3 - Lay Beliefs & Lay Networks Flashcards
What is the biomedical model of medicine?
- Traditionally not interested in psychological or social factors
- Illness understood in terms of biological and physiological processes, treatments involve physical intervention
What is health?
A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity
What is the biopsychosocial model of health and illness?
Health and illness affected by:
- Biological factors (physiology, genetics, pathogens)
- Psychological factors (cognition, emotion, behaviour)
- Social factors (social class, employment, social support)
What are lay beliefs and how can they impact on behaviour?
- Definitions of health and illness vary, with potential gaps between lay and medical concepts
- What health means to people
- Impact on compliance (adherence) with treatments
What are the three lay perceptions of health?
Negative definition - health equates to absence of illness
Functional definition - health is ability to do certain things
Positive definition - health is a state of wellbeing and fitness
What influences peoples lay theories of health and illness?
- Cultural, social and personal knowledge and experiences
- Medical information may be rejected if it is incompatible with competing ideas
Why do patients often believe their condition ‘should never have happened to them’?
- Candidacy system is fallible (sometimes very unhealthy individuals live a long life)
- Randomness and fate (mechanism not understood)
- Implications for seeking help
What is health behaviour?
Activity that impacts on health or helps to prevent illness
What is illness behaviour?
Activity of an ill person to define illness and seek solution
What is sick role behaviour?
Formal response to symptoms, including seeking formal help and action of a person as a patient
Why is smoking as a health behaviour more prevalent in lower socioeconomic groups?
- Higher social classes are more likely to have positive definition of health (focus on wellbeing and fitness)
- Higher social groups can expect to remain healthy if they quit
- Lower social groups have less incentive to quit, would rather improve immediate environment or use as a coping mechanism
What is the ‘illness iceberg’ and how does it relate to illness behaviour?
- Most symptoms of illness never reach a doctor, hidden below the surface (hence ‘illness iceberg’)
- In a 2 week period ~75% of people experience symptoms of ill health
> half do nothing
> 35% lay-care and OTC medicines
> 12% see their GP
What factors influence illness behaviour (defining illness and seeking help)?
- Culture
- Visibility of symptoms
- Extent to which symptoms disrupt life
- Frequency and persistence of symptoms
- Tolerance threshold
- Information and understanding
- Availability of resources
- Lay referral
What is lay referral?
- Advice-seeking from other lay people prior (or instead of) seeking help from healthcare professionals
- Rare for people to visit a doctor without first discussing symptoms with others
Why is lay referral important for us to understand?
Helps us understand:
- why people delay in seeking help
- how, why and when people consult a doctor
- use of health services and medication
- use of alternative medicines
Many people delay seeking medical advice, what are 4 main themes influencing their decision?
- Symptoms experienced
- Symptom evaluation (what they think it might be)
- Knowledge of diseases and their treatments
- Experience and attitude towards health professionals
In terms of adherence to treatments, what 3 groups can patients be put into?
- Deniers and distancers
- Acceptors
- Pragmatists
What are deniers and distancers?
Deniers - deny having the condition
Distancers - deny having the “proper” condition
- Claim their symptoms don’t interfere with life
- Use complex strategies to hide it
- Don’t take drugs or attend clinics
What are acceptors?
- Accept their diagnosis and doctors advice
- Live a normal life with control of symptoms through medication
- Happy to use medication in public - no stigmatised identity
What are pragmatists?
- Accept the condition but see it as mild or acute
- Only take medication when it gets bad
- Acknowledge the condition but not the extent of it
