Illness Behavior & Perception

7/28/2019 Illness Behavior & Perception

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Illness Behavior andPerceptions of Illness


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How do people determine when

theyre ill?

Illness is a condition of pronounced deviation

from the normal healthy state

Illness is a subjective experience

When do patients report illness?

When theyre unable to engage in day-to-day activities

When they have decreased stamina

When they feel pain, nausea, fatigue

When they just dont feel well


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Illness Behavior

What do you do when you feel ill?

Most people do not consult a doctor or a

health professional when they first feel ill

When and why do people seek

professional attention?


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Illness Behavior

Illness behavior is described as the state

when the individual feels ill and behaves in a

particular way

Illness is a psychological concept:

It has different meanings for different people

Its based upon an individuals personalevaluation of his/her bodily state and ability to

function


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Illness

Often it is difficult to decide objectively

whether someone is ill or not

Some suggest using scales that define illnessbased on a total score of symptoms

However, illness is a relative concept, and

is often functionally based

Lets return to your thoughts on how you

know when your ill


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Symptoms

Illness is recognized because of the presenceofsymptoms, either physical or mental

People respond to symptoms in a variety ofways including dismissing, ignoring, denying,and/or maximizing their symptoms

If we experience unusual symptoms, whichare severe enough, we may feel that we areill and then behave in certain ways


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Symptoms

Illness is recognized because of the presence

of symptoms

Recognition of symptoms can beaffected by a patient's beliefs and

expectations


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Symptoms Patient recognition of a symptom depends on

the cognitive schemata that the patient has of

the symptom The more we know, the more our awareness

of symptoms diagnoses increase

Health professionals themselves may be very

aware of physical symptoms and this may

contribute to professional stress


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Symptom Reporting

When do people decide its time to report

their symptoms?

People do not necessarily report all of their

symptoms and certainly choose to whom they

report them


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Symptom Reporting

Factors that influence symptom

reporting:

Number and persistence of symptoms Extent of the social and physical disability

resulting from the symptoms

Recognition and identification of thesymptom

Perceived severity of the symptoms

Symptom change


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Cultural Influences on Illness

Behavior

There are many cultural and demographic

influences on health and these affect illness

behavior

Consider Chinese traditional medicine with

Western medicine


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Cultural Influences

Chinese traditional medicine is based on the

forces of Yin and Yang and the interaction of

the five elements (metal, water, wood, fire,

and earth)

Traditional Chinese doctors look to balance

the Yin and Yang by the use of acupuncture,

Chinese herbs, and massage

This contrasts with Western medicine which

uses drugs or surgery to treat symptoms


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Cultural Influences Culture and the cancer pain experience Taoism: Pain results when Qi is blocked. Pain

relief comes via removing the blockage and living in

harmony with the universe

Buddhism: Pain is suffering; suffering is relieved by

following the 8 right ways (i.e., right view, right

intention, right speech, right action, right livelihood,

right effort, right mindfulness, and right

concentration)

Confucian: Pain is an essential element of life;

hence, endurance is the key

(Chen, Dodd, & Pantilat, 2008)


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Sociological and Demographic

Influences on Illness Behavior

More illness is found in community surveys in

lower socio-economic groups

However, people in higher socio-economic

groups are more likely to seek health care

Older people consult their doctorless than

younger people do in relation to their level of

illness


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Illness Representation

Symptom recognition is not necessarilyenough to make people think that they are ill

Symptoms on their own have no meaningand are merely bodily sensations

Different symptoms will be accounted for in

different ways

Consider the symptom of a backache


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Illness Representation

Illness representations interpret symptoms

and give them meaning

The course of action taken will be

determined by the representation


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Symptoms

Symptoms may also suggest the course ofthe illness

So, if symptoms disappear does this mean

the illness is over?

If they are tightly joined to one another, then

if the symptoms improve, the illness may bethought to have gotten better and the personmay stop treatment


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Symptoms

There is an asymmetrical relationshipbetween symptoms and the diagnosticlabel:

People with symptoms seek a diagnosticlabel

People given a diagnosis seek symptoms

Having recognized that they havesymptoms, what do people do?


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Self Medication

An Australian study evaluated theactions taken by 360 people who hadminor symptoms or condition in theprevious two weeks

Their actions included using:

Left over prescription medicines

Home remedies

Over-the-counter medicines

(Wilkinson et al., 1987)


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Self Medication

Elderly people were found to be twice aslikely to treat a minor illness with an over thecounter medication than any other option

Because drugs are available without aprescription, they may be thought to beharmless

Poly-pharmacy among elderly people isvery common and prescribed drugs may betaken in combination with over the countermedicines and the combination may change

their effectiveness


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Self Medication

The practice of taking over the counter

medicines may begin in early adulthood

Headaches are common in all age groups In a study of adolescents, it was found that

most of them used medication to cope with

headaches


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Self Medication

Self-medication is extremely common

It has been suggested that those who

take non-prescription medicine may beless likely to consult doctors


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The Sick Role

The sick role any activity undertaken forthe purpose of getting well by those whoconsider themselves ill

This is a social role

A patient who enters the sick role has both

rights and obligations There are positives and negatives to the sick

role


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The Sick Role

Advantages Exempt from many

daily activities

Able to rest and be

taken care of

Social support

Meaning

Workers

compensation,

disability

Disadvantages Behaviors are

scrutinized

Others may view

behaviors as

illegitimate attempt to

gain advantages

Confusion, discomfort,decreased

functioning, and

distress


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The Sick Role

People are not expected to will themselvesbetter by effort, and the illness is notconsidered to be their fault

However, the symptoms must be recognizedby others

Sick people are expected to want to getbetter

They are also expected to seek professionalhelp if needed and to comply with healthrecommendations


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The Sick Role

The (societal) obligations: The persons symptoms must correspond

with a diagnosis recognized by society

There must be overt symptoms before otherswill recognize the illness

The patient must accept the sick role, and isexpected to take steps to get well


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The Sick Rolemore (societal)

obligations

Sick people are expected to remainoptimistic and cheerful and not displaydistress

Not everyone is willing to act sick andsome people may conceal their symptoms

to avoid becoming dependent In some conditions this is seen as desirable


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The Sick Role

Most believe being ill is temporary and in mostcases, this is true

Chronic diseases bring about different

responsibilities and the person cannot stay inthe sick role forever

Most people have symptoms of one sort or

another at any one time, but whether or notthey enter the sick role may be only loosely

related to the severity or persistence of

symptoms


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THANK YOUReported by Tani Stevenson Telow RN, MN-

NAS(c)

Illness Behavior & Perception

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