Models of Illness & Triggers to Consultation Flashcards

1
Q

What does the biopsychosocial model believe health is the result of?

A

An interaction between biological, psychological & social factors

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2
Q

WHO definition of health?

A

A state of complete physical, mental & social well-being, not merely the absence of disease or infirmity

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3
Q

What are the 3 ways health can be defined?

A
  • 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
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4
Q

Why are definitions of health important?

A

Define how we treat health, determine health, perceive health & when clinicians get involved

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5
Q

What are some possible lay perceptions of health?

A
  • 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
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6
Q

Differences between illness & disease?

A

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

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7
Q

Define disease.

A
  • A biological part or process is functioning at a level below the norm - an abnormality in structure (sub-optimal functioning)
  • Diagnosed by an expert
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8
Q

Problems with the disease approach to understanding ill health?

A

-Disregards individual experiences - undermines patient
-REDUCTIONIST - only accounts for biological view of ill health

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9
Q

Define illness.

A

-‘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

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10
Q

Problems with defining illness as described, in a reductionist way (ill health = no disease) - Engel 1977 (biopsychosocial model)?

A

-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

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11
Q

How does a diagnosis affect the patient?

A

-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

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12
Q

What is the social construction of reality (& so illness) & how does it fit into perceptions of illness?

A

-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)

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13
Q

Is illness a natural or social phenomena?

A

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)

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14
Q

What shapes meanings & believed treatments of illness, & what does this mean?

A

-Regions
-Ethics
-Culture
-Experience
–> illness = dynamic - changes as perceptions do

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15
Q

So, what actually counts as an illness?

A

Anything that an individual perceives as abnormal - perhaps in affecting their ability to function -> fail to comply to societal expectations of them

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16
Q

So, what actually counts as an illness (as sub-optimal) - when can we define something as an illness?

A

Anything that an individual perceives as abnormal - perhaps in affecting their ability to function -> fail to comply to societal expectations of them

17
Q

What is sickness?

A

The social role a person with an illness or sickness takes or is given in society

18
Q

What is needed for being considered ill - what do we need (social experience of illness)?

A

-Others to recognise our symptoms
-Dr to label our suffering
–> when are we officially ill enough to be said so?

19
Q

Impacts of sickness on society?

A

= disruptive
-So have ways to manage -> sick leave work absence - but this is disruptive to social order
-Sick people are given social roles - where certain things are expected of them
–> so illness = deviance - threatens social order (which is why we manage)

20
Q

What is the sick role?

A

-Social response to sickness/illness
= patterns of beh expected of ill people

21
Q

What are the rights of people with the sick role?

A

-Excused from normal activities & responsibilities (e.g., work)
-Need caring for
-‘Forgiven’ for having their illness

22
Q

What are the obligations/expectations of people with the sick role?

A

-A want to get better - temporary role
-Seek prof advice & cooperate (only ill if require prof help = new view)
(only get sick role privileges if follow the set obligations)

23
Q

-ves of sick role?

A

-Temporary - not applicable to chronic illnesses (not able to return to normal responsibilities)
-‘Blame’ person for own health - ind responsibility
-People may refuse to participate in sick role
-Ind diffs in seeking help for symptoms
–> other ways of dealing w/ than medical advice

24
Q

Why do people behave differently - some go to Drs v. early on (minor symptoms), late on (severe symptoms), not at all - for symptoms?

A

-Symptoms are NOT cues
-Individual perceptions of when they are able to be legitimately ill & need help
-People don’t always know they are ill

25
Q

Proportions of people seeking medical help for symptomatic diseases?

A

1/3 = do nothing
1/3 = self-medicate or seek alternative therapies
1/3 = consult Dr

26
Q

Why might some people delay going to Drs?

A

Feeling ill/having symptoms is a requirement before can go

27
Q

What determines a person’s course of action - seeking medical advice & when?

A

If they have a disease
-How they/others respond to their symptoms

28
Q

Why is it a +ve that not all people go to Drs for all symptoms of ‘illness’?

A

-Health services would be overwhelmed

29
Q

What are sectors of health care systems?

A

-Popular sector = media, google, news
-Folk sector = non-mainstream NHS service e.g., home remedies

30
Q

What is the popular sector - what is its place in healthcare?

A

-Lay non-profs & their social networks
-Recognise & cope will illness
-Large pert involves - self-care & self-medicating
-Decide whether to start & end these treatments
-Unpaid care = defining feature

31
Q

What is the lay referral system?

A

Seeking help from systematically from family to more distinct laymen until reach professionals
-Network of who we live with & their opinions, what is in media, past experiences, societal expectations

32
Q

What are some socio-demographics to describe likelihood of people accessing healthcare?

A

-More women than men
-More men in relationships than men not
-More children & elderly than young adults, middle aged
…–> others regard: social class, ethnic origin, marital status, family size related to utilisation
(lower socioeconomic groups = more to worry about - less emphasis on health (view their health as undeserving), vs more affluent - more time for health –> worries hierarchy

33
Q

What are the social triggers to consultation - what makes people go to Drs/triggers help seeking?

A

-Interpersonal crisis occurs e.g. divorce or job loss - more focussed on symptoms
-Symptoms interfere w/ vocational or physical activity
-Symptoms interfere w/ social or personal relations
-Sanctioning e.g. ‘I didn’t want to bother you but xxx insisted I should come’
-Temporalising of symptoms e.g. ‘if this symptom has not disappeared by Monday, I’ll go to the doctor’

34
Q

Other triggers to consultation…?

A

-Media stories - pandemic - hospital = where people catch covid, overwhelmed hospitals - don’t want to be burden
-Politics - political changes influencing healthcare systems - e.g., USA - contraceptive pill had to be paid for
-Economy

35
Q

What is delay behaviour in terms of accessing healthcare?

A

-People delaying accessing medical help

36
Q

Why might people show delay behaviour?

A

-Anxiety - don’t want bad news, don’t want covid - so won’t go
-Embarrassment/stigma of certain diseases - e.g., STIs, mental illness
-Lack of awareness/uncertainty about meaning of symptoms
-Competing social demands e.g., ignoring
symptoms due to work/family/social responsibilities
-Problematic doctor-patient interaction
e.g., fear being labelled ‘hypochondriac’ or ‘worrier’/Not being taken seriously (don’t want to be told are making stuff up)
-Structural barriers e.g., inadequate
transportation, geographical distance,
health care professional shortages
-Normalising symptoms if can e.g., just old age