1. Patient-Centred Model
You decide if you are ill
You decide what to do about it, eg whether to go to the doctors, or to use alternative therapies, or whether to see no-one at all
If you are involved with health professionals, you tell them you’re preferred treatment ideas
Why do you think this fits in with Leventhal’s self regulatory method of illness

2. Leventhal’s Self Regulatory Model of Illness (1980)
1. Problem Representation
3. Appraisal
2. Coping
This model can be known as Patient-Centred because…

3. Leventhal’s Self Regulatory Model of Illness (1980)
1.Problem Representation
3. Appraisal
2. Coping
Leventhal’s Self Regulatory Model of Illness (1980)
Problem Representation – how we decide if we are ill by:
Our own perception of internal sensations
Information from other people (lay referral system)
Our previous experiences of illness
Our own perception of internal sensations: pain, rumblings and grumblings of belly etc
Info from other people: our lay referral system: friends, family, magazines etc
Previous experiences: have we had these symptoms before, have others?
We think about all these things.
so YOU decide if YOU are ill by….

4. Leventhal’s Self Regulatory Model of Illness (1980)
1.Problem Representation
3. Appraisal
2. Coping
Understanding of Physical Conditions
Identity – the signs & symptoms of a condition. We label the illness according to the symptoms
Consequences –We have certain ideas about what the illness will do to us
Causes – most people try and make sense of their illness by determining its cause eg genetic factors, stress, bad luck etc We have ideas about how we got the illness
Time line – We have beliefs about how long the illness will last (Acute, recurrent or chronic)
This is still in the problem representation part of the model, eg how do we decide if we are ill? People describe illness in terms of 4 features:
Identity – once we have identified the signs and symptoms as an illness we give it a name, eg if you had white spots on your tonsils you would identify you had tonsilitis. You would then look for other symptoms and signs of tonsilitis eg swollen glands, headache, sore throat etc. what are the symptoms of a mumps? (swollen glands etc), what other signs might you look for once mumps has been diagnosed?
2. Consequences – we perceive the consequences of diseases according to the implications for physical self-image, social interaction, financial implications and emotional upset. With tonsilitis, people might perceive the illness to give you bad breath, stop you going out or smoking, you might need 2 weeks off work and so not be able to earn or get something on your sick record for work/college, and it might cause you to feel very unhappy with the physical pain. None of these things will last though, so it is all short term.
What might be the consequences of HIV+?
Students to discuss in pairs the consequences of HIV+ in terms of physical self-image, social interaction, financial implications and emotional upset.
3. causes_ - people make sense of their illness by determining its cause eg genetic factors, environmental hazards, own behaviour, bad luck etc. why do people want to make sense of why they are ill? If you woke up with a stick neck, what would you think?
4. Time line – we classify illness as a clue to how long we should expect to feel ill. Eg if we have tonsilitis we might see this as an acute, recurrent illness that won’t last a long time but will be an inconvenience. We will expect to feel ill for about 2 or 3 weeks. If you woke up with a stiff neck, how long would you expect it to last?
The combination of our internal perceptions (pain etc), information from family and friends, our experience of illness before and our understanding of physical conditions will determine our decision as to whether we are ill or not and what further action we need to take.

5. YOU decide how to treat the illness
Leventhal’s Self Regulatory Model of Illness (1980)
1.Problem Representation
3. Appraisal
2. Coping
2. Coping - once we decide we are ill we are motivated to cope with this problem
Problem-focused coping: constructive actions to resolve the problem
Emotional-focused coping: behaviour to help relieve the worry & anxiety of being ill
Problem focused coping: seek medical help, taking rest, self-medication (paracetamol/st johns wort), plan changing lifestyle choices such as smoking, eating habits,
Emotional Focuses coping: want to feel better through eating, drinking, taking drugs, smoking, denial, getting angry (venting emotions can help people deal with emotions)
When people are terminally ill, denial can be a useful strategy because it stops people worrying about their illness. Usually illness can be treated, so delaying treatment by being in denial can be detrimental to health.
In pairs write the difference between problem focused and emotion focused coping. Make a list of the strategies you used to cope the last time you were ill. Separate these into problem focused and emotion focuses strategies. Use HP4 for students to make their lists.
YOU decide how to treat the illness

