Why Do Patients Consult?

Question 1

What is Kleinmans model of healthcare systems

Answer 1

All health and illness are dealt and managed by three different interlinking factors
1. Popular sector - biggest sector. Non healthcare (family, friends)
2. Folk sector - alternative medicine (traditional remedies, CAM)
3. Professional sector - healthcare professionals and modern medicine

Question 2

How people move about the sectors in Kleinmans model

Answer 2

Sectors interlinked
People move continuously between sectors until they are well
E.g. when first unwell ask family members, might make them try CAM, then CAM doesn’t work so go to doctors

Question 3

WHO definition to health

Answer 3

Health is a state of complete physical, mental, social wellbeing and not just the absence of disease

Question 4

Health defined as in sociology:

Answer 4

Negatively defined as absence of illness
Functionally as the ability to cope with everyday activities
Positively as fitness and wellbeing

Question 5

Why can health be defined differently

Answer 5

Health is a concept
Social factors influence health
Like age, gender, culture, personal goals

Question 6

What is disease

Answer 6

A pathological process
Deviation from biological norm

Question 7

What is illness

Answer 7

Patients experience of ill health
Sometimes no disease found

Question 8

What is sickness

Answer 8

Role (of unhealthy person) negotiated with society

Question 9

Definition of healing and wholeness

Answer 9

Whatever process results in the experience of greater wholeness of the human spirit

Question 10

How do people make the decision to see the doctors

Answer 10

Symptoms: feelings that patients experience that alert them health is not well
Signs: pointer the doctor identifies that signify ill heath

A doctor will listen to Symptoms but will objectively look for signs

Question 11

What are the stages of illness

Answer 11

1. Person may experience symptoms
2. May seek advice fam and friends
3. Professional advice from doc
4. Doc confirms sickness
5. Patient assumes sick role
6. Recovery (not for chronic conditions)

Question 12

What is the clinical ice berg

Answer 12

Idea that many patients who show signs and symptoms won’t consult
Believe they are healthy
Disease goes unreported
People with chronic conditions more likely to report symptoms

Question 13

Factors that affect consulting rates

Answer 13

Smoking status
Social class
Age
Gender
Ethnicity

Question 14

What do people of lower social class consult more

Answer 14

Free prescriptions instead of buying meds
Poor housing may increase risk of disease

Question 15

Why are elderly and youngsters more likely to consult

Answer 15

More likely to have comorbidities
Elderly lonely
Parents pedantic when comes to protection of children

Question 16

Why do women consult more than men

Answer 16

Less social stigma for women to consult
Women have more problems generally
Women more likely to take fam members
Men find difficulty expressing intimate problems

Question 17

Decision to consult based on sequence of thought

Answer 17

Are my symptoms normal or abnormal?
Should I go to the drs?
What else can I do? (Self care)
What are costs and benefits of seeing doc? (Time of work/ travel costs)

Question 18

Mechanics (1978) variable known to influence illness behaviour

Answer 18

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.)

Question 19

Zolas (1973) 5 Social triggers for why patients consult

Answer 19

1. Perceived Interference with vocational or physical activity
2. Perceived interference with social or personal relations - visible symptoms more likely to get checked out
3. Occurrence of an interpersonal crisis
4. Kind of temporalising symptomatology - “if I still have headache next week I’ll go see doctor” setting personal time limit
5. Sanctioning - someone else encouraging that U see doc

Question 20

What happens when someone takes on a “sick role”

Answer 20

Sick person exempt from all normal social duties
Must recover asap
Sick role temporary phase
May need to seek appropriate medical care

Question 21

Parsons obligations and privileges of patient with sick role

Answer 21

Intention to recover asap
Should seek professional medical advice and coop with doctor
Drop some responsibilities
Regarded as being in bed of care

Question 22

Parsons expectations of doctors professional role when dealing with sick patient

Answer 22

High degree of skills and knowledge to problem of illness
Act in interest of patient and community not self interest
Objective and emotionally detached
Use guidance on professional practice

Question 23

(Parsons) Rights of professional doctors when dealing with sick patients

Answer 23

Right to examine patients physically and enquire about personal life
Granted Considerable autonomy in professional practice
Occupies position of authority in relation to patient