Resources
The Breakdown
Important
- Individual Differences / Personality – This is the biggest and most important factor influencing how symptoms are detected, including tendencies like hypochondriasis or neuroticism.
- Five Distinct Components of Illness Schemas – It is important to understand these components that shape a patient’s personal interpretation of an illness: identity (label), consequences, causes, duration, and cure.
- Acute Illness – A short-lasting illness, typically bacterial or viral, that is treated and managed until it passes.
- Chronic Illness – An illness that lasts for a long time and is multifactorial, meaning it has several contributing factors.
- Cyclic Illness – An illness characterized by alternating periods of activity, where symptoms come and go over a long duration.
- Age as a Predictor of Healthcare Use – Young children and older adults tend to be heavy users of the healthcare system, while those in mid to late adulthood use it less.
- Gender as a Predictor of Healthcare Use – Women tend to use the healthcare system more than men, often due to factors like childbirth-related appointments and a higher propensity to report illness.
- Socioeconomic Status (SES) as a Predictor of Healthcare Use – Higher SES is associated with more specialist visits, whereas visible minorities, who often have lower SES, tend to visit general physicians more frequently but specialists less.
- Physical Appearance and Administration of Placebo – For a properly run placebo-controlled trial, the physical appearance and administration of the placebo must be identical to the active comparator to avoid biasing results.
- Double-Blind Experiment – This is the gold standard for clinical trials, where neither the patient nor the doctor knows who is receiving the active treatment or the placebo, to prevent bias.
Core concepts
- Recognition & Interpretation of Symptoms: Understanding how individuals perceive and make sense of their bodily symptoms.
- Predictors of Use of Health Services: Factors that influence who accesses healthcare and why, including age, gender, socioeconomic status, and culture.
- Patient Experience: The subjective perception of care and interaction with healthcare providers.
- Health Care Provider: The various professionals who offer health services, beyond just physicians.
- Non-Adherence: Situations where patients do not follow prescribed treatment plans.
- Placebo Effect: The therapeutic benefit derived from a non-active treatment due to psychological and physiological responses.
Theories and Frameworks
- Health Belief Model: A model that posits perceived threat to health and belief in the efficacy of intervention as two important predictors of healthcare service utilization.
- Biopsychosocial (BPS) Model: A comprehensive model of health that emphasizes a positive state of well-being, encompassing body, brain, and social networks, and places ownership of health on the individual, moving beyond a purely disease-focused view.
- Illness Representation (Schema): A patient’s personal, common-sense beliefs about their illness, which are shaped by their understanding of the disease, its identity, consequences, causes, duration, and potential for cure.
- Biomedical Model: An older model that primarily focuses on treating symptoms, often contrasted with the more holistic approach of the Biopsychosocial Model.
Notable Individuals
- Terry: A recurring hypothetical patient used in various examples throughout the lecture to illustrate concepts such as symptom detection, delay behaviour, and treatment non-adherence.
- Nancy: A hypothetical colleague or nurse mentioned by a doctor in a scenario about a severe butt rash.
- Gulliver: A hypothetical disease, “Gulliver’s disease,” mentioned as an example in the context of “medical student’s disease”.
- Columbo/Magnum PI: Fictional detectives referenced to describe a patient’s implicit hope that a doctor will uncover their underlying psychological issues without explicit disclosure.
- Mr. Johnson: A hypothetical elderly patient used in an example to illustrate “elder speak” in doctor-patient communication.
- Dr. Johnson: A non-Asian doctor in a predominantly Asian clinic, used to demonstrate how linguistic and cultural barriers can impact a patient’s perceived quality of care.
- Dr. Hooge: A hypothetical doctor used in an example to illustrate how perceived status or appearance might influence a patient’s access to appointments.