In the recent past it was assumed that knowledge guided health related behaviour. Knowledge in turn was seen as driven by information. This led to a simple model that suggested that patients’ health related behaviours are driven by information. The approach implied a somewhat passive role for patients whose behaviours could be easily influenced through providing them with information. This position also resulted in surprise at some patients’ health related decisions and behaviours, which appeared counterproductive for their health, contrary to medical advice or sometimes idiosyncratic. However, it is apparent that the behaviours of individuals are affected by the attitudes and beliefs they hold. If individuals think something is appropriate for them they may do it; if not, they don’t. With regards to their health or ill health, these beliefs and attitudes may be related to undergoing treatments, taking medications, or performing health maintenance behaviours. Importantly, the beliefs and attitudes that guide patients’ behaviours are influenced by more than information provision from health care professionals and may be inconsistent with this information.

Fundamental to this approach is to see individuals as active processors and interpreters of their environment who construct models and hold beliefs about the world. When confronted with symptoms or an illness or a threat to their health, individuals appear to actively construct cognitions and beliefs to conceptualise their condition. These influence how they manage the situation and evaluate their management and potential recovery. Patients’ cognitions are important influences at all stages of their experience of an illness, including: the perception of symptoms; searching for attributions for the underlying disease; changing of personal behaviours to affect the course and development of the illness; while undergoing therapy or treatment; during the rehabilitative process; and the decision to return to normal daily activities. Treating patients as active theorisers, with models …