Lecture 7

Question 1

Define Illness Behavior

Answer 1

The way symptoms are perceived, evaluated, and acted upon by a person who recognizes pain, discomfort, or organic malfunction (David Mechanic, 1961)

Question 2

Stage 1: symptom behavior

Answer 2

Mechanic (1968)
Individuals sense something is wrong leading to help seeking behavior

(remember 3)
Symptom recognition
– Seriousness of symptoms
– Symptoms disrupt life
– Frequencyandpersistence
– Tolerance for this biological deviance
– Available information, knowledge and cultural assumptions and understandings
– Anxiety and fear may develop
– Needs compete with illness response
– Competing interpretations of symptoms sometimes occur
– Available treatment, proximity, psychological and monetary resources

Question 3

Stage 2: Assumption of Sick Role

Define sick role

Answer 3

Social role characterized by exemptions, rights and obligations which are shaped by society, groups and cultural traditions

Question 4

Stage 2: Assumption of Sick Role

Sickness is….

Answer 4

deviant behavior

disrupts normal social roles and is dysfunctional to work and family

Question 5

Stage 2: Assumption of Sick Role

Society exerts….

Answer 5

Society exerts social control over the sick

Question 6

Stage 2: Assumption of Sick Role

what has been created for sickness?

Answer 6

Institutions have been created to deal with it because sickness is a special kind of deviant behavior

Question 7

Stage 2: Assumption of Sick Role

what are the two exemptions?

Answer 7

Excused normal social roles

Not held responsible for sickness

Question 8

Stage 2: Assumption of Sick Role

what are the two requirements?

Answer 8

Must want to get well

Expected to seek care and follow advice

Question 9

The Medicalization of Deviance

Peter Conrad definition

Answer 9

Increasing number of behaviors and conditions are now interpreted in medical terms

Question 10

The Medicalization of Deviance

Good side of turning to definitions

Answer 10

Labeling some as sick is less punitive and stigmatizing

Question 11

The Medicalization of Deviance

bad side of turning to definitions

Answer 11

Societal endorsed stamp of disapproval:

AIDS, Opioid crisis and individualizes illness

Question 12

Stage 2: Assumption of Sick Role

Freidson’s typology 1970

Answer 12

Illness label is not objective, but reflection of societal norms.

Question 13

Labeling Approach to Illness

Symbolic Interaction

Answer 13

See illness as subjective matter worked out in cultural context and in Dr-Pat encounters

Question 14

Stage 3: Medical Care Contact/ Self Care

Three factors to seek care

Answer 14

The background of the patient – poverty, homelessness, age, gender, minorities. Large literature on disparities in access and discrimination.

The patient’s perception of illness – See Zola’s 5 triggers on the next slide

The social situation of occurrence – Timing, for instance, weekends or lack of ability to get away from work.

Question 15

Medical Care Contact

Irving Zola’s 5 triggers

Answer 15

Perceived interference with physical 
Perceived interference with social
Interpersonal crisis
Deadline for getting better has past 
Pressure from family and friends

Question 16

Use of Medical Care: Demo Differences

What demographics are different than the 6 times year average in the US

Answer 16

Number of contacts increase with age
Higher utilization for females than males
Highest among people in the lowest income category

Question 17

HC Utilization: Race/Ethnic Diffs

AA white disparity

Answer 17

African American-White disparity in utilization of health services has narrowed: Whites ave. 1 more visit per year

Question 18

HC Utilization: Race/Ethnic Diffs

Hispanics

Answer 18

Hispanics have the lowest utilization rates of any racial or ethnic group

Question 19

HC Utilization: Age Diffs

children v older people

Answer 19

Children <5 ave. 7.2 physician contacts

Older Persons use the most health care
– People over 65 (12% of pop) use 33% of all health care services

Question 20

HC Utilization: Gender Diffs

Answer 20

Women use more HC than men

Question 21

Stage 4: Dependent Patient Role

Four concerns with stage 4

Answer 21

Impairment of cognitive functioning
Loss of independence
Changes in body image
Withdrawal from key social roles

Question 22

Stage 5: Recovery and Rehabilitation

Relinquish sick role for some, ___ for others

Answer 22

For others continuing along the path between sickness and health (society defines one’s situation)

Question 23

The Concept of Self Care

Definition

Answer 23

Behaviors by individual to promote, prevent, detect symptoms, heal acute illness, and manage chronic symptoms: Such as?
These occur in social networks

Question 24

The Concept of Self Care

Self Help Movement of 1970s

Answer 24

Promote health involvement and responsibility
– Part of larger critique of authority in society
– Personal initiative and management of illness has grown
• Alternative medical philosophies,
• Behavioral approaches
• Health promotion in the workplace

Question 25

Self Help Groups

Answer 25

Groups of individuals who experience common problems, who share personal stories and knowledge and help one another cope with their situation and simultaneously help and are helped

Question 26

what is chronic illness?

Answer 26

ongoing, recurrent and persists for a long time

Question 27

what is impairment?

Answer 27

is loss of some anatomical or physiological function

Question 28

what is disability?

Answer 28

is a consequence of impairment such as walking or climbing stairs

Question 29

Chronic Illness and Sense of Self

Answer 29

George Herbert Mead described the development of sense of self

With chronic illness, prior “sense of self” is challenged (Charmaz, 1991)
– Interruption (initial diagnosis)
– Intrusive (continuous attention - HIV)
– Immersion (it becomes your life – ESRD)

Question 30

The role of social stigma in chronic illness

Answer 30

If demeaning, they impose STIGMA or discrediting labeling on the person

Question 31

Living with Chronic Illness and Disability

Answer 31

Involves a period of assessment, emotional adjustment and mental-physical accommodation