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Perceptions of disease. Values and attitudes of patients and medical students

Brorsson, Annika LU (1999)
Abstract (Swedish)
Popular Abstract in Swedish

Sjukdomsuppfattningar. Värderingar och attityder hos patienter och medicine studerande. Utvecklingen av den biomedicinska kunskapen och de demografiska förändringarna under 1900-talet har inneburit en ökning av såväl behov av som efterfrågan på hälso- och sjukvård. Illabefinnande utan påvisbara sjukdomstecken och rädsla för sjukdom ligger ofta bakom vårdsökande. Officiellt är primärvården basen i den svenska sjukvården, men mål och prioriteringar är otydliga. En avsevärd andel av alla allmänläkare pensioneras inom tio till femton år och andelen av medicinstudenterna som uttrycker intresse för att utbilda sig inom specialiteten räcker inte till för att kompensera för pensionsavgångarna. Syftet med... (More)
Popular Abstract in Swedish

Sjukdomsuppfattningar. Värderingar och attityder hos patienter och medicine studerande. Utvecklingen av den biomedicinska kunskapen och de demografiska förändringarna under 1900-talet har inneburit en ökning av såväl behov av som efterfrågan på hälso- och sjukvård. Illabefinnande utan påvisbara sjukdomstecken och rädsla för sjukdom ligger ofta bakom vårdsökande. Officiellt är primärvården basen i den svenska sjukvården, men mål och prioriteringar är otydliga. En avsevärd andel av alla allmänläkare pensioneras inom tio till femton år och andelen av medicinstudenterna som uttrycker intresse för att utbilda sig inom specialiteten räcker inte till för att kompensera för pensionsavgångarna. Syftet med denna studie var att utforska patienters och medicine studerandes värderingar och attityder rörande sjukdomar samt att undersöka dessa värderingars och attityders ursprung i kulturen, den personliga erfarenheten och utbildningen. Familjeanamnesen, det vill säga familjens sjukdomshistoria, påverkade patientens tolkning av det aktuella problemet i åtskilliga fall. Att man uppfattade sjukdomen som drabbade den anhörige som allvarlig föreföll vara en förutsättning för sådan påverkan. Familjeanamnesen påverkan skedde via olika mekanismer. Vissa farhågor hängde samman med funderingar om ärftlighet, andra berodde på känslomässig närhet till den sjukdomsdrabbade anhörige. Ytterligare andra föreföll snarast vara exempel på allmänt förekommande uppfattningar om hälsa och sjukdom. Rädslan för en sjukdom var relaterad till en mer eller mindre medveten uppskattning av dess stigmatiserande potential. Hot mot autonomi tycktes vara av betydande vikt. Olika aspekter av identitet och kontroll var framträdande teman. Analogt gör vissa medicine studerande sitt yrkesval för att få kontroll över sjukdom och lidande. Auktoritet, makt och kontroll var gemensamma nämnare. Medicine studerandes uppfattningar om sjukdomar tycks ha bestämts av allmänt förekommande uppfattningar å ena sidan och privata och arbetsrelaterade erfarenheter å den andra. De sjukdomar som omnämndes som mest skrämmande hade karakteristika som tog kontrollen ifrån både patienten och läkaren; inga metoder för förebyggande, extremt smittsamma, inga botemedel, oförutsägbart förlopp, potential att ändra patientens utseende och beteende. Sistaårsstuderande på läkarutbildningen var mera intresserade av att ha hand om patienter med tillstånd för vilka effektiv behandling är tillgänglig och mindre rädda för tillstånd där risken att drabbas uppfattades som låg. Utbränning hade ersatt HIV som ett av de fem mest fruktade sjukdomstillstånden. Resultaten antyder att inte bara teoretisk och praktisk kunskap, utan också värderingar och attityder förmedlas under utbildningen. (Less)
Abstract
During the 20th century, the development of biomedical knowledge and the demographical changes have increased the needs and demands for health care in industrialised countries. Illness without evidence of disease and fear of disease are often the reasons for seeking medical care. Primary care is the official foundation of the Swedish health care system but priorities are vague and frequently changing. A considerable proportion of family physicians will retire within 10-15 years and the proportion of the medical students with preference for family medicine is insufficient to replace these doctors. The aim of this study was to explore the values and attitudes concerning disease expressed by patients and medical students and investigate their... (More)
During the 20th century, the development of biomedical knowledge and the demographical changes have increased the needs and demands for health care in industrialised countries. Illness without evidence of disease and fear of disease are often the reasons for seeking medical care. Primary care is the official foundation of the Swedish health care system but priorities are vague and frequently changing. A considerable proportion of family physicians will retire within 10-15 years and the proportion of the medical students with preference for family medicine is insufficient to replace these doctors. The aim of this study was to explore the values and attitudes concerning disease expressed by patients and medical students and investigate their origin in culture, personal experience, education and training. The medical history of the family influenced the patients' interpretation of their present problem in several cases. The perceived seriousness of the condition in the family history was a prerequisite for this impact. The family history could influence the thoughts of patients through different mechanisms. Some fears may be linked to thoughts