REASONS FOR CONSULTATION AND EXPLANATIONS OF ILLNESS AMONG FINNISH PRIMARY-CARE PATIENTS

The aim of this study is to describe triggers to consultation, and to further understanding of how patients construct explanations for what is wrong with them. Patients consulting a general practitioner were in terviewed about the process that had led to their consultation and exp lanations for the causes of their illness. The results show that the f actors which trigger professional consultation are related to the ever yday demands of work, home and other people on the one hand, and to th e interpretation of bodily symptoms on the other. Characteristically, symptom interpretation often involves a veiled dialogue with the tax-f unded municipal health care system about a justification for the lay d iagnosis. The results further show a domination of biomedical illness explanations among the patients studied. A third of the explanations c oncerned infectious, toxic and noxious agents, and a quarter constitut ional defects in the body. Ten per cent were philosophical and metaphy sical, and 16 per cent psychosocial in nature. The remainder were base d on life style and risk behaviour, and on problems of medical care. T he results are discussed from the standpoint of lay and professional m odels of explanation for illness.