1. © 2012 McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin© 2012 McGraw-Hill Companies, Inc. All rights reserved. Health Psychology 8 th edition Shelley E. Taylor Chapter Eight: Using Health Services

2. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-2 Recognition and Interpretation of Symptoms Recognition of a symptom: - individual differences in personality: - some people are consistently more likely to notice symptoms than other people - most frequent symptoms are physical symptoms - neurotics recognize and report symptoms more quickly than those who are not neurotic

3. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-3 Recognition and Interpretation of Symptoms (cont.) Cultural differences: - Anglos report infrequent symptoms - Mexicans report frequently-occurring symptoms Attentional differences: - those who focus on themselves are quicker to notice symptoms

4. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-4 Recognition and Interpretation of Symptoms (cont.) Situational factors: - boring situations make people more attentive to symptoms than when in interesting situations - symptoms are noticed more on days at home than on days full of activity - medical students’ disease: - as medical students study an illness, many imagine they have it

5. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-5 Recognition and Interpretation of Symptoms (cont.) Stress: - precipitates or aggravates the experience of symptoms Mood: - people in positive moods report fewer symptoms than people in negative moods

6. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-6 Recognition and Interpretation of Symptoms (cont.) Interpretation of symptoms: - a psychological process - individual, historical, cultural, social and psychological factors are all important in understanding people’s interpretations of their symptoms

7. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-7 Recognition and Interpretation of Symptoms (cont.) Interpretation of symptoms (cont.): - prior experience - expectations: - people ignore symptoms that are not expected and amplify symptoms that are expected - seriousness of symptoms: - serious symptoms are likely to require more attention than less serious symptoms

8. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-8 Recognition and Interpretation of Symptoms (cont.) Cognitive representations of illness: - illness schemas - illness representations: - organized conceptions of illness - include the identity, consequences, causes, duration and cure of an illness - three models of illness: - acute illness - chronic illness - cyclic illness

9. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-9 Recognition and Interpretation of Symptoms (cont.) Lay referral network: - an informal network of family and friends who offer an interpretation of symptoms well before medical treatment is sought - the preferred mode of treatment in many communities

10. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-10 Recognition and Interpretation of Symptoms (cont.) Complementary and Alternative Medicine (CAM): - on the rise worldwide - used by one in three American adults - some of the remedies do work

11. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-11 Recognition and Interpretation of Symptoms (cont.) The Internet: - a lay referral network of its own - more than 100,000 health-related websites - most physicians believe the Internet affects health care positively

12. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-12 Who Uses Health Services? Age: - the very young and the elderly use health services most frequently - young children develop a number of infectious childhood diseases - in late adulthood people develop chronic conditions and diseases

13. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-13 Who Uses Health Services? (cont.) Gender: - women use medical services more frequently than men - pregnancy and childbirth - women are not subjected to the same social norms - perception that getting treatment disrupts women’s lives less than men

14. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-14 Who Uses Health Services? (cont.) Social class and culture: - lower social classes use medical services less than the affluent - financial reasons - only seek treatment in emergency situations - beliefs about the illness lead some people to use the lay referral system instead of formal treatment

15. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-15 Who Uses Health Services? (cont.) Social psychological factors: - factors that involve an individual's attitudes and beliefs about symptoms and health services - whether or not a person seeks treatment for a symptom depends on two factors: - e xtent to which the person perceives a threat to health - the degree to which the person believes health measures will be effective in reducing that threat

16. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-16 Misusing Health Services Using health services for emotional disturbances: - stress and emotional responses create a number of physical symptoms - t he ‘worried well’: - people concerned about physical and mental health; inclined to perceive minor symptoms as serious and believe they should take care of their own health - ‘Somaticizers’: – those who express distress and conflict through bodily symptoms

17. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-17 Misusing Health Services (cont.) Delay behavior: - person may live with one or more serious symptoms for months without seeking care - appraisal delay - illness delay - behavioral delay - medical delay

18. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-18 Misusing Health Services (cont.) Appraisal delay: - the time it takes a person to decide that a symptom is serious Illness delay: - the time between recognizing that a symptom implies an illness and the decision to seek treatment Behavioral delay: - the time between deciding to seek treatment and actually doing so Medical delay: - t he time between making an appointment and receiving appropriate care

19. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-19 Misusing Health Services (cont.) Who delays? - those who perceive treatment as expensive - those who believe the symptoms are not serious - the elderly - those who have no regular contact with a physician - those who seek treatment primarily in response to pain and social pressure - those who are fearful of doctors, examinations, surgery and medical facilities

20. © 2012 McGraw-Hill Companies, Inc. All rights reserved.8-20 Misusing Health Services (cont.) Symptoms and delaying: - individuals delay seeking treatment for previous symptoms that were not serious and seek treatment for new symptoms - seeking treatment is delayed if symptoms are easily accommodated and do not provoke alarm Treatment delay: - 25% percent of patients delay recommended treatments Provider delay: - health care practitioners account for 15% of all delay behavior