3)Lay Beliefs Flashcards
What are lay beliefs?
How people understand and make sense of health and illness, constructed by everyday people with no specialised knowledge.
Socially embedded, constructed in different ways (opinions of friends, family, social media)
What are the 3 perceptions of health?
- Negative definition
- Functional definition
- Positive definition
What do the perceptions of health determine?
The extent to which different people engage with health promotion information and services
Describe negative definition of health
Health equates to the absence of illness.
No symptoms= healthy
Common amongst people of lower SES
People avoid seeking advice until present with symptoms
What is a functional definition of health?
Health is the ability to do certain things, important to the individual ie work, look after children
Common in the elderly as they don’t want to move into a care home
Present to healthcare when their symptoms prevent them from doing these activities
What is a positive definition?
Health is a state of wellbeing and fitness, this is worked towards ad achieved over time.
Common in people of higher SES, understand that the effort input now will reap positive consequences later.
When can medical information be rejected?
Medical information may be rejected if it is incompatible with competing ideas (lay beliefs) for which people consider there is good evidence
What are the 2 issues investigated in lay epidemiology?
- Understand why and how illness happen
- Why this happened to a particular person at a particular time
What is health behaviour?
Activity undertaken for the purpose of maintaining health and preventing illness.
What the patient is willing to do.
What is illness behaviour?
The activity of an ill person to define illness and seek solution (diagnosis and treatment plan), depends on how patients interpret their symptoms.
What is sick role behaviour?
A formal response to symptoms, including seeking formal help and action of the person as a patient
What is meant by the ‘illness iceberg’?
Most symptoms are never seen by a doctor (GP)
Underneath the surface are patients with a) no symptoms, b)symptoms but do nothing to resolve and c) patients who self medicate or seek alternative practitioners
What are the 7 influences of illness behaviour?
- culture ie ‘stoical attitude’-inhibits health seeking behaviour
- visibility or salience of symptoms
- extent to which symptom disrupt life
- frequency and persistence of symptoms
- tolerance threshold ie to pain
- information and understanding (do they know what a red flag is?)
- Availability of resources (registered to GP? Know how to book? Organise transport?)
- lay referral (from family friends/internet)
Lay referral system is?
The chain of advice-seeking contacts which the sick make with other lay people prior to- or instead of- seeking help from healthcare professionals
Why is lay referral important?
Helps us to understand:
- why people might have delayed seeking help
- how, why and when people consult a doctor
- how understand your role as a doctor in their health
- use of health services and medication
- use of alternative medicines
What are the 3 groups of patients in relation to lay beliefs and adherence?
- Deniers and distancers- didn’t accept diagnosis, doesn’t attend health checks/reviews. Doesn’t consider themselves a sufferer
- Accepters- adhere to treatment plan and attends regular checks.
- Pragmatists- doesn’t believe condition is Long term, series of acute exacerbations. Only engages with treatments during attacks ie asthma -use inhalers
What are the 3 main implications for medical professionals?
- Adherence is tied to people’s beliefs about condition, social circle and threat to identity
- ‘Irrational’ non-adherence may be deeply embedded in complex social identities that have to be acknowledged and managed
- Meanings of symptoms and treatments will be different from patients to workers
What are long term conditions?
Wide range of conditions (prolonged, profound influence on lives of sufferers, often co-morbid conditions)
Manifestations vary greatly form day-to-day(unpredictable hence difficult to manage)
Controlled NOT cured
Will increase within the ageing population, but not exclusive to it
Describe the sociological approach to LTCs
- Focuses on how LTCs impact on social interaction and role performance
- Derived mostly from interactionist tradition
- Concerned with patient experiences and meaning of LTCs and their effects
List the 5 types of work of LTCs
- illness work
- everyday life work
- emotional work
- biographical work
- identity work
Briefly describe illness work
- Getting a diagnosis- may be long periods of uncertainty and unpleasant testing. Diagnosis can be shocking, a relief or threatening
- Managing symptoms- coping with physical manifestations of the disease. BEFORE coping with social relationships. May experience change between body and identity (low self esteem)
- Self-management- difficult to achieve (poor adherence, reduced quality of life, poor psychosocial wellbeing). Requires brief interventions.
What does everyday life work entail?
Coping- cognitive processes involved in dealing with illness
Strategy- actions/processes used to manage condition/its impact
Normalisation- can try to to keep pre-illness lifestyle (disguising or minimising symptoms) or designate your new life as ‘normal’
What is emotional work?
Work that people do to protect the emotional wellbeing of others.
Friendships may be disrupted, patients may strategically withdraw or restrict social time
May down play pain/symptoms
Presenting ‘cheery self’——must be able to see through this as a clinician
How does emotional work impact on roles?
- impact of illness on role may be devastating- unable to perform role in the way they wish to, damages their identity
- dependency, may develop feeling of uselessness to self and others
- especially devastating to younger patients (commonly not anticipated)
What is the relevance of biographical work?
- living with chronic illness may result in a loss of self
- former self-image degrades without the simultaneous development of an equally valued new self-image. (Struggle to lead valued lives and maintain positive definitions of self)
- involves the mind-body interaction (must take a holistic view)
What is the concept of biographical disruption?
The idea that chronic illness is a major disruptive experience both physically and socially.
Biographical shift from a perceived normal trajectory of life (expectations) to an abnormal one.
What is the importance of identity work?
- different conditions carry different connotations, this will affect how people see themselves and how others see them.
- illness can become the defining aspect of identity
What is stigma in relation to identity work and chronic illness?
Stigma is a negatively defined condition, attribute, trait or behaviour conferring a ‘deviant’ status.
What are the different forms of stigma?
Discreditable and discredited
Felt vs enacted
Describe discreditable stigma
Experienced when a condition cannot be seen, but if discovered people may think/behave differently towards the individual
Eg mental illness, or a HIV positive individual
Describe discredited stigma
This involves a physically visible characteristic or well known stigma that sets the individual apart from everyone else
Eg physical disability, known suicide attempt
Give an example of a condition that is both discreditable and discredited
Epilepsy
What is enacted stigma?
Enacted stigma is the real experience of prejudice, discrimination and disadvantage (as a consequence of a condition)
Ie employer will not employ an individual with a physical disability
What is felt stigma?
This is the fear of enacted stigma, also encompasses a feeling of shame associated with having a condition.
This can result in selective concealment- in which the individual is careful about who knows they have the condition. May be particularly mindful when/where they take medication (may impact on their ability to adhere to treatment)
