L2- Lay beliefs and lay networks

Question 1

the biomedical model

Answer 1

• Illness understood in terms of biological and physiological processes
• Treatment involves physical interventions (drugs/surgery)
• Too narrow a picture

Question 2

Health definition

Answer 2

‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease of infirmity’

Question 3

the biopsychosocial model

Answer 3

nterdisciplinary model that looks at the interconnection between biology, psychology, and socio-environmental factors

Question 4

physco

Answer 4

cognition
emotion
behaviour

Question 5

Bio

Answer 5

physiology
genetics
pathogens

Question 6

social

Answer 6

social class
employment
social support

Question 7

why has the biopsychosocial model replaced the biomedical model

Answer 7

provides a more whole picture of health

• treating patient as a holistic persona and not a malfunctioning disease

Question 8

lay theories about health and illness draw on

Answer 8

cultural, social and personal knowledge and experience and own biography. E.g. medical info may be rejected if incompatible with competing ideas for which people consider there is good evidence

Question 9

how many definitions of heatlh

Answer 9

3

Question 10

3 definitions of health

Answer 10

negative
positive
functional

Question 11

negative definition of health

Answer 11

health equates the absence of illness

Question 12

positive definition of health

Answer 12

health is the state of wellbeing and fitness

Question 13

functional definition of health

Answer 13

health is the ability to do certain things

Question 14

there is an interplay between lay and medical beliefs

Answer 14

public surrounded by professional concepts- difficult for lay understanding to develop independently

but profession concepts interpreted and made sense of in light of everyday life experience

Question 15

influence of lay beliefs on behaviour (3)

Answer 15

1) health behaviour
2) illness behaviour
3) sick role behaviour

Question 16

health behaviour

Answer 16

activity that impacts on health or helps prevent illness

e.g. smoking is more prevalent in lower socioeconomic groups

Question 17

illness behaviour

Answer 17

activity of ill person to define illness and seek solution

Question 18

sick role behaviour

Answer 18

formal response to symptoms, inc seeking formal help and acting as a patient

Question 19

Higher social class more likely to have a

Answer 19

positive definition of health
o Incentive of giving up smoking are more evident for groups who expect to remain health- more able to focus on long term investments e.g. quitting is the rational choice

Question 20

• Lower social class, incentives are less clear

Answer 20

o More of a focus on improving immediate environment
o Smoking used as a coping mechanism
o May be normalised behaviour e.g. smoking is a rational choice

Question 21

most symptoms never get

Answer 21

to a doctor

Question 22

what influences illness hevaiour?

Answer 22

• Culture e.g. stoical attitude
• Visibility or salience of symptom
• Extent too which symptoms disrupt life
• Frequency and persistence of symptoms
• Tolerance threshold
• Info an understanding
• Availability of resource
• Lay referral

Question 23

lay referral

Answer 23

Relatively rare for someone to visit their doctor without first discussing symptoms with others (3/4 do)

Question 24

Lay referral system

Answer 24

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

Question 25

Why is it important for Drs to understand lay referral?

Answer 25

• Why people might have delayed in seeking help
• How, why and when people consult a doctor
• Your role as a doctor in their health
• Use of health services and medication
• Use of alternative medicines

Question 26

Four main themes influence decision to go to doctor with symptoms

Answer 26

1. symptom experience
2. symptom evaluation
3. knowledge of RA and treatments
4. experience of, and attitudes towards, health professionals

Question 27

early presenters to GPs

Answer 27

experienced significant and rapid impact on functional ability

Question 28

late presents to GPs (delayers)

Answer 28

often developed explanations for symptoms that related to preceding activities

Question 29

sick role

Answer 29

Sick role described as: ‘a temporary, medically sanctioned form of deviant behaviour’

Question 30

Sick role mechanism

Answer 30

• In order to be excused from normal duties and be considered not responsible for their condition the sick person is expected to seek profession advice and adhere to treatments
• Medical practitioners are empowered to sanction their temporary absence from the work force and family duties as well as to absolve them from blame

Question 31

Limitations of the ‘sick role’

Answer 31

• Not all illnesses are temporary
• Does not acknowledge differences between people
• Does not acknowledge individual agency in defining and coping with illness i.e. not involving medical profession

Question 32

Lay beliefs and adherence to treatment

Answer 32

Many patients don’t take medication as prescribed. “Irrational” use of medication is deeply embedded in complex social identities that have to be managed.
Three broad groups:
1)	Deniers and distancers
2)	Acceptors
3)	Pragmatists

Question 33

deniers and distancers

Answer 33

e.g. half the sample denied either having asthma at all (deniers) or denied having “proper” asthma (distancers)

• Claim symptoms don’t interfere with everyday life
• Use complex or drastic strategies to hide it
• Taking medication relies on accepting asthmatic identity e.g.
  o Don’t take the drugs
  o Don’t attend asthma clinics

Question 34

acceptors

Answer 34

Accepted diagnosis and doctors advice completely. Normal life involved having control over symptoms through medication.

Asthma was not a stigmatised identity- happy to use inhalers in public

Question 35

pragmatists

Answer 35

Did use preventative medication but only when asthma was bad.

• Accepted they had asthma but saw it as a mild acute illness