Models of Illness & Triggers to Consultation Flashcards
What does the biopsychosocial model believe health is the result of?
An interaction between biological, psychological & social factors
WHO definition of health?
A state of complete physical, mental & social well-being, not merely the absence of disease or infirmity
What are the 3 ways health can be defined?
- Negative (absence/presence of disease) - emphasises deficit
- Positive (fitness and well-being) - emphasises overall health
- Functional (ability to cope with activities) and/or being fit
Why are definitions of health important?
Define how we treat health, determine health, perceive health & when clinicians get involved
What are some possible lay perceptions of health?
- More likely about lifestyle - eating well. food, exercise, sleep, checkups (healthy things - make us feel healthy)
- Body maintenance (look good = feel good)
- Sense of physical, mental & social well-being
- Not being ill
Differences between illness & disease?
Illness
-Absence of health
-Subjective/opinion driven
-More socially constructed
-Can’t quantify (qual)
Disease
-Can prove
-Objective/scientific proof
-Biological
-Defined symptoms
-Diagnosable
-Quantifiable
-Has beginning & end
Define disease.
- A biological part or process is functioning at a level below the norm - an abnormality in structure (sub-optimal functioning)
- Diagnosed by an expert
Problems with the disease approach to understanding ill health?
-Disregards individual experiences - undermines patient
-REDUCTIONIST - only accounts for biological view of ill health
Define illness.
-‘The experiences of disease, relates to a way of being for the individual concerned’ (Radley, 1993)
-Being/feeling ill - but can’t always diagnose/classify (harder to treat)
-The ill heath the person subjectively experiences & identifies
Problems with defining illness as described, in a reductionist way (ill health = no disease) - Engel 1977 (biopsychosocial model)?
-Social learning defines what is abnormal - so if we can’t classify abnormal, are we ill?
-Drs MUST know beh & soc links to clinical aspects of illness (as patients will only be exposed to these - lay)
-Do people report onset initially or wait - links to lifestyle
-Presence of disease not account when patients view themselves or are viewed by others as sick or when patient enters healthcare system
-Patients can still feel ill even after biological alleviation/improvement of disease
-Dr-pat relationship = vital influence on therapeutic outcome
How does a diagnosis affect the patient?
-Once diagnosed the patient will change accordingly
-Diagnosis creates illness - being legitimately ill
-(‘allowed to be ill’)
-Dr is expert - will tell us what is wrong
What is the social construction of reality (& so illness) & how does it fit into perceptions of illness?
-We become convinced that we are what we are named/labelled (ill)
-Due to social order - beliefs that distort reality (can’t see from how they actually are)
-Society defines meanings for things in our env
-What counts as illness varies between people in society & changes over time
-Results in individual perspectives - subjective interpretations of reality
-So our beliefs of what is healthy varies between people, places, & in time
-Illness has cultural meaning
-Illnesses = socially constructed –> & so too is medical knowledge (society decides what is relevant)
Is illness a natural or social phenomena?
Social –> as changes (isn’t fixed)
-We live illness (we don’t just have it) - embodied (illness is expressed - physically) & so social experience plays a part
ALSO because…
-definitions & believed treatments of illness differ between people & cultures (e.g in western society - medicalised - others - see as natural e.g., menopause, ageing)
-people access help for illness differently
Soc, cult, psych systems shape experience & meanings of illness (cultural/religious traditions)
What shapes meanings & believed treatments of illness, & what does this mean?
-Regions
-Ethics
-Culture
-Experience
–> illness = dynamic - changes as perceptions do
So, what actually counts as an illness?
Anything that an individual perceives as abnormal - perhaps in affecting their ability to function -> fail to comply to societal expectations of them