Biomedical Model Of Health Research Articles

Visibilidade da equipe de transplante de medula óssea no contexto ecossistêmico

Objetivo: Analisar, no contexto ecossistêmico, a visibilidade profissional dos membros da equipe de Transplante de Medula Óssea, na visão do usuário. Métodos: Abordagem quali-quantitativa, utilizando a Análise de Conteúdo de Bardin e análise estatística descritiva dos resultados, empregando o Statistical Package for the Social Sciences. Realizou-se a análise da frequência, porcentagem das variáveis observadas e análise estatística de estimação intervalar. Na coleta de dados utilizou-se de um instrumento com 35 questões. A amostra constitui-se de 40 entrevistados em dois serviços de transplante de dois países. Resultados: Os dados demonstram que os usuários visualizaram mais de um profissional a oferecer orientações para o cuidado no domicílio. 90% (n=36) responderam que foi o(a) médico(a) que mais orientou para a alta; 72,5% (n=29) referiram o enfermeiro(a), 42,5% (n=17) o nutricionista e 27,5% (n=11) citaram o atendimento de outros profissionais. Conclusão: A visibilidade profissional dos membros da equipe de transplante, na visão do usuário, demonstrou ainda estar influenciada pelo modelo biomédico de saúde, evoluindo, gradativamente, para a identificação de representatividades profissionais, perpassando pela conquista dos espaços destinados a cada membro na equipe de saúde do transplante em relação a orientações para a alta hospitalar após transplante.

Pathologizing the Wounded?: Interrogating the Efficacy of 'Post-traumatic Stress Disorder' in An Era of Gun Violence

Drawing on the 2017 Las Vegas Shooting as a potent example of trauma, this article investigates how classifying post-traumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (APA, 2013) shapes cultural understandings of traumatization and survival in an era of gun violence. “PTSD” reproduces colonizing arrangements of power, as elucidated by an activ¬ity theory analysis of the DSM-5, the global authority on psychiatric diagnoses, alongside both diagnostic protocols for PTSD and PTSD discourse in news cov¬erage of the Las Vegas Shooting. This rhetorical approach to the DSM-5 as a complex system of activity exposes conflicting effects: classifying post-traumatic stress as “mental disorder” qualifies traumatized survivors for medical treatment, while also pathologizing the debilitating, long-term trauma that mass shootings can cause. This potential conflict between alleviating and pathologizing suffering shores up an individual or biomedical model of health, in contrast to a public health model oriented around the health of populations, that may shame survivors and commodify their pain.

Educação em saúde provida pelo enfermeiro ao cuidador à luz do pensamento ecossistêmico

O presente estudo tem como objetivo analisar, na visão do cuidador, a educação em saúde provida pelo enfermeiro, durante o período de internação do usuário com doença crônica não transmissível para a continuidade do cuidado no domicílio, à luz do Pensamento Ecossistêmico. Pesquisa descritiva, exploratória e qualitativa. Coleta de dados por entrevista semiestruturada. A análise, seguiu as etapas do método da Análise Temática. As ações educativas, não são vistas como atributos inerentes à prática de trabalho dos enfermeiros, e, quando realizada pelo enfermeiro, é de forma fragmentada e pontual, ancorada no modelo biomédico em saúde. A educação em saúde, provida pelo enfermeiro, necessita transcender as limitações do modelo cartesiano, prescritivo e determinístico. Recomenda-se ancorar as ações em saúde nos princípios do Pensamento Ecossistêmico, a partir de sua compreensão sistêmica e contextualizada, possibilitando superar as lacunas apontadas pelos cuidadores dessa pesquisa.

