Session 1 - Biopsychosocial model and medicine (plus public health)

Question 1

Describe the biopsychosocial model of medicine

Answer 1

• The biopsychosocial model describes health and illness as a complex that emerges from an interplay of 3 factors:

1. Biological - physiology, genetics etc.
2. Social - social class, employment etc.
3. Psychological - e.g. cognition, behaviour etc.

• These factors determine the cause, manifestation and outcome of wellness and disease

Question 2

What components are included in biological, social and psychological aspects of the biopsychosocial model? / draw the diagram

Answer 2

Question 3

Explain the biomedical model in terms of its beliefs and how treatment is approached

Answer 3

Biomedical model (traditional medicine):
- Illness is understood in terms of biological and physiological processes
- Treatment for illness is approached with interventions (drugs, surgery etc.)

Question 4

Contrast a biomedical and biopsychosocial approach to medicine

Answer 4

The biopsychosocial model acknowledges psychological and social factors in causing disease. Practitioners are able to provide more of a holistic treatment approach such as counselling ect.

Whereas the biomedical model (dominant in western medicine) understands illness in terms of biological and physiological processes alone.Treatment involves physical intervention (drugs, surgery).

Question 5

Explain why the biopsychosocial model is important in modern medicine

Answer 5

Many Modern illnesses such as heart diseases and cancer have been found to have social and psychological influences to their aetiology.

e.g. 30% of all cancers have been linked to smoking (social factor)

It also helps the heath professionals to obtain a holistic insight to the patient’s situation in order to provide a more individualised, care plan that is specific to the individual’s needs.

Question 6

Describe culturally-appropriate healthcare

Answer 6

• Considering and supporting a patient’s culturally influenced preferences in the care that we provide

Question 7

Give examples of culturally-appropriate healthcare (4)

Answer 7

• Linguistic or cultural supports (e.g. translator, chaperone – especially around gender)
• Enabling appropriate food and drink or dietary practices (e.g. around fasting)
• Enabling wishes for important life events that have cultural significance (e.g. birth of child, end-of-life care)
• Enabling a request for a procedure, or accepting refusal of a procedure/treatment (e.g. circumcision, blood transfusion)

Question 8

Why is culturally-appropriate healthcare important to practice? (5)

Answer 8

• Improves patient outcomes and increases patient safety
• Improved patient experiences & quality of life
• Reduces disparities in health care outcomes
• Protects people from discrimination (conscious or unconscious)
• Improves doctor-patient relationship and ongoing healthcare interactions

Question 9

Explain why people in different cultural settings experience health and illness differently (7)

Answer 9

• Different dietary/bodily practices or preference
• Different values around age or gender
• Different conceptions of stigma
• Different understandings of symptoms and health conditions
• Different languages or understanding of concepts
• Different ideas about who should be part of care

Question 10

Define public health

Answer 10

The art and science of preventing disease, prolonging life and promoting health, through organised efforts of society

Question 11

What are the public health values?

Answer 11

Question 12

Identify the three domains of public health

Answer 12

Question 13

List the 3 domains of public health and 2 examples of each

Answer 13

1. Health improvement
   e.g. smoking substance misuse services, sexual health services, public mental health
2. Health protection
   e.g. screening, immunisation and vaccination
3. Healthcare public health
   e.g. service design, evaluation and research

(all underpinned by epidemiology, health economics, sociology and psychology)

Question 14

Define health inequality

Answer 14

Differences between people or groups of people that have been socially constructed and not due to differences in genetics or physiology, such as gender or age (Black Report on Health Inequalities in the UK, 1980)

Question 15

Define the inverse care law

Answer 15

‘The availability of good medical care tends to vary inversely with the need for it in the population served’ (Julian Tudor Hart, The Lancet February 27, 1971)

Question 16

Outline primary prevention, secondary prevention and tertiary prevention

Answer 16

Primary prevention:
- Preventing the onset of a disease
e.g. campaigns on the risk of drug addiction

Secondary prevention:
- Preventing the worsening of an already established disease
e.g. early identification through screening and treatment

Tertiary prevention:
- Limiting the impact of a disease/symptoms on an individual’s life and improving their quality of life, e.g. reducing mortality
e.g. treating addicted individuals

Question 17

Define evidence-based medicine

Answer 17

The process of turning clinical problems into questions and then systematically locating, appraising, and using contemporaneous research findings as the basis for clinical decisions

Question 18

What does PICO stand for?

Answer 18

Patient/Population, intervention, comparator and outcome

Question 19

Formulate an answerable clinical question using PICO (patient, intervention, comparator and
outcome)** Wait for group work

Answer 19

Is dietary management or insulin better for type 2 diabetes management in adults?

Question 20

How is public health underpinned by population and social science?