Review for Exam 1 (part 2—Chapter 3 Seeking and Receiving Health Care & Chapter 4 Adhering to Medical Advice

Personal Factors influencing illness behavior

A person’s view of their own body, stress levels, and personality traits that affect health-seeking behavior. people who

experience a great deal of stress are more likely to seek health care than

those under less stress, even with equal symptoms. People who score high

on neuroticism generally had high self-reports of illness whether or not objective evidence confirmed their reports

Social and Demographic Factors

Women seek out medical care more than men. those with higher social economic status experience fewer symptoms and report a higher level of health than those at lower SES. However, when high SES individuals are sick, they are more likely to seek medical likely due to greater access to appropriate and affordable resources.

Stigma: higher levels of perceived stigma may deter a person from

seeking care

Race: European Americans are more likely than other racial groups to obtain medical care. Various explanations offered include lack of

resources/insurance coverage and access to care, discrimination, cultural insensitivities

Symptom characteristics

Heighten visibility, perceived severity, degree to which

the symptom interferes with a person’s life, and persistence and recurrence can lead to a higher likelihood of the person seeking medical care

Optimistic Bias

The tendency to believe one will not encounter the negative effects of nonadherence.

Cognitive-Behavioral Intervention

Interventions like teaching positive self-talk to help reduce stress and improve adherence to health practices.

Perceived Severity of Disease

An individual's assessment of how serious their disease is, which affects their adherence to treatment.

Strategies for helping young children cope with medical procedures

providing parent/child understandable and age-appropriate information,

• the use of toys/books and other fun tools to discuss health procedures,

• the use of distraction (for short-term procedures),

• modeling (use an effective and relatable model who models the ability to successfully go through the procedure),

• cognitive-behavioral intervention (e.g., teaching positive self-talk to reduce stress)

Multicomponent Approach

Using multiple strategies to improve health-related outcomes, especially effective with young children.

Estimates of the problem of noncompliance

can range from 15% to 93%

Strategies to measure adherence

1) asking the practitioner (the least valid because practitioners generally

overestimate adherence rates)

2) asking the patient (problematic because patients tend to present themselves as being more compliant than they are and/or they are not very accurate at rating their adherence)

3) asking other people such as other hospital staff or family members

4) measuring adherence through objective measures such as pill counts, number

of prescriptions or refills

5) examining biochemical evidence

USE A COMBO!!!

Tenents of the Health Behavior Model (Ajzen)

1) Perceived susceptibility to disease

2) perceived severity of the disease

3) perceived benefits of doing the health behavior

4) perceived barriers of doing the health behavior

Does not consider self efficacy.

Tenets of the theory of planned behavior

1) one’s attitude toward the behavior

2) one’s perception of how much control they have over their own behavior

3) social norms/pressure to perform the behavior

Not predictive or unpredictable beahvior

Positive reinforcement

positively valued stimulus will likely increase a behavior (e.g., receiving $20 contingent on appearing for your doctor’s appointment on time)

Negative reinforcement

the removal/reduction of a negative stimulus by engaging in a behavior will strengthen that behavior (e.g., a reduction in pain by taking a prescribed medicine will likely strengthen the patient’s adherence to the prescription

Strategies for improving adherence

Clearly written instructions,

--Simple prescriptions

--Follow-up calls for missed appointments

--Rewards for compliant behavior

--Cues to assist in following medical regimen

--Involvement of significant others in support of regimen

--Contingency contracting

Note: combination of techniques is the most effective