Elective Impairment Minus Elective Disability: The Social Model of Disability and Body Integrity Identity Disorder

Individuals with body integrity identity disorder (BIID) seek to address a non-delusional incongruity between their body image and their physical embodiment, sometimes via the surgical amputation of healthy body parts. Opponents to the provision of therapeutic healthy-limb amputation in cases of BIID make appeals to the envisioned harms that such an intervention would cause, harms such as the creation of a lifelong physical disability where none existed before. However, this concept of harm is often based on a normative biomedical model of health and disability, a model which conflates amputation with impairment, and impairment with a disability. This article challenges the prima facie harms assumed to be inherent in limb amputation and argues in favour of a potential treatment option for those with BIID. To do this, it employs the social model of disability as a means to separate the concept of impairment and disability and thereby separate the acute and chronic harms of the practice of therapeutic healthy-limb amputation. It will then argue that provided sufficient measures are put in place to ensure that those with atypical bodily constructions are not disadvantaged, the chronic harms of elective amputation would cease to be.

A Comparative Assessment of Maternal Health and Maternal Health Policies in India and the U.S.: Need to Transition from a Biomedical Model to a Biopsychosocial Model for Maternal Health Policies

More than 300,000 women died due to pregnancy related causes in 2015, a global maternal mortality ratio (MMR) of 216 per 100,000 live births (Alkema et al., 2016). Millennium Development Goals have led to a 44% decline in global MMR, but significant variations still remain across geographical regions (United Nations [UN], 2015). India accounts for the second highest maternal deaths in the world (World Health Organization [WHO], 2015). In contrast, the U.S. is the only developed country with an increasing MMR in recent years (“Maternal Mortality,” 2015). However, little attention has been given to maternal health in public policy research and practice in both countries. This paper compares and contrasts maternal health status and analyzes maternal health policies in India and the U.S. two health models. Based on comparative case analysis, the overall recommendation is to expand the scope of maternal health from a biomedical health model towards a biopsychosocial model and restructure the policy frameworks. This paper contributes to the maternal health discourse and hopes to garner attention of global and regional health policy scholars and policy makers.

Associations between occupational stress and demographic characteristics in petroleum workers in the Xinjiang arid desert.

Owing to the transformation of the biomedical model of health, more and more professionals pay close attention to the occupational social psychological factors, such as occupational stress. Due to the socioeconomic impact of occupational stress and the petroleum workers stationed in the unique environment in Xinjiang, a cross-sectional study was carried out between May and December 2016 to investigate the relationship between occupational stress and demographic characteristics. A total of 1480 workers were selected. Occupational stress was evaluated with the Occupational Stress Inventory-Revised Edition. The findings of the present study revealed that the values of the Occupational Roles Questionnaire results (t = 9.266, P < .001) and Personal Strain Questionnaire results (t = 21.381, P < .001) were found to be higher than the national normal. Personal Resources Questionnaire values (t = −17.575, P < .001) were found to be lower than the national normal in petroleum workers stationed in the arid desert, and suggested a strong correlation between occupational stress and demographic characteristics. These data provide evidence that different demographic characteristics are associated with different occupational stress levels in petroleum workers stationed in the arid desert.

Food stories: Unraveling the mechanisms underlying healthful eating

The biomedical model of health (BMH) studies the causes and origins of disease. When applied to nutrition research, eating is studied as a behavior that supports physical health. However, the lack of attention the BMH pays to social and historical circumstances in which health behaviors are constructed has been widely addressed in literature. When people are studied without considering contextual influences, the relevance to everyday life is limited. As a result, how individuals actively deal with their context to manage healthful eating is poorly understood. This research applies a complementary model, salutogenic model of health (SMH), and uses life course research methodology to study a group of healthy eaters. The purpose of this research is to unravel how healthful eating develops in everyday life. Healthy eaters (n = 17) were identified and recruited from the NQplus research panel at Wageningen University, the Netherlands. Life course experiences were examined through narrative inquiry. Participants recalled and visually explored life experiences with food and health using timelines. Results indicate that healthful eating results from exposure to individual- and context-bounded factors during childhood and adulthood and involves specific mental and social capacities relevant to coping including amongst others, critical self-awareness; flexibility, craftiness, and fortitude. Through life-course learning moments, participants were able to develop proactive coping strategies which strengthened their sense of agency and helped them in overcoming stressors and challenges. Findings show that nutrition strategies should not only focus on strengthening food-specific factors like cooking skills and nutrition knowledge, but other factors like stress management, empowerment, and participation. Such factors support the development of adaptive skills and behaviors, enable individuals to deal with the demands of everyday life, and are building blocks for health promotion.