about genetic predisposition, while others may depend more directly on the emotional closeness to the affected relative. Also, some may be reflections of prevailing beliefs and values about health and disease. The fear of a disease seemed to be related to a more or less conscious estimation of its potential to stigmatise. The threat against autonomy could have a general importance. Different aspects of identity and control were important themes. The results of this study indicate that some medical students choose their career in order to achieve control over disease and suffering. Authority, power and control were the common denominators. The perceptions of medical students concerning certain diseases seemed to be determined by prevailing values and beliefs on one hand and by private and professional experiences on the other. The diseases mentioned as most fear provoking all had characteristics that put the patient as well as the doctor out of control; no preventive measures, extremely contagious, no remedies, an unpredictable course, a potential to alter bodily appearance and behaviour. Final year medical students were more interested in conditions for which effective treatment is available and less frightened by conditions, which they have low probability to be afflicted by. Moreover, the results indicated that not only theoretical and practical knowledge, but also values and attitudes were transmitted to the students during the process of professionalisation. (Less)
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author
opponent
  • Mattsson, Bengt
organization
publishing date
type
Thesis
publication status
published
subject
keywords
values, risk factor, autonomy, Attitudes, consultation, disability, disease, family history, family medicine, fear, identity, illness, medical education, medical students, patient-centred, qualitative method, primary care, Social medicine, Socialmedicin, samhällsmedicin
pages
104 pages
publisher
Department of Community Medicine, Malmö University Hospital
defense location
Jubileumsaulan, Medicinskt forskningscentrum
defense date
1999-05-06 13:15
external identifiers
  • Other:ISRN LUMEDW/MESO--1020--SE
ISBN
91-628-3535-1
language
English
LU publication?
yes
id
d2eb0f75-d296-4c76-a91c-692b2286e835 (old id 39478)
date added to LUP
2007-08-01 11:26:37
date last changed
2016-09-19 08:45:09
@misc{d2eb0f75-d296-4c76-a91c-692b2286e835,
  abstract     = {During the 20th century, the development of biomedical knowledge and the demographical changes have increased the needs and demands for health care in industrialised countries. Illness without evidence of disease and fear of disease are often the reasons for seeking medical care. Primary care is the official foundation of the Swedish health care system but priorities are vague and frequently changing. A considerable proportion of family physicians will retire within 10-15 years and the proportion of the medical students with preference for family medicine is insufficient to replace these doctors. The aim of this study was to explore the values and attitudes concerning disease expressed by patients and medical students and investigate their origin in culture, personal experience, education and training. The medical history of the family influenced the patients' interpretation of their present problem in several cases. The perceived seriousness of the condition in the family history was a prerequisite for this impact. The family history could influence the thoughts of patients through different mechanisms. Some fears may be linked to thoughts about genetic predisposition, while others may depend more directly on the emotional closeness to the affected relative. Also, some may be reflections of prevailing beliefs and values about health and disease. The fear of a disease seemed to be related to a more or less conscious estimation of its potential to stigmatise. The threat against autonomy could have a general importance. Different aspects of identity and control were important themes. The results of this study indicate that some medical students choose their career in order to achieve control over disease and suffering. Authority, power and control were the common denominators. The perceptions of medical students concerning certain diseases seemed to be determined by prevailing values and beliefs on one hand and by private and professional experiences on the other. The diseases mentioned as most fear provoking all had characteristics that put the patient as well as the doctor out of control; no preventive measures, extremely contagious, no remedies, an unpredictable course, a potential to alter bodily appearance and behaviour. Final year medical students were more interested in conditions for which effective treatment is available and less frightened by conditions, which they have low probability to be afflicted by. Moreover, the results indicated that not only theoretical and practical knowledge, but also values and attitudes were transmitted to the students during the process of professionalisation.},
  author       = {Brorsson, Annika},
  isbn         = {91-628-3535-1},
  keyword      = {values,risk factor,autonomy,Attitudes,consultation,disability,disease,family history,family medicine,fear,identity,illness,medical education,medical students,patient-centred,qualitative method,primary care,Social medicine,Socialmedicin,samhällsmedicin},
  language     = {eng},
  pages        = {104},
  publisher    = {ARRAY(0x814d888)},
  title        = {Perceptions of disease. Values and attitudes of patients and medical students},
  year         = {1999},
}