Exploring issues in women's health
Exploring issues in women's health

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2.3 Lay perspectives matter

It is important that professionals consider a woman’s understanding of their health when responding to her health issues. The biomedical approach has traditionally viewed lay perspectives as inferior, driven by personal opinion, and they often deviate from the scientific and technical knowledge of experts. Traditionally therefore, under a biomedical approach, the voices of female patients, their carers and other non-experts are viewed as less important than professional voices, knowledge and expertise.

By contrast, the social model of health suggests that a good understanding of lay knowledge can usefully inform expert knowledge. Rather than reinforce the distinctions between these forms of knowledge, academics following the social model argue that understanding how people construct and interpret health and wellbeing is vital to maintaining and supporting health (Yuill et al., 2010).

Women construct and interpret their own health and wellbeing based on all aspects of their personal identity and background. Psychiatrist Dr Micol Ascoli believes that being able to work with people’s own cultural interpretations of mental illness is crucial to supporting their recovery. She spoke to broadcaster and psychologist Claudia Hammond, about her work at Newham Centre for Mental Health in London. In the next activity, you will consider Dr Ascoli’s approach to her work and hear from one of her patients, Angela.

Described image
Figure 5 A therapy session

Activity 4 Working with lay perspectives of illness

Part 1

Listen to the following audio, which is an extract from the radio programme Mental health: mad or sad.

Download this audio clip.Audio player: Audio 2
Audio 2
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Part 2

What lay perspectives on bipolar disorder are discussed in the audio? How did the speakers report the lay perspectives as being helpful? Add your findings below.

Lay perspectives described by: How this knowledge can help:
Angela
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Dr Ascoli
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Words: 0
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Discussion

You may have found it refreshing to hear a medical practitioner so deeply engaged with lay perspectives. Below are some notes in response to the questions.

Lay perspectives described by: How this knowledge can help:
Angela

She talked about her upbringing and religious background, particularly with regards to her believing in ‘the spirit’.

She believes that her bipolar disorder is a gift from God.

Medication is also a ‘gift’.

She is able to make sense of manic and depressive episodes by linking to passages in the Bible.

The way she views medication helps it to fit with her belief system.

Dr Ascoli

A patient’s desired outcomes from medical treatment can be quite different from the medical outcomes that the doctors normally work towards.

Some groups can have different cultural constructs that cause professionals confusion. For example, some ethnic minorities may refer to ’brothers and sisters’ in a completely different sense to that normally applied in Western societies.

Recognising that medical models are also culturally determined, and that taking lay views of health seriously helps patients.

Better communication between healthcare professionals and service users can broaden understanding and ‘fill the gap’.

Part 3

Think about a condition – a disease or disorder – that you or perhaps someone close to you has. What are your own beliefs about the causes of this condition? Are there any aspects of your background that helped to shape these beliefs?

Reflect on the two questions and then write a brief response below.

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Whatever a woman’s beliefs about health are, it is likely they will have been shaped by many factors that are specific to that woman and may not always reflect wider assumptions held by society more broadly, or indeed fit with the biomedical model. This, however, does not diminish their potential value for understanding health and wellbeing because they will affect health behaviours, personal resilience and the ability to achieve health goals. Furthermore, sometimes the experiences and views of a particular group can have a profound and powerful effect on the views of wider society and alter the professional knowledge base as a result.

In the next section, you will consider the impact of social and cultural contexts on health and wellbeing by exploring issues of particular salience in terms of women’s health.

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