Lay Beliefs about Health and Illness Flashcards
What are lay beliefs?
How people understand and make sense of health and illness
Who are lay beliefs constructed by?
People with no specialied knowledge
What is the result of lay beliefs being constructed by people with no medical knowledge?
Potential gaps between lay and medical concepts
Are lay beliefs a watered down version of medical knowledge?
No
Why are lay beliefs complex?
Because they draw on cultural, social, and personal knowledge and experience, and own biography
When may medical information be rejected?
It is is incompatible with competing ideas for which people consider there is good evidence
What is the result of the way that people interpret and accept information?
Means it may turn into something very different from the original message
What impact on behaviour may lay beliefs have?
- How people manage and safeguard health
- How people seek help
What do lay beliefs have an impact on?
Compliance/non-compliance with treatment
What are the potential perceptions of health?
- Negative definition
- Functional definition
- Positive definition
What is the negative definition of health?
The health equates to the absence of illness
Where is the negative definition of health common?
In lower socio-economic gorups
What is the functional definition of health?
Health is the ability to do certain things
What is the positive definition of health?
Health is a state of wellbeing and fitness, and something you can work towards and can achieve by doing certain things
Where is the positive definition of health and illness common?
In higher socioeconomic groups
What are the two distinct issues in lay epidemiology?
- Understand why and how illness happens
- Why it happened to a particular person at a particular time
How many a person develop a system of ‘candidacy’?
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’
How secure is a persons system of ‘candidacy’?
It is fallible, and could quickly undermine ideas of candidacy
Why is there an interplay between lay and medical beliefs?
- 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
What is health behaviour?
Behaviour undertaken for the purpose of maintaining and preventing illness
What is illness behaviour?
The activity of an ill person to define illness and seek solution
What is sick role behaviour?
The formal response to symptoms
What does sick role behaviour include?
- Seeking formal help
- Action of person as a patient
Why may smoking be more prevalent among lower socioeconomic groups?
- 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
In a two week period, what % of the population will experience one or more symptom of ill health?
75%
What % of people who experience symptoms of ill health do nothing?
Almost 1/2
What % of people who experienced symptoms of ill health used lay-care?
35%
Give an example of lay-care?
Over the counter medicine
What % of symptoms of ill health lea to consultation with a primary health care professional?
12%
What is the symptom, or illness, iceberg?
The fact that most symptoms never get to a doctor
Should all people with symptoms consult a doctor?
No, the DH supports self-care
What prevents a lot of people with symptoms from presenting?
Powerful social sanctioning of ‘hypochondriac’ behaviour - going to the doctors too quickly, or too often, is viewed negatively socially
What influences health behaviour?
- 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
What is meant by the extent to which symptoms disrupt life?
How much they interfere with what you want/need to do
What is the lay referral system?
The chain of advice seeking contacts with the seeker makes with other lay people prior to, or instead of, seeking health care professional
What % of those visiting the doctor have discussed their symptoms with another person?
Up to 75%
Is the lay referral system good or bad?
Can be either
Why may the lay referral system be good?
May prompt to see doctor when they need to
When may the lay referral system be bad?
May act as barrier to seeking heatlh
What can be understood by understanding lay referra
- 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
Why is it important to understand why people may have delayed seeking help?
Help stop it from being a problem in the future
What is medication behaviour tied to?
Peoples beliefs about condition, social circumstances, and threat to identity
What is irrational use of medication deeply embedded into?
Complex social identities that have to be managed
What is it important to consider regarding the meanings of symptoms for patients?
They may be different from those for professionals
Give three examples of conditions where lay beliefs are important?
- Rheumatoid arhritis
- Women and MI
- Asthma
What does good disease control require in rheumatoid arthritis?
Early intervention
What is the problem with early intervention in RA?
Many delay seeking medical advice
What factors influenced the decision to seek medical advice in RA?
- Symptom experience
- Symptom evaluation
- Knowledge of RA and treatments
- Experience of, and attitudes towards, health professionals
What did early presenters of RA experience?
Significant and rapid impact on functional ability
What did delayed presenters of RA experience?
Insidious and gradual onset of symptoms
What was the result of the gradual and insidious onset of symptoms in delayed presenters of RA?
They often developed explanations for symptoms that related to preceding activities
What frequently prompted consulatation in delayed presenters of RA?
Recognition that this explanation was inadequate to explain symptom progression, sometimes a time limit
What happens with many women having MIs?
- Have trouble interpreting, understanding, and linking symptoms
- Tried to self-manage discomfort and chest pain
- Have difficulty making final decision to seek medical help
Why do women having MIs sometimes have difficult making the final decision to seek medical help?
Don’t want to be seen as a hypochondriac, or silly
Why may women having MIs delay seeking medical help?
Perceptions of MI - typical victim/candidate, and typical heart attack being sudden, which is often not the case for women
What are the broad groups of asthmatics regarding adherence?
- Deniers and distancers
- Acceptors
- Pragmatists
What % of asthmatics are deniers and distancers?
Half the sample
What do asthmatics that are deniers and distancers do?
- 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
What does taking medication depend on in asthma?
Accepting the asthmatic identity
What do asthmatics that are acceptors do?
Accepted diagnosis and doctors advice completely
What does normal life involve for acceptors?
Having control over symptoms through medicatio n
What is the result of acceptor asthmatics not seeing asthma as a stigmatised identity?
They are happy to use inhalers in public
What do asthmatics that are pragmatists do?
- Accepted they have asthma
- Used preventative medication, but only when asthma was bad
Do pragmatists accept that they have asthma?
Yes, but saw it as a mild acute illness
How do pragmatists percieve asthma?
A series of acute exacerbations, not a chronic condition that is there all the time
How do pragmatics percieve management of their asthma?
Didn’t think they could do anything to prevent it, just manage acute exacerbations
