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THE BIOPSYCHOSOCIAL HEALTH PARADIGM: THE LENS THROUGH WHICH MEDICINE IS APPRECIATED


Health Paradigms

A paradigm is a generally accepted model for making sense of phenomena in a given discipline at a particular time (Jonas, 2005).


It is a shared understanding among scientists or scholars working in a discipline regarding the important problems, structures, values, and assumptions determining that discipline.
The health system has a number of paradigms by which it operates to interpret and explain the reasoning behind diseases in all its complexities. Some of these paradigms include:
●     The biomedical paradigm
●     Behavioral paradigm
●     Family support system
●     Psychoanalytic paradigm
●     Cognitive paradigm
●     Biopsychosocial health model – the working paradigm for the WHO

THE BIOPSYCHOSOCIAL PARADIGM

The biopsychosocial framework assumes health problems are hardly limited to just one domain of human experience but rather have a biological (medical), psychological (mental) and social aspect. Nothing exists in isolation; our society, environment and mental capacity have a great deal of influence on our health status. That is, whether or not we are susceptible to diseases and if we are, how is it going to progress? All these aspects make us who we are and play a part in our health-seeking behaviours.
Our population today is one which is medically complex and environmentally challenged. Thus, physical medicine and rehabilitation alone do not suffice. Unhealthy states may be due to several causative factors: biological, mental, physical, emotional and financial.
As such, our approach to restoring one’s health status should encompass all these aspects. It is very laudable that the WHO defines health as a state of complete PHYSICAL, MENTAL and SOCIAL wellbeing of an individual and not merely the absence of infirmities. This is to say cuts, scrapes and sepsis alone do not make the cut.

Application

Depression, as a medical condition, may be as a result of a biological condition such as a chronic disease like cancer, or a social condition like the loss of a loved one or even a person’s inability to cope well with the difficulties of life (as in impaired mental health). Depression, irrespective of its cause, can also lead to some biological conditions such as wasting and nutritional deficiencies due to the loss of appetite and inactivity, psychological conditions presenting as suicidal thoughts and social symptoms such as social withdrawal. The approach to the management of depression can also be through a biological or physical method-antidepressants and exercise, a psychological means-cognitive therapy, or by a social approach-urging the patient to interact with others. Together, these approaches are going to be helpful in lifting the person's depressed mood.
Looking at a patient who survived a near fatal accident, there may be a physical presentation-loss of /impaired use of a limb and a psychological presentation-feelings of low self-worth and inferiority. A good social support system can go a long way to help boost the person’s confidence as he or she comes to accept all is not lost. This translates to the zeal with which rehabilitation would be done to restore some amount of function back into the affected limb. The analgesics and other prescriptions can only do so much but the compliance to following the doctors’ orders can only be achieved by a sound mind in a positive social setting and an understanding that there is much to live for.
True, not all disease states and medical cases will present with a physical, social and psychological aspect all at the same time. It may be just two of these or even only one but it is better to investigate to rule out than overlook and miss a real chance to make things better.

Call To Action – Smile Over Scalpel

It is a good idea, as health practitioners, to keep in mind that diseases may be more complicated than they seem so having a tunnel vision is not helpful. This paradigm shows man as a biological, psychological and social creature, which is not far from the truth. There are great insights to the biomedical paradigm but that is not all there is to disease causation and medicine. Let us raise the status quo as doctors and look beyond the microbes and surgeries as we appraise the possible psychological and social causes and maintenance factors of the disease state.

Gladys Afia Adoma Berko



REFERENCES

https://www.mentalhelp.net/self-help/the-bio-psycho-social-model/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071421/

Engel GL. The need for a new medical model: A challenge for biomedicine. Science. 1977;196:129–136. [PubMed] [Google Scholar]

Prof. Angela Ofori-Atta; Lecture notes on health paradigms

Jonas W., 2005, Mosby's Dictionary of Complementary and Alternative Medicine - Elsevier Health Science (https://corp.credoreference.com/component/booktracker/edition/183.html)

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