Common Sense Model of Illness Flashcards
What is meant by self-regulation ?
‘Problem-solving’
Identification of the goal
Selecting strategy and implement
Did the strategy achieve goal OR not
Sources of health-related goals and messages (CSM)
Messages from our body
Messages from outside
List some messages from our body
Mood/emotions
Physical sensations, symptoms
List some messages from outside our body
Diagnosis
Illness running in the family
Test results
Goal of the CSM
To maintain or return to our normal/healthy state
Steps involved in the concept of self-regulation
Interpretation -Try to make sense of ‘messages’
Coping - Select methods to cope with threat
Appraisal - Evaluation of effectiveness
Assumptions of the common sense model
Patient as a common-sense scientist/physician.
Patients regulate their experiences, symptoms and changes over time.
Self-regulation as problem solving.
What does the CSM framework serve to do ?
Understand :
- People’s perceptions of health and illness
- People’s reactions to health threats, and how they think about their illness representation.
- How people cope with illness
What do health threats generate ?
A representation of illness risk —> danger control –> appraisal
Emotional reactions (e.g. fear, worry) –> fear control –> appraisal
Parts of the CSM
Cognitive
Emotional
Components of Illness representations (IMPOTRANT)
Identity
Perceived cause
Timeline
Consequences
Curability / controllability
What is meant by illness representations ?
Patient’s common sense beliefs about their illness
Identity
Symptoms experienced by the person as well as the person’s label for the disease.
Symptoms can be abstract (the diagnosis) and perceptual (the symptoms).
Cause
Perceived cause of illness,
e.g. biological (virus etc), or psychosocial
Timeline
Patient’s belief about how long the illness will last, whether it’s acute, chronic or cyclical.
Consequences
Patient’s perceptions of the possible effects of the illness on their life.
e.g. physical, emotional, financial, social
Cure/Controllability
Patient’s beliefs about whether illness can be cured and the extent to which the outcome of their illness is controllable (by themselves or by powerful others)
Uses of the CSM
Patient’s illness representation/mental model has been shown to predict health behaviours such as medication adherence.
What has the common sense model been used and supported by research on ?
Hypertension
Asthma
Myocardial infarction
Diabetes
Huntingtons disease
CFS
Hypertension
A silent, asymptomatic condition (challenge identity)
Requires long-term adoption of a variety of prescribed behaviours (e.g. medication taking, weight loss, diet change)
Not adhering to medical regimens is very common, so hypertension is poorly controlled.
Statistics relating to hypertension
Only 12.5% of the people with hypertension are adequately controlled.
1/2 the people with hypertension don’t know it
1/2 of those who are diagnosed are not in treatment
CSM founders
Leventhal sand colleagues
3 types of timeline
Acute
Chronic
Cyclic
Acute
The disease will be cured
Chronic
The disease will stay for a lifetime
Cyclic
The disease will come and go
Asthma CSM
Patients beliefs may be :
Presence of symptoms —> Take medication
Absence of symptoms —> No medication
What was the asthma CSM used to test ?
No symptoms, no asthma: self-regulation, knowledge, beliefs and behaviours amongst inner city adults.
What was the myocardial infarction CSM used to test ?
Role of the patient’s view of their illness in predicting return to work and functioning after myocardial infarction.
Chronic timeline
Slower return to work and social duties
Importance of evaluating a patient’s illness perceptions
Assessment of illness perceptions may have a valuable role in identifying which patients ate likely to benefit from rehabilitation programmes.
What was the brief in-hospital intervention ?
Expanding patient’s casual models of MI beyond just stress
Beliefs about consequences were discussed
Symptoms and medications were discussed
Early intervention of MI results
Returning to work sooner
Fewer symptoms of angina
