Health and Illness Quiz

Defining Health and Illness

• The World Health Organisation (WHO) defines health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." (1947)
• Achieving complete health is an unrealistic standard, as most people would likely not meet this definition. (Huber 2011)
• There is a strong subjective component to health and illness, influenced by personal experience and social values.

Distinguishing Health, Illness and Disease

• Disease is an objective, medical diagnosis, with identifiable signs and symptoms. It refers to a pathological change in the structure or function of the body.
• Illness is a subjective experience, perceived by the individual as a negative change in their state of well-being and social function.
• Hypertension is an example of disease without illness.
• Phantom limb painis an example of illness without disease.

Biopsychosocial Model of Illness

• This model acknowledges the interplay of biological, psychological, and social factors in contributing to health and illness.
• It recognizes that biological processes (e.g., genetics, exposure to pathogens), psychological factors (stress, coping strategies), and social factors (community support, socioeconomic status) all have a significant impact on health outcomes.
• This model is a departure from the traditional biomedical model, which solely focused on biological factors.

Symptom Perception and Illness

• Individuals vary significantly in their attention to and interpretation of bodily symptoms.
• Social influences and media attention regarding specific illnesses can increase symptom perception (e.g., mass psychogenic illness).
• The knowledge of symptoms can also increase their perception (e.g., "medical student's disease").
• Factors that enhance symptom perception include:
  • Painful or disruptive symptoms
  • Novel or unfamiliar symptoms
  • Persistent symptoms
  • Pre-existing chronic diseases.

Illness Representations and Outcomes

• Individual interpretations of their illness (illness representations) impact their healthcare seeking behavior, self-care practices, attitudes towards treatment, and overall quality of life.

Personality and Health Outcomes

• The Big Five Theory of Personality suggests that personality traits, often shaped by genetics, can influence health outcomes.
• Traits like extraversion, neuroticism, and openness to experience have shown links to physical and mental health outcomes.
• A meta-analysis (Strickhouser 2017) found that personality, particularly neuroticism, was most strongly associated with mental health, followed by health behaviors, and with a lesser effect on physical health.

Relevancy of Personality in Medical Practice

• Understanding personality traits can help clinicians tailor treatment approaches, potentially leading to better outcomes.

Conclusions

• There is nuance in the concepts of health and illness, and the biopsychosocial model emphasizes that individuals do not always respond uniformly to disease.
• Illness perceptions shape individual responses to medical care and health outcomes.
• It is important to acknowledge individual differences in symptom perception and healthcare-seeking behaviors.

Defining Health and Illness

• The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
• Huber (2011) argues that the WHO definition’s requirement for complete health is unrealistic, excluding most of the population as unhealthy.
• Health and illness are subjective and encompass social and moral values, beyond only biological aspects.

Disease vs Illness

• Disease refers to objective pathological changes diagnosed by signs and symptoms. It implies an abnormality in the structure or function of body organs or systems.
• Illness is the subjective experience of negative changes in well-being and social function. Perception and response to illness vary greatly among individuals.
• Examples: Hypertension is a disease but may not cause illness without symptoms. Phantom limb pain is an illness in the absence of any demonstrable disease.

Biopsychosocial Model

• The biopsychosocial model acknowledges that multiple factors contribute to illness. This perspective contrasts with the traditional biomedical model, which primarily focuses on biological factors.
• The biopsychosocial model emphasizes a holistic approach, acknowledging the interrelationship between biological, psychological, and social factors in health and illness.

Symptom Perception

• Individual reactions to symptoms vary greatly.
• Research has shown that people may be aware of stroke warning signs but not act accordingly due to various factors - lack of confidence, misinterpreting symptoms, or simply denying them.
• Attentional states influence symptom perception. Increased knowledge of symptoms can lead to increased perception, as is often seen with medical students.
• Distractions, conversely, can reduce symptom perception.

Factors Increasing Symptom Perception

• Painful or disruptive symptoms requiring adaptation are more likely to be perceived as symptoms.
• Novel symptoms are more likely to be considered indicators of something serious.
• Persistent symptoms beyond usual durations or despite self-medication increase perception.
• Chronic conditions increase the number of other symptoms perceived and reported.

