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RR469 - Lay conceptualisations of occupational disease

Objectives People’s beliefs about the causes, treatments, symptoms, and duration etc. of an illness form a model that influences what they define as illness and how they respond to it (treatment seeking, absenteeism). Members of the lay public and the experts they might consult about their illnesses may have very different models of illness. Further, lay and expert groups may perceive different sources of information as more or less trustworthy. Any differences are important to examine, as such differences may results in poor communication and treatment compliance. These ideas have never been tested with respect to a comparison of occupational and non-occupational illness. This was the aim of this project.

Methods Differences between lay and expert models of illnesses were examined using (1) an interview study with expert (occupational physicians, occupational psychologists: N =21) and lay participants (N = 19), (2) a field based experiment based on random sample of the UK population (N = 1947) compared to a sample of experts (N = 240) and (3) a structural cognitive mapping study with experts (N = 15) and lay participants (N = 15). Four illnesses were studied: multiple sclerosis and lung cancer were selected as they were generally viewed as nonoccupational diseases, with asthma as potentially occupational and stress as occupational.

Results Experts were more likely to see work conditions as a cause of stress than lay people and viewed external impersonal sources (HSE, employers) as offering more trustworthy information about the diseases. Lay participants viewed inter-personal sources of information (friends, GPs) as more trustworthy. Lay participants were more likely to endorse work related consequences for illnesses than experts. Experts were more knowledgeable about medically well known illnesses (lung cancer and asthma), and in general were more confident.

Conclusions Experts are more likely to perceive work characteristics as causes of stress. This may lead experts – who advise lay people – to over-emphasise work characteristics as a cause of stress.

This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect HSE policy.

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Updated 2010-03-19