There are models that detail the decision-making process that prospective patients go through in making decisions about seeking healthcare from physicians. One such model is the Health Belief Model (HBM), which suggests that people are more likely to take action to prevent or treat a health condition if they believe that they are susceptible to the condition, that the condition is serious, and that taking action will be effective in preventing or treating the condition.
Another model is the Theory of Planned Behavior (TPB), which suggests that people's behavior is influenced by their attitudes, subjective norms, and perceived behavioral control. Attitudes refer to a person's positive or negative evaluation of the behavior (in this case, seeking healthcare from a physician). Subjective norms refer to the perceived social pressure to perform the behavior, while perceived behavioral control refers to the perceived ease or difficulty of performing the behavior.
In terms of cardiology specifically, there are models such as the Cardiac Illness Perception Questionnaire (CIPQ), which assesses patients' perceptions and beliefs about their cardiac illness, including their understanding of the illness, perceived control over the illness, and emotional response to the illness. The CIPQ can provide insights into how patients make decisions about seeking healthcare for their cardiac condition.
Overall, these models can be useful in understanding patients' decision-making processes regarding seeking healthcare from physicians, including for cardiac conditions.
Here are some more details about the Health Belief Model (HBM) and the Theory of Planned Behaviorj (TPB), as well as the Cardiac Illness Perception Questionnaire (CIPQ) that is specific to cardiology:
Health Belief Model (HBM):
The Health Belief Model (HBM) is a psychological model that was developed in the 1950s to explain why some people take preventative health measures while others do not. The HBM suggests that people are more likely to take action to prevent or treat a health condition if they believe that they are susceptible to the condition, that the condition is serious, and that taking action will be effective in preventing or treating the condition. The model includes the following components:
- Perceived susceptibility: The extent to which an individual believes they are at risk of developing the health condition.
- Perceived severity: The extent to which an individual believes the health condition will have serious consequences.
- Perceived benefits: The extent to which an individual believes that taking action will be effective in preventing or treating the health condition.
- Perceived barriers: The extent to which an individual believes that there are obstacles to taking action, such as financial costs, time constraints, or unpleasant side effects.
- Cues to action: The triggers that prompt an individual to take action, such as a doctor's recommendation or a health scare.
- Self-efficacy: The individual's belief in their ability to take action and succeed in preventing or treating the health condition.
- Patients who perceive themselves to be at risk of a health condition are more likely to seek healthcare: In a study by Janz and Becker (1984), women were surveyed about their beliefs and attitudes toward breast cancer screening. The researchers found that women who perceived themselves to be at high risk of breast cancer were more likely to seek mammography screening than women who perceived themselves to be at low risk.
- Perceived barriers to healthcare can hinder healthcare-seeking behavior: In a study by Champion and Skinner (2008), men were surveyed about their attitudes and beliefs toward prostate cancer screening. The researchers found that men who perceived more barriers to prostate cancer screening, such as lack of knowledge or embarrassment, were less likely to seek screening than men who perceived fewer barriers.
- Social norms can influence healthcare-seeking behavior: In a study by Janz et al. (2002), women were surveyed about their attitudes and beliefs toward mammography screening. The researchers found that women who perceived more social support for mammography screening, such as from family members or healthcare providers, were more likely to seek screening than women who perceived less social support.
- Perceived susceptibility and severity can motivate healthcare-seeking behavior: In a study by Rosenstock et al. (1985), patients with type 2 diabetes were surveyed about their attitudes and beliefs toward self-monitoring of blood glucose levels. The researchers found that patients who perceived themselves to be at higher risk of complications from diabetes (perceived susceptibility) and who believed that these complications would be severe (perceived severity) were more likely to engage in self-monitoring of blood glucose levels.
Theory of Planned Behavior (TPB):
The Theory of Planned Behavior (TPB) is a psychological model that was developed in the 1980s to explain the relationship between attitudes, social norms, perceived control, and behavior. The TPB suggests that people's behavior is influenced by their attitudes, subjective norms, and perceived behavioral control. The model includes the following components:
- Attitudes: The individual's positive or negative evaluation of the behavior, in this case, seeking healthcare from a physician.
- Subjective norms: The perceived social pressure to perform the behavior, such as the beliefs of family members, friends, or healthcare professionals.
- Perceived behavioral control: The individual's perception of how easy or difficult it is to perform the behavior, taking into account factors such as time, money, and access to healthcare.
