Biopsychosocial model of illnesses in primary care: A hermeneutic literature review

Abstract

Biopsychosocial model is a useful worldview for primary care or family doctors. However, it is often considered as impractical or too complicated. The objective of this study is to review the implementation of the biopsychosocial model in clinical practice, and its contributions to clinical outcomes. Hermeneutic circle literature review was conducted to provide experiential learning in an attempt to understand biopscyhosocial model, first developed by George Engel. Literature search started with review articles in Medline and Scopus as search engines. Citations from previous articles, editorials, and research articles were identified and interpreted in the context of the knowledge derived from all identified relevant articles. The progress of biopsychosocial model has been slow, and primary care doctors do not implement biopsychosocial medicine in their practice, while biomedical thinking and approach are still the dominant model. Biopsychosocial research addressed chronic illnesses and functional disorders as conditions in need for biopsychosocial model implementation. As payment scheme, clinical guidelines and clinical performance indicators are biomedically oriented, there is no incentive for primary care doctors to adopt biopsychosocial model in their practice. Workload and lack of competence in primary care may hinder the implementation of biopsychosocial model. Biopsychosocial model helps primary care doctors to understand interactions among biological and psychosocial components of illnesses to improve the dyadic relationship between clinicians and their patients and multidisciplinary approaches in patient care. Biopsychosocial model potentially improves clinical outcomes for chronic diseases and functional illnesses seen in primary care.

WITHDRAWN: Applicability of a Tool for Comprehensive Assessments: the Expanded Guide for Monitoring Child Development

“…Since the 1970s when Engel published in Science the crucial need for the biopsychosocial model for medicine [1], it has been emphasized that this model must be implemented in healthcare delivery for adults and children alike [2]. There are still major gaps, however, in applying this model, as clinicians in many countries encounter constraints including inadequacies in the workforce, insu cient time devoted to healthcare visits, inadequate training and paucity of related tools [2][3][4][5][6]. The new type coronavirus disease (COVID-19) pandemic brings novel challenges by adding inordinate stress on the health system and further jeopardizing the time that needs to be spent during face-to-face history taking to obtain holistic biopsychosocial information.…”

Physical exposure during patient transfer and risk of back injury & low-back pain: prospective cohort study

“…With the present analysis we add to the literature by showing that - even when accounting for several known confounders - consistent and appropriate use of technologically-advanced assistive devices may provide a small protective effect against increases LBP among healthcare workers. Within the complex model of the biopsychosocial approach to health and its growing role within healthcare [ 59 , 60 ], it is therefore not unlikely that the “bio”-aspect can be improved upon by diminishing the accumulative physical load throughout a day, month and career [ 22 – 24 ].…”

Physical Exposure during Patient Transfer and Risk of Back Injury & Low-back Pain: Prospective Cohort Study

“…With the present analyses we add to the literature by showing that -even when accounting for several known confounders -consistent and appropriate use of technologically-advanced assistive devices may contribute to a protective effect against LBP in healthcare workers. Within the complex model of the biopsychosocial approach to health and its growing role within healthcare [56,57], it is therefore not unlikely that the "bio"-aspect can be improved upon by diminishing the accumulative physical load throughout a day, month and career [22][23][24].…”