Determinants of health-related lifestyle. Comparative study of the functioning of young adults in 2003 and 2013

Abstract Background - Early adulthood is the developmental stage during which, for the first time, an individual can independently choose their own lifestyle. For the future health of a young adult, it is important that they incorporate healthy behaviors from different health dimensions (somatic, mental, social) into their lifestyle. Analyzing the foregoing issue gives rise to a fundamental question: did intensive social changes experienced after Poland’s accession to the European Union lead to changes in different aspects of a healthy lifestyle? Method - The presented study involved 504 people. The research data was collected in two separate measurements in 2003 (n = 284) and 2013 (n = 220). Subjects were asked to complete sets of questionnaires which measured: health behaviors, health beliefs, social influence, intention. Results - Statistical comparison of means tests and regression equations were conducted. Results demonstrate that young adults were similarly engaged in pro-health activities in both 2003 and 2013. A detailed analysis of health lifestyle factors shows that young adults from the 2013 group care more about their diet, physical activity, and more frequently undergo preventive medical health examinations. Moreover, significant changes in healthy lifestyle factors were reported. The most important observation concerned the changes in health beliefs. Beliefs derived from a holistic-functional model of health played a major role in the 2003 group, whereas in the 2013 group beliefs close to the biomedical model of health were more important. Conclusions - Analyses demonstrate changes in detailed healthy lifestyle factors. At the same time, no significant differences in global measures of concern for one’s health were observed. Importantly, results show modifications in healthy lifestyle factors. It is suggested that the observed differences stem from the social change of the last decade.

The challenge of making health services people-centred: how are policy-makers in Asia approaching it?

As early as 2005, the World Health Organization's Regional Office for the Western Pacific (WPRO) had worked closely with countries in its region to promote people-centred health care and provide practical guidance on health policies and interventions that can lead to better quality of health care, better health outcomes and improved well-being. The people-centred approach to health makes the perspectives of individuals, families and communities central to the organization of health services and systems, and is critical in improving service quality and contributing to progress towards Universal Health Coverage (UHC). WHO convened a policy roundtable to in Asia on the topic of People-Centred Integrated Health Services, and brought together 36 policy-makers and experts from 12 countries in the WHO Western Pacific Region. Challenges of implementing people-centred, integrated health services were shared and good practices for developing health services that were people-centred and integrated were discussed. The sessions discussed good practices on engagement with patients and families, ideas to strengthening governance and accountability, and coordination of services around the needs of people. Participants shared on the challenges of the current health systems, which were historically developed to provider-centric and hospital-centric, built on the bio-medical model of health. Recent changes in population demographics, healthcare needs and community expectations require health systems to evolve and adapt, to be more needs- and value-based. However in many settings, health services and social services are not well-integrated, and have contributed to poor outcomes and resource optimization. These can be worsened by technological or system barriers to timely communication and information sharing between healthcare providers. In several areas, lack of regulatory oversight has led to over-commercialization and commoditization of healthcare services. To advance people-centred, integrated health services and move towards universal health coverage, patients, families and communities need to be recognized as key partners and stakeholders in health, and be engaged accordingly. Links between health and social sectors need to be strengthened at all levels to better address the co-dependency between social and health for the population. Health systems need to promote communications and teamwork between providers and create platforms to facilitate information sharing. Alignment of policy directions and incentives is critical to generate the desired behaviors in healthcare providers and users. Health systems should collect data on what is meaningful to patients, families and communities, and shift our health systems’ KPIs to become more value-based.

