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1.
Turk J Med Sci ; 52(3): 667-676, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36326328

RESUMO

BACKGROUND: This study aimed to investigate the effectiveness of a supervised group exercise therapy based on the biopsychosocial model introduced simultaneously with antitumor necrosis factor (TNF) therapy in anti-TNF-naive patients with active ankylosing spondylitis (AS). METHODS: Forty-eight patients were divided into two groups: the control group (CG; n = 36) received only anti-TNF therapy, and the study group (SG; n = 12) received the supervised exercise therapy based on the biopsychosocial model in addition to anti-TNF therapy. The measurements of disease activity and functionality were evaluated by The Bath AS Disease Activity Index (BASDAI) and The Bath AS Functional Index (BASFI) respectively. Other outcome measures evaluated biopsychosocial status, emotional state, spinal mobility, pain, fatigue, sleep, and quality of life. All measurements were applied to both groups at baseline and repeated 12 weeks later. RESULTS: BASDAI and BASFI analyses revealed significant differences between groups in favor of the SG (p < 0.05). At the end of the 12 weeks, the results showed that there were additional improvements in all outcome measurement parameters in the SG compared to the CG. DISCUSSION: The supervised group exercise therapy based on the biopsychosocial model introduced simultaneously with anti-TNF therapy is more effective than only anti-TNF therapy in anti-TNF-naive patients with active AS.


Assuntos
Espondilite Anquilosante , Humanos , Espondilite Anquilosante/tratamento farmacológico , Inibidores do Fator de Necrose Tumoral , Qualidade de Vida , Modelos Biopsicossociais , Índice de Gravidade de Doença , Terapia por Exercício/métodos , Resultado do Tratamento
2.
Psychiatr Q ; 93(4): 949-970, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36199000

RESUMO

This theoretical review proposes an integrated biopsychosocial model for stress recovery, highlighting the interconnectedness of intra- and interpersonal coping processes. The proposed model is conceptually derived from prior research examining interpersonal dynamics in the context of stressor-related disorders, and it highlights interconnections between relational partner dynamics, perceived self-efficacy, self-discovery, and biological stress responsivity during posttraumatic recovery. Intra- and interpersonal processes are discussed in the context of pre-, peri-, and post-trauma stress vulnerability as ongoing transactions occurring within the individual and between the individual and their environment. The importance of adopting an integrated model for future traumatic stress research is discussed. Potential applications of the model to behavioral interventions are also reviewed, noting the need for more detailed assessments of relational dynamics and therapeutic change mechanisms to determine how relational partners can most effectively contribute to stress recovery.


Assuntos
Trauma Psicológico , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia , Modelos Biopsicossociais , Apoio Social , Adaptação Psicológica
3.
Int J Psychophysiol ; 182: 119-128, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36273715

RESUMO

We examined the relation between psychological flow and cardiovascular markers of challenge. According to flow theory and the biopsychosocial model of challenge and threat (BPS-CT) optimal motivational states (flow, challenge) arise during activities where task demands meet personal resources. Participants (N = 154) played Tetris in either an underload, fit, or overload condition. Cardiovascular responses were measured during the task and a flow state scale was completed afterwards. Unexpectedly, it was in the underload condition where cardiovascular responses developed in the direction of challenge. Moreover, it was under this condition where relative challenge related positively to both task performance and self-reported flow. Similar results were found for cardiovascular markers of task engagement. In line with the BPS-CT, when only selecting clearly task-engaged participants a tendency towards challenge was found in the fit condition. We discuss why flow and challenge might have co-occurred in the underload condition, as well as the further theoretical and methodological implications of the study. We conclude that at least under some circumstances flow and challenge relate to each other but that future research should examine this relation further.


Assuntos
Sistema Cardiovascular , Modelos Biopsicossociais , Humanos , Estresse Psicológico/psicologia , Motivação , Análise e Desempenho de Tarefas
6.
J Headache Pain ; 23(1): 100, 2022 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-35953769

RESUMO

Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.


Assuntos
Dor Crônica , Transtornos de Enxaqueca , Doença Crônica , Humanos , Transtornos de Enxaqueca/terapia , Modelos Biopsicossociais
7.
Acta Paediatr ; 111(11): 2115-2124, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36000514

RESUMO

AIM: The paper aims to show how the biopsychosocial (BPS) model can be applied as a clinical method and guide the assessment and treatment of children and adolescents with somatic symptom disorders (SSD). METHODS: Based on relevant literature and our clinical work with children and adolescents with SSD, we have developed a method to ensure a structured, interdisciplinary examination of biological, psychological and social factors, operationalising the BPS model into a clinical method. RESULTS: The BPS model renders assessment and treatment of complex conditions as a basis for evaluating phenomena not confined by diagnostic tools, but still includes all information from these tools. It requires an interdisciplinary approach, giving individual patient and caregivers a central position. A thorough medical examination is required as a starting point for assessments. Good results rest upon a shared understanding between patient, caregivers and professionals. CONCLUSIONS: 'Biopsychosocial' is often claimed as a basis for clinical work with complex cases, medical, functional and psychiatric, but scarcely with a corresponding BPS method or practice. The BPS method should guide further development of holistic, interdisciplinary health care on all levels, to assess and help children and adolescents with SSD.


Assuntos
Sintomas Inexplicáveis , Adolescente , Criança , Humanos , Modelos Biopsicossociais , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/terapia
8.
Contrast Media Mol Imaging ; 2022: 7547001, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36043148

RESUMO

The purpose of this study was to explore the value of extended care based on a biopsychosocial medicine model in patients with abnormal tumor markers on physical examination. One hundred and fifty-two cases with abnormal primary screening tumor markers who were examined in our medical examination center between January 2020 and January 2022 were selected as the subjects of this study and divided into intervention and control groups according to the random number table method, with 76 cases in each group. The control group was given the usual extended care intervention and the intervention group was given the extended care intervention based on the biopsychosocial medicine model. The compliance rates of regular follow-up, reasonable diet, appropriate exercise, and regular rest were compared between the two groups. After the intervention, the disease-related knowledge score in the intervention group was higher than that in the control group (P < 0.05). The compliance rates of regular return visits, reasonable diet, appropriate exercise, and regular routines in the intervention group were higher than those in the control group (P < 0.05). After the intervention, the scores of psychological states such as anxiety, depression, and post-traumatic growth in the intervention group were better than those in the control group (P < 0.05). After the intervention, the total scores of objective support