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Bio-Psychosocial Factors - Essay Example

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The author of the "Bio-Psychosocial Factors" paper selects an incident from the author's clinical experience and discusses how consideration of bio-psychosocial factors informed this incident. Psychological factors are detrimental to the recovery of diseases among patients…
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Bio-Psychosocial Factors
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Bio-Psychosocial Factors Bio-Psychosocial Factors Psychological factors are detrimental to the recovery of diseases amongpatients. Psychological aspects of our bodies have a tendency of affecting our physical and mental health. In some cases, most visits to physicians can be traced to stress-related illnesses. Factors relating to health such as diseases and contextual factors such as the social and physical environment a role to play in determining the health condition of an individual. People operate as the whole body, body part, and societal role and lack of operation in any section denotes disability. The ICF is an organization that addresses issues of health in cases of disability. The disability can be caused by physical incidents such as accidents or psychological states such as depression. This creates the need for biopsychosocial model of psychology that addresses mental, physical, and social aspects of health. I visited a 78 year old man at the hospital, who had fallen down on concrete from a couple of stairs in front of his temple. He was flown to the hospital where he was diagnised with a C1 fracture. The medical team performed an operation and inserted a hallo brace that he stayed with for 3 months. When I met him, he was optimistic about re-educating his walking pattern, but was constantly complaining and refused anything related to his right hand mobility. However, he agreed to undergo rehabilitation and was happy to do exercises but refused functional tasks like eating, brushing teeth. His reason was that the hospital and staff were supposed to take care of him. Beliefs can be defined as the cognitive perceptions that shape our behavior (Borrell-Carrió and Epstein, 2004). They are acquired by internalizing the beliefs or people around us during childhood, adopting beliefs of others, or physical trauma. Individuals from the same background can be identified through common beliefs held, and they cling to them even against their own interest. The health belief model (HBM) was developed as a way of understanding peoples’ resistance to preventive services (Glanz,Rimer& Lewis, 2002). The model incorporated the likelihood of experiencing a health problem, perceived severity of the problem, beliefs of the health action, and perceived barriers associated with the health action. The model has expanded to include other factors such as inclusion of self-efficacy. This concept asserts whether or not people undertake a health action and whether the health behavior will depend on their judgment (Glanz, Marcus, and Rimer, 1997). HBM can be used to identify health beliefs underlying threat and behavioral evaluations. This provides a framework for understanding differences in health behavior and creating interventions for changing behavior. The biopsychosocial model (BPS) emphasizes the importance of human health and illnesses (Borrell-Carrió, Suchman and Epstein, 2004). It provides a systematic approach to biological, psychological and social factors that have complex interactions with health, illness, and healthcare delivery (Miresco and Kirmayer, 2006; Waterman and Schwartz, 2002). Behavioral and social aspects are important in the delivery of health care. According to BPS model, the health of an individual is determined by the interaction between the biological, social and psychological factors interact to determine the health state of an individual (Frankel, Quill and McDaniel, 2003). ICF provides a standard framework and language for describing health and health-related states (WHO 2002). It provides a classification of health domains that help us describe changes in body functions and structure. These domains are classified from the body, individual, and the society. The framework lists the body functions and structure, and lists domains for participation. According to ICF, functioning refers to body functions, participation, and activities and disability refers to impairments, activity limitations and restrictions to participation. Biological factors The man suffered a fracture and the doctors inserted a halo brace on the leg. This caused weakness on his leg reducing mobility. The confinement to the hospital bed caused trunk ataxia, right hand numbness and other weaknesses. These factors introduced the disability in the body according to ICF. Studies indicate that diagnosis alone cannot predict service needs, hospitalization period, level of care and functional outcomes (WHO, 2002). This integrates ICF into medical classification as a way of providing the information required for health planning and management (Ghaemi, 2003; Lovibond andLovibond, 2002). These trends have necessitated the need for reliable and valid disability statistics. The health and related sectors need to take into account the peoples’ functional status such as employment, education, and social security. Policy development in these sectors is important for determining functional status of people (Brown et al, 1997). Activity limitation Another form of disability is activity limitation whereby the man cannot be placed in a standing position and cannot walk without the full support. The right hand is unable to manipulate objects due to numbness and suffers from decreased balance while seated. Another limitation in activities is the limited field of vision. The capacity qualifier refers to the ability of an individual to execute an action. This defines the highest functioning level of the individual within the given domain. When the person has incapacity due to a health condition, then that incapacity is part of their health (WHO, 2002). The performance is determined by the ability to execute actions or tasks within their current environment. This performance is based on activity participation in life activities including personal assistance and assistive devices. Participation restriction Disability can be considered the inability to participate in the social sphere of a human being. The man depends on hospital staff for the daily activities with limited control over the environment. He depends on bed wash since he is unable to shower and has difficulties getting careers to look at the position of the halo brace. Environmental factors such as social attitudes, legal and social structures, architectural characteristics, and the climate contribute to disability. Personal factors such as gender, coping styles, social background, behavior pattern, and character influence the way an individual experiences disability (Engel, 2001; Berkman andKawachi,2000). An