Lecture 7 Flashcards
Define Illness Behavior
The way symptoms are perceived, evaluated, and acted upon by a person who recognizes pain, discomfort, or organic malfunction (David Mechanic, 1961)
Stage 1: symptom behavior
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
Stage 2: Assumption of Sick Role
Define sick role
Social role characterized by exemptions, rights and obligations which are shaped by society, groups and cultural traditions
Stage 2: Assumption of Sick Role
Sickness is….
deviant behavior
disrupts normal social roles and is dysfunctional to work and family
Stage 2: Assumption of Sick Role
Society exerts….
Society exerts social control over the sick
Stage 2: Assumption of Sick Role
what has been created for sickness?
Institutions have been created to deal with it because sickness is a special kind of deviant behavior
Stage 2: Assumption of Sick Role
what are the two exemptions?
Excused normal social roles
Not held responsible for sickness
Stage 2: Assumption of Sick Role
what are the two requirements?
Must want to get well
Expected to seek care and follow advice
The Medicalization of Deviance
Peter Conrad definition
Increasing number of behaviors and conditions are now interpreted in medical terms
The Medicalization of Deviance
Good side of turning to definitions
Labeling some as sick is less punitive and stigmatizing
The Medicalization of Deviance
bad side of turning to definitions
Societal endorsed stamp of disapproval:
AIDS, Opioid crisis and individualizes illness
Stage 2: Assumption of Sick Role
Freidson’s typology 1970
Illness label is not objective, but reflection of societal norms.
Labeling Approach to Illness
Symbolic Interaction
See illness as subjective matter worked out in cultural context and in Dr-Pat encounters
Stage 3: Medical Care Contact/ Self Care
Three factors to seek care
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.
Medical Care Contact
Irving Zola’s 5 triggers
Perceived interference with physical Perceived interference with social Interpersonal crisis Deadline for getting better has past Pressure from family and friends
Use of Medical Care: Demo Differences
What demographics are different than the 6 times year average in the US
Number of contacts increase with age
Higher utilization for females than males
Highest among people in the lowest income category
HC Utilization: Race/Ethnic Diffs
AA white disparity
African American-White disparity in utilization of health services has narrowed: Whites ave. 1 more visit per year
HC Utilization: Race/Ethnic Diffs
Hispanics
Hispanics have the lowest utilization rates of any racial or ethnic group
HC Utilization: Age Diffs
children v older people
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
HC Utilization: Gender Diffs
Women use more HC than men
Stage 4: Dependent Patient Role
Four concerns with stage 4
Impairment of cognitive functioning
Loss of independence
Changes in body image
Withdrawal from key social roles
Stage 5: Recovery and Rehabilitation
Relinquish sick role for some, ___ for others
For others continuing along the path between sickness and health (society defines one’s situation)
The Concept of Self Care
Definition
Behaviors by individual to promote, prevent, detect symptoms, heal acute illness, and manage chronic symptoms: Such as?
These occur in social networks
The Concept of Self Care
Self Help Movement of 1970s
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
Self Help Groups
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
what is chronic illness?
ongoing, recurrent and persists for a long time
what is impairment?
is loss of some anatomical or physiological function
what is disability?
is a consequence of impairment such as walking or climbing stairs
Chronic Illness and Sense of Self
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)
The role of social stigma in chronic illness
If demeaning, they impose STIGMA or discrediting labeling on the person
Living with Chronic Illness and Disability
Involves a period of assessment, emotional adjustment and mental-physical accommodation
