3)Lay Beliefs

Question 1

What are lay beliefs?

Answer 1

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)

Question 2

What are the 3 perceptions of health?

Answer 2

• Negative definition
• Functional definition
• Positive definition

Question 3

What do the perceptions of health determine?

Answer 3

The extent to which different people engage with health promotion information and services

Question 4

Describe negative definition of health

Answer 4

Health equates to the absence of illness.
No symptoms= healthy
Common amongst people of lower SES
People avoid seeking advice until present with symptoms

Question 5

What is a functional definition of health?

Answer 5

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

Question 6

What is a positive definition?

Answer 6

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.

Question 7

When can medical information be rejected?

Answer 7

Medical information may be rejected if it is incompatible with competing ideas (lay beliefs) for which people consider there is good evidence

Question 8

What are the 2 issues investigated in lay epidemiology?

Answer 8

1. Understand why and how illness happen
2. Why this happened to a particular person at a particular time

Question 9

What is health behaviour?

Answer 9

Activity undertaken for the purpose of maintaining health and preventing illness.
What the patient is willing to do.

Question 10

What is illness behaviour?

Answer 10

The activity of an ill person to define illness and seek solution (diagnosis and treatment plan), depends on how patients interpret their symptoms.

Question 11

What is sick role behaviour?

Answer 11

A formal response to symptoms, including seeking formal help and action of the person as a patient

Question 12

What is meant by the ‘illness iceberg’?

Answer 12

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

Question 13

What are the 7 influences of illness behaviour?

Answer 13

• 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)

Question 14

Lay referral system is?

Answer 14

The chain of advice-seeking contacts which the sick make with other lay people prior to- or instead of- seeking help from healthcare professionals

Question 15

Why is lay referral important?

Answer 15

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

Question 16

What are the 3 groups of patients in relation to lay beliefs and adherence?

Answer 16

1. Deniers and distancers- didn’t accept diagnosis, doesn’t attend health checks/reviews. Doesn’t consider themselves a sufferer
2. Accepters- adhere to treatment plan and attends regular checks.
3. Pragmatists- doesn’t believe condition is Long term, series of acute exacerbations. Only engages with treatments during attacks ie asthma -use inhalers

Question 17

What are the 3 main implications for medical professionals?

Answer 17

1. Adherence is tied to people’s beliefs about condition, social circle and threat to identity
2. ‘Irrational’ non-adherence may be deeply embedded in complex social identities that have to be acknowledged and managed
3. Meanings of symptoms and treatments will be different from patients to workers

Question 18

What are long term conditions?

Answer 18

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

Question 19

Describe the sociological approach to LTCs

Answer 19

• 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

Question 20

List the 5 types of work of LTCs

Answer 20

• illness work
• everyday life work
• emotional work
• biographical work
• identity work

Question 21

Briefly describe illness work

Answer 21

1. Getting a diagnosis- may be long periods of uncertainty and unpleasant testing. Diagnosis can be shocking, a relief or threatening
2. Managing symptoms- coping with physical manifestations of the disease. BEFORE coping with social relationships. May experience change between body and identity (low self esteem)
3. Self-management- difficult to achieve (poor adherence, reduced quality of life, poor psychosocial wellbeing). Requires brief interventions.

Question 22

What does everyday life work entail?

Answer 22

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’

Question 23

What is emotional work?

Answer 23

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

Question 24

How does emotional work impact on roles?

Answer 24

• 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)

Question 25

What is the relevance of biographical work?

Answer 25

• 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)

Question 26

What is the concept of biographical disruption?

Answer 26

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.

Question 27

What is the importance of identity work?

Answer 27

• 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

Question 28

What is stigma in relation to identity work and chronic illness?

Answer 28

Stigma is a negatively defined condition, attribute, trait or behaviour conferring a ‘deviant’ status.

Question 29

What are the different forms of stigma?

Answer 29

Discreditable and discredited

Felt vs enacted

Question 30

Describe discreditable stigma

Answer 30

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

Question 31

Describe discredited stigma

Answer 31

This involves a physically visible characteristic or well known stigma that sets the individual apart from everyone else
Eg physical disability, known suicide attempt

Question 32

Give an example of a condition that is both discreditable and discredited

Answer 32

Epilepsy

Question 33

What is enacted stigma?

Answer 33

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

Question 34

What is felt stigma?

Answer 34

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)