Why Do Patients Consult? Flashcards
what is the sick role?
(when someone has been diagnosed with an illness)
The sick person is exempted from carrying out some/all of normal social duties (e.g. work, family).
The sick person must try and get well as soon as possible– the sick role is only a temporary phase.
In order to get well, the sick person may need to seek and submit to appropriate medical care.
explain the roles of both patients (sick role) and doctors (professional role)?
what is Kleinman’s model of healthcare systems?
all health and illness are dealt with and managed by three different interlinking sectors.
All these sectors are interlinked and this is a dynamic model - people move between sectors continuously until they are ‘well’
E.g. when someone is unwell, they may first start with asking family members /check the internet. This may make them decide to go try complementary/alternative therapy. If the complementary therapy doesn’t work they go and see a doctor who informs then of what to do.
what are the 3 sectors in Kleinman’s model of healthcare systems?
what is WHOs definition of health and illness?
Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
from a sociological POV, what is the definition of health and illness (Blaxter, 1990) ?
Health can be defined:
negatively as the absence of illness
functionally as the ability to cope with everyday activities
positively, as fitness and well-being.
is the way people define health the same?
The ways different individuals define health is different and can be influenced by social factors e.g. gender, age, culture and their own personal goals.
what is the difference between Disease, Illness, Sickness, Healing & wholeness?
Disease – pathological process, deviation from biological norm
Illness - patients experience ill health, sometimes no disease is found
Sickness - role negotiated with society.
Healing & wholeness – whatever process results in the experience of greater wholeness of the human spirit
How do people make decisions about approaching the formal healthcare system?
Signs and symptoms
Symptoms: feelings of patients which alert them to ill health
Signs: Outward pointers the doctor identifies that signify existence of illness
A doctor will listen to symptoms but will look for objective signs
what are the stages of illness?
- person experiences symptoms
- may seek advice from relatives & friends
- may seek professional advice from a doctor
- doctor confirms person is sick (legitimises sick role)
- Patient assumes the sick role - identified by tests, referral, prescription, sick note (i.e. medicalisation)
- Recovery (not true in chronic conditions)
what is the clinical iceberg?
idea that many who show signs & symptoms won’t consult –> believe themselves to be healthy –> diseases go unreported
People with chronic conditions more likely to report symptoms
what are the factors affecting consulting rates (SSAGE) ?
Smoking status:
Major risk factor for a lot of diseases.
Social class:
socially deprived consult more frequently
free prescriptions instead of buying medication over the counter
poor housing may increase risk of disease e.g. respiratory problems due to mould
Age:
young & elderly consult more as they are the most vulnerable age groups
elderly are more likely to have comorbidities
Elderly may live in isolation - loneliness
Parents are often very pedantic when it comes to the protection of their children
Gender:
women tend to consult more than men
less social stigma for women to consult than men
women have more problems generally i.e. menopause, periods, pregnancy, infertility, birth etc
women more likely to take family members (child/relative) to Drs
men may find it more difficult to express intimate problems
Ethnicity:
S. Asians & Chinese consult more than white Brits
explain what happens during the decision to consult - based on a sequence of thought
Are my symptoms normal or abnormal? (personal perception e.g. old people having joint pains is normal whereas young people it isn’t)
Should I go to the Drs on this occasion?
What else can I do? (self care)
What are the costs & benefits of seeing the Dr? (Have to get a bus, long walk, taking time off work)
People resist going to Drs as they believe they will not get a GP appt quickly - rise in complementary medicine
what are Zola’s 5 triggers for why patients consult?
- Perceived interference with vocational or physical activity (work or leisure activities)
- Perceived interference with social or personal relations (e.g. visible skin rash more likely to go get checked out)
- The occurrence of an interpersonal crisis - e.g. a divorce or death of a family member somehow brings symptoms to the forefront. (decreases tolerance to ongoing symptoms)
- A kind of temporalising of symptomatology - setting time limit to symptoms by patient - if I still have that headache next week I’ll go to the doctor
- Sanctioning - someone else encouraging you to go to the Drs e.g. work or family
what are Mechanic’s (1978) 10 variables known to influence illness behaviour?
- Recognisability of signs & symptoms (e.g. a rash on leg is less recognisable than rash on face)
- Perceived severity of symptoms
- Extent of disruption to family, work & social activity by symptoms
- Frequency of appearance of signs & symptoms (e.g. persisting pain vs occasional pain)
- Tolerance threshold (e.g. severity of pain)
- Available knowledge, cultural assumptions & understanding of evaluator
- Denial of symptoms (scared)
- Needs competing with illness responses
- Competing interpretations that can be assigned to the symptoms e.g. a symptom of cancer is fatigue but fatigue is also a symptom to many other conditions.
- Availability of treatment resources (i.e. cost, distance, stigma, social distance, can’t get an appointment etc.)
