Download Seeking Health Care II - People Server at UNCW

Seeking Health Care II
Seeking Medical Attention
What Influences Seeking Medical
Attention



Seeking medical attention is a special
case of engaging in health related
behavior
The same models discussed previously
apply
Research using these models has found a
number of factors related to seeking health
care
Illness Behavior

Activities undertaken by people
experiencing symptoms in order to:
Define the illness
 Seek relief


Seeking health care is one of many illness
behaviors
Factors Influencing Illness
Behavior


Personal Reluctance
Personal View of Illness

Attitudes about illness/health care
Social and Demographic Factors




Age
Gender
Cultural
Economic
Symptom Characteristics




Visibility of symptoms
Perceived Severity
Interference
Frequency and persistence
Sick-Role Behavior


Behavior after diagnosis
Same goal as illness behavior, different
dynamics
Not the person’s fault
 Relief from responsibility
 Take steps to get well
 The right to make health-related decisions
 The right to become dependent on others


Being in the hospital is a special case
Being in the Hospital



First “hospitals” were temples in ancient Greece
Throughout history hospitals have been run by
religious groups
Catered to poor, who usually died of diseases
they didn’t have when they entered



People with resources were treated at home
All this changed as medical technology
advanced
Currently hospitals = medical centers. Provide
numerous services
Length of Hospital Stay
Average Stay (in days)
8
7.5
7
6.5
6
1970
1975
1980
1985
1990
9
Use of Hospitals (Class Session #7)
Discharges per 1,000 Population
170
160
150
140
130
120
110
1970
1975
1980
1985
1990
10
Being in the Hospital: Problems

Depersonalization


Lack of Information



Treating as if the
person were not there
Information overload
Sometimes the
medical staff just
doesn’t know
Loss of control
“Good” patient versus “bad”
patient

“Good” patient refers
to one who






conforms and
complies.
assumes non-person
role
does not complain
appears cheerful
conforms to routine
Learned
Helplessness

“Bad” patient







asks questions
demands answers
complains
attempt to restore
control
fails to conform
Disobedient
Reactance
Preparing for Procedures

Preparation is fundamentally about increasing
perceived control

Information Control

Providing Information


Modeling Procedures


Children
Cognitive Control


Anderson (1987)
Focus on the benefits
Behavioral Control

Anderson (1987)
Information and Behavioral Control: Anderson
(1987) Study
Hypothesis: Does information and coping
preparation improve recovery?
Practical purpose: How to improve hospital care to
help patients cope with surgery?
Design: 60 male open-heart surgery patients
randomly assigned to 1 of 3 treatment groups:
 Standard Care (control group)
 Information Only
 Information plus Coping
14
Standard Care (Control Group)
 Pamphlets
 Nurse Contacts
Information Only
 Standard care
 Videotape: subjective and objective
information
Information plus Coping
 Standard care
 Information Only treatment
 Exercise training: coughing, breathing,
movement
15
Results: Anxiety
44
Standard Care
42
Anxiety Score
40
38
36
Information Only
34
32
Info + Coping
30
Admission
Before Surgery
After Surgery
16
Results

In addition, compared to Standard Care,
both psychological treatments equally . . .


improved physical recovery

reduced complications
Information Plus Coping provided no
added benefit beyond Information Only
17
Modeling Procedures

Modeling is often used with children

Puppet shows


Preschoolers and young school children
Videos/demonstrations

Older children