Use of health services

Question 1

Why is health care utilisation important?

Answer 1

Healthcare utilisation. is important as seeking early diagnosis of some illnesses can make a significant difference

Question 2

What are the 2 actions patients must take when perceiving symptoms and seeking medical attention?

Answer 2

1. Finding a doctor to contact when unwell

2. Deciding when unwell enough to require medical care;

Question 3

How are symptoms used in making diagnosis?

Answer 3

• symptoms accompany illness
• when symptoms disappear, you are well again (usually!)
• specific symptoms reliably signal specific illnesses
• specific symptoms are > serious than others

Question 4

How does a patient finally make the decision to seek medical advice?

Answer 4

Decisions made after perceiving & interpreting symptoms

Question 5

Does every disease have symptoms?

Answer 5

No - Hypertension has no symptoms

Question 6

What percentage of the population will experience 1 or more symptoms of ill health?

Answer 6

75%

Question 7

What percentage of the 75% of the population who experience symptoms of ill health seek help from a GP?

Answer 7

33%

Question 8

What 4 divisions is the symptom iceberg split into?

Answer 8

25% - No symptoms
25% - Symptoms but do nothing
25% - Self medicate, alternative
25% - Visit GP

Question 9

What are the 3 features of symptoms?

Answer 9

• Intensity/Severity
• Familiarity
• Duration and frequency

Question 10

How can patients find symptom perception difficult?

Answer 10

It is very difficult and complex when perceiving symptoms.

I.e - When does a normal headache become one to be concerned about?

Question 11

What time frame of seeking help aids good health outcomes?

Answer 11

Seeking help within first 12 weeks of symptoms are very important for getting good health outcomes

Question 12

What percentage of patients delay getting treatment for Rheumatoid arthritis?

Answer 12

50%

Question 13

What is the difference in signs between early and advanced Rheumatoid arthritis?

Answer 13

Early RA shows soft tissue swelling

Advanced RA shows swelling in joints

Question 14

What are the 5 factors affecting symptom perception?

Answer 14

• Features of symptom
• Individual differences - Variation
• Competing environmental stimuli
• Psychosocial influences
• Socio-cultural differences

Question 15

What questions are asked when assessing individual differences in symptom perception?

Answer 15

Individual differences — variation;

• how quickly a physical experience is noticed
• number/ intensity of sensations experienced
• amount of attention paid to internal states

Question 16

What are Monitors and Blunters according to Miller et al?

Answer 16

Monitors - in tune with their symptoms and seek help

Blunters - Not in tune with symptoms, get treatment but don’t care why they care getting treatment they just take it

Question 17

What are the reasons that patients vary amongst receiving medical care?

Answer 17

Due to internal states (Pennebaker)
‘Monitors’ & ‘Blunters’
Hypochondriacs — may overuse medical care
Some symptoms go un-noticed, regardless of how strong

Question 18

Explain the competing environmental stimuli that affects symptom perception?

Answer 18

Competing environmental stimuli -extent of attention paid to internal stimuli at any given time
influenced by nature of environmental stimuli present (sensory info)

E.g -
Sunderland star reveals he broke through
the pain barrier and played on with a cracked rib during
vital win

Question 19

How to Psychosocial factors influence symptom perception?

Answer 19

Psychosocial influences - Play important role in understanding and managing symptoms

1) . Cognitive influence - i.e - when call a doctor and feel better already
- placebos (Latin - “to. please”

2). Combined roles of cognitive, social, emotional factors
‘medical student’s disease’ - Medical students believe they have diseases they study abound self-diagnose

3). ‘mass psychogenic illness’
widespread symptom perception with no medical basis.
• Increase stress causes sensations to be exaggerated,
modelling as if they have that disease

Question 20

How to Psychosocial differences influence symptom perception?

Answer 20

Socio-cultural differences - awareness of, attention to symptoms

Examples;
- Females have a lower tolerance to painful stimulus
- Asian people report more physical symptoms with psychological basis
than people of other cultures

Question 21

What are the 4 main factors that an individuals symptom perception depends upon? (important*)

Answer 21

An individuals symptom perception depends on:

1) . Strength of underlying physical sensation
2) . Tendency to pay attention to internal states
3) . Degree to which external stimuli competes for attention
4) . Variety of cognitive, social, emotional processes

Question 22

What are the 4 main factors that an individuals symptom perception depends upon? (important*)

Answer 22

An individuals symptom perception depends on:

1) . Strength of underlying physical sensation
2) . Tendency to pay attention to internal states
3) . Degree to which external stimuli competes for attention
4) . Variety of cognitive, social, emotional processes

Question 23

What are the reasons why a patient may interpret and respond to their diagnosis?

Answer 23

• Due to their prior experiences
• Due to their experienced based knowledge
• Due to a lay referral

Question 24

What is a lay referral?

Answer 24

When someone who isn’t a healthcare professional tells you to go to the doctor (body of friends or family who provide advice of how to interpret a symptom)

Help to interpret a symptom

Question 25

What do Common Sense Models affect and what 3 things are they used for?

