Developmental levels in adult's conceptions of health and disease

Abstract

-A socio-cognitive developmental perspective suggests that conceptions regarding health and disease processes may present different levels of openness, flexibility, inclusiveness and differentiation, and thus can be ordered into different levels. We present a qualitative study on lay significations regarding health and disease processes, endorsed by 67 adults. The results show that these adults have different socio-cognitive developmental competences related to health and disease processes. For each dimension of significations of health and disease, it is possible to sequence lay person's conceptions developmentally. Each level is distinct qualitatively, including responses characterized by a higher degree of differentiation, integration and complexity than the previous level. Finally, the implications of this approach to clinical and educational methods are discussed.Keywords: adult's conceptions of health and disease; socio-cognitive development. Níveis de Desenvolvimento nas Concepções dos Adultos sobre Saúde e DoençaRESUMO -Na perspectiva do desenvolvimento sociocognitivo, as concepções de saúde e doença podem apresentar diferentes níveis de abertura, flexibilidade, inclusividade e diferenciação e podem ser ordenadas em diferentes níveis de desenvolvimento. O presente estudo incidiu sobre as significações leigas de saúde e doença de um grupo de 67 adultos. Os resultados indicam que esses adultos se situam em diferentes níveis nas suas competências de desenvolvimento sociocognitivo relacionadas com os processos de saúde e doença, tendo sido possível sequenciar as suas significações em níveis distintos. Cada nível é distinto qualitativamente, incluindo respostas caracterizadas por uma maior diferenciação, integração e complexidade em relação ao nível precedente. As implicações dessa abordagem para os métodos clínicos e educativos são discutidas.Palavras-chave: concepções de saúde e doença em adultos; desenvolvimento sociocognitivo.

Breast cancer meanings: a cognitive‐developmental study

“…However, there were no women with a response typical of the highest level. These findings are not surprising, but are consistent with other empirical studies that found that only a very small number of adults can function at this highest level .…”

“…Specifically, results indicate that these women function at varying developmental levels regarding their illness, which are congruent with those of other theoretical and empirical studies in the field of health psychology [22,23,30,31,[47][48][49] and psychotherapy [18,20,25,50]. However, there were no women with a response typical of the highest level.…”

“…From this analysis, it was possible to create a developmental sequence of meanings for breast cancer, based on and adapted from the developmental sequence of meanings regarding disease in adults . This new sequence is presented and summarized in Appendix C. In brief, in level 1, the perception of illness is based on concrete and isolated ‘symptoms’ and disease can be defined simply as ‘lack of health’.…”

“…The same raters assessed the transcripts' content on the basis of the developmental criteria (Appendix B). These criteria mirror the general model of developmental theory in four dimensions, namely biological, psychological, social/moral and biopsychosocial relationships . In order to establish the reliability of the developmental categories, the two raters first analyzed a random sample of one quarter of the interviews and cross‐checked their criteria.…”

“…Empirical studies in health and other domains indicate that adults operate at varying developmental levels . This has implications for clinical practice .…”