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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