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The biological model is a health and illness structure that intellectualizes disease in which prognosis, diagnosis, treatment, and cause are based on the physical and biological elements. In this framework, little or no attention is given to an illnesss environmental, psychological, social, and spiritual aspects. The biomedical model explains the disease as an invasion of parasites, genetic mutation, metabolic disorder, or neurotransmitter imbalance. The model uses the concept of reductionism, where a complex system is broken down into subsystems to identify the dysfunctional part. Using ontological reductionism, the world is viewed to be having a single origin of the causal level.
George Angel brought about the biopsychosocial model; the model focused on clinicians giving attention to the psychological, biological, and social dimensions of illness. The model is an alternative to the biological model because the biological model is involved in its operation. The model criticizes the biological model as it views the patients as objects rather than humans. The model is significant as it ends the reign of the dehumanization of medicine and the disregard of patients. The model drives the introduction of empathy in the field of medicine. The model perceives health and illness as an outcome of the genes, social conditions like family relationships, cultural influences, etc., and the behavioral such as health beliefs, stress, and lifestyle. In this model, health professionals like nurses and doctors work hand in hand with health psychologists to help patients deal with the cognitive and emotional challenges of health and illness. These include developing programs that enhance medical treatments, such as smoking cessation and weight loss programs.
The introduction of the biopsychosocial model is crucial in medicine as it widens the scope of the health and illness analysis. The patients analysis is enhanced in that attention is given to the patient not just as a patient with a specific disease but as an individual who has been deviated from normal functioning (Baria et al., 2018). The clinicians, therefore, analyze the patient with great care with many avenues to explore before making the diagnosis. The caregiver provides the patient with preventive measures that will enable the patient to live a healthy lifestyle (Fava & Sonino, 2017). The model is useful in training doctors in medical schools as it focuses on compassion, understanding, and communication.
Biopsychosocial challenges the biomedical model in various cases, such as the cause of the disease, diagnosis, prognosis, and treatment. It contextualizes the disease in an individual as a whole; it goes for the location of the dysfunctional process and finding out the dysfunctional system and causing problems to the whole system (Frazier, 2020). In this case, the healthcare methodological assumption is that the individual is at risk of trouble because of the dysfunctional system in the body. Firstly in disease causes, the biomedical model focuses on explaining how diseases have a single cause (Gagliese et al., 2018). The biopsychosocial model focuses on explaining the several causes of disease, disorder, and illness. For example, the biomedical model explains the cause of type II diabetes from a single pathophysiological cause. The biopsychosocial model focuses on explaining the family history, which involves the environment, disease, poor diet, and sedentary job (Gask, 2018). It explains the cause of type II diabetes as the combination of the factors above. When healthcare understands how these factors combine to give rise to the disease, healthcare can prescribe the best solution to the treatment of the disease.
From the system theory, the system function cannot be explained without involving its operating environment. One central attribution to a dysfunctional system is that the individual failed to fit in the expected environment (Ghaemi, 2017). This consists of the individuals behavior in that environment when the environment expects a different behavior. There is a poor fit between an individuals behavior and the environment in complex systems, and many queries arise to identify the potential change. In cases where individual conditions are lifelong, the potential for change is implied elsewhere and not in the individual but other factors such as resources and social attitudes (Lehman et al., 2017). Acquired long-term health conditions are related to the individual environment with social support, quality health care, good self-management, and non-discrimination (Plakun, 2018). To come up with a reliable treatment depends on identifying a large enough cause of the disease. The biopsychosocial model has made it easy for the healthcare provider to identify various causes through psychologys involvement.
Secondly, in diagnosis, the biomedical model focuses on using laboratory tests, scans, radiographs, and the patients of value to identify the most appropriate test for diagnosis. The biopsychosocial model diagnosis is based on the medical history of the patients (Stilwell & Harman, 2019). Medical history is an essential aspect when handling patients with chronic diseases. For example, in a primary health care setting, a patient who seeks medication regarding cough probably has a prior probability of pneumonia (Stilwell & Harman, 2019). Using the patients medical history, the caregiver identifies the current likelihood of pneumonia by modifying additional information derived from the patients medical history. This probability will later be adjusted using the data that has been derived from the clinical examination (Wade & Halligan, 2017). With radiography tests and the patients medical history, the patients post-test probability is calculated. The diagnosis that incorporates the patients medical history is very significant as it increases the chances of identifying the certainty of the disease.
