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Chapter Eight: Using Health Services Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. •Recognition and interpretation of symptoms •Who uses health services? •Misusing health services Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 2 Individual differences • Hypochondriacs believe normal bodily symptoms are indicators of illness • Neurotic people either exaggerate symptoms or are more attentive to real symptoms Attentional differences • People who are focused on themselves are quicker to notice symptoms • People with more distractions and who attend less to themselves experience fewer symptoms Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 3 Situational factors • Boring situations make people more attentive to symptoms • Medical students’ disease: Students believing they are ill with the same illness about which they are studying Stress • Stress-related physiological changes are interpreted as symptoms of illness Mood • Affects perception about symptoms and perceived vulnerability to illness Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 4 •Prior experience - Common disorders are regarded as less serious than rare disorders •Expectations - Unexpected symptoms are ignored and expected symptoms are amplified •Seriousness of the symptoms - Treatment is sought only when the symptom: • Affects a highly valued body part • Causes pain Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 5 •Commonsense beliefs - Held by people about their symptoms and illnesses • Result in organized illness representations •Includes basic information about an illness • Identity - Name of the illness • Causes - Factors believed to have led to the illness Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 6 • Consequences - Symptoms, treatments, and their implications for quality of life • Time line - Length of time the illness is expected to last • Control/cure - Whether the person believes the illness can be managed or cured • Coherence - How well these beliefs represent the disorder Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 7 Acute illness • Believed to be caused by viral or bacterial agents • Short in duration, with no long-term consequences Chronic illness • Believed to be caused by multiple factors • Long in duration, with severe consequences Cyclic illness • Alternating periods of either no symptoms or many symptoms Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 8 •Family and friends who offer their own interpretations of symptoms way before the treatment is sought •Advice is offered regarding: • What the symptom means • Advisability of seeking medical treatment • Various home remedies Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 9 •Two-thirds of Internet users have used it to find health information •Many physicians depend on it for the most up-to-date information on illnesses and treatments Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 10 •Age - Infants and the elderly use it most frequently •Gender • Women use it more than men • Pregnancy and childbirth account for it • Women have better homeostatic mechanisms • Women’s medical care is more fragmented • Men are expected to ignore pain and not give in to illness Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 11 •Social class and culture - Lower social classes use it less than affluent ones •Social psychological factors • Individual’s attitudes and beliefs toward health services and symptoms • Children learn how to use health services from their parents Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 12 •Psychological complaints - Nonmedical complaints that stem from anxiety and depression •People use health services for psychological complaints as: • They are accompanied by physical symptoms • Medical disorders are perceived to be more legitimate than psychological ones Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 13 • It leads to secondary gains • Secondary gains: Benefits gained from being ill • They need to document their absence in order to collect wages at work Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 14 Putting off seeking treatment for one or more potentially serious symptoms Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 15 Appraisal delay • Time taken to decide that a symptom is serious Illness delay • Time between the recognition that a symptom implies an illness and the decision to seek treatment Behavioral delay • Time between deciding to seek treatment and actually doing so Medical delay • Time that elapses between the person’s calling for an appointment and his or her receiving appropriate medical care Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 16 •Common among people: • With no regular contact with a physician • Who are phobic about medical services •Symptoms that delay seeking treatment • Those similar to a previous one that turned out to be minor • Those that do not hurt or change quickly • Those that are easily accommodated Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 17 •Typical symptoms of a disorder are more likely to be treated •Delay in taking recommended treatments • Patients no longer feel any urgency about their condition • Patients become alarmed by the symptoms and avoid thinking about them altogether Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 18 • Delay in the part of the health care practitioner • Medical delay is likely when a patient deviates from the profile of the average person with a given disease Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 19