Illness behaviour and studies of communications between doctors and patients

Abstract

Individuals who seek medical care clearly represent only the tip of the illness iceberg. To explain how individuals cope with medically unreported health status, deviations, a situational conception of everyday illness behavior is proposed. The primary assumption of this conceptualization is that illness and pathology may not be reported because persons are able to contain signs and symptoms of illness within socially defined situations. Several factors influence this process, namely: (a) commitment to and engrossment in situations; (b) tolerance quotient and idiosyncrasy credit given by others; (c) power relationships among participants; (d) coping resources of the situations; (e) symptom meaning; (f) the presence of normal processes and chronic diseases; and (g) age and sex as circumstances. Definitions of illness emerge when there is a cumulative decline in the individual's ability to contain sign and symptoms over a significant proportion of his “situation set”. How illness emerges and is contained within daily social situations in the absence of medical care is a significant issue in the development of health care policy.