Explain Biopsychosocial model? Write down its clinical application.

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 Health Care Models

  1. Bio-Psycho-Social model of health and disease
  2. The Integrated Model of health care
  3. The Public Health Care Model
1. Bio-Psycho-Social Model:
In 1977, George Engel theorised the importance of integrating the traditional biological aspects of medicine with the behavioural sciences. 
Engel's BPS model was based on three principles:

  •  Disease is a result of multiple factors that interact to make an individual feel ill. 
  •  An individual that is composed of a complex , integrated system composed of interacting subsystem elements of mind, body and spirit.
  •  Biological, Psychosocial, and social factors form a triad to interact and serve as determinants of disease.
He proposed that the biological, psychological and social systems work together to cause disease.
Biological System:  The biological system ensures a structural , biochemical and a molecular study of a disease.
Psychological System:  The psychological system provides insight into the role of personality, attitudes, attributes and motivation in the genesis of illness.
Social System:  The social system emphases the impact of family, society, social forces and culture on the aetiology, presentation and the management of a given illness.
Importance:
  • The BPS model provides a comprehensive clinical approach towards the practice of holistic medicine.
  • This approach lays great emphasis on the Doctor-Patient relationship.
Clinical Application:
Researches shows that biomedical and behavioural factors come into play in infectious as well as non-infectious disorders.
Infectious Disorder:   
  • Biological Level: A pt. of Dengue fever is suffering at this level on account of breakdown of the body's reticuloendothelial system.
  • Social level: Social issues related to drainage of fresh water, poor disposal of waste.
  • Psychological factors: Such as risk taking behavior and inappropriate dressing in high risk settings are involved in spreading infectious diseases. 
Non-Infectious Disorders;
  • Non-Infectious disorders are also affected by biopsychosocial factors. This includes heart disease, diabetes mellitus, cancer and depression.
  • This is because of changes in hormones, immune factors, metabolism and neurotransmitters all are associated with socioeconomic stressors.
Clinical Scenario:
  • Hamid and Hassan were good friends. Hamid was parentless, While Hassan had a family.
  • They got admission in medical college. Hamid decided to stay in hostel.
  • Both decided to start smoking to achieve their concentration in studies.
  • Hamid soon developed a cough, Hassan's  parents found out and tell him the dangerous consequences of smoking.
  • Hassan gave up the smoking and started gym. He also tried to convince Hamid to join gym.
  • With a year, Hamid became addicted to stimulants. That's why, his physical and mental health become disturbed.
  • So, Hamid's studies are also disturbed while, Hassan went on to continue his medical studies enjoying good health.
Outcomes:
The story of Hamid and Hassan illustrates an interplay of biological, social and psychological factors resulting outcomes between both friends. 
  • The story highlights how homeostatic behavior failed Hamid.
  • On the other hand, restorative and predictive allostatic behavior such as parental concern, joining a gym helped Hassan overcome a stress they both shared.
  • So, social support were in place for Hassan and not for Hamid.
References:
Handbook Of Behavioral Sciences
Editors: Mowadat H Rana, Roop Z Rana, Mansoor Mustafa.
About Author:
Tayyba Saleem (PT )
 Doctor Of Physiotherapy 


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