1. Seeking Health Care II Seeking Medical Attention

2. What Influences Seeking Medical Attention Seeking medical attention is a special case of engaging in health related behavior Seeking medical attention is a special case of engaging in health related behavior The same models discussed previously apply The same models discussed previously apply Research using these models has found a number of factors related to seeking health care Research using these models has found a number of factors related to seeking health care

3. Illness Behavior Activities undertaken by people experiencing symptoms in order to: Activities undertaken by people experiencing symptoms in order to: Define the illness Define the illness Seek relief Seek relief Seeking health care is one of many illness behaviors Seeking health care is one of many illness behaviors

4. Factors Influencing Illness Behavior Personal Reluctance Personal Reluctance Personal View of Illness Personal View of Illness Attitudes about illness/health care Attitudes about illness/health care

5. Social and Demographic Factors Age Age Gender Gender Cultural Cultural Economic Economic

6. Symptom Characteristics Visibility of symptoms Visibility of symptoms Perceived Severity Perceived Severity Interference Interference Frequency and persistence Frequency and persistence

7. Sick-Role Behavior Behavior after diagnosis Behavior after diagnosis Same goal as illness behavior, different dynamics Same goal as illness behavior, different dynamics Not the person’s fault Not the person’s fault Relief from responsibility Relief from responsibility Take steps to get well Take steps to get well The right to make health-related decisions The right to make health-related decisions The right to become dependent on others The right to become dependent on others Being in the hospital is a special case Being in the hospital is a special case

8. Being in the Hospital First “hospitals” were temples in ancient Greece First “hospitals” were temples in ancient Greece Throughout history hospitals have been run by religious groups Throughout history hospitals have been run by religious groups Catered to poor, who usually died of diseases they didn’t have when they entered Catered to poor, who usually died of diseases they didn’t have when they entered People with resources were treated at home People with resources were treated at home All this changed as medical technology advanced All this changed as medical technology advanced Currently hospitals = medical centers. Provide numerous services Currently hospitals = medical centers. Provide numerous services

9. 9 Length of Hospital Stay

10. 10 Use of Hospitals (Class Session #7)

11. Being in the Hospital: Problems Depersonalization Depersonalization Treating as if the person were not there Treating as if the person were not there Lack of Information Lack of Information Information overload Information overload Sometimes the medical staff just doesn’t know Sometimes the medical staff just doesn’t know Loss of control Loss of control

12. “Good” patient versus “bad” patient “Good” patient refers to one who “Good” patient refers to one who conforms and complies. conforms and complies. assumes non-person role assumes non-person role does not complain does not complain appears cheerful appears cheerful conforms to routine conforms to routine Learned Helplessness Learned Helplessness “Bad” patient asks questions demands answers complains attempt to restore control fails to conform Disobedient Reactance

13. Preparing for Procedures Preparation is fundamentally about increasing perceived control Preparation is fundamentally about increasing perceived control Information Control Information Control Providing Information Providing Information Anderson (1987) Anderson (1987) Modeling Procedures Modeling Procedures Children Children Cognitive Control Cognitive Control Focus on the benefits Focus on the benefits Behavioral Control Behavioral Control Anderson (1987) Anderson (1987)

14. 14 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) Standard Care (control group) Information Only Information Only Information plus Coping Information plus Coping

15. 15 Standard Care (Control Group) Pamphlets Pamphlets Nurse Contacts Nurse Contacts Information Only Standard care Standard care Videotape: subjective and objective information Videotape: subjective and objective information Information plus Coping Standard care Standard care Information Only treatment Information Only treatment Exercise training: coughing, breathing, movement Exercise training: coughing, breathing, movement

16. 16 Results: Anxiety Standard Care Information Only Info + Coping

17. 17 Results In addition, compared to Standard Care, both psychological treatments equally... In addition, compared to Standard Care, both psychological treatments equally... improved physical recovery improved physical recovery reduced complications reduced complications Information Plus Coping provided no added benefit beyond Information Only Information Plus Coping provided no added benefit beyond Information Only

18. Modeling Procedures Modeling is often used with children Modeling is often used with children Puppet shows Puppet shows Preschoolers and young school children Preschoolers and young school children Videos/demonstrations Videos/demonstrations Older children Older children