L2- Lay beliefs and lay networks Flashcards
the biomedical model
- Illness understood in terms of biological and physiological processes
- Treatment involves physical interventions (drugs/surgery)
- Too narrow a picture
Health definition
‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease of infirmity’
the biopsychosocial model
nterdisciplinary model that looks at the interconnection between biology, psychology, and socio-environmental factors
physco
cognition
emotion
behaviour
Bio
physiology
genetics
pathogens
social
social class
employment
social support
why has the biopsychosocial model replaced the biomedical model
provides a more whole picture of health
- treating patient as a holistic persona and not a malfunctioning disease
lay theories about health and illness draw on
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
how many definitions of heatlh
3
3 definitions of health
negative
positive
functional
negative definition of health
health equates the absence of illness
positive definition of health
health is the state of wellbeing and fitness
functional definition of health
health is the ability to do certain things
there is an interplay between lay and medical beliefs
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
influence of lay beliefs on behaviour (3)
1) health behaviour
2) illness behaviour
3) sick role behaviour
health behaviour
activity that impacts on health or helps prevent illness
e.g. smoking is more prevalent in lower socioeconomic groups
illness behaviour
activity of ill person to define illness and seek solution
sick role behaviour
formal response to symptoms, inc seeking formal help and acting as a patient
Higher social class more likely to have a
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
- Lower social class, incentives are less clear
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
most symptoms never get
to a doctor
what influences illness hevaiour?
- 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
lay referral
Relatively rare for someone to visit their doctor without first discussing symptoms with others (3/4 do)
Lay referral system
chain of advice-seeking contacts which the sick make with other lay people prior to- or instead of – seeking help from professional
Why is it important for Drs to understand lay referral?
- 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
Four main themes influence decision to go to doctor with symptoms
- symptom experience
- symptom evaluation
- knowledge of RA and treatments
- experience of, and attitudes towards, health professionals
early presenters to GPs
experienced significant and rapid impact on functional ability
late presents to GPs (delayers)
often developed explanations for symptoms that related to preceding activities
sick role
Sick role described as: ‘a temporary, medically sanctioned form of deviant behaviour’
Sick role mechanism
- 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
Limitations of the ‘sick role’
- 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
Lay beliefs and adherence to treatment
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
deniers and distancers
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
acceptors
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
pragmatists
Did use preventative medication but only when asthma was bad.
- Accepted they had asthma but saw it as a mild acute illness
