Health seeking behavior
Ova Emilia
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• Ruli mengalami nyeri perut dan punggung hilang timbul sejak 3 bulan terakhir. Nyeri tersebut hilang bila minum asam mefenamat. Ibunya menyarankan Ruli untuk urut “siapa tahu ada organ yang tidak pas tempatnya”. Kakaknya mendorong Ruli untuk periksa ke puskesmas atau Rumah sakit. Ruli tidak peduli dengan saran itu. 2
Mengapa perlu dipahami? • Diare
• Kanker
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Health Belief Model (Rosenstock, 1974, cited in Jones, 2003)
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Health behavior • Preventive health behavior
intended to reduce susceptibility to disease, as well as to reduce the effects of chronic diseases when they occur in the individual
• Illness behavior
related to the control of a disease that an individual has or that is incipient in the individual
• Sick role behavior.
directed towards reducing the impact and progression of symptomatic disease in the individual. 5
Hubungan timbal balik
Consumer
Provider
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What is health seeking behavior • The process of responding to „illness‟ or seeking care
Beli obat
Dokter terdekat
Rumah sakit
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When a family member sick
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Access to health facility
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Cost of health care
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What is health seeking behavior Dipengaruhi oleh faktor Si kon Budaya Sosial Personal Pengalaman
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What is health seeking behavior • Involves multiple steps (Uzma et al, 1999), and can rarely be translated into a simple one of choice or act, or be explained by a single model of health seeking behaviour.
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Penting • Memahami bagaimana masyarakat masuk dalam sistem pelayanan kesehatan
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Health promotion
Good health seeking behavior
Is not sufficient
Individual
Element dynamic, collective, interactive
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Dua pendekatan health seeking behavior 1. Menekankan pada „end point‟ (utilisation of the formal system, or health care seeking behaviour); 2. Menekankan pada„process‟ (illness response, or health seeking behaviour). Tipping and Segall (1995). 15
Health seeking behavior issues
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Tuberculosis • a classic public health issue • effective diagnosis, treatment and control are important for the whole of a society.
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Tuberculoasis • Late presentation and delayed diagnosis are key problems • When occurs, reflecting both individual and social factors, and system failures. • Delay can be related to social stigma, gender, fear or „multiple health seeking behavior‟. 18
Tuberculosis • Understanding of health seeking behaviour may improve treatment compliance and shorten delay to diagnosis. • Health education should be promoted at family and community level. • „Multiple health seeking‟ with better cooperation between public and private providers in particular. • The doctor-patient relationship. 19
MCH Maternal health and health seeking behaviour of mothers have a huge impact not only on the lives of women, but also on the lives of their children.
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MCH • The way in which women reach the decisions • Improve women‟s embededness in health systems and social structures that is as yet under-developed in the literature. • The introduction of public sector charges 21
Komplikasi persalinan
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Health seeking behavior pattern (Koenig et al, 2007)
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HIV, STI The very „social‟ nature of the spread of HIV, and the reflection of cultural beliefs around sexuality, virility and reproduction
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HIV, STI • Prevention through community education • Stigma reduction: preparation of staff • Comparable services: management • Follow up of cases
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Barriers-determinants
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Process – pathway of seeking – traditional healers, – village homeopaths, or untrained allopathic doctors – formally trained practitioners – government health facilities
(Ahmed et al, 2001).
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• drawing out the factors which enable or prevent people from making „healthy choices‟, in either their lifestyle behaviours or their use of medical care and treatment. • behaviour is best understood in terms of an individual‟s perception of their social environment. • Model: Health belief model, social cognition model
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Basic Components of The Health Belief Model (Rosenstock, 1990, cited in Simon-Morton, Green & Gottlieb, 1995)
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Social cognition model
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Perubahan perilaku: Teori kognitif sosial Self management: Self observation Self judgment Self reaction
Modelling:
Diberi contoh perilaku Menggunakan tokoh panutan/idola profesional kesehatan sebaiknya mengaplikasikan perilaku sehat
Skill training:
Diberikan latihan keterampilan 33
But • These only based on individuals
• KABP model not always work
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MacPhail and Campbell (2001) • begin to explore the neglected societal, normative and cultural contexts in which individual-level phenomena such as knowledge, attitudes and behaviour are negotiated or constructed.
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Bedri (2001) • Health seeking behaviour clearly varies for the same individuals or communities when faced with different illnesses.
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Tahapan Perubahan Perilaku transtheoretical theory (Simon-Morton, Greene & Gottlieb, 1995) Tahapan
Pendekatan Intervensinya
Prekontemplasi
Informasi terkini, komunikasi persuasif, pengalaman
Kontemplasi
Informasi, komunikasi persuasif, pengalaman
Persiapan
Cara untuk melakukan perubahan, pengembangan keterampilan, perubahan sikap
Aksi
Keterampilan untuk mempertahankan perilaku yang sudah diubah, penguatan, dukungan, manajemen diri, perubahan sikap
Mempertahankan
Keterampilan pencegahan kekambuhan, manajemen diri, dukungan sosial dan lingkungan 37
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