DIFFERENCES IN MEANINGS OF HEALTH - AN EXPLORATORY-STUDY OF GENERAL-PRACTITIONERS AND THEIR PATIENTS

Objectives. Many health-related behaviours, particularly non-complianc e with medical advice, seem irrational to professionals. 'Health' is a planned goal of health care but the extent to which doctors and patie nts agree about its meaning is unknown. We hypothesized that general p ractitioners (GPs) construe health as an absence of disease (medical m odel) to a greater extent than their patients in general and that asth matic patients construe health in a manner biased to preserve their se lf-esteem. Method. Forty-eight patients with asthma, 48 matched well p atients and 34 GPs each gave up to six personal definitions of 'health '. Their definitions were classified into nine categories of meaning. Results. Results showed significant differences in the ways in which g eneral practitioners and patients defined 'health' (chi-squared betwee n GPs and asthmatics was 98, df = 7, P < 0.0001; chi-squared between G Ps and well patients was 85, df = 7, P < 0.0001). As hypothesized, the category of meaning used most by general practitioners was an absence of disease, whereas patients expressed the meaning of health in terms of 'being able', 'taking action' and 'physical well-being'. Support f or the second hypothesis, although consistent, was weak.Conclusions. T he way in which differences in beliefs provide a basis for understandi ng apparently irrational patient behaviours is discussed in the contex t of social identity theory. Implications for doctor-patient communica tion and the psychological validity of subjective health status and qu ality of life measures are also noted.