Solution Manual for Health Psychology, 11th Edition,

Shelley Taylor, Annette L. Stanton

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Solution Manual for Health Psychology, 11th Edition, Shelley Taylor, Annette L. Stanton

1
Chapter 8: Using Health Services

Chapter 8
Using Health Services

Chapter Outline

I. Recognition and Interpretation of Symptoms

A. Recognition of Symptoms
B. Interpretation of Symptoms
C. Cognitive Representations of Illness
D. Lay Referral Network
E. The Internet
II. Who Uses Health Services?
A. Age
B. Gender
C. Social Class and Culture
D. Social Psychological Factors
III. Misusing Health Services
A. Using Health Services for Emotional Disturbances
B. Delay Behavior

Learning Objectives

1. Describe the social and psychological factors that influence the recognition and
interpretation of symptoms.
2. Explain how the use of health services is spread across different populations.
3. Define illness representations and illness schema and explain their influence on the
interpretation of symptoms.
4. Describe the nature and function of the lay referral network.
5. Describe the use of the Internet as a lay referral network.
6. Describe the demographic factors that predict the use of health services.
7. Describe the sociocultural factors that predict the use of health services.
8. Explain why people misuse health services for emotional disturbances.
9. Explain the nature and consequences of delay behavior.

Lecture Suggestions

1. Somatization and Using Health Services

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Chapter 8: Using Health Services

Patients with medically unexplained symptoms are frequent. Brown (2004) reviews the
three classical theories: dissociation, conversion, and somatization. Each theory explains
some but not all of the categories of symptoms. Brown presents a model that proposes that
these unexplained symptoms can be understood within the framework of mainstream
cognitive psychology. The model integrates and expands the three historical theories. One
should note that this is not a model of malingering. The assumption is that the pain and the
symptoms are real and disabling but are not attributable to underlying physical causes. He
provides numerous schematics that are useful in understanding all of the models. Hiller and
others (2006) investigate the prevalence of somatization or physical symptoms not caused
by medical disease, and they report that although a medically unexplained symptom is a
common phenomenon, this problem is not well understood.

2. The Old Stereotype and Medical Ageism

Geropsychologists seek to understand the negative age stereotypes with regard to health
issues (Dittmann, 2008). Elderly people are often stereotyped as incompetent and forgetful
(Cuddy et al., 2005; Erber et al., 1996), and such beliefs may lead elderly individuals and
health professionals to associate health symptoms with aging, which can have tragic
outcomes. For instance, Sarkisian and colleagues (2006) published an article regarding the
growing body of research investigating beliefs about aging and health, and they reported
that if older adults attribute their health problems to aging, they may not seek medical
treatment, which results in greater mortality. Moreover, medication nonadherence is
frequent among older adults because of low self-efficacy or a lack of confidence in their
physician (Chia et al., 2006).

Gurwitz et al. (2003) showed that adverse drug events are common and often preventable
among older persons in the ambulatory clinical setting. Prevention strategies should target
the prescribing and monitoring stages of pharmaceutical care. Interventions focused on
improving patient adherence with prescribed regimens and monitoring of prescribed
medications may be beneficial. Health practitioners hold cognitive representations of
illness and the patient prototypes. Thus, practitioner stereotypes about their patients may
influence the diagnosis of symptoms as well as the quality of care provided to the patient
(Mandy, Lucas, and Hodgson, 2007).

3. The Sick Role and Self-Enhancement

A study by Hamilton and Janata (1997) may be used to expand on the text’s discussion of
the use of health services for nonmedical reasons. These researchers investigated abnormal
illness behavior (that is, the overreporting or exaggerating of physical symptoms,

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 3
Chapter 8: Using Health Services

preoccupation with illness, medical tests, and so forth), and they proposed that people with
low self-esteem or identity problems engage in these behaviors in an effort to construct a
positive sense of self. Another article by Miczo (2004) argues that sick-role behavior may
be better conceptualized as a set of illness attitudes and care-seeking behaviors. He found
that attitudinal factors (release, consideration, burden, and deviance) were moderate
predictors of care-seeking intentions, as were stressors and social support for the sick role.

Parent perceptions of illness can have a profound influence on children’s sick role
behavior. Among adolescents, for example, parents are more likely to reinforce sick role
behavior if a symptom is described as anxiety inducing, as opposed to neutral (Bilsky et
al., 2018a, 2018b).

Recommended Reading

1. Center for Disease Control and Prevention. Health Care and Insurance Factsheets
available at https://www.cdc.gov/nchs/fastats/health-care-and-insurance.htm

The CDC website provides up-to-date statistics on healthcare utilization in the US and can
be used as a resource for instructors.

2. Dean M. Harris. (2011). Ethics in Health Services and Policy: A Global Approach.

This all-inclusive book examines the ethical topics of health and health care from a
worldwide perspective.

Activities

1. Providing Quality Health Care

Ask the students to form five groups for a critical-thinking exercise and a team problem-
solving assignment. Assign each group one of the following projects (given below). After
discussing the problems and potential interventions in each scenario for approximately 20
minutes, have the groups report their findings to the class.

Project 1: You have been provided with state and federal funding to establish a
comprehensive family practice clinic in the inner city. Describe your patients’ profiles.
What steps will you take to maximize patient use of this clinic?

