to understand a person's medical
condition it is not simply the biological factors to consider, but
also the psychological and social factors [1].
• Bio (physiological pathology)
• Psycho (thoughts emotions and behaviours such as
psychological distress, fear/avoidance beliefs, current coping
methods and attribution)
• Social (socio-economical, socio-environmental, and cultural
factors suchs as work issues, family circumstances and
benefits/economics)
• This model is commonly used in chronic pain, with the
view that the pain is a psychophysiological behaviour
pattern that cannot be categorised into biological,
psychological, or social factors alone. There are
suggestions that physiotherapy should integrate
psychological treatment to address all components
comprising the experience of chronic pain.
Physiotherapists must know how biopsychosocial factors interact
in patients with chronic pain to explain the perpetuation of this
condition and use it as a basis for planning the intervention
program.

The evidence has suggested a clinical biopsychosocial


assessment for the physiotherapeutic management of patients
with chronic pain in order to understand and explain the
predominant mechanism of pain and psychosocial factors that
may or may not be modified for the patient to improve their
condition.[3]

This clinical evaluation is carried out during the data collection at


the patient's entrance.
A practical guide is proposed to take biopsychosocial data using
the PSCEBSM (Pain–Somatic and medical factors–Cognitive
factors–Emotional factors–Behavioral factors–Social factors–
[3]
P- Type of pain
Clinical identification and differentiation of the
dominant pain mechanism:
•nociceptive pain
•neuropathic pain
•non-neuropathic pain of central sensitization.
Using the following tools:
1.Classification criteria for differentiating predominant
pain proposed by Nijs et al.
2.Widespread pain index/Body Diagram : ≥ 7 score
suggesting generalized pain, therefore, non-
neuropathic pain of central sensitization
3.Central Sensitization Inventory (CSI) : 40 score
suggesting non-neuropathic pain of central sensitization
S- Somatic and medical factors
For physical therapist the physical examination is a very
important part of his intervention - essential to:
•Be aware that some findings of clinical examinations such as
mobility, strength, neurodynamics, coordination, etc. could be
altered because there is greater sensitivity to mechanical
stimulation and modified movement patterns in patients with
non-neuropathic pain of central sensitization.

•Main goal in this stage is to evaluate the quality of movement,


if the pattern of movement causes the pain to persist and if
there is kinesiofobia
•Ask about current or previous health conditions, the disuse of
body parts, changes in movement patterns, exercise capacity,
strength and muscle tone during movement, the action of the
drug in the CNS It is useful for data collection
C- Cognition / Perceptions
Both influence biologically on hypersensitivity in the
brain by activating neuromatrix pain and also influence
the emotional and behavioral factors. :
1.Ask about perceptions: expectations of the
intervention, expectations of the prognosis of their pain,
understanding of their situation and the strategies they
have available to face their situation, what the pain
represents emotionally
2.Brief Illness Perception Questionnaire (Brief IPQ)
3.Pain Catastrophizing Scale (PCS)
E- Emotional factors
Ask if there is fear of specific movements,
avoidance behaviors, psychological traumatic
appearance of pain, psychological problems at work,
family, finances, society, etc. It is also suggested to use
the following scales:
1.State-Trait Anxiety Inventory (STAI)
2.Tampa-Scale of Kinesiophobia (TSK) and Fear Avoidence
Belief Questionare
3.Injustice Experience Questionnaire (IEQ)
4.Patient Health Questionnaire-2 (PHQ-2), or Patient
Health Questionnaire-9 (PHQ-9), or Center of
Epidemiologic Studies Depression Scale (CES-D)
B- Behavioral factors
Can lead to avoid activity or movement due to fear,
which in turn is presented as physical inactivity or disuse
and, finally, disability. Therefore it is important to
evaluate the behavior and adaptations that the patient
has made due to the pain.
S- Social factors
It refers to the social and environmental factors in which
the patient develops, which could be useful and
supportive or harmful and stressful for the improvement
of the patient's health condition. The data collection can
be divided as follows:
1.Housing or living situation
2.Social environment
3.Work
4.Relationship with the partner
5.Previous interventions
M- Motivation
Evaluating the motivation in the patient and his
willingness to change is useful to modify his thoughts
regarding the relationship pain-kinesiophobia, pain-
disability, and acceptance-catastrophism.
For this purpose, the following scale can be used
1.Psychology Inflexibility in Pain Scale (PIPS)
Clinical Contribution
•The use of the biopsychosocial model as a clinical
practice guide in physiotherapy allows the
physiotherapist to be aware of all the factors that
influence the patient's state of health.
• In addition, it allows laying the foundations of
pain neuroscience education.

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