1 Copyright, 1996 © Dale Carnegie & Associates, Inc. Wellness, Illness, Wholeness Karan Dawson, Ph.D., R.Ph. Pharm 440: Human Behavior and Communication in Pharmacy School of Pharmacy University of Washington

2 Wholeness

3 Wellness Total person Integrated method of functioning to maximize one’s potential Influenced by personal choices and environment Personal responsibility Individualized

4 Health: WHO Definition State of complete well being Physical Mental Social Not just an absence of disease

5 Health: Functional Definition The ability to meet one’s expectations to perform social roles “optimum capacity of an individual for the effective performance of the roles and tasks for which he has been socialized” Is self-assessed

6 Attibutions Property or characteristic Observer attributes that a person is honest based on some behaviors Behavior may be situational (e.g., not cheating because others might see] If generalize from one to all situations erroneous attributions

7 Erroneous Attributions People tend to attribute traits to others (generalize from one situation to all) People tend to see their own behavior in terms of situations - interpret own behavior as response to different situations

8 Trait versus State: Implications Disease is situational to the patient Seem compelled to tell you about a particular situation When patients ask about a particular symptom in a given situation, they are helping you understand how they are experiencing their problem When you encourage patients to keep records of symptoms and the situations that accompany the symptoms, you are in harmony with many people’s views of their symptoms Use experiential terms that will help patients understand your information---what will they see, hear feel, experience Encourage patients to define a UTI in terms of a temporary infection rather than in terms of pain on urination so that they will be more likely to continue treatment after the pain subsides Avoid trait attributions based on symptoms or brief situational observation( (for DM focus on SX control or objective measure that shows symptom control -- blood sugar around meals

9 Trait versus State: Implications Disease is Situational to the Patient Use experiential terms to help patients understand your information--- What will they see, hear, feel, experience? Encourage patients to define a UTI in terms of a temporary infection rather than in terms of pain on urination so that they will be more likely to continue treatment after the pain subsides Avoid trait attributions based on symptoms or brief situational observation-- DM focus on SX control or objective measure that shows symptom control -- blood sugar around meals

10 Trait versus State: Implications Focus on the Dynamic Disease Process

11 Relevance Disease Oriented Evidence (DOEs) Patient Oriented Evidence that Matters (POEMs)

12 Health Belief Model Behavioral model Premise: People are motivated to action by perceived threat to health Threat is determined by perceived – Value of health –Susceptibility to the disease –Seriousness of the condition

13 Health Belief Model Developed to help hcp understand why and under what conditions people take preventive health action Health behaviors depends on –psychological readiness to take action –degree action will benefit in  health threat –presence of cue to act

14 HBM, continued “2 dimensions define whether a state of action exists.” –degree person feels vulnerable to a condition –perception of seriousness of condition ‘2 dimensions define benefit of action –degree behavior viewed as beneficial –costs or barriers to behavior

15 HBM, continued 2 dimensions to cues –internal –external –strength of cue helps determine whether one acts

16 Theory of Reasoned Action Adds to HBM –recognizes importance of significant others in a person’s decision making (subjective norm) –desire to comply with these others’ beliefs –separates intention from behavior

Readiness to Change Model

18 Sickness - Parson’s Sick Role Two rights –Freedom from blame for illness –Exemption from normal tasks and roles Two duties –Do everything possible to recover –Seek technically competent help

19 Wellness A Total Person Concept What is My Role in My Patient’s Wellness?

20 Introduction First year pharmacy school = knowledge deficit! Pressure to know Experience rich Desire to help others

21 Wellness Premise: we can live long, healthy, and active lives Patients seek wellness Pharmacists seek wellness Pharmacists are expected to be patient resources regarding wellness

22 My Wellness Profile?

23 My Patient’s Wellness Profile?