ASBHDS Session 1 - Biopsychosocial Model and Social Context of Illness
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What were the key features of the biomedical model?
• Ilness was understood in terms of biological and physiological processes • Treatment involved physical intervention (drugs, surgery)
Name 2 factors which have contributed to the advancement of healthcare.
• Medical advances - Social improvements
Compare and contrast the common illnesses and causes of death at the start and end of the 20th century.
• Start of 20th century: TB, pneumonia, measles, diphtheria - End of 20th century: Heart disease, cancer, stroke, respiratory disease (COPD)
Outline the different components of the biopsychosocial model.
Bio - physiology, genetics, pathogens Psycho - cognition, emotion, behaviour Social - social class, employment, social support
Outline the three different definitions of health.
Negative definition - health equates to the absence of illness Functional definition - health is the ability to do certain things Positive definition - health is a state of wellbeing and fitness
What are lay beliefs?
• How people understand and make sense of health and illness. • Constructed by people with no specialised knowledge • Socially embedded • Draw on cultural, social and personal knowledge and experience and own biography • Drawn from multiple sources (ie. complex)
Outline the interplay between lay beliefs and medical knowledge.
• The public is surrounded by professional concepts so it’s difficult for lay beliefs to develop independently • Professional concepts are interpreted and made sense of in light of everyday life experience
The influence of lay beliefs on health behaviour results in 3 distinct behaviours. Outline them.
• Health behaviour - activity undertaken for the purpose of maintaining health and preventing illness • Illness behaviour - activity of an ill person to define illness and seek solution • Sick role behaviour - formal response to symptoms, including seeking formal help and action of person as a patient.
Outline the illness iceberg.
• Over a 2 week period, about 75% of people experience 1/more symptoms of ill health. • Almost 50% of the symptoms, respondents did nothing. • 35% of the symptoms resulted in the use of lay care • 12% of the symptoms led to consultation with a primary care health professional • Most symptoms never get to the doctor
Name the primary influences on illness behaviour.
• Culture • Visibility of symptoms • Frequency and persistence of symptoms • Disruption of symptoms • Tolerance threshold • Information and understanding • Availability of resources • Lay referral
What is Lay Referral?
Lay referral: the chain of advice-seeking contacts which the sick make with other lay people prior to - or instead of - seeking help from healthcare professionals
Why is lay referral so important?
• Understand why people delayed before seeking help • Understand how, why and when people consult a doctor • Understand one’s role as a doctor in their health • Understand the use of health services and medication • Understand the use of alternative medicines
With reference to a case study such as Rheumatoid arthritis, name the 4 main themes influencing patients’ decisions to delay seeking medical advice.
• Symptom experience • Symptom evaluation • Knowledge or Rheumatoid Arthritis and treatments • Experience of, and attitudes towards health professionals.
Name the three broad groups of patients when taking medication.
• “Deniers and distancers” • “Accepters” • “Pragmatists”
Adherence to medication and medical advice is tied to what three factors?
• People’s beliefs about the condition • Their social circumstances • Their social identity
According to the Black Report, what are the 6 main explanations, theories & pathways for inequalities in health?
• Artefact • Social selection • Behaviour-cultural • Materialist • Psychosocial • Income distribution
More deprived socio-economic groups have higher rates of use of which services?
• GP services - Emergency services
More deprived groups seem to have under use of which services?
• Preventive services - Specialist services