HaDSoc Week 4

Question 1

What is meant by lay beliefs?

Answer 1

Beliefs about health and illness
Held by non-professionals (no specialist knowledge)
Some are sensible and reasonable while others have little basis in evidence or reality
Doesnt necessarily prevent them being widely held
Socially embedded
Complex - drawn from many different sources
Not just a watered down version of medical knowledge - cant solve by giving lots of information

Question 2

What do lay beliefs affect in terms of clinical practice?

Answer 2

Definitions of health and illness vary between different individuals
Gaps between lay and medical concepts
Impacts behaviour - e.g. Adherence
Language used by people - might have a different understanding of the words

Question 3

Give some different perceptions of health

Answer 3

Negative definition - absence of illness - as long as no symptoms, youre healthy - lower socioeconomic group
Functional definition - ability to do certain things - if you can get on with these things youre healthy - elderly
Positive definition - state of wellbeing and fitness - higher socioeconomic groups

Question 4

Describe lay theories about health and illness

Answer 4

Complex and sophisticated
Draw on cultural, social and personal knowledge and experience
And on own biography

Question 5

What impact can lay theories have on clinical practice?

Answer 5

Medical information can be rejected if it is incompatible with competing ideas for which the individual considers there is good evidence
E.g. Inheritance of a disease
Reinterpreted what you say to fit in with what they know and understand

Question 6

How do lay understandings develop?

Answer 6

Interplay between lay and medical beliefs
Professional concepts are interpreted and made sense of in light of everyday experience
Sometimes professionals change the way that they start to talk to people, the way they explain things and understand things (if working in complicated sector)

Question 7

Define health behaviour

Answer 7

Activity undertaken for purpose of maintaining health and preventing illness

Question 8

How do lay beliefs effect health behaviour?

Answer 8

Example - smoking more prevalent among lower socioeconomic groups
Higher social class - more positive definition of health - incentive to give up - expect to remain healthy - able to focus on long term investments - rational to give up
Lower social class - more negative definition of health - incentives less clear - focus on improving immediate environment - smoking a coping mechanism, normalised behaviour - rational to continue smoking

Question 9

Define illness behaviour

Answer 9

Activity of an ill person to define an illness and seek a solution

Question 10

How do lay beliefs affect illness behaviour?

Answer 10

Almost half of all symptoms respondents did nothing
35% of symptoms resulted in OTC meds etc.
12% of symptoms resulted in primary care visit
Most symptoms never get to a doctor - symptom or illness iceberg

Question 11

What influences illness behaviour?

Answer 11

Culture - stoic (being hard)
Visibility or salience of symptoms 
Extent to which disrupt life
Frequency and persistence
Tolerance
Information and understanding 
Availability of resources
Lay referral

Question 12

Do we want everyone to come to the doctor when they get any kind of symptoms?

Answer 12

No
DH support self care
NHS would COLLAPSE :o
Get right symptoms to the doctor at the right time

Question 13

What is a lay referral?

Answer 13

3/4 of those visiting a doctor have discussed their symptoms with another person
Lay referral system - chain of advice-seeking contacts which the sick make with other lay people prior to – or instead of – seeking help
from health care professionals - can be a prompt or barrier to seeking help
Is the patient in front of you being influenced negatively from coming to see the doctor when they really need to?

Question 14

Why is the concept of lay referral important?

Answer 14

Helps you to understand:
• Why people might have delayed in seeking help
• How, why and when people consult a doctor
• Your role as a doctor in their health (e.g. Last resort )
• Use of health services and medication
• Use of alternative medicines (what else are they using, where are they getting the info about this from?)

Question 15

What is a key factor in influencing how quickly medical advice is sought?

Answer 15

Symptom evaluation - e.g. Is this bad enough to go see a doctor? Have i had it that long? Is it just after effect of working too hard etc?
- Typical candidate in head e.g. Smoking, obese, drinking, old
- Typical condition e.g. Heart attack –> sudden, death
If doesnt fit with own perception find hard to recognise
Prompting to seek help sooner than otherwise would - technique used in health promotion

Question 16

How do lay beliefs affect adherence to treatment?

Answer 16

Example - asthma
Deniers and distancers - deny having asthma or deny having “proper” asthma -symptoms do not interfere with everyday life - complex or drastic strategies to hide it - didn’t take drugs or attend asthma clinics

Acceptors - accept diagnosis and doctors advise completely - normal life involves having control over symptoms with medication - not stigmatised identity - happy to use treatment in public
Pragmatists - only use reliever medication when asthma bad - accepted having asthma but saw it as mild and acute - didnt use preventative methods/ proactive

Question 17

What are the implications of lay beliefs for medical professionals?

Answer 17

Medication behaviour is tied to people’s beliefs about
condition, social circumstances, and threat to identity
“Irrational” use of medication is deeply embedded in
complex social identities that have to be managed
Meanings of symptoms for patients may be different from
those for professionals

Question 18

What is candidacy?

Answer 18

Identifying a candidate for an illness based on risk factors from a combination of personal, familial and social sources of knowledge
System fallible - can think of people who either did fit in with this stereotype and didnt get the illness or didnt fit in with the stereotype and did get the illness
Undermines - always an exception - start to fall back on luck, fate, chance to explain it

E.g. COPD patients rejecting smoking as cause for their condition because knew someone who smoked all their life and didnt get COPD - but thought more plausible that things that they couldnt have done anything about were the cause e.g. Familial history of lung disease, exposed to pollutant at work - takes responsibility off them

Question 19

What is lay epidemiology?

Answer 19

Efforts to understand:
How and why an illness happens
Why it happens to a particular person at a particular time

Generate hypotheses from what we see going on around us all the time

Question 20

What is sick role behaviour?

Answer 20

Formal response to symptoms e.g. Seeking formal help, how people behave as patients