Lay Beliefs about Health and Illness

Question 1

What are lay beliefs?

Answer 1

How people understand and make sense of health and illness

Question 2

Who are lay beliefs constructed by?

Answer 2

People with no specialied knowledge

Question 3

What is the result of lay beliefs being constructed by people with no medical knowledge?

Answer 3

Potential gaps between lay and medical concepts

Question 4

Are lay beliefs a watered down version of medical knowledge?

Answer 4

No

Question 5

Why are lay beliefs complex?

Answer 5

Because they draw on cultural, social, and personal knowledge and experience, and own biography

Question 6

When may medical information be rejected?

Answer 6

It is is incompatible with competing ideas for which people consider there is good evidence

Question 7

What is the result of the way that people interpret and accept information?

Answer 7

Means it may turn into something very different from the original message

Question 8

What impact on behaviour may lay beliefs have?

Answer 8

• How people manage and safeguard health
• How people seek help

Question 9

What do lay beliefs have an impact on?

Answer 9

Compliance/non-compliance with treatment

Question 10

What are the potential perceptions of health?

Answer 10

• Negative definition
• Functional definition
• Positive definition

Question 11

What is the negative definition of health?

Answer 11

The health equates to the absence of illness

Question 12

Where is the negative definition of health common?

Answer 12

In lower socio-economic gorups

Question 13

What is the functional definition of health?

Answer 13

Health is the ability to do certain things

Question 14

What is the positive definition of health?

Answer 14

Health is a state of wellbeing and fitness, and something you can work towards and can achieve by doing certain things

Question 15

Where is the positive definition of health and illness common?

Answer 15

In higher socioeconomic groups

Question 16

What are the two distinct issues in lay epidemiology?

Answer 16

• Understand why and how illness happens
• Why it happened to a particular person at a particular time

Question 17

How many a person develop a system of ‘candidacy’?

Answer 17

Observe and generate hypotheses from experiences of those around us, which feeds into a combination of personal, familial, and social sources of knowledge, leading to the development of a system of ‘candidacy’

Question 18

How secure is a persons system of ‘candidacy’?

Answer 18

It is fallible, and could quickly undermine ideas of candidacy

Question 19

Why is there an interplay between lay and medical beliefs?

Answer 19

• Public are surrounded by professional concepts, so difficult for lay understandings to develop independantly
• Professional concepts are interpreted and made sense of in light of everyday concepts

Question 20

What is health behaviour?

Answer 20

Behaviour undertaken for the purpose of maintaining and preventing illness

Question 21

What is illness behaviour?

Answer 21

The activity of an ill person to define illness and seek solution

Question 22

What is sick role behaviour?

Answer 22

The formal response to symptoms

Question 23

What does sick role behaviour include?

Answer 23

• Seeking formal help
• Action of person as a patient

Question 24

Why may smoking be more prevalent among lower socioeconomic groups?

Answer 24

• Higher social class more likely to have positive definition of health
• Incentives of giving up smoking are more evident for groups who could expect to remain healty, so are more able to focus on long term investments
• Incentives to quit are less clear for disadvantaged groups, so smoking is a coping mechanism which may be normalised behaviour - for these people, smoking is a rational choice as get a lot of benefit and pleasure

Question 25

In a two week period, what % of the population will experience one or more symptom of ill health?

Answer 25

75%

Question 26

What % of people who experience symptoms of ill health do nothing?

Answer 26

Almost 1/2

Question 27

What % of people who experienced symptoms of ill health used lay-care?

Answer 27

35%

Question 28

Give an example of lay-care?

Answer 28

Over the counter medicine

Question 29

What % of symptoms of ill health lea to consultation with a primary health care professional?

Answer 29

12%

Question 30

What is the symptom, or illness, iceberg?

Answer 30

The fact that most symptoms never get to a doctor

Question 31

Should all people with symptoms consult a doctor?

Answer 31

No, *the DH supports self-care*

Question 32

What prevents a lot of people with symptoms from presenting?

Answer 32

Powerful social sanctioning of 'hypochondriac' behaviour - going to the doctors too quickly, or too often, is viewed negatively socially

Question 33

What influences health behaviour?

Answer 33

* Culture * Visibility and salience of symptoms * Extent to which symptoms disrupt life * Frequency and persistence of symptoms * Tolerance threshold * Information and understanding * Availability of resources * Lay referral

Question 34

What is meant by the extent to which symptoms disrupt life?