Project 2: You are on the administrative board of County General Hospital. The hospital

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Chapter 8: Using Health Services

has charged the board with the task of developing a program targeting delay behavior (e.g.,
seeking treatment for a suspected tumor). Describe the educational and institutional
interventions you might implement to minimize delay behavior.

Project 3: You are on the administrative board of a private hospital that is committed to
increasing patient satisfaction with care. Describe your patients’ profiles. Describe the
steps you might take to minimize depersonalization and to enhance patient perceptions of
control.

Project 4: You are on the administrative board of a pediatric hospital that is committed to
increasing patient and parent satisfaction with care. Describe your patients’ profiles.
Describe the steps you might take to minimize depersonalization and to enhance patient
perceptions of control.

Project 5: Discuss the various factors that medical schools should take into account when
training their physicians (think of the various stereotypes that individuals have, vis-à-vis
the elderly and/or the obese population and young children).

2. Quackery

Discuss in class the factors that make patients susceptible to the influence of practitioners
of medical fraud and quackery. Two examples that might stimulate classroom discussion
are the claims that multivitamin compounds can reverse AIDS (Kapp, 2005) and that
human growth hormones can reverse aging (Perls, 2004).

Videos

1. Sicko by Moore, M. (2007)

This is a documentary examining health care in the United States and other countries.

2. Films for the Humanities and Sciences available at http://ffh.films.com

• The Uninsured: Forty-Four Million Forgotten Americans (2000)

• Peter Jennings Reporting: Breakdown - America’s Health Insurance Crisis (2005)
• Brokaw, T. Reports: Critical Condition (2004)
• Who Cares: Chronic Illness in America - A Fred Friendly Seminar (2001)
• Geriatric Medicine: Innovations and Applications (2001)

3. Investigative Reports, Medical Mistakes

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Chapter 8: Using Health Services

This documentary exposes some high-profile human errors in the medical profession.

4. Charlie Rose available at www.charlierose.com (2007)

This shows a conversation with Sir Paul Nurse and others about global health in the
twenty-first century.

References

Bilsky, S. A., Feldner, M. T., Bynion, T. M., Rojas, S. M., & Leen-Feldner, E. W. (2018a). Child
anxiety and parental anxiety sensitivity are related to parent sick role reinforcement.
Parenting, 18(2), 110-125.

Bilsky, S. A., Cloutier, R. M., Bynion, T. M., Feldner, M. T., & Leen-Feldner, E. W. (2018b).
An experimental test of the impact of adolescent anxiety on parental sick role reinforcement
behavior. Behaviour research and therapy, 109, 37-48.

Brown, T. (2004). Psychological Mechanisms of Medically Unexplained Symptoms: An

Integrative Conceptual Model. Psychological Bulletin, 130, 793–812.

Chia, K., Schlenk, E. A., and Dunbar-Jacob, J. (2006). Effects of Personal and Cultural Beliefs
on Medication: Adherence in the Elderly. Drugs and Aging, Vol 23, 191–202.

Cuddy, A. J. C., Norton, M. I., and Fiske, S. T. (2005). This Old Stereotype: The Pervasiveness
and Persistence of the Elderly Stereotype. Journal of Social Issues, 61, 267–285.

Dittmann, M. (2008). Fighting Ageism. The Monitor. Retrieved 2/1/08 from

http://www.apa.org/monitor/may03/fighting.html

Erber, J. T., Prager, I. G., Williams, M., and Caiola, M. A. (1996). Age and Forgetfulness:
Confidence in Ability and Attribution for Memory Failures. Psychology and Aging, 11, 310–
315.

Gurwitz, J. H., Field, T. S., Harrold, L. R., Rothschild, J., Debellis, K., Seger, A. C., ... & Bates,
D. W. (2003). Incidence and preventability of adverse drug events among older persons in
the ambulatory setting. JAMA, 289(9), 1107-1116.

Hamilton, J. C., and Janata, J. W. (1997). Dying to Be Ill: The Role of Self-enhancement
Motives in the Spectrum of Factitious Disorders. Journal of Social and Clinical Psychology,

Copyright ©2021 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill
Education
Solution Manual for Health Psychology, 11th Edition, Shelley Taylor, Annette L. Stanton

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Chapter 8: Using Health Services

16, 178–199.

Hiller, W., Rieft, W., and Brahler, E. (2006). Somatization in the Population: From Mild Bodily
Misperceptions to Disabling Symptoms. Social Psychiatry and Psychiatric Epidemiology,
41, 704–712.

Kapp, C. (2005). SA Health Minister Urged to Stop Vitamin-peddling Doctor. Lancet, 366,
1837–1838.

Mandy, A., Lucas, K., & Hodgson, L. (2007). Clinical educators' reactions to ageing. Internet
Journal of Allied Health Sciences and Practice, 5(4), 9.

Miczo, N. (2004). Stressors and Social Support Perceptions Predict Illness Attitudes and Care-
seeking Intentions: Re-examining the Sick Role. Health Communication, 16, 347–361.

Perls, T. T. (2004). Anti-aging Quackery: Human Growth Hormone and Tricks of the Trade—
more Dangerous than Ever. Journal of Gerontology: Series A: Biological Sciences and
Medical Sciences, 59A, 682–291.

Sarkisian, C. A., Shunkwiler, S. M. Aguilar, I., Moore A. A. (2006). Ethnic Differences in

Expectations for Aging among Older Adults. Journal of the American Geriatrics Society,
54, 1277–1282.

Copyright ©2021 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill
Education

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