The Biomedical and Biopsychosocial Model - Essay Example

?Biomedical/Biopsychosocial Model The Bio-medical and Biopsychosocial Model and McKeown/Hyperkinesis Theory The biopsychosocial model of illness is an extension of the earlier biomedical model. It is a model that utilizes a new approach to the relationship between social, psychological, and biological factors in illness and health. The model proposes that the action of a human being is in the form of an interactive system through which the biological factors associate with the social factors and psychological factors; the interactions occur “within the social context of human activity and existence” (Janowski 2009, p11). The model distinguishes two sides and they include somatopsychic and psychosomatic relationships. Psychosomatic relationships entail individual factors (such as behavioral tendencies, personality, and temperament), situational factors, psychosocial risk factors of illness; these factors act through the inception of psychological stress. Somatopsychic relationships include psychosocial outcomes of illness and they entail illness behavior. Most of the times, the psychosocial outcomes of illness are not favorable and lead to negative emotions (Janowski 2009, p11). Hyperkinesis is a behavior disorder and it is estimated that it affects 3 to 10% of the elementary school children or population. Hyperkinesis is also referred to as childhood hyperkinetic disorder, hyperactive syndrome, and minimal brain dysfunction. The disorder is characterized by hyperactivity (excessive motor activity), restlessness, very short attention duration (the child flutters from one activity to the other), fidgetiness, clumsiness, alternating mood swings, and aggressive-like behavior (Conrad 2006, p9). There are two factors relevant to hyperkinesis and they include social factors and clinical factors. Clinical factors include events that are closely related with the diagnosis and management or treatment of hyperkinesis. Social factors include factors that are not closely related with hyperkinesis but are important (Conrad 2006, p10). Social factors that affect hyperkinesis are divided into three categories; (a) government action, (b) pharmaceutical revolution, and (c) medical profession trends (Conrad 2006, p12). According to McKeown, social factors such as income level, living environment, and class manipulate health and that the medical profession is supposed to address these issues by moving away from the biological paradigms (Colgrove 2002, p725). McKeown stated the major contributors of mortality decline could not be attributed to medical treatments since majority of these treatments were introduced after the trend of decline in mortality had begun. Public health advances also did not play a big role either. Improvements in the social and economic conditions (such as improved diet) lead to the decline in mortality (Colgrove 2002, p726). From both models, illness and health result from social, psychological, and biological factors. These factors interact within the social context of the human existence and activity. Hyperkinesis is a behavioral disorder that affects children and it leads to hyperactivity. The disorder can be associated with the models since the psychosomatic entail individual factors. These individual factors comprise of behavioral tendencies, personality, and temperament; hyperkinesis is a behavioral tendency. McKeown asserts that social factors have a lot of influence on health and the decline in mortality is attributed to the improvements in social and economic conditions. References Colgrove, J. (2002) The McKeown thesis: A historical controversy and its enduring influence. American Journal of Public Health 92(5), pp725-729. Conrad, P. (2006) Identifying hyperactive children: The medicalization of deviant behavior, Burlington, VT: Ashgate Publishing Ltd. Janowski, K. (2009) Biopsychosocial aspects of health and disease vol. 1, Lublin, Poland: CPPP Scientific Press. Health and Illness Social Process of Becoming Ill Health and sickness are not products of nature but products of culture. Three stages of social process are involved in becoming ill. The first stage is concerned with how people feel; in most cases, people feel unwell but they have a greater choice of action in this stage. These individuals have the choice of treating themselves, getting an official agreement from the doctor that they are sick, using alternative medicines like homeopathy, or putting up with the symptoms. A visit to the doctor and being formally defined as ill is not a decision that is straightforward. Ethnicity, gender, social class, and culture affect an individual’s choice of action. For instance, in most of the cultures, men are not socialized to display weakness and thus, they are less likely to determine symptoms as illness (Chapman 2004, p97). The second stage entails the definition of symptoms as illness by the doctors. However, the process is not straightforward as it looks since few cases of misdiagnosis do occur. It is worth noting that the interaction or the relationship between the patient and the doctor is important in this case. Research conducted indicates that the working-class patient often feel demoralized by the characteristics of a middle-class health care. Thus, they may be very unwilling to pay their doctor a visit. Chapman (2004, p97) states that “middle-class patients feel comfortable with their doctors, are more articulate about their symptoms and consequently are more likely to be officially diagnosed as ill and treated.” The third and last stage deals with diagnosis and the action suggested by the doctor. Diagnosis done results to an action being suggested by the doctor. Recently, there were suggestions from the sociologists that medical treatment can assist in creating illness. This is because the medical professionals often make errors and recommend drugs that ultimately result to