individual functions at three levels: body part, whole person, and social function. Becoming dysfunctional at one level can be termed as a disability due to impairment, participation restrictions, and activity limitations. Personal The man suffers from limited concentration, poor planning, poor memory, and the fear of pain. Difficulties in adhering to commands, communicating, listening, and avoiding pain limit his participation in activities. These factors limit his options for social participation and interaction. Health care professionals provide medical intervention that can correct the problem. The behavior pattern affects the character of an individual, which is influenced by as gender, age and coping styles (WHO, 2002). An individual with difficulty in memory, planning, and communicating has problems when coping with disability. Social participation involves communication and interaction with other people and depends on the personal abilities of an individual. People experiencing hardships in communication, coordination and memory experience problems when interacting with other members of the society. Psychological factors Stress especially traumatic stress experienced by people after an incident can cause profound effects on the physical and mental health (Epstein, 2003; Mausner-Dorschand Eaton, 2000). Stress in psychology refers to the pressure or demand exerted on an organism for adjustment or adaptation (Stanfeld, 2002; Stacey, 2001). An individual develops an adjustment disorder as a maladaptive reaction to a perceived stressor. The maladaptive reaction consists of impairment in social, academic, or occupational functioning and states of emotional distress. In the case of the 78 year old man, the accident on the staircase can be viewed as the stressor. The psychological state was affected by the reduction in mobility caused by the halo brace. Stress causes a domino effect on the endocrine system responsible for producing and releasing hormones into the blood stream. The body’s response to stress involves several endocrine glands (Fraser and Greenhalgh, 2001). Stress hormones from adrenal glands help the body prepare to cope with a stressor. When the stress is recurring, the body releases stress hormones regularly and stimulates other organs that become overworked with time leading to poor health (Ubel, 2002; Weick and Sutcliffe, 2001). The C1 fracture and reduced mobility caused prolonged the effect of the stressor that caused effects on ordinary activities such as brushing teeth. Environment The man lives in a ground level flat, and the main care giver is his disabled wife, who is currently admitted at the same hospital. The man is a retired accountant, has one mature child and a grandson living outside London. The social aspect of BPS corresponds to the social model of disability where disability is considered a socially created problem. In the social model, a political response is required for addressing disability since it is caused by an unaccommodating physical environment causes by attitudes and other features of the social environment (Cohen and Brown, 2010). The interaction of an individual with personal features can lead to disability. This makes medical and social interventions towards disability appropriate for addressing psychological and physical health. The BPS model is important for understanding the biological, psychological, and social factors affecting the health condition of an individual. These factors affect the function of the body in the personal and social spheres. ICF defines disability as the inability to function in a body part, whole body, or in the social sphere. The disability can originate from biological factors, personal limitations, environmental conditions, or social factors. This inability causes psychological effects of stress, anxiety and depression and can increase dependence on care givers. The health of a disabled person can deteriorate due to limited participation in other spheres such as the social and activity spheres. This leads to poor health and leads to more complications such as body weakness and psychological disturbance. References Berkman, L and Kawachi, I. 2000.Social Epidemiology.Oxford, New York: Oxford University Press. Borrell-Carrió, F and Epstein, R.M. 2004.Preventing clinical errors: a call for self-awareness. Annals of Family Medicine, 2:310-316. Brown, T.A, Chorpita, B. F, Korotitsch, W and Barlow, D.H. 1997. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behavior Restoration Therapy 35, 79–89. Cohen, J., Brown, C.S. 2010.John Romano and George Engel: Their Lives and Work. University of Rochester Press, Rochester, NY, and Boydell and Brewer Limited, Suffolk. Engel, P. 2001. George L. Engel, M.D., 1913-1999: Remembering His Life and Work; Rediscovering His Soul.Psychosomatics, 42(2), 94-9. Epstein, R. M. 2003. Mindful practice in action (II): cultivating habits of mind. Family System Health, 21: 11-17. Fraser, S.W, and Greenhalgh T. 2001.Coping with complexity: educating for capability.British Medical Journal, 323:799-803. Frankel, R.M., Quill, T.E.,and McDaniel, S.H. 2003. The Biopsychosocial Approach: Past, Present, Future. New York: University of Rochester Press. Glanz, K., Rimer, B.K. & Lewis, F.M. 2002.Health Behavior and Health Education. Theory, Research and Practice. San Fransisco: Wiley & Sons. Glanz, K., Marcus Lewis, F. &Rimer, B.K. 1997.Theory at a Glance: A Guide for Health Promotion Practice.National Institute of Health. Ghaemi, S.N. 2003. The Concepts of Psychiatry: A Pluralistic Approach To The Mind And Mental Illness., Baltimore: Johns Hopkins University Press. Lovibond, S. H and Lovibond, P. F. 2002. Manual for the Depression Anxiety Stress Scales. School of Psychology, University of New South Wales, Sydney. Mausner-Dorsch, H and Eaton, W. W. 2000. Psychosocial work environment and depression: epidemiologic assessment of the demand-control model. American Journal of Public Health 90, 1765–70. Miresco, M. J and Kirmayer, L. 2006. The Persistence of Mind-Brain Dualism in Psychiatric Reasoning about Clinical Scenarios.The American Journal of Psychiatry, 163(5), 913-8. Stanfeld, S. A, and Fuhrer, R. 2002. Depression and coronary heart disease. In: Stansfield S.A, Marmot M.G, editors.Stress and the heart: Psychosocial pathways to coronary heart disease. 2nd ed. London: BMJ Books; 2002. pp. 45–63. Stacey, R.D. 2001.Complex Responsive Processes in Organizations: Learning and Knowledge Creation. London: Routledge. Ubel, P.A. 2002. “What should I do, doc?”: Some psychologic benefits of physician recommendations. Archives of Internal Medicine, 162:977-980. Waterman, S and Schwartz, R.J. 2002.The Mind-Body Problem.The American Journal of Psychiatry 159(5), 878-9. Weick, K.M and Sutcliffe, K.M. 2001.Managing the Unexpected: Assuring High Performance in an Age of Complexity. San Francisco, Calif: Jossey-Bass. WHO. 2002. Towards a Common Language for Functioning, Disability and Health ICF. World Health Organization, Geneva. Read More
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