During diagnosis, the information gathered from the patient is very crucial as it directs the care. Subsequent visits of the patient will require less provision of information as it will just be reviewing the previously provided information by the patient (Zegarra-Parodi et al., 2019). The biopsychosocial model is crucial in diagnosing chronic illness, and other diseases are identified through medical history (Wade & Halligan, 2017). The medical history also enhances the diversion of diagnosis of patients. When a patients medical history is reviewed, it contains in-depth information about the patients medical issues, such as illness that patient is currently experiencing and the previous diseases that the patient had undergone.
Additionally, medical history incorporates records of invasive procedures that the patient had undertaken. The family history in the patients medical history is vital in providing information regarding the genetic predisposition of a particular disease (Stilwell & Harman, 2019). The social history includes the patients social aspects such as the drug history, smoking, alcohol use, and other elements such as the spiritual life, pertinent sexual habits, occupation, mental status, and hobbies (Lehman et al., 2017). This information is very crucial when diagnosing a patient with an acute disease.
Some patients experience allergies, and with the biopsychosocial model, potentially life-threatening consequences are avoided. Allergies are critical, and it is imperative that the patient is always asked to clarify the matter as its reaction to certain medication may lead to adverse effects (Fava & Sonino, 2017). Diagnosis using medical history helps identify certain cases like drug interactions in patients who have taken a lot of drugs. Biomedical alone is not sufficient for diagnosis as infants parents are required to give information regarding prematurity and complications during pregnancy and delivery (Frazier, 2020). The patients immunization status is also essential when handling the patient as there are various medications and vaccination that require prior information.
Thirdly, with the introduction of the biopsychosocial model, it utilizes information from the patients to establish the prognosis. By gathering data from the patients, especially the medical history and interviews, the outcome of the disease is well predicted. Using the biomedical approach, healthcare providers give the outcome of the illness based on the statistics of how the disease is manifesting in the general population (Baria et al., 2018). With this statistics, some people tend to differ in the way they come out of illness. Some respond positively and others negatively, while a significant population may respond averagely to the disease (Wade & Halligan, 2017). For example, in diseases like cancer, prognosis depends on various factors such as the stage of the disease during diagnosis, tumor molecular profile, gender, and the subtype of cancer.
The biopsychosocial model utilizes the information gathered from the patient to form a database of data while looking at other peoples data. A patients history forms the basis of personalized medical history, and this helps in outcome analysis. However, the previous biomedical model used statistics that focused on a general cause and outcome (Stilwell & Harman, 2019). The study is mostly from other people, and primarily the data used for comparison is outdated as it involves data collected in the past few years (Wade & Halligan, 2017). The time the data was reported has considerable differences in identifying the outcome of the disease. For example, a five-year survival rate of a certain illness may not give a correct prediction outcome as better treatments have been established within that period.
With the introduction of new drugs in the market, mortality resulting from a given disease is minimized, and therefore, the lifespan of an individual having a certain illness increases. For example, the prognosis of an individual having stage four lung cancer with a single genetic mutation would have been approximately a year or less (Zegarra-Parodi et al., 2019). The percentage of individuals having stage four cancer and are expected to live for the next five years is approximately 2 percent (Lehman et al., 2017). The biopsychosocial model shows that the patients information is vital in identifying the disease prognosis as it considers other factors such as nutrition and environment. The combination of these factors and the information gathered from patients gives a prediction. Conversely, the biomedical model focuses on technology and data that is applied to the general population.
Fourthly, in treatment, the biomedical model focuses on the actions of the health care providers such as surgery and medication. Administering treatment using the biopsychosocial model involves the healthcare providers (Ghaemi, 2017). Patients diagnosed with the same disease will not preferably receive the same medication as psychological and social factors are considered before determining the exact treatment (Gagliese et al., 2018). The biopsychosocial model utilizes various stages when treating a patient; it begins with goal setting, which ensures that the patients overall functionality is enhanced. For example, anxiety, mobility, pain, strength, and reduction of stress. Depending on the injury type, symptoms, and patients decision, different levels of care can be administered to treat patients having a chronic illness.
