S4 - Lay Beliefs and Long-Term Conditions Flashcards
what are lay beliefs
- how people understand and make sense of health and illness
- contructed by people with no special knowledge
- socially embedded
- complex - drawn from many different sources
perceptions of health
- negative definition health equates to the absence of illness (found more commonly in lower socioeconomic backgrounds)
- functional definition health is the ability to do certain things (more commonly in older populations)
- positive definition health is a state of wellbeing and fitness, so something you can work towards over time (more commonly in higher socioeconomic backgrounds, and able to focus more on long term investments)
influence of lay beliefs on behaviour
health behaviour
activity undertaken for purpose of maintaining health and preventing illness
illness behaviour
activity of ill person to define illness and seek solution
sick role behaviour
formal response to symptoms, including seeking formal help and action of person as patient
what influences illness behaviour
- culture, eg having stoical attitude will inhibit treatment seeking
- visibility or salience of symptoms
- extent to which symptoms disrupt life
- frequency and persistence of symptoms
- tolerance threshold
- information and understanding ie knowledge of ‘red flags’
- availability of resources, eg registered with GP?
- lay referral (more details on next card)
what is lay referral
ie discussing symptoms with others
* relatively rare for someone to decide to visit a doctor without first discussing their symptoms with others
* lay referral system = the chain of advice-seeking contacts in which the ill make with other lay people prior to (or instead of) seeking health from HCPs
lay referral is important because it helps us to understand…
* why people might have delayed seeking help
* how, why and when people consult a doctor
* your role as a Dr in their health
* use of services and medication
* use of alternative medicine
what are long term conditions
- long term
- often profound influence on lives of sufferer
- often co-morbid conditions
- manifestations vary greatly day-to-day
- controlled but not cured
- eg rheumatoid arthritis
- people with LTCs account for bulk of GP appointments, outpatient appointments and inpatient beds
sociological approach to long term conditions
- focuses on how LTCs impact on social interaction and role performance
- concerned with experiences and meanings of LTCs and their effects
- interested in how people manage and negotiate LTCs in everyday life
illness work: getting a diagnosis
- may be prolonged period of uncertainty
- ambivalent status of some diagnoses, ie not sure what it really means
- processes can be very unpleasant
- diagnosis can be: profoundly shocking, very threatening and a relief for patient
illness work: managing symptoms
- dealing with physical manifestations of illness has to be done before coping with social relationships
- interaction between the body and identity
- bodily changes → self conception changes
self management
* optimum self-management is difficult to achieve due to poor rates of treatment adherance, reduced quality of life and poor psychological wellbeing
* brief interventions to improve self-management include telephone/in person check-ins with patient… these vary in effectiveness
expert patient programme
briefly what is it, and the pros/cons
peer-led self care support programme for people living with any long term condition, their carer and families
pros
* coping and condition management skills
* aims to reduce hospital admissions
* patient centred approach
cons
* responsibility for care placed on very ill patients
* real agency and understanding?
* little evidence of efficiency savings
what is the difference between coping and strategy (everyday life work)
coping
the cognitive processes involved in dealing with illness
strategy
the actions and processes involved in managing the condition and its impact
what is normalisation
- trying to keep pre-illness lifestyle and identity
- this can be done by disguising or minimising symptoms
- or can redesignate new life as ‘normal life’ (which may involve people signalling changes in their identity rather than preserving old ones)
emotional work involved in long term conditions
- work that people to do protect the emotional well-being of others
- maintaining normal activities becomes deliberately conscious
- people find that friendships may be disrupted and then strategically withdraw socially
- may involve downplaying pain and other symptoms eg presenting cheery self
impact on role
* ie impact on role as breadwinner, wife, mother etc may have devistating impact on emotional wellbeing
* dependency - ie feeling uselessness to self and others
* higher impact on younger people
emotional work involved in long term conditions
- work that people to do protect the emotional well-being of others
- maintaining normal activities becomes deliberately conscious
- people find that friendships may be disrupted and then strategically withdraw socially
- may involve downplaying pain and other symptoms eg presenting cheery self
impact on role
* ie impact on role as breadwinner, wife, mother etc may have devistating impact on emotional wellbeing
* dependency - ie feeling uselessness to self and others
* higher impact on younger people
biographical work: loss of self
- where former self-image crumbles away without development of equally-valued new self-image
- constant struggle to lead valued life
- struggle to maintain positive definitions of health
- foussing on physical discomfort minimised broader significance of suffering for people with chronic illness
- interaction between body and identity
- grief for a former life