Answer 34

How much they interfere with what you want/need to do

Question 35

What is the lay referral system?

Answer 35

The chain of advice seeking contacts with the seeker makes with other lay people prior to, or instead of, seeking health care professional

Question 36

What % of those visiting the doctor have discussed their symptoms with another person?

Answer 36

Up to 75%

Question 37

Is the lay referral system good or bad?

Answer 37

Can be either

Question 38

Why may the lay referral system be good?

Answer 38

May prompt to see doctor when they need to

Question 39

When may the lay referral system be bad?

Answer 39

May act as barrier to seeking heatlh

Question 40

What can be understood by understanding lay referra

Answer 40

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

Question 41

Why is it important to understand why people may have delayed seeking help?

Answer 41

Help stop it from being a problem in the future

Question 42

What is medication behaviour tied to?

Answer 42

Peoples beliefs about condition, social circumstances, and threat to identity

Question 43

What is irrational use of medication deeply embedded into?

Answer 43

Complex social identities *that have to be managed*

Question 44

What is it important to consider regarding the meanings of symptoms for patients?

Answer 44

They may be different from those for professionals

Question 45

Give three examples of conditions where lay beliefs are important?

Answer 45

* Rheumatoid arhritis * Women and MI * Asthma

Question 46

What does good disease control require in rheumatoid arthritis?

Answer 46

Early intervention

Question 47

What is the problem with early intervention in RA?

Answer 47

Many delay seeking medical advice

Question 48

What factors influenced the decision to seek medical advice in RA?

Answer 48

* Symptom experience * Symptom evaluation * Knowledge of RA and treatments * Experience of, and attitudes towards, health professionals

Question 49

What did early presenters of RA experience?

Answer 49

Significant and rapid impact on functional ability

Question 50

What did delayed presenters of RA experience?

Answer 50

Insidious and gradual onset of symptoms

Question 51

What was the result of the gradual and insidious onset of symptoms in delayed presenters of RA?

Answer 51

They often developed explanations for symptoms that related to preceding activities

Question 52

What frequently prompted consulatation in delayed presenters of RA?

Answer 52

Recognition that this explanation was inadequate to explain symptom progression, *sometimes a time limit*

Question 53

What happens with many women having MIs?

Answer 53

* Have trouble interpreting, understanding, and linking symptoms * Tried to self-manage discomfort and chest pain * Have difficulty making final decision to seek medical help

Question 54

Why do women having MIs sometimes have difficult making the final decision to seek medical help?

Answer 54

Don't want to be seen as a hypochondriac, or silly

Question 55

Why may women having MIs delay seeking medical help?

Answer 55

Perceptions of MI - typical victim/candidate, and typical heart attack being sudden, *which is often not the case for women*

Question 56

What are the broad groups of asthmatics regarding adherence?

Answer 56

* Deniers and distancers * Acceptors * Pragmatists

Question 57

What % of asthmatics are deniers and distancers?

Answer 57

Half the sample

Question 58

What do asthmatics that are deniers and distancers do?

Answer 58

* Deny having asthma at all (deniers), or denied having 'proper' asthma (distancers) * Claimed symptoms did not interfere with everyday life * Used complex or drastic strategies to hide it * Didn't take drugs or attend asthma clinics

Question 59

What does taking medication depend on in asthma?

Answer 59

Accepting the asthmatic identity

Question 60

What do asthmatics that are acceptors do?

Answer 60

Accepted diagnosis and doctors advice completely

Question 61

What does normal life involve for acceptors?

Answer 61

Having control over symptoms through medicatio n

Question 62

What is the result of acceptor asthmatics not seeing asthma as a stigmatised identity?

Answer 62

They are happy to use inhalers in public

Question 63

What do asthmatics that are pragmatists do?

Answer 63

* Accepted they have asthma * Used preventative medication, but only when asthma was bad

Question 64

Do pragmatists accept that they have asthma?

Answer 64

Yes, *but saw it as a mild acute illness*

Question 65

How do pragmatists percieve asthma?

Answer 65

A series of acute exacerbations, *not a chronic condition that is there all the time*

Question 66

How do pragmatics percieve management of their asthma?

Answer 66

Didn't think they could do anything to prevent it, just manage acute exacerbations