The model has three levels which are primary, secondary, and tertiary. Primary care focuses on addressing the acute symptoms linked with the injury or disease while maximizing the functionality of the affected area (Fava & Sonino, 2017). The physical symptoms in this stage are addressed through manual techniques, exercises, modalities for pain relief and movement. The psychological factor includes anxiety and fear which are related to re-injury and pain (Frazier, 2020). Patients who have experienced trauma and other forms of injury recover very well using the primary level of care. The secondary level of care uses the multidimensional treatment method where physical rehabilitation programs are preferred to referrals from healthcare providers.
Furthermore, approaches like cognitive-behavioral treatments and neuroscience pain education are also put in place. The secondary level of care aims to reduce physical deconditioning and eradicate the psychological barriers that interfere with recovery (Baria et al., 2018). The secondary approach has proved to be significant as it provides positive outcomes. If the two levels of care do not produce a positive effect, the patient is subjected to the tertiary level of care. This level is set up because of the patients poor response to the psychological and physical recovery (Gagliese et al., 2018). Other factors that lead to poor recovery are work-related issues and legal issues, leading to increased stress. An example of tertiary care is functional restoration, whose aim is to prevent the occurrence of permanent disability. At this treatment level, the patient receives care from an interdisciplinary team such as physical therapists, psychiatrists, disability case managers, psychologists, and primary health care providers (Ghaemi, 2017). This team works together to enhance the patients functionality by developing a treatment plan that addresses coping skills and stress management (Ghaemi, 2017). In cases where patients are addicted to opioid or narcotics medication, they are detoxified. Patients experiencing chronic pain have proven to be helped through the usage of functional restoration programs.
Many illnesses such as cancer and heart disease are associated with social and psychological components. Approximately 30% of the cancers are linked to heavy tobacco usage, and diet is also among the top leading cause of digestive tract cancer (Baria et al., 2018). With the biopsychosocial model, psychological factors like perceived control and self-esteem have been identified to promote a healthy lifestyle (Fava & Sonino, 2017). Behavior such as reducing alcohol consumption and exercising promotes health. Coronary heart disease is enhanced by activities such as intake of high cholesterol, smoking, and hypertension. When healthcare is aware of these factors, it helps in coming up with an intervention that will help reduce the susceptibility of individuals to coronary heart disease by encouraging better lifestyles.
Various illnesses are caused by increased stress, anxiety, and behavioral patterns. The environmental conditions and other activities make individuals have difficulties coping, which enhances adverse physiological and psychological changes linked with the outcome of the disease (Frazier, 2020). Using the biopsychosocial model, stress is examined from various perspectives, such as biological and psychological factors. Biological factors include muscle tension, high blood pressure, and resistance reduction to disease because of immuno-suppression (Ghaemi, 2017). With psychological factors, risk behaviors such as drinking irresponsibly, smoking, mechanism of copying to changes, and susceptibility to anxiety are among the factors that can be examined.
In conclusion, the introduction of the biopsychosocial model by George Angel is crucial in understanding the dimensions of illness such as social, biological, and psychological. The model is an improvement to the biological model as it views patients as people who deserve respect. The model is a breakthrough in medicine as it ended the reign of dehumanization of medicine and disregard of patients. Through this model, empathy is introduced to medicine and gives a different view of health and illness. The model perceives illness as an outcome involving cultural inferences, genes, family relationships, and social conditions. Other factors considered include behavior such as lifestyle and beliefs.
The biopsychosocial model challenges the biomedical model in various areas such as the cause of disease, diagnosis, prognosis, and treatment. Starting with the cause of the illness, the biomedical model views disease as having a single cause. The biopsychosocial model views disease as having a variety of causes such as social support, behavior, and genetic. The biomedical model uses tests such as scans, radiography, laboratory tests, and patient of value information in diagnosing diseases. The biopsychosocial model gives insights into the patients medical history to provide a diagnosis, which makes it favorable. In prognosis, the biomedical model uses technology to give the outcome of the patient. The biopsychosocial model utilizes information provided by the patient to predict the outcome. Lastly, on treatment, the biomedical medical relies on the action of health professionals. The biopsychosocial model uses three levels of treatment: primary, secondary, and tertiary to enhance treatment. This method is has proven to provide significant results.
References
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Zegarra-Parodi, R., Draper-Rodi, J., & Cerritelli, F. (2019). Refining the biopsychosocial model for musculoskeletal practice by introducing religion and spirituality dimensions into the clinical scenario. International Journal of Osteopathic Medicine, 32, 44-48.
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