Case 1.

Obj 14

The factors triggering to professional consultation

1)Trigger to consult involved the inability to go to work and perform household tasks. 2)Concern by other people In a few cases, the concern or exasperation of family members was reported as the factor leading to medical consultation. 3)Familiarity of the symptoms The interpretation of the seriousness of the symptoms was based on earlier experiences of consultations and the patient's own illness history. Both familiarity and strangeness of the symptoms could lead to the decision to seek medical advice. Interpretation was often based on knowledge about the patient's typical reaction to illness. 4)When the symptoms were unfamiliar, the decision making was often based on 'worst possible' logic. If, for instance, a person has never experienced headache, and it then occurs for the first time (at an older age), the headache could be taken as a sign of some serious cerebro-vascular disease. Or, when a child is seriously ill for the first time, even the possibility of cancer is considered. 5)Growing worry The patients' own worries which drove them to seek medical help were usually related to the fear of progression of the illness or development of additional symptoms. They often used the analogy of 'the bug is going deeper, moving to another organ. 6)Experimenting with symptoms An interesting category was that of testing one's own ideas. People 'act as scientists' by observing, interpreting and carrying out experiments with their symptoms. Their decision to consult a doctor is based on 'if-then logic'. If the symptoms did not disappear, or if they had got worse, professional consultation followed. 7)Intolerable discomfort When the symptom as such was reported as the reason for medical consultation, the pain was described as intolerable both physically and psychologically. Typical physical pain involved high temperatures and chest pain, and a typical psychologically unbearable situation was a child's inability to sleep. As example- intolerable consequences of alcoholism.

Crisis

People may experience a form of crisis such as a death in the family.

Relationships May feel they can't sleep or concentrate which affects their relationships with others. Sanctioning Other people's suggestion: "Oooh, you don't look well," or " You look pale, have you seen a doctor?"

Temporalising Setting time limits - "I know, I'll leave my sore leg till Monday and if it isn't better i'll go to the doctor" Activities Interference with sporting or social activities.