6. YOU decide if YOU are better and what to do next
Leventhal’s Self Regulatory Model of Illness (1980)
1.Problem Representation
3. Appraisal
2. Coping
3. Appraisal
Following their coping strategy, people go through a process of appraisal where they evaluate the success of their coping. This means they work out if their coping strategy has worked or not.
The appraisal stage leads back to the problem representation stage, eg trying to find if they have illness or disease. They go through the cycle until a state of normality is achieved.
YOU decide if YOU are better and what to do next

7. Biomedical Model of Health & Illness
It looks at people as though they are a biological machine
If something is going wrong we need to fix the machine the way we might fix a car

8. Biomedical Model of Health & Illness
Reductionism the model tries to reduce explanations of illness to the simplest possible process – if there is a biological problem it won’t then look at any other factors which could contribute to the illness, but just treat the ear ache
Carol has head & ear ache. The medical model would treat the physical symptoms, but not look at the social factors which could have caused it.
The medical model would give her medicine rather than investigate the social factors
Reductionism – if someone has ear ache and is not sleeping they would prescribe medicine, not look at the fact they work in a noisy environment, if you gave them ear-defenders at work they would not have ear ache and if they did not have ear ache they would be able to sleep better. So they would not actually need any medicine.
WHAT SOCIAL FACTORS COULD BE CAUSING THE HEAD AND EAR ACHE? THINK ABOUT IT IN BUZZ GROUPS AND FEEDBACK.

9. Biomedical Model of Health & Illness
Single Factor Causes
The biomedical model looks for THE cause of a disorder rather than looking for a range of contributory factors.
If someone has a skin rash on their leg the medical approach would look for THE cause of it, but there may be many causes, it may be an allergy, it may be an allergy mixed with heat, it may only come when the person is under stress, it may respond well to medical treatment, or it may be because of environment etc. The cause may be heat, but the other contributory factors might make it worse or mean it cannot be treated with a regular cream.
What factors could have caused this rash? How could it be treated (apart from medicine?)

10. Biomedical Model of Health & Illness
Mind-body Distinction
Western science has made a distinction between the mind and body. It sees people as split into two parts:
body & soul,
or ghost & machine
It does not see that you can treat the mind and the body as one. Can you think of a situation where the mind and the body are treated (hypnosis for surgery or to give up smoking?)
What about a self-harmer. There is no point treating the wounds if you are not going to treat the cause of the wounds, which would involve psychological help and treatment of the mind and body.

11. Biomedical Model of Health & Illness
Illness not Health
“If it aint broke don’t fix it”
is the idea behind the biomedical model.
It deals with the development of illness rather than the promotion of good health.

12. The Social Model of Illness
The social model of health places emphasis on changes that can be made in society and in people's own lifestyles to make the population healthier
What differences could these people change about their lifestyle to have a healthier life?

13. The Social Model of Illness
It defines illness from the point of view of the individual's functioning within their society rather than by looking at changes in biological or physiological signs.
Which sociological perspective does this sound like to you?
Sounds like functionalist because its looking at whether an individual can function in this society – rather than biological and physiological signs. So if someone had a banging headache, and yet was willing to function in society then they would. This is a functionalist way of looking at things, are you well enough to function, and if not, then what is it that is making you not function properly?

14. The Biopsychosocial Model
Ecological Systems
Social Systems
Psychological Systems
Biological Systems
Physical Systems
Molecules Atoms Sub-atomic Particles
Biosphere Life forms Human beings
Nation Culture Family
Cognition Emotion Behaviour
Organs Tissue Cells

15. The Biopsychosocial Model
I am a living biological being with thoughts and feelings. I am influenced by the way I was brought up, the country I live in, the way I process information, the way my body deals with illness and who I know. All these things affect my health.