Transcript Seeking Health Care II - People Server at UNCW

Seeking Health Care II
Seeking Medical Attention
What Influences Seeking Medical
Attention
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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
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Activities undertaken by people
experiencing symptoms in order to:
Define the illness
 Seek relief
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Seeking health care is one of many illness
behaviors
Factors Influencing Illness
Behavior
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Personal Reluctance
Personal View of Illness
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Attitudes about illness/health care
Social and Demographic Factors
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Age
Gender
Cultural
Economic
Symptom Characteristics
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Visibility of symptoms
Perceived Severity
Interference
Frequency and persistence
Sick-Role Behavior
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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
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Being in the hospital is a special case
Being in the Hospital
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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
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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
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Use of Hospitals (Class Session #7)
Discharges per 1,000 Population
170
160
150
140
130
120
110
1970
1975
1980
1985
1990
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Being in the Hospital: Problems
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Depersonalization
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Lack of Information
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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
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“Good” patient refers
to one who
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conforms and
complies.
assumes non-person
role
does not complain
appears cheerful
conforms to routine
Learned
Helplessness
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“Bad” patient
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asks questions
demands answers
complains
attempt to restore
control
fails to conform
Disobedient
Reactance
Preparing for Procedures
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Preparation is fundamentally about increasing
perceived control
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Information Control
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Providing Information
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Modeling Procedures
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Children
Cognitive Control
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Anderson (1987)
Focus on the benefits
Behavioral Control
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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
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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
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Results: Anxiety
44
Standard Care
42
Anxiety Score
40
38
36
Information Only
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32
Info + Coping
30
Admission
Before Surgery
After Surgery
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Results
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In addition, compared to Standard Care,
both psychological treatments equally . . .
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improved physical recovery
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reduced complications
Information Plus Coping provided no
added benefit beyond Information Only
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Modeling Procedures
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Modeling is often used with children
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Puppet shows
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Preschoolers and young school children
Videos/demonstrations
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Older children