- Attitudes toward healthcare can influence healthcare-seeking behavior: In a study by Cooke et al. (2010), patients with back pain were surveyed about their attitudes and beliefs toward seeking healthcare. The researchers found that patients who had more positive attitudes toward seeking healthcare, such as believing that it was important for their health, were more likely to seek care than patients with less positive attitudes.
- Social norms can influence healthcare-seeking behavior: In a study by Ajzen and Madden (1986), women were surveyed about their attitudes and beliefs toward breast self-examination. The researchers found that women who perceived more social pressure to perform breast self-examination, such as from friends or healthcare providers, were more likely to perform the behavior than women who perceived less social pressure.
- Perceived behavioral control can affect healthcare-seeking behavior: In a study by Rise et al. (2016), patients with chronic obstructive pulmonary disease (COPD) were surveyed about their attitudes and beliefs toward physical activity. The researchers found that patients who had a higher perception of their ability to engage in physical activity (perceived behavioral control) were more likely to engage in physical activity than patients with a lower perception of their ability.
- Attitudes and perceived behavioral control can predict adherence to medication: In a study by Saarti et al. (2014), patients with hypertension were surveyed about their attitudes and beliefs toward taking medication. The researchers found that patients who had more positive attitudes toward taking medication and a higher perception of their ability to take medication (perceived behavioral control) were more likely to adhere to their medication regimen.
Cardiac Illness Perception Questionnaire (CIPQ):
The Cardiac Illness Perception Questionnaire (CIPQ) is a tool that was developed to assess patients' perceptions and beliefs about their cardiac illness. It consists of 18 items that assess six domains:
- Illness identity: The patient's understanding of their illness and its symptoms.
- Consequences: The patient's perception of the impact of their illness on their life, including physical, psychological, and social consequences.
- Timeline: The patient's perception of how long their illness will last.
- Personal control: The patient's perception of their ability to control or manage their illness.
- Treatment control: The patient's perception of the effectiveness of treatment options.
- Emotional representations: The patient's emotional response to their illness, including anxiety, depression, and fear.
- Patients with coronary artery disease (CAD) have different illness perceptions than patients with angina or heart failure: In a study by Broadbent et al. (2009), patients with CAD, angina, or heart failure completed the CIPQ.
- The researchers found that patients with CAD had higher scores on the consequences domain (indicating a greater perceived impact of their illness on their life) and lower scores on the personal control domain (indicating a lower perception of their ability to control their illness) than patients with angina or heart failure.
- Illness perceptions are associated with adherence to medication: In a study by Petrie et al. (2002), patients with hypertension completed the CIPQ and were followed up for 12 months to assess their adherence to medication. The researchers found that patients who believed their hypertension would have more severe consequences (higher consequences domain score) were more likely to adhere to their medication regimen.
- Patients' illness perceptions change over time: In a longitudinal study by Petrie et al. (2005), patients with myocardial infarction completed the CIPQ at 1 month and 12 months after their cardiac event. The researchers found that patients' perceptions of their illness changed over time, with increases in personal control and decreases in emotional representations and consequences scores over the course of the year.
- Illness perceptions are associated with depression and anxiety: In a study by Dickens et al. (2008), patients with heart failure completed the CIPQ and were assessed for symptoms of depression and anxiety. The researchers found that patients who scored higher on the consequences and emotional representations domains of the CIPQ were more likely to have symptoms of depression and anxiety.
- Patients with heart failure have different illness perceptions than patients with other cardiac conditions: In a study by Al-Ruthia et al. (2018), patients with heart failure, coronary artery disease, or atrial fibrillation completed the CIPQ. The researchers found that patients with heart failure had higher scores on the consequences and emotional representations domains of the CIPQ than patients with other cardiac conditions.
- Illness perceptions are associated with quality of life: In a study by Jin et al. (2016), patients with coronary artery disease completed the CIPQ and were assessed for their quality of life. The researchers found that patients who scored higher on the consequences and emotional representations domains of the CIPQ had lower quality of life scores.
- Illness perceptions are associated with healthcare utilization: In a study by Ge et al. (2018), patients with coronary artery disease completed the CIPQ and were followed up for 6 months to assess their healthcare utilization. The researchers found that patients who scored higher on the consequences domain of the CIPQ were more likely to use healthcare services, such as hospitalization and emergency room visits.