Why do people consult?

Question 1

Explain the role of the lay referral system

Answer 1

network of people in the community, who give informal, medical advice

Question 2

Explain what is meant by the clinical iceberg

Answer 2

Large amounts of people wjo experience symptoms either take no action or self medicate

health professionals only see fraction of those with symptoms-the tip of the iceburg, largest part of iceburg is under water, as are these patients who self treat

Question 3

List and explain the 3 healthcare systems described by Kleinman (1985)

Answer 3

Popular sector = lay people, symptoms first experienced in the community, e.g. friends. media

Professional sector = doctors and healthcare professionals

Folk sector = cultural beliefs

Question 4

Describe how consulting behaviour may differ by age, ethnicity, gender, social class, employment status

Answer 4

• age = top and bottom ends
  
  • over 60’s, minor complaints have big impacts on daily activities
• ethnicity = minority consult more
• gender = females > males
  
  • more reason- menstruation, social norms(macho image for men not to consult), surgery times
• social class
  
  • upper class- health awareness
  • bottom class- free prescription, manual work, less knowledge
• employment status = unemployed consult more
  
  • more time off+ unemployment big impact on mental health

Question 5

List and explain 10 variables known to influence illness behaviour according to Mechanic (1978)

Answer 5

1. visibility, recognisability of signs and symptoms
2. perceived as serious?
3. disrupt family, work, other social activities
4. frequency of symptoms/signs
5. tolerance threshold
6. available information, cultural assumptions and understandings
7. basic needs that lead to denial
8. needs competing with illness responses
9. competing possible interpretation that can be assigned to the symptoms
10. availability of treatment resources, physical proximity, costs

Question 6

List and explain 5 triggers to consultation according to Zola.

Answer 6

1. perceived interference with vocational/physical activity
2. perceived inference with social or personal relations e.g. rash on face
3. the occurrence of an interpersonal crisis e.g. divorce
4. a kind of temporising of symptomatology e.g. not better by next tuesday
5. sanctioning e.g. being allowed to go to doc

Question 7

Describe the ‘sick role’ according to Parson’s

Answer 7

• must want to get well
• should seek medical advice and cooperate
• allow/be expected to shed some normal activities/responsibilities
• regarded as being in need of care and unable to get better by his or her own decisions and will