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Vital ConversationsImproving Communication Between Doctors and Patients$
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Dennis Rosen

Print publication date: 2014

Print ISBN-13: 9780231164443

Published to Columbia Scholarship Online: November 2015

DOI: 10.7312/columbia/9780231164443.001.0001

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Disease, Illness, and Sickness

Disease, Illness, and Sickness

(p.81) 4 Disease, Illness, and Sickness
Vital Conversations

Dennis Rosen

Columbia University Press

This chapter describes how the patient's understanding of his disease, shaped both by personal experience and cultural background, can profoundly influence his illness behavior. David Mechanic of Rutgers University, defined illness behavior as “the ways in which given symptoms may be differentially perceived, evaluated and acted (or not acted) upon by different kinds of people.” Mechanic found that illness behavior can be influenced by the frequency of a disease within a specific population, how familiar members of the population are with its symptoms, the predictability of its outcome, and by how threatening the disease is perceived to be. Without open dialogue between physician and patient about how the patient understands his disease, it is very difficult for the physician to identify those concerns that may serve as barriers to effective treatment, and to help the patient overcome them. In addition, the “sick role” cast upon patients by society also influences illness behavior, as well as the physician's behavior.

Keywords:   disease, illness behavior, David Mechanic, physician-patient communication, sick role, society

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