II-10 Misusing Health Services

Question 1

Identify five reasons why people use health services for emotional disturbances.

Answer 1

• Stress and its emotional responses, including anxiety and depression, create a number of physical symptoms.
• Somaticizers may experience stress through physical symptoms.
• Medical disorders are perceived as more legitimate than psychological ones.
• Illness brings benefits, termed secondary gains, including the ability to rest, to be freed from unpleasant tasks, to be cared for by others, and to take time off from work.
• Some individuals may be malingering, or faking illness, because they do not want to get out of a personal or professional obligation and they know that the only acceptable excuse is illness.

Question 2

Distinguish among the four types of delays in the use of health services.

Answer 2

• Appraisal delay: The time it takes an individual to decide that a symptom is serious.
• Illness delay: The time between the recognition that symptom implies an illness and the decision to seek treatment.
• Behavioral delay: The time between actually deciding to seek treatment and actually doing so.
• Medical delay: The time that elapses between the person’s calling for an appointment and receiving appropriate medical care.

Question 3

Indicate who is most likely to delay seeking treatment.

Answer 3

• Middle-aged individuals appear to delay more than the elderly, particularly if they experience symptoms judged to be potentially serious.
• Poorer people seem to delay treatment, because the perceived expense of treatment is a major factor in delay.
• People with no regular contact with a physician may be discouraged by the extra burden of finding someone from whom to seek it.
• People who do not believe in the medical model.

Question 4

Describe the kinds of symptoms that lead to delay behavior.

Answer 4

Familiar symptoms that turned out to be minor before get delayed; so do symptoms that can be accommodated easily and that do not provoke alarm.

Question 5

worried well

Answer 5

Individuals free from illness who are nonetheless concerned about their physical state and frequently and inappropriately use medical services.

Question 6

somaticizer

Answer 6

Someone who expresses distress and conflict through bodily symptoms

Question 7

secondary gains

Answer 7

Benefits of being treated for illness, including the ability to rest, to be freed from unpleasant tasks, and to be taken care of by others.

Question 8

delay behavior

Answer 8

The act of delaying seeking treatment for recognized symptoms.