Chapter 8 Using Health Services
Recognition and Interpretation of Symptoms people have some awareness of what is going on
inside them, but that may be limited. This limitation leaves a great deal of room for social and
psychological factors to operate in the recognition of symptoms and the interpretation of illness.
Recognition of a Symptom some people fail to recognize, whereas some take to their beds the
moment they detect any minor bodily disturbance.
Individual Difference in Personality some people are more likely to notice symptoms than others.
- Hypochondriacs people who are preoccupied and worried that normal bodily symptoms are
indicators of illness. 4-5% of the population.
- The most frequent symptoms that show up amongst patients who convert their distress into
physical symptoms are back pain, joint pain, pain in the extremities, headache, abdominal
symptoms such as bloating, allergies and cardio symptoms.
- Older people report more symptoms and women compared to men.
- Neuroticism also affects the perception of symptoms; it is a pervasive dimension of personality
marked by negative emotions, self-consciousness, and a concern with bodily processes. People
high in neuroticism recognize and report symptoms quickly because they exaggerate their
symptoms or may be more attentive, they believe they have serious diseases.
Cultural Differences influences how quickly and what kind of symptoms are recognized.
- Anglos report more infrequent symptoms, and Mexicans report symptoms that are more frequent.
Attentional Differences influence the experience of symptoms. People who are focused on
themselves are quicker at identifying symptoms but people who are focused on external things are
not. Therefore, more the distraction less illness they will report
Situational Factors influence whether a person will recognize a symptom or not. A boring
situation make people more attentive to symptoms ex: at home than outside, or in a boring part of the
movie than exciting part.
- Medical students disease each of them think they have it, so any situational factor that makes
illness or symptoms more obvious promotes their recognition.
Stress can precipitate or aggravate the symptoms of an illness. People under stress may believe they
are more vulnerable to illness.
Mood influences self appraised health. People who have positive mood rate themselves as healthy
and report fewer symptoms. People with bad moods report more symptoms, are more pessimistic and
perceive themselves as more vulnerable to illness.
Interpretation of Symptoms psychological process, ex: man brings 6 family members to
emergency because of his sore throat, but later found that their brother had died an year earlier of
Hodgkins disease which started with a sore throat. Therefore, social and psychological factors can be
part of people interpretation of symptoms and that a persons historical, cultural and social factors do
influence the symptom interpretation.
Prior Experience people who have experience with a medical condition estimate their symptom to
be greater and often regard the condition as less serious than people with no history.
Expectations influence the interpretation of a symptom, people may ignore symptoms they are not
expecting and amplify symptoms they do expect.
Seriousness of a symptom symptoms that affect highly valued parts of the body are seen as more
serious and more likely to require attention. Above all, if the symptom causes pain, it will lead a
person to seek treatment.
Cognitive representations of illness
Illness Schemas people who have concepts about health and illness that will influence how they
react to symptoms, aka illness representations. Acquired through the media personal experience,
family and friends who have had experience with particular disorders.
- Range from being inaccurate or very extensive, influence peoples preventive behaviours
- Include basic information about an illness, the identity of the illness (name), consequences
(symptoms/treatments), causes (environment or behavioural factors), duration, and the cure.Three models of illness acute illness caused by viral or bacterial agents, short duration, and no
long term consequences. (ex: flu)
Chronic illness caused by several factors, including health habits, long duration, severe
consequences. (ex: heart disease)
Cyclic marked by alternating periods during which there are symptoms or no symptoms ex: herpes.
- Peoples conceptions of the disease give them a basis for interpreting new information, treatment
seeking decisions, lead them to alter or fail to their treatment.
The beginning of treatment meaning of a symptom ultimately blends into diagnosis.
- Lay referral network an informal network of family and friends who offer their own
interpretations of symptoms well before any medical treatment is sought.
- The patient may mention the symptom to a friend who may give advice to follow.
- The preferred mode of treatment in many communities, often recommend home remedies as more
- A powerful lay figure who has many years of experience is seeked.
- Folk medicine is on the rise; therefore world health organization has evaluated the efficacy of
these treatments and gets rid of unsuccessful ones. Ex: Chinese herb ma huang which helps in
breathing, Ginko biloba: stimulates circulation but can also enhance bleeding.
- Unconventional therapies include relaxation techniques, chiropractic, massage, imagery, spiritual
healing, diets, herbal, megavitamin therapy, self help groups, energy healing, bio feedback,
hypnosis, homeopathy, and acupuncture.
- Many of these are used in combination with conventional treatments.
- Some home remedies do work, the actual or apparent cures perpetuate the use of the lay referral
network and much formal illness is never treated within the medical community.
The Internet may constitute a lay referral ne