Inglês

This article aimed to know the production of scientific knowledge about quality of life in children. The methodused was the integrative review. The databases consulted were SciELO, LILACS and MEDLINE. In total were found 47 articlespublished from 2006 to 2016. The results showed that the years biggest issue was the 2012 and 2013 with 7 articles published eachyear, the focus area with the largest number of articles published was medicine 16 articles and as the subject noticed a predominancein issues relating to quality of life of children diseases (78%) of published articles and only 4.7% related the most social issues. Thescientific literature on the quality of life of children is still focused on the biomedical model of health and there are few scientificproductions directed to the full model in health. Therefore, it is necessary to spread the production of scientific knowledge in the child'squality of life area in the context in which she lives and not just the disease, in which old research questions are giving way to newquestions and new paradigms health.

“Christ offered salvation, and not an easy life”: How do port chaplains make sense of providing welfare for seafarers? An idiographic, phenomenological approach analysis

The shipping industry has historically leaned towards a biomedical model of health when assessing, treating and caring for seafarers. In recent years there has been more concern for the mental health of seafarers in both the academic literature and the commercial world, however, the psychological and emotional well-being of seafarers still largely falls on the shoulders of the port chaplains. The aim of the study was to explore how port chaplains make sense of providing welfare for seafarers by taking an idiographic, phenomenological approach (IPA). Six male participants working as chaplains in United Kingdom ports took part in recorded face-to-face, semi-structured interviews covering three areas of questioning: role, identity and coping. Interviews were transcribed verbatim, and data analysed using interpretative phenomenological analysis. Three super-ordinate themes were identified from participants accounts; "We walk a very strange and middle path", "Exploited" and "Patching up". Rich data emerged in relation to the personal impact chaplains felt they made, which was facilitated by the historical role of the Church; this led to the second super-ordinate theme of how chaplains felt towards seafarers. Lastly, the analysis demonstrates how chaplains adapt to the limitations forced upon them to provide welfare, and a degree of acceptance at the injustice. Results were discussed in reference to theoretical models, including self-efficacy, empathic responding and the transactional model of stress and coping. Chaplains in ports perform their role autonomously with no input from healthcare professionals. Recommendations are made for a biopsychosocial model of health involving primary care, benefiting the health and well-being of seafarers and providing support and guidance for port chaplains at the frontline of welfare for seafarers.

Genotype vs. Phenotype and the Rise of Non-Communicable Diseases: The Importance of Lifestyle Behaviors During Childhood

Despite continued research and growing public awareness, the incidence of non-communicable diseases (NCD) continues to accelerate. While a person may have a genetic predisposition to certain NCDs, the rapidly changing epidemiology of NCDs points to the importance of environmental, social, and behavioural determinants of health. Specifically, three lifestyle behaviours expose children to important environmental cues and stressors: physical activity, nutritional intake, and sleep behaviour. Failure to expose children to proper gene-environment interactions, through the aforementioned lifestyle behaviours, can and will predispose children to the development of NCDs. Reengineering the environments of children can induce a paradigm shift, from a predominantly biomedical health model of treating symptomology, to a more holistic model based on encouraging appropriate behavioral decisions and optimal health.

