Lay Concepts and Strategies for Handling Symptoms of Disease: A sample of adult men and women experiencing back pain symptoms

Abstract

A population sample of 60 men and women who had experienced back pains were interviewed in-depth with semi-structured techniques. Though two thirds of the sample had symptoms of severe or moderately severe character, less than half had any current contact with doctors. Interviews were taped and analysed qualitatively.

Results show that almost all respondents continually develop ideas and concepts about their disease built upon the experiences and experiments of everyday activities over a long period, rather than upon medical information. Most respondents subscribed to a multifactorial view of the disease and some had quite sophisticated models of processes leading to symptom emergence. However, models almost invariably were of the “black-box type”, specifying influences and outcomes but being blank on what was going on inside the body.

Most respondents preferred not to see themselves as ill. They were nevertheless concerned with disease concepts and causes because correct disease modelling would give them information on the likely future development of symptoms, i.e. prognostic information, which in turn reduced anxiety and strengthened their mental and practical control of illness.

Control of illness was practiced in several ways. We identified four main types of strategy towards illness: 1. Ignoring/neclecting symptoms of disease. 2. Routine treatment during symptom periods (professional/self-care) 3. Preventive behaviour 4. Permanent change or modification of life situation. Roughly half of respondents were strategy-two users.

The current concept and policy of individual health responsibility is discussed in light of the results.

Key Words:

• Concept of disease
• Back pain
• Illness behaviour
• Causal model
• Qualitative research methods
• Medical Sociology