RT Journal Article
SR Electronic
T1 How people present symptoms to health services: a theory-based content analysis
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 267
OP 273
DO 10.3399/bjgp11X567090
VO 61
IS 585
A1 Barbara Farquharson
A1 Marie Johnston
A1 Carol Bugge
YR 2011
UL http://bjgp.org/content/61/585/267.abstract
AB Background How people present symptoms to health services may influence the care they subsequently receive. Leventhal's Commonsense Model of Self-Regulation (CS-SRM) posits that individuals develop cognitive illness representations elaborated around five main components (identity, timeline, cause, consequences, and cure/control), coherence, and emotional representations.Aim To examine whether initial presentations to health services consist of the components of illness representation proposed by the CS-SRM.Design and setting A CS-SRM-based content analysis of calls to the Scottish national telephone advice service, NHS 24.Method A random sample of callers to NHS 24 was identified. A quota sample of 60 consented to participate. Their consultations were transcribed verbatim. Responses to an initial open question regarding the reason for calling were identified and divided into ‘meaning units’. A coding schedule was developed using Leventhal's definitions of illness representations. Meaning units were coded independently by two researchers.Results Fifty-nine eligible initial presentations contained between 1 and 13 coding units, (mean = 4). A total of 230 coding units were available for coding. Overall, 202 (88%) coding units were coded to at least one component of illness representation. All 59 (100%) participants made reference to identity, 26 (44%) to timeline, nine (15%) to cause, eight (14%) to consequences, 22 (37%) to cure/control, and 11 (19%) to the degree of coherence. Emotional representations were identified in six (10%) participants' presentations.Conclusion Leventhal's CS-SRM accounts for a large proportion of initial presentations to health services. Most people offer identity plus at least one additional component of illness representation. It may be necessary for clinicians to prompt remaining components to obtain a comprehensive understanding of patients' representations of illness.