‘Better than Medicine’: Theatre and health in the contemporary Norwegian context

Abstract This article documents the practice of act2 and Teater Vildenvei, two collaborative theatres in health companies in Norway. Based on an analysis of the companies’ aims and objectives, their ethos, their particular working methods and the plays they have produced, I will examine the values that underpin the work of the two companies. The aim here is to assess what strategies the companies use in their work to promote health and well-being for marginalized and socially excluded groups in society. Working with people affected by addiction and mental health service users, respectively, act2 and Teater Vildenvei are using the medium of theatre to facilitate change processes that help the participants gain access, networks and a voice to enable empowerment. If health is the manifestation of empowerment, what might the empowerment of these voices mean for both individuals and for the groups at large? This article will not address the health effects of theatre in terms of medical effects, but it will assess why some participants of act2 and Teater Vildenvei describe the interventions as ‘better than medicine’ and ‘good medicine’. A tentative explanation is that both act2 and Teater Vildenvei provide radically different solutions to people’s problems than those offered by the biomedical model of health. Instead of treatment and diagnosis, act2 and Teater Vildenvei focus on resources, personhood, enablement, social support and empowerment in their attempt to promote health and well-being.

Longitudinal relationship between inflammation and poor self-rated health in elderly

Self-rated health (SRH) predicts future objective health and summarizes information in a way that goes beyond the biomedical health model. Low-grade inflammation contributes to poor SRH, but previo ...

Realities of Primary Care Mental Health Integration: Lessons Learned While on the Road

The concept of mental health primary care integration has existed for over 30 years is gradually becoming a standard of care. Many factors have contributed to the need for collaboration including calls to improve the nation's health and the overall quality of healthcare, a need to decrease healthcare costs, and a desire to reduce stigma associated with mental health treatment thereby improving access to care. The integration of mental health and primary care is by its very nature biopsychosocial, allowing providers to move away from the outdated biomedical model of health.

Oral Health Related Quality Of Life: Perspectives

AbstractGood oral health is essential for the overall wellbeing of an individual. Oral diseases like dental caries, periodontal diseases and oral cancer are highly prevalent and can lead to pain, discomfort, anxiety, poor facial appearance, low self esteem and impaired function. With patient centric measures gaining importance, it is essential to incorporate patient centric measures while restoring the oral health. OHRQoL aims to add this wider view to the clinical assessment of an individual's oral health. It challenges biomedical model of health and provides complete view of the health and disease status of an individual. It is an individual's assessment of how functional, psychological, social and other factors affect personal wellbeing. Various generic and oral health specific quality of life instruments have been developed to assess oral health related quality of life. It has implications in routine clinical practice, research, patient education, surveys and policy formulations. The overall result is a satisfied individual, clinician, researcher and community.

Humanizing clinical dentistry through a person-centred model

The clinical approach in dentistry stems from a biomedical model of health that is anchored in positivism. This biomedical model was never explicitly developed or reflected on, but rather implicitly acquired as a product of historical circumstance. A reductionist understanding of health served dentistry well in the past, when health afflictions were mostly acute. Today, however, in the age of chronic illnesses, the current clinical approach is no longer adequate: patients and dentists are both dissatisfied, and there are problems with dental education and dental public health. After a thorough review of the literature, highlighting the current state of the profession, we propose an alternative clinical model upon which updated approaches can be based. We call this model "Person-Centred Dentistry". Our proposed model is rooted on the notion of sharing of power between the dentist and the patient: a sharing of power in the relationship and epistemology. This leads to an expanded understanding of the person and the illness; a co-authoring of treatment plans; and interventions that focus not only on eliminating disease but also on patient needs.

Saúde, religião e cultura: um diálogo a partir das práticas afro-brasileiras

Parte-se da constatação de que o modelo biomédico de atenção à saúde é incapaz de lidar isoladamente com a complexidade dos problemas de saúde. Sendo assim, produz-se maior interesse pelas ciências sociais aplicadas ao campo da saúde para se pensar a atenção integral ao paciente e a integração dos conhecimentos biológicos, sociais e culturais na compreensão das doenças. Este trabalho busca compreender as relações da religiosidade com a saúde e os processos de cura, procurando entender as formas como os indivíduos vivenciam a doença, o sofrimento, a dor e as práticas de cura. Trata-se de pesquisa exploratória de caráter etnográfico, com observação participante em um templo religioso afro-brasileiro, localizado no Rio de Janeiro. Um efeito fundamental da religião é alterar o significado de uma doença para aquele que sofre, não implicando necessariamente remoção dos sintomas, mas mudança positiva dos significados atribuídos à doença. A religiosidade dá sentido à vida, diante do sofrimento, ao criar uma rede social de apoio. Constatamos que a prática religiosa tem complementado as práticas médicas oficiais. As informações coletadas nos permitem afirmar que as práticas religiosas se constituem em lugares de acolhimento, de cura e de saúde para aqueles que as buscam. Apontamos para a necessidade de aprofundamento de estudos dessa temática que venham a se somar enquanto possibilidades de ajuda e alternativa de "cura" às pesquisas da prática biomédica.