The Common Sense Model of Illness

• The Common Sense Model of Illness (CSM) attempts to understand how individuals perceive and cope with illness.
• It's a self-regulation model, suggesting that individuals use their own knowledge and experiences to understand their illness, make decisions about treatment, and manage their condition.
• The CSM identifies five key aspects of illness representations:
  • Identity: The label given to the illness and its associated symptoms.
  • Causality: Beliefs about what caused the illness.
  • Timeline: Beliefs about how long the illness will last.
  • Consequences: Perceived effects of the illness on daily life.
  • Curability/Controllability: Whether the illness is considered curable and if it can be controlled by the individual or through external interventions.

Illness Representations and Clinical Practice

• Understanding an individual's illness representations can guide clinical practice.
• Questions about illness representations can help clinicians gain a better understanding of a patient's perspectives and experiences:
  • What is the individual's understanding of the illness?
  • What do they think caused their health problem?
  • What are their beliefs about the potential outcomes of the illness?
  • How do they perceive their ability to manage their condition?

Personality, Health, and Illness

• Personality traits can influence health behaviors and, consequently, health outcomes.
• Perceived stress is a key mechanism linking personality to health behaviors and physical health.
• The direct impact of personality on physical health is less robust and often mediated by its effect on health behaviors.

Conclusion

• Health and illness are multifactorial concepts influenced by biological, psychological, and social determinants.
• Individual responses to illness are diverse.
• Illness perceptions play a critical role in shaping coping mechanisms and therefore, influencing health outcomes.
• The biopsychosocial model and the Common Sense Model of Illness provide valuable frameworks for understanding the complex nature of health and illness, ultimately guiding effective healthcare practices.

Health, Illness and Disease

• The World Health Organisation (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
• The WHO's definition is considered to be a high standard and likely excludes most of the population.
• Illness is a subjective experience.
• Disease is a biological state, illness is a social construct.
• Illness can exist without disease, and disease can exist without illness.
• There is a complex interaction between disease and illness.
• The historical model for understanding health and illness is the biomedical model.
• The biomedical model focuses solely on exposure to pathogens and their impact, ignoring psychological and social factors.
• The modern biopsychosocial model recognizes the influence of multiple factors on health and illness outcomes.
• The biopsychosocial model emphasizes the interconnectedness of biological, psychological, and social factors, including personal history, genetic predisposition, and learned behaviors.
• The biomedical model promotes a passive patient role, while the biopsychosocial model encourages active involvement in managing health and illness.

Symptoms and Illness Perception

• The perception of symptoms is subjective and influenced by various factors, including attentional state and personal experiences.
• Increased knowledge of symptoms can lead to increased perception of them, potentially leading to medical student's disease.
• The perception of symptoms is also influenced by social factors, such as media coverage and public awareness.
• Painful or disruptive symptoms are more likely to be perceived as significant.
• Novel symptoms, persistent symptoms, and pre-existing chronic diseases may increase symptom perception.

Common Sense Model of Illness

• The common-sense model of illness attempts to explain how individuals understand and cope with illness experiences.
• The model identifies five key themes that shape illness representations: identity, causality, timeline, consequences, and curability/controllability.
• Illness representations influence decision-making regarding medical treatment, self-care, and behaviour change.

Personality and Health Outcomes

• The Big Five Theory of Personality identifies five major personality traits:
  • Openness to experience
  • Conscientiousness
  • Extraversion
  • Agreeableness
  • Neuroticism
• The Big Five Theory is a trait approach to personality, emphasizing stable and enduring dimensions.
• Personality traits are linked to health outcomes, particularly mental health, health behaviors, and physical health.
• The impact of personality on health is moderated by various factors, underscoring the complexity of the relationship between personality and health.

Test your understanding of the definitions of health, illness, and disease based on the WHO's framework and the biopsychosocial model. Explore the subjective and objective aspects of these concepts and enhance your knowledge on the distinctions between them.