Patient-Centered, Family-Focused, Community-Approach to Health, Introduction to Clinical Family and Community Medicine (Biopsychosocial Approach)

DISEASE PREVENTION AND CONTROL: LE 2 | TRANS 1 Patient-Centered, Family-Focused, Community-Approach to Health, Introduction to Clinical Family and Community Medicine (Biopsychosocial Approach)

I. Biomedical Model

  • Definition of Health: World Health Organization definition: Health is defined as the highest possible level or state of complete physical, mental, and social well-being and not merely the absence of disease.

II. Biopsychosocial Model

  • Dr. George Engel:

    • Highlights that disease and illness cannot solely be understood through smaller biological components.

    • Emphasizes the importance of considering psychosocial and environmental factors.

  • Holistic Care: The biopsychosocial model promotes comprehensive patient care addressing biological, psychological, and social aspects of health.

  • Important Times for Psychosocial Intervention:

    • Natural family life transitions

    • Patient compliance and lifestyle issues impacting health

    • Dramatic changes in patient symptoms

    • Significant diagnoses leading to psychosocial crises

    • Chronic illnesses requiring ongoing psychosocial support

III. Biological Factors

  • Demographic Profile:

    • Age, sex, race, education, and occupation influence health outcomes.

  • Genetic Characteristics:

    • Familial and hereditary diseases affect individual health predispositions.

    • Newborn screening programs exist for early intervention.

  • Lifestyle Characteristics:

    • Healthy or unhealthy behaviors such as exercise, diet, smoking, and substance use significantly influence health risks.

IV. Psychological Factors

  • Influence on Health:

    • Affective, cognitive, and behavioral dimensions impact health beliefs and behaviors.

  • Filipino Healing Modalities:

    • Includes traditional methods like orasyon, alkularyo, and manghihilot which may not have strong clinical evidence.

  • Primary Care Counseling:

    • Techniques such as Catharsis - Education - Action (CEA) and Catharsis - Insight - Action (CIA) help address emotionally critical perceptions (ECMs) impacting health.

V. Social Factors

  • Definition of Family:

    • Traditional and modern definitions encompass biological, marital kinship, and strong emotional ties.

  • Family Characteristics:

    • Impact of family on health beliefs and behaviors; families can be sources of both stress and emotional support.

  • Family Structures:

    • Nuclear, Extended, Blended, Single Parent, and Communal Families each have different health implications.

  • Family Assessment Tools:

    • Tools like family genograms and the APGAR scale assess functioning and relationships.

    • Family Genogram: Visual representation of family structure and health history, highlighting hereditary conditions.

    • Family A.P.G.A.R.: Measures adaptability, partnership, growth, affection, and resolve within the family.

    • Family Map and SCREEM: Assess family dynamics, needs, and resource availability.

VI. PFC Approach (Patient-Centered, Family-Focused, Community-Oriented)

  • Patient-Centered Healthcare:

    • Focuses on individual patient experiences and needs; emphasizes communication.

  • Family-Focused Healthcare:

    • Evaluates family dynamics and caregivers; provides educational resources and counseling.

  • Community-Oriented Healthcare:

    • Considers external social determinants, resources, and the environment affecting health.

    • Encourages networking and multidisciplinary teamwork to enhance patient care.

VII. Illness Trajectory

  • Stages of Illness Trajectory:

    1. Onset to Diagnosis: Initial symptoms before seeking care.

    2. Impact Phase: Emotional and cognitive response to diagnosis.

    3. Major Therapeutic Efforts: Focus on treatment options.

    4. Recovery Phase: Adjustment based on health outcomes.

    5. Adjustment to Permanency: Coping with chronic conditions or loss.

VIII. Hospice and Palliative Medicine

  • Focused on improving the quality of life for terminally ill patients and their families through holistic care.

  • Advanced Directives and Decision Making: Ensures patient preferences in care are respected.

IX. Review Questions

  • Assess understanding of models, family structures, and the illness trajectory in a multiple-choice format.

X. References

  • DPC Manual and supporting educational materials.