Why do people consult? Flashcards
What influences individuals definition of “health” and “illness”?
social factors such as gender, age, culture and social class
the lay and medical definitions may also var considerably
What does the bio-medical model suggest?
it suggests that people normally consult a doctor when they cannot cure their symptoms by self-treating. However a large amount of illness is managed informally in the community without reference to health professionals
What is Kleinman’s model of healthcare systems?
Sections include: professional sector, folk sector, popular sector
The professional and folk sectors may or may not overlap in particular local settings
What is involved in the professional sector of kleinman’s model of healthcare systems?
HCPs and complementary practitioners that are regulated are within this sector
What is involved in the popular sector of kleinman’s model of healthcare systems?
When someone seeks advice from family or friends or social media - appears outside OF healthcare system
People start evaluating what is wrong with them
People in the community giving advice - tends to be women not mends because they tend to take the more caring role and read more about health.
What is involved in the overlap between popular sector and professional sector of kleinman’s model of healthcare systems?
People may try to self-manage and then go to consult a doctor if they can’t treat it themselves. They will the re-evaluate HCP advice back in popular sector and if someone else says to them they had bad side effects from a certain treatment, this may stop the other person taking the treatment and could cause that person to stop taking advice from their doctor
What is involved in the folk sector of kleinman’s model of healthcare systems?
Complementary lay practioners- old wives tales, such as hot toddies.
What is a key issue nowadays once a person decides to consult a doctor?
Often it can take a long time to get a consultation and this can lead to the patient finding alternative treatments
What is Blaxter (1990) definition of health and illness?
“health can be defined negatively as the absence of illness, functionally, as the ability to cope with everyday activities or positively as fitness and well-being”
What factors influence our definition of health and illness?
Duty to be healthy/illness as failure - government keeps communicating about the importance of looking after yourself e.g. getting the flu jab
Emphasis on body maintenance - media cover this all the time
Normal illness/serious illness- e.g. breast cancer can now be seen as something that can be lived with. Attribution - old person having joint pain early in the morning isn’t too alarming whereas in a young person that would be very alarming
What is the definition of symptoms?
those feeling states patients experience which alert them to the possibility that all is not well
What is the definition of signs?
those pointers the doctor identifies which signify the existence of the underlying pathological lesion
What are the stages of illness (model of the processes a patient goes through)?
- Person experiences symptoms
- May seek advice from friends and relatives
- May seek professional advice from a doctor
- Doctor confirms person is sick (legitimise sick role)- providing a diagnosis - doctor hands over prescription or provides a referral or could sign them off work
Sometimes doctors are unable to make a diagnosis e.g. ME - sick role
- recovery
What did the clinical iceberg study show?
HCPs only see tip of the iceberg as most of it is underwater which is representing all the people that have symptoms within the community but are not altering their GP (study in 1000 adults living in London)
Out of the 1000 adults most of them had a symptoms but most are managed in the community and as a GP you only see a small percentage at one time
What ages groups tend to consult more than others?
Elderly and very young children to tend to have higher consultation rates- more at risk groups
- elderly tend to have more co-morbidites
- elderly can sometimes feel lonely, therefore they just want to go in for a chat
- children tend to get sick very quickly
- Parents are well informed about childhood illnesses
- sick children can’t go to school/nursery but parents need childcare
Which gender is more likely to consult a doctor?
Women are more likely
- more points in women health which causes them to visit HCP
- women tend to know more about health
- social perception that men need to be strong
How does social class influence someone decision to consult a doctor?
Higher social classes tend to consult about more trivial things
Lower social classes have higher consultation rates for more severe issues - don’t want to pay for OTCs so have consultations for prescriptions
How do people decide whether or not to consult a doctor?
- are my symptoms normal or abnormal?
- should i go to the doctor on this occasion?
- what else can i do?
- what are the costs and benefits of seeing the doctor?
Summary of decisions people make when deciding whether to consult or not
What are Zola’s 5 social triggers which together encompass the way in which symptoms comes to be seen as abnormal?
- perceived interference with vocational or physical activity - e.g. hobbies
- perceived interference with social or personal relations e.g. acne
- occurrence of an interpersonal crisis e.g. family issue, divorce, societal event
- Kind of temporising of symptomatology - setting a time limit on symptoms
- Sanctioning - given permission by someone else to encourage them to go
How does employment influence someone decision to consult a doctor?
unemployed have higher consultation rate- stressful situation
Physical and mental issues increase
What are the mechanic’s (1978) variables known to influence illness behaviour?
- visibility, recognisability or perceptual salience of signs and symptoms
- extent to which the symptoms are perceived as serious
- extent to which symptoms disrupt family, work, and other social activities
- frequency of the appearance of the signs or symptoms their persistence or their frequency or recurrence
- tolerance threshold of those who are exposed to and evaluate the signs and symptoms
- available info 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 costs of taking action (not only physical distance and costs of time, money and effort but also costs such as stigmas, social distance and feelings of humiliation)
What is the patient’s role in the Parson’s sick role?
Obligations and privileges:
- must want to get well as quickly as possible
- should seek professional medical advice and co-operate with the doctor
- allow and may be expected to shed some normal activities and responsibilities - e.g. employment and household tasks
- regarded as being in need of care and unable to get better by his or her own decisions and will
What is the doctor’s role in the Parson’s sick role?
Expected to:
- apply a high degree of skills and knowledge to the problems of illness
- act for welfare of patient and community rather than their own self-interest, desire for money, advancement
- be objective and emotionally detached- should not judge patient’s behaviour in terms of personal value system or become emotionally involved with them
Rights:
- granted right to examine patients physically 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