dependency (Chapman 2004, p97). Defining Health Inequalities For close to a century, the experience of morbidity and mortality has always been better for the higher socio-economic groups than those in the lower socio-economic groups; this is an international phenomenon common in all countries. The definition of health inequalities is a difficult task within the scientific enterprise. It is suggested that health inequalities is defined in three different methods both in the academic and policy work. It is defined as (a) the health gap between the richest and the poor, (b) the gradient in morbidity or mortality traced across all the positions within the socio-economy in the whole population, or (c) the health status of the poor (Gabe 2009, p223). Technically, the definition of health inequalities requires explicit specification of the significance of the social position. In other words, it must offer the merits and demerits of the social hierarchies. They must also stipulate the types of comparisons that are significant, that is, comparisons that reveal distributive justice concerns. This is because; the concerns or issues are politically sensitive and can lead to the redistribution of the resources according to the social hierarchies (Carrin et al. 2009, p95). References Carrin, G., Buse, K., Heggenhougen, K. & Quah, S. R. (2009) Health systems policy, finance, and organization, Burlington, MA: Academic Press. Chapman, S. (2004) Sociology, Letts and Lonsdale. Gabe, J. (2009) The new sociology of the health service, New York, NY: Taylor & Francis. Stress Stress Map A stress map is a visual representation of the causes or sources of stress in one’s life. Stephen Palmer developed a technique referred to as stress mapping. Stress mapping is a visual method, which offers an explicit understanding “of the effects of interpersonal and environmental factors on a client’s stress, particularly when it arises from an especially complex situation” (Milner and Palmer 2006, p81). This method of identifying a problem puts the client in the middle of a diagram of a particular aspect of his or her life (either in a relationship or in a works setting). The diagram is further developed to offer a representation of the stress levels which the patient or the client believes to have been generated by the practical conditions in that setting or to have been generated by other individuals; each of these levels is written in a particular box (Milner and Palmer 2006, p81). Other stress aspects such as internal demands and the external demands (such as introduction of new computers at the work place) that the clients put on themselves are shown in the stress map relative to the client. After completion of all the boxes, the client weighs them on a scale of 1 to 10 where 10 represent the highest level of stress. Stress map is also used to determine how much stress the client can cause on other people. Stress mapping is an important tool for looking at the social, family, and work conflict. It is also important for looking at distress from the individual and subjective notion of the client. It can assist both the counselor and the client in making connections inside and between work systems, interpersonal, and families’ relationships (Milner and Palmer 2006, p82). Definition of Stress and Its Effects on the Body Stress is defined as the body’s reaction to change that necessitates response a response or an adjustment. The reaction to these changes by the body is in form of emotional, mental, and physical responses. It worth noting that stress is an ordinary part of daily life. Most of the things that we associate with places stress on our bodies. The human body is conditioned to undergo stress and respond to it. Stress can be either positive or negative. Positive stress keeps an individual alert and it make him or her prepared to avoid danger. Negative stress occurs when an individual faces constant challenges without relaxation or relief between the challenges. The resultant effect is that the individual becomes overworked and thus, there is build-up of stress-related tension. Distress is a negative stress reaction and it results from continuous stress without relief. Distress can cause physical symptoms such as upset stomach, chest pain, problems with sleeping, increased blood pressure, and headaches; these symptoms can be brought or worsened by stress. It is important to note that stress can cause weakening of the immune system and thus, it can result into diseases such as flu and colds. In conclusion, stress can cause both positive and negative effects on the body (Chakraburtty 2010, p1). References Chakraburtty, A. (2010) The effects of stress on your body [online], WebMD. Available from: [accessed 26 Nov. 2011]. Milner, P. & Palmer, S. (2006) Integrative stress counseling: A humanistic problem-focused approach, London, UK: SAGE. Social Causes Solid Facts – How People’s Health Are Affected by Their Social and Economic Circumstances Despite the fact that less well off people live in countries that are affluent, they have more illnesses and short life expectancies than their rich counterparts do. These variations in health are significant social injustices and they have drawn attention from the scientific world in relation to the strong determinants of health standards in the modern society. They have resulted in a greater understanding of the health to social environment sensitivity; a phenomenon referred to as social determinants of health (Marmot and Wilkinson 2003, p7). Poor economic and social circumstances have an impact on health all the way through life. Individuals at the lower side of the social ladder run twice the risk of premature death and serious illness than those at the upper side of the social ladder. The effects are not only felt by the poor, the health social gradient cuts across the society and thus, the lower ranking staff and the middle class office workers suffer