Why do Patients consult?

Question 1

Disease definition

Answer 1

The pathological process, deviation from biological norm

Question 2

Illness definition

Answer 2

The patient’s experience of ill health (sometimes when no disease can be found)

Question 3

Sickness definition

Answer 3

The role negotiated with society

Question 4

Healing definition

Answer 4

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

Question 5

Signs definition

Answer 5

Pointers the doctor identifies which signify the existence of the underlying pathological lesion

Question 6

Symptoms definition

Answer 6

Those feeling states patients experience which alert them to the possibility that all is not well

Question 7

6 stages of illness

Answer 7

1. Person experiences symptoms
2. May seek advice from friends/family
3. May seek advice from doctor
4. Doctor confirms they are sick
5. Sick role
6. Recovery

Question 8

Zola’s 5 social triggers which together encompass the way in which symptoms come to be seen as abnormal

Answer 8

• Perceived interference with vocational or physical activity
• Perceived interference with social or personal relations
• The occurrence of an interpersonal crisis
• A kind of temporalising of symptomatology (time-scale)
• Sanctioning

Question 9

Mechanic’s variables known to influence illness behaviour

Answer 9

• Visibility, recognisability or perceptual salience of signs and symptoms
• The extent to which the symptoms are perceived as serious
• The extent to which symptoms disrupt family, work and other social activities
• The frequency of the appearance of the signs or symptoms, their persistence, or their frequency or recurrence
• The tolerance threshold of those who are exposed to and evaluate the signs and symptoms
• Available information knowledge and cultural assumptions and understandings of the evaluator
• Basic needs that lead to denial
• Needs competing with illness responses
• Competing possible interpretations that can be assigned to the symptoms once they are recognised
• Availability of treatment resources, physical proximity and psychological and monetary cost of taking action (not only physical distance and cost of time, money and effort, but also costs such as stigma, social distance and feelings of humiliation)

Question 10

Obligations and privileges of patient in the sick role

Answer 10

• Must want to get better as soon as possible
• Should seek professional medical advice and co-operate with doctor
• Allow shedding of some normal activities and responsibilities

Question 11

Expectations of doctor in the professional role

Answer 11

• Apply a high degree of skill and knowledge to the problems of illness
• Act for welfare of patient and community rather than for own self-interest, desire for money, advancement, etc.
• Be objective and emotionally detached
• Be guided by rules of professional practice

Question 12

Rights of doctor in professional role

Answer 12

• Granted right to examine patients physically and to enquire into intimate areas of physical and personal life
• Granted considerable autonomy in professional practice
• Occupies position of authority in relation to the patient