Answer 25

Common Sense Models affect our health-related behaviour and can be used to; - Aquire meaning - We use them to understand why patients aren't seeking healthcare, what their intentions are - Predict - e.g - Investigate the effect of. smoking - Control - Changing things, ie - Reduce stress to stop a patient from having to smoke

Question 26

What do Common Sense Models affect and what 3 things are they used for?

Answer 26

Common Sense Models affect our health-related behaviour and can be used to; - Aquire meaning - We use them to understand why patients aren't seeking healthcare, what their intentions are - Predict - e.g - Investigate the effect of. smoking - Control - Changing things, ie - Reduce stress to stop a patient from having to smoke

Question 27

Draw the Health Belief model?

Answer 27

Look at diagram....

Question 28

What do modifying factors do?

Answer 28

Modifying factors influence the perceived thread of disease, which then influences the likelihood of behavioural change

Question 29

What is behavioural change influenced by?

Answer 29

Likelihood of behavioural change is influenced by the perceived threat of disease and also this cost benefit of evaluation to behaviour change

Question 30

What is the perceived that of disease influenced by?

Answer 30

In turn the perceived threat of disease is influenced by individual perceptions, perceived susceptibility/severity of disease

Question 31

What is the perceived that of disease influenced by?

Answer 31

In turn the perceived threat of disease is influenced by individual perceptions, perceived susceptibility/severity of disease

Question 32

What is the Health Belief Model and what are its processes used for?

Answer 32

Useful as a model applied to people's seeking health care as it describes processes people use for: — primary prevention behaviour (going for check-up) — symptom-based behaviour in secondary prevention (going to doctor when sick) — sick-role behaviour in tertiary prevention (rehabilitation program following stroke)

Question 33

How may cancer patient vary in the time it takes to seek medical care if they both are symptom aware but have different beliefs?

Answer 33

Patient who believes cancer cannot be treated effectively or cured delays seeking medical care Patient who believes that cancer treatment can be successful has a less delay in seeking medical care

Question 34

What are cues to action and give an example?

Answer 34

Cues to action influence people's practice of preventative measures e.g. 'REMINDERS' to perform self-examination Breast and testicular cancer posters

Question 35

What are the 6 examples of factors that affect the utilisation of health services?

Answer 35

Factors affecting utilisation of health services; • Differences in symptom perception • Influence of prior experience, lay referral • Individual health beliefs and ideas held • Cost-benefit evaluation of seeking medical attention • Social and emotional factors • Quality of r'ship with doctor

Question 36

What 4 social factors influence the use of health services ?

Answer 36

Social factors influencing use of health services; Sex-role stereotypes - sign of weakness? (Usually men) - 'stiff upper lip' - ignore signs of cancer reluctant to cause a fuss Environmental factors and access - distance from surgery Family income - High income = increased health care - Low income seek = a decrease in. preventative care (typical in America ) - This causes an increase in episodes of major illness and increase use of hospital ER Sanctioning — social trigger, significant others - I.e wife to husband "you really need to go see the doctor", go because it will please their other half

Question 37

Name some emotional factors that prevents the use of health services?

Answer 37

Emotional factors; • Emotional reactions to symptoms • Anxiety and fear driven by symptom perception • Fear of serious diagnosis • Expectation/ fear of pain in investigation/ treatment (i.e - Dentist) • Embarrassment (e.g. bladder control) • Belief in treatment efficacy • Sense of control over events in one's life

Question 38

What percentage of malpractice cases are linked to poor doctor - patient communication?

Answer 38

70%

Question 39

How might the quality off the relationship with the doctor affect a patients use of healthcare?

Answer 39

- Negative experiences may cause patient to not come back - Patients may have different beliefs and attitudes of health professional - Patients may not trust you as a health professional - May worry there is no confidentiality (i.e if confidentiality was broke by another doctor and gossip) - Discrimination (e.g. minority groups may feel discriminated against) - May think that. their doctor has poor communication skills and there is no point

Question 40

Who are the 4 types of health car users based on age, gender, chronic and acute cases?

Answer 40

Type of health service users; Age; — infants and very young children — elderly Gender; — women vs men (generally more women) - pregnancy and childbirth - Women have more of a focus on physical state CHRONIC REGULAR USER; - long term conditions (i.e diabetes) ACUTE IRREGULAR USER - (i.e Broken Leg)

Question 41

What is treatment delay?

Answer 41

Treatment delay is the time that elapses between 1st perception of symptom and when the person enters medical care

Question 42

What are the 3 stages to treatment delay?

Answer 42

3 stages to treatment delay; 1. APPRAISAL DELAY the time a person takes to interpret a symptom as an indication of illness (delay: sensory experience of symptom) 2. ILLNESS DELAY the time between recognising one is ill and deciding to seek medical attention (delay: thoughts about symptom, new?) 3. UTILISATION DELAY the time after deciding to seek medical care until actually going in to use that health service (delay: benefits and barriers)

Question 43

What are the 3 stages to treatment delay? *

Answer 43

3 stages to treatment delay; 1. APPRAISAL DELAY the time a person takes to interpret a symptom as an indication of illness (delay: sensory experience of symptom) 2. ILLNESS DELAY the time between recognising one is ill and deciding to seek medical attention (delay: thoughts about symptom, new?) 3. UTILISATION DELAY the time after deciding to seek medical care until actually going in to use that health service (delay: benefits and barriers)