Seeking Health Care II

1. Seeking Health Care II Seeking Medical Attention

2. What Influences Seeking Medical Attention • 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

3. Illness Behavior • Activities undertaken by people experiencing symptoms in order to: • Define the illness • Seek relief • Seeking health care is one of many illness behaviors

4. Factors Influencing Illness Behavior • Personal Reluctance • Personal View of Illness • Attitudes about illness/health care

5. Social and Demographic Factors • Age • Gender • Cultural • Economic

6. Symptom Characteristics • Visibility of symptoms • Perceived Severity • Interference • Frequency and persistence

7. Sick-Role Behavior • 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 • Being in the hospital is a special case

8. Being in the Hospital • 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 • People with resources were treated at home • All this changed as medical technology advanced • Currently hospitals = medical centers. Provide numerous services

9. Length of Hospital Stay

10. Use of Hospitals (Class Session #7)

11. Being in the Hospital: Problems • Depersonalization • Treating as if the person were not there • Lack of Information • Information overload • Sometimes the medical staff just doesn’t know • Loss of control

12. “Good” patient refers to one who conforms and complies. assumes non-person role does not complain appears cheerful conforms to routine Learned Helplessness “Bad” patient asks questions demands answers complains attempt to restore control fails to conform Disobedient Reactance “Good” patient versus “bad” patient

13. Preparing for Procedures • Preparation is fundamentally about increasing perceived control • Information Control • Providing Information • Anderson (1987) • Modeling Procedures • Children • Cognitive Control • Focus on the benefits • Behavioral Control • Anderson (1987)

14. 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

15. 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

16. Results: Anxiety Standard Care Information Only Info + Coping

17. Results • In addition, compared to Standard Care, both psychological treatments equally . . . • improved physical recovery • reduced complications • Information Plus Coping provided no added benefit beyond Information Only

18. Modeling Procedures • Modeling is often used with children • Puppet shows • Preschoolers and young school children • Videos/demonstrations • Older children