Lecture 8 - Using health Services Flashcards
What is a Symptom?
Sensory experience that is interpreted as indicating that something is not working properly
what are some Common Physical Symptoms
Pain Itchiness Numbness Congestion Wheezing Vomiting Constipation Fainting Fatigue Soreness Tingling Shortness of breath Cough Nausea Diarrhea Dizziness Heart palpitations Vision problems
Factors that Influence Noticing Sensations or Recognizing Symptoms
ìSituational factors ì Stress ì Mood ì Social factors ì Cultural differences
explain Noticing Sensations/Recognizing Symptoms: Situational Factors
Busy vs. nothing to do
ì Perceptual and environmental determinants of
coughing (Pennebaker, 1980)
explain Medical Student’s Disease
ì Studying the symptoms of diseases leads students to notice their own fatigue and other internal sensations
ì These sensations are then recognized as being consistent with the disease under study
explain Noticing Sensations/Recognizing Symptoms: Mood
Mood-congruent perception ì Salovey & Birnbaum 1989
Mood as information
ì Positive mood –> things going well
explain Noticing Sensations/Recognizing Symptoms:
Mass Psychogenic Illness
Physicians might consider a group sickness as being caused by mass psychogenic illness if:
ì Physical exams and tests normal
ì Doctors can not find anything wrong with the
space
ì Many people get sick
explain Noticing Sensations/Recognizing Symptoms: Personality and Individual Factors
Chronically increased sensitivity:
ì Recognizing normal bodily sensations
as symptoms of disease
ì Exaggerated interpretation of mild symptoms as more severe and indicators of severe disease
explain Hypochondriasis
Noticing Sensations/Recognizing Symptoms: Personality and Individual Factors
ì Preoccupied and worried that normal bodily signs/sensations are indicators of disease
+ dysfunctional beliefs
ì = maladaptive coping; ì Reassurance seeking ì Recurrent checking
ì Persists despite contrary evidence, reassurance from physicians
ì 4-5% of Canadians
what is “Worried Well”
ì Term used for individuals who are healthy but nonetheless concerned about their physical and mental health and frequently and unnecessarily use medical services
ì Educated about health/medicine
ì Higher fear of uncertainty (=> higher need for
reassurance)
ì No dysfunctional beliefs
why is ‘worried well’ increasing
cause of
ì societal emphasis on healthy lifestyle
ì media attention to new health problems and diagnostic tests
Noticing Sensations, Recognizing them as Symptoms: Summary
ì Depends on level of attention to cues
ì Influenced by current environment
ì Or chronically salient due to enduring personality (e.g. health anxiety)
how to interpret Symptoms - Seriousness Body Part Affected and Pain
ì Highly valued parts of the body
ì Pain = seek treatment more promptly
explain Illness Schemata
Contain concepts ì Identity (name of illness) ì Consequences ì Causes ì Duration ì Cure
what are the 5 Components (Diefenbach & Leventhal, 1998) of illness schemata
ì Identity: name of illness
ì Consequences: perceptions of the range of symptoms and treatments resulting from a specific illness
ì Causes: factors that the person believes gave rise to the illness (environmental/behavioural)
ì Duration: the length of time that the illness will last
ì Cure: whether the person believes the illness can be cured by treatment
what is the Importance of illness schemata
Schema one holds determines health care seeking behavior
–>Incorrect schema components may lead people to not seek treatment
Schema one holds determines psychological adjustment to disease (and related behaviors)
–> e.g. chronic vs. acute
Health Services Use by Age: Highest among who
ì Elderly people (chronic conditions and diseases)
ì Young children (infectious childhood diseases, unintentional injuries such as falls and poisonings)
ì They typically require more medical attention and are more prone to health complications
The use of health services is lowest among:
ì Adolescents and young adults
When do People Seek Medical Care?
Most help-seeking when symptoms are: n New n Unexplainable n Painful n Highly visible n Affecting valued body parts
what are the stages of Delaying Medical Care
Appraisal delay (Stage 1) Illness delay (Stage 2) Behavioural delay (Stage 3) Medical delay (Stage 4)
explain Appraisal delay (Stage 1)
Time it takes an individual to decide if a symptom is serious
explain Illness delay (Stage 2)
Time between the recognition that a symptom implies an illness
and the decision to seek treatment (intention)
explain Behavioural delay (Stage 3)
Time between deciding to seek treatment and actually doing so
explain Medical delay (Stage 4)
Time between making an appointment and receiving appropriate medical care
what are the Factors correlated with delaying medical care (Safer et al., 1979)
ì Appraisal delay: shorter if pain, knowledge
ì Illness delay: shorter if new
ì Behavioural delay: shorter if pain, belief it can be cured, judged as affordable to seek treatment
how is A hospital is a unique culture:
ì Professionals use high-tech language, ask personal
questions
ì People dress and act differently
ì Procedures may seem to be ritualistic, unknown
ì Loss of control over one’s health and well-being
ì One is not feeling well
explain Loss of Control: Depersonalization
Taking away a person’s sense of individuality ì May be result of …
ìimpersonal interactions ìhospital clothing, wristbands
ìbeing referred to by illness - not by name ìlack of privacy
explain Hospital Culture: Loss of Control
Total Institution (Goffman, 1961)
Possible Reactions:
§ Reactance
§ Learned Helplessness
Closely linked to need for information: ì Monitoring style
ì Blunting style
explain Having Information Can Increase Control
Post-operative patient as roommate (Kulik & Mahler, 1987) ì able to obtain information about what to expect after surgery ì relieved to see that their roommate survived the surgery
explain Control-Enhancing Interventions (at hospital)
ì Preparation for surgery
ì Videos about upcoming procedures
ì Informing patients (Janis, 1958)
ì Evaluated effects of pre-surgical control-enhancing
interventions for coping with stressful medical procedures
ì Patient coping is facilitated by information about the procedure
explain Control-Enhancing Interventions: The Changing Roles of Hospitals
ì Nowadays, people are often treated in clinics within the hospital but then go home (day surgery)
ì As consequences: fewer hospitalizations ì
Advantages:
ì The costs associated with hospitalizations are very high
ì Risk of contracting illnesses from others is increased when hospitalized
ì Potentially better rest, healing, support, etc. at home
