Consultation and illness behaviour in response to symptoms: A comparison of models from different disciplinary frameworks and suggestions for future research directions
Consultation and illness behaviour in response to symptoms: A comparison of models from different disciplinary frameworks and suggestions for future research directions
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DOI：
10.1016/j.socscimed.2013.03.007
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发表时间：
2013-06-01
影响因子：
5.4
通讯作者：
Hunt, Kate
中科院分区：
文献类型：
--
作者：
Wyke, Sally;Adamson, Joy;Hunt, Kate
我们都会生病，社会科学对我们如何应对疾病的兴趣有增无减。现有的模式是有用的，但都是在学科孤岛内开发和应用的，导致智力和经验努力的浪费，缺乏跨学科的知识积累。我们提出了一个批判性的审查和详细比较的三个过程模型的反应症状：疾病的行动模型，常识模型的自我调节的健康和疾病和网络事件模型。我们提出了一个综合框架，其中症状，反应和行动同时解释和评估积累的知识，并通过互动。评估可能是潜意识的，并受到症状自我施加的程度、对结果的期望、可用资源以及对症状突出性和可能结果的理解的影响。所采取的行动是解决问题的过程的一部分，通过这个过程，个人和他们的直接社会网络寻求（重新）实现“正常”。反应还受到社会结构（直接和间接）、对健康的文化期望、症状的含义以及获得和理解合法使用服务的影响。知识的变化、具体化的状态和情绪的变化都可以在任何时候直接影响。我们并没有低估在不同分析层面实施综合框架的难度。要做到这一点，需要我们在学科理解之间轻松地移动，进行前瞻性的、纵向的研究，使用新的方法来调查在情感和认知反应以及社交网络内的相互作用的背景下对症状的反应。虽然这种方法具有挑战性，但它将促进跨学科知识的积累，并使运动超越描述，以改变个人和组织的反应。(C)2013爱思唯尔有限公司版权所有。
We all get ill and social scientific interest in how we respond the study of illness behaviour continues unabated. Existing models are useful, but have been developed and applied within disciplinary silos, resulting in wasted intellectual and empirical effort and an absence of accumulation of knowledge across disciplines. We present a critical review and detailed comparison of three process models of response to symptoms: the Illness Action Model, the Common Sense Model of the Self-Regulation of Health and Illness and the Network Episode Model. We suggest an integrated framework in which symptoms, responses and actions are simultaneously interpreted and evaluated in the light of accumulated knowledge and through interactions. Evaluation may be subconscious and is influenced by the extent to which the symptoms impose themselves, expectations of outcomes, the resources available and understanding of symptoms' salience and possible outcomes. Actions taken are part of a process of problem solving through which both individuals and their immediate social network seek to (re)achieve 'normality'. Response is also influenced by social structure (directly and indirectly), cultural expectations of health, the meaning of symptoms, and access to and understandings of the legitimate use of services. Changes in knowledge, in embodied state and in emotions can all be directly influential at any point. We do not underestimate the difficulty of operationalising an integrated framework at different levels of analysis. Attempts to do so will require us to move easily between disciplinary understandings to conduct prospective, longitudinal, research that uses novel methodologies to investigate response to symptoms in the context of affective as well as cognitive responses and interactions within social networks. While challenging such an approach would facilitate accumulation of knowledge across disciplines and enable movement beyond description to change in individual and organisational responses. (C) 2013 Elsevier Ltd. All rights reserved.