Wk4 Why Do Patients Consult

Question 1

What does the biomedical model suggest?

Answer 1

people normally consult the doctor when they cannot cure their symptoms by self-treatment. However a large amount of illness is managed informally in the community without reference to health professionals.

Question 2

What does kleinman’s model of healthcare systems suggest?

Answer 2

• all health and illness we deal with are sorted by 3 factors - all interlink
• they evaluate everything first before going to doctor
• professional sector (doctors)
• popular sector (books, people - no internet at this point)
• folk sector (traditional remedies)

Question 3

Define health (WHO)

Answer 3

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

Question 4

What are the associated factors with health?

Answer 4

• Wellness: ‘the state of being in good health, especially as an actively pursued goal
• The duty to be healthy/illness as failure
• The emphasis on body maintenance
• Normal illness/serious illness

Question 5

Define disease

Answer 5

The pathological process, deviation from a biological norm

Question 6

Define illness

Answer 6

the patient’s experience of ill health, sometimes when no disease can be found

Question 7

Define sickness

Answer 7

the role negotiated with society

Question 8

Define healing & wholeness

Answer 8

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

Question 9

How do people make decisions about approaching the formal healthcare system?

Answer 9

Symptoms: those feeling states patients experience which
alert them to the possibility that all is not well
Signs: The pointers the doctor identifies which signify the existence of the underlying pathological lesion

Question 10

What are the stages of illness

Answer 10

Person experiences symptoms
↓
May seek advice from friends and relatives
↓
May seek professional advice from a doctor
↓
Doctor confirms person is sick (legitimises sick role)
↓
Sick role
↓
Recovery

Question 11

How do people decide whether or not to consult the doctor?

Answer 11

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?

Question 12

What are the 5 social triggers to realise symptoms become abnormal

Answer 12

▪ 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
▪ Sanctioning

Question 13

Mechanic’s (1978) variables known to influence illness behaviour

Answer 13

• 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 recognized
• 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 stigma, social distance and feelings of humiliation)

Question 14

What’s a patients ‘sick role’? (Obligations and privileges)

Answer 14

1. Must want to get well as quickly as possible.
2. Should seek professional medical advice and co-operate with the doctor.
3. Allow (and may be expected) to shed some normal activities and responsibilities (e.g. employment and household tasks).
4. Regarded as being in need of care and unable to get better by his or her own decisions and will.

Question 15

Doctor’s professional role (expectations)

Answer 15

1. Apply a high degree of skills and knowledge to the problems of illness.
2. Act for welfare of patient and community rather than for own self-interest, desire for money, advancement, etc.
3. Be objective and emotionally detached (i.e. should not judge patients’ behaviour in terms of personal value system or become emotionally involved with them).
4. Be guided by rules of professional practice.

Question 16

Doctors professional role (rights)

Answer 16

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