Why Do Patients Consult? Flashcards
What is Kleinmans model of healthcare systems
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
How people move about the sectors in Kleinmans model
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
WHO definition to health
Health is a state of complete physical, mental, social wellbeing and not just the absence of disease
Health defined as in sociology:
Negatively defined as absence of illness
Functionally as the ability to cope with everyday activities
Positively as fitness and wellbeing
Why can health be defined differently
Health is a concept
Social factors influence health
Like age, gender, culture, personal goals
What is disease
A pathological process
Deviation from biological norm
What is illness
Patients experience of ill health
Sometimes no disease found
What is sickness
Role (of unhealthy person) negotiated with society
Definition of healing and wholeness
Whatever process results in the experience of greater wholeness of the human spirit
How do people make the decision to see the doctors
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
What are the stages of illness
- Person may experience symptoms
- May seek advice fam and friends
- Professional advice from doc
- Doc confirms sickness
- Patient assumes sick role
- Recovery (not for chronic conditions)
What is the clinical ice berg
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
Factors that affect consulting rates
Smoking status
Social class
Age
Gender
Ethnicity
What do people of lower social class consult more
Free prescriptions instead of buying meds
Poor housing may increase risk of disease
Why are elderly and youngsters more likely to consult
More likely to have comorbidities
Elderly lonely
Parents pedantic when comes to protection of children
Why do women consult more than men
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
Decision to consult based on sequence of thought
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)
Mechanics (1978) variable 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.)
Zolas (1973) 5 Social triggers for why patients consult
- Perceived Interference with vocational or physical activity
- Perceived interference with social or personal relations - visible symptoms more likely to get checked out
- Occurrence of an interpersonal crisis
- Kind of temporalising symptomatology - “if I still have headache next week I’ll go see doctor” setting personal time limit
- Sanctioning - someone else encouraging that U see doc
What happens when someone takes on a “sick role”
Sick person exempt from all normal social duties
Must recover asap
Sick role temporary phase
May need to seek appropriate medical care
Parsons obligations and privileges of patient with sick role
Intention to recover asap
Should seek professional medical advice and coop with doctor
Drop some responsibilities
Regarded as being in bed of care
Parsons expectations of doctors professional role when dealing with sick patient
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
(Parsons) Rights of professional doctors when dealing with sick patients
Right to examine patients physically and enquire about personal life
Granted Considerable autonomy in professional practice
Occupies position of authority in relation to patient