Healthcare Professionals' Response to Cachexia in Advanced Cancer: A Qualitative Study

To explore healthcare professionals' experience, understanding, and perception of the needs of patients with cachexia in advanced cancer. A qualitative approach based on symbolic interactionism. A regional cancer center in a large teaching hospital in the United Kingdom. 34 healthcare professionals who had experience providing care to patients with cachexia in advanced cancer. Data collection consisted of two phases: focus group and semistructured interviews. Interviews were digitally recorded and transcribed verbatim for analysis. This article reports on findings from the second phase of data collection. Analysis revealed that professional approaches to cachexia were influenced by three overarching and interthinking themes: knowledge, culture, and resources. Healthcare professionals commonly recognized the impact of the syndrome; however, for nonpalliative healthcare professionals, a culture of avoidance and an overreliance on the biomedical model of care had considerable influence on the management of cachexia in patients with advanced cancer. Cachexia management in patients with advanced cancer can be difficult and is directed by a variable combination of the influence of knowledge, culture of the clinical area, and available resources. Distinct differences exist in the management of cachexia among palliative and nonpalliative care professionals. This study presented a multiprofessional perspective on the management of cachexia in patients with advanced cancer and revealed that cachexia is a complex and challenging syndrome that needs to be addressed from a holistic model of care. Cachexia management in patients with advanced cancer is complex and challenging and is directed by a combination of variables. An overreliance on the biomedical model of health and illness occurs in the management of cachexia in patients with advanced cancer. Cachexia needs to be addressed from a holistic model of care to reflect the multidimensional needs of patients and their families.

Health trends and health indicators.

Among the myriad of indicators available for measuring health, which ones are most appropriate for following health trends over time in the elderly population? Health in older people is often characterised by the simultaneous presence of multiple conditions, with or without disease, which cannot be cured. Morbid conditions interact with the environment and with the ageing process in ways we do not yet understand. The biomedical model of health is not enough to describe and analyse health in old people. We must complement the model with models of health as multi-dimensional and contextual, that is, consider the impact of the social and physical environment. When we attempt to measure changes in health over time, it can be difficult to discern what is change in health and what is contextual change. For example, living conditions, access to care, definitions and awareness of disease, and expectations change over time and affect prevalence rates of health indicators. There are two main reasons to study trends: to monitor and estimate needs for care, and to understand the forces and factors driving population health. To estimate needs for, e.g., home help or institutionalisation, indicators that encompass context may be most useful. For example, walking ability is contingent on access to walking aides. As aides have become better and more accessible, the needs for help with shopping may decrease, regardless of ability to walk without aides. To estimate needs for, e.g., orthopaedic care, indicators of range of motion, ability to kneel, and pain may be more useful. If we want to understand what is driving population health we also need a variety of health indicators, perhaps especially indicators that are less sensitive to contextual change. In the example above, the ability to kneel or a test of range of motion would be less dependent on contextual change compared to ability to walk a given distance. In conclusion, studies of health trends require a variety of health indicators that reflect multiple dimensions of health. Indicators should have varying degrees of objectivity and dependence on contextual change. The greatest challenge in trend studies is often to maintain consistency in successive waves in regards to health indicators and fieldwork in order to maintain comparability over time.