premature death and more illness than the high-ranking staff. Psychosocial and material causes lead to these variations and their outcomes extend to causes of diseases and death. Disadvantage takes many forms and it can be relative or absolute. It may include things such as insecure employment, poor housing, and poor education (Marmot and Wilkinson 2003, p10). Stressful situations make individuals feel the inability to cope, anxious, and worried. These situations damage health and may cause premature death. Psychological and social situations lead to long-term stress. Constant insecurity, social isolation, insecurity, lack of direct control over home life and work, low self-esteem, and anxiety have considerable impacts on health. These psychosocial risks build up during an individual’s life and they increase the probability of premature death and poor mental health. Longer durations of insecurity and anxiety and the absence of friends who are supportive result in a considerable damage regardless of the level of life they arise. These problems are common among individuals in the lower side of social hierarchy of the industrialized countries (Marmot and Wilkinson 2003, p12). An explanation is given as to why these psychosocial factors affect the physical health. During emergencies, the nervous system and the body prepares the individual to deal with the instant physical threat. This is done by triggering flight or fight response thus, mobilizing the stored energy, increasing alertness, redirecting blood to muscles, and increasing the heart rate. Modern urban life stresses rarely demand for moderate or strenuous physical activity (Marmot and Wilkinson 2003, p12). Activating the stress responses redirects the resources and energy from the physiological processes necessary for the long-term maintenance of health. The immune and the cardiovascular systems are both affected. For a short period, the effect is not considerable, but if the individuals are more tensed or the tension lasts for a considerable period, they become susceptible to a variety of conditions such as high blood pressure, stroke, aggression, depression, heart attack, diabetes, and infections (Marmot and Wilkinson 2003, p13). References Marmot, M. & Wilkinson, R. ed. (2003) Social determinants of health: The solid facts, Copenhagen, Denmark: WHO Regional Office for Europe. Lifecourse & End of Life Changing From Midlife to End of Life Can Be Linked With Midlife Activity Most people are of the idea that the onset of decline in one’s life is marked by midlife. They also think that the only mature method to deal with aging is the acceptance of the increasing limitations. These individuals consider these notions as common sense. However, such a notion is overrated and midlife represents an exciting moment in one’s life, since, it is “a time when people have the opportunity to re-examine even their most basic assumptions” (Ruttenberg and Strenger 2008, p2). It is important to note the problems faced during midlife crisis such as physical limitations do exist as well as opportunities for reexamination; health issues are a major concern at this age (Ruttenberg and Strenger 2008, p2). The midlife years can be a time for unique opportunities of inner growth. Growth motivations are more evident than deficiency motivations at this age. Deficiency motivations are as a result of lack. For instance, individuals who lack food will be inspired by the necessity to look for nourishment. For those who do not possess self-esteem, the driving force will be to prove their worth. Thus, it can be clearly stated that people at midlife have more freedom than any other time (Ruttenberg and Strenger 2008, p3). In other words, midlife activity possess this age as they transit from midlife to the end of life. By midlife, majority of the people loss pressure for urgency and they no longer riddled by the worry that they are worthy or by the requirement to confirm that they are worthy. The only thing they have is the freedom to impart self-knowledge (Ruttenberg and Strenger 2008, p4). Breaking of Bad News Breaking bad news is a task that is not favorable to many people. Doctors and other health professionals have broken bad news to patients, and their family or carers. However, it is important to understand how the delivery of such information can affect the doctors/other professionals, patients, and their carers/parents. There are various definitions of bad news among individuals and they include; (a) any information that seriously affects a person’s outlook of his or her future, (b) conditions in which the feeling of hope lacks, and (c) a risk to an individual’s physical or mental well-being (National Council for Hospice and Specialist Palliative Care Services 2003, p3). There are strategies for breaking bad news and they include: Preparation (set up of the interview) – the bearer or the carrier of the bad news needs to prepare for the interview with carer or the patient. The setting must also be prepared and it should exhibit some level of privacy (National Council for Hospice and Specialist Palliative Care Services 2003, p7). Preparation of the patient – the patient’s perception about the condition affecting him or her is important before breaking the bad news. This is the stage at which the carrier of the bad news clarifies any misunderstanding and is able to assess the state of the patient (in wishful thinking or in denial). The carrier of the bad news must also obtain permission from the patient before breaking the news to him or her (National Council for Hospice and Specialist Palliative Care Services 2003, p8). References National Council for Hospice and Specialist Palliative Care Services. (2003) Breaking bad news … regional guidelines, Belfast: Department of Health, Social Services and Public Safety. Ruttenberg, A. & Strenger, C. (2003) The existential necessity of midlife change. Harvard Business Review, pp1-10. Read More