Lecture 8 - Using health Services

Question 1

What is a Symptom?

Answer 1

Sensory experience that is interpreted as indicating that something is not working properly

Question 2

what are some Common Physical Symptoms

Answer 2

Pain Itchiness Numbness Congestion Wheezing Vomiting Constipation Fainting Fatigue
Soreness
Tingling
Shortness of breath Cough
Nausea
Diarrhea
Dizziness
Heart palpitations Vision problems

Question 3

Factors that Influence Noticing Sensations or Recognizing Symptoms

Answer 3

ìSituational factors 
ì Stress
ì Mood
ì Social factors
ì Cultural differences

Question 4

explain Noticing Sensations/Recognizing Symptoms: Situational Factors

Answer 4

Busy vs. nothing to do
ì Perceptual and environmental determinants of
coughing (Pennebaker, 1980)

Question 5

explain Medical Student’s Disease

Answer 5

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

Question 6

explain Noticing Sensations/Recognizing Symptoms: Mood

Answer 6

Mood-congruent perception ì Salovey & Birnbaum 1989

Mood as information
ì Positive mood –> things going well

Question 7

explain Noticing Sensations/Recognizing Symptoms:

Mass Psychogenic Illness

Answer 7

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

Question 8

explain Noticing Sensations/Recognizing Symptoms: Personality and Individual Factors

Answer 8

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

Question 9

explain Hypochondriasis

Noticing Sensations/Recognizing Symptoms: Personality and Individual Factors

Answer 9

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

Question 10

what is “Worried Well”

Answer 10

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

Question 11

why is ‘worried well’ increasing

Answer 11

cause of
ì societal emphasis on healthy lifestyle
ì media attention to new health problems and diagnostic tests

Question 12

Noticing Sensations, Recognizing them as Symptoms: Summary

Answer 12

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)

Question 13

how to interpret Symptoms - Seriousness Body Part Affected and Pain

Answer 13

ì Highly valued parts of the body

ì Pain = seek treatment more promptly

Question 14

explain Illness Schemata

Answer 14

Contain concepts
ì Identity (name of illness) ì Consequences
ì Causes
ì Duration
ì Cure

Question 15

what are the 5 Components (Diefenbach & Leventhal, 1998) of illness schemata

Answer 15

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

Question 16

what is the Importance of illness schemata

Answer 16

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

Question 17

Health Services Use by Age: Highest among who

Answer 17

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

Question 18

The use of health services is lowest among:

Answer 18

ì Adolescents and young adults

Question 19

When do People Seek Medical Care?

Answer 19

Most help-seeking when symptoms are:
n New
n Unexplainable
n Painful
n Highly visible
n Affecting valued body parts

Question 20

what are the stages of Delaying Medical Care

Answer 20

Appraisal delay (Stage 1)
Illness delay (Stage 2)
Behavioural delay (Stage 3)
Medical delay (Stage 4)

Question 21

explain Appraisal delay (Stage 1)

Answer 21

Time it takes an individual to decide if a symptom is serious

Question 22

explain Illness delay (Stage 2)

Answer 22

Time between the recognition that a symptom implies an illness
and the decision to seek treatment (intention)

Question 23

explain Behavioural delay (Stage 3)

Answer 23

Time between deciding to seek treatment and actually doing so

Question 24

explain Medical delay (Stage 4)

Answer 24

Time between making an appointment and receiving appropriate medical care

Question 25

what are the Factors correlated with delaying medical care (Safer et al., 1979)

Answer 25

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

Question 26

how is A hospital is a unique culture:

Answer 26

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

Question 27

explain Loss of Control: Depersonalization

Answer 27

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

Question 28

explain Hospital Culture: Loss of Control

Answer 28

Total Institution (Goffman, 1961)
Possible Reactions:
§ Reactance
§ Learned Helplessness

Closely linked to need for information: ì Monitoring style
ì Blunting style

Question 29

explain Having Information Can Increase Control

Answer 29

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

Question 30

explain Control-Enhancing Interventions (at hospital)

Answer 30

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

Question 31

explain Control-Enhancing Interventions: The Changing Roles of Hospitals

Answer 31

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