1. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Chapter Eight: Using Health Services

2. 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 2

3. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Hypochondriacs believe normal bodily symptoms are indicators of illness Neurotic people either exaggerate symptoms or are more attentive to real symptoms Individual 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 Attentional differences 3

4. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 Situational factors Stress-related physiological changes are interpreted as symptoms of illness Stress Affects perception about symptoms and perceived vulnerability to illness Mood 4

5. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 5

6. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 6

7. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 7

8. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Believed to be caused by viral or bacterial agents Short in duration, with no long-term consequences Acute illness Believed to be caused by multiple factors Long in duration, with severe consequences Chronic illness Alternating periods of either no symptoms or many symptoms Cyclic illness 8

9. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 9

10. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 10

11. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 11

12. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 12

13. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 13

14. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 14

15. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Putting off seeking treatment for one or more potentially serious symptoms 15

16. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. Time taken to decide that a symptom is serious Appraisal delay Time between the recognition that a symptom implies an illness and the decision to seek treatment Illness delay Time between deciding to seek treatment and actually doing so Behavioral delay Time that elapses between the person’s calling for an appointment and his or her receiving appropriate medical care Medical delay 16

17. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 17

18. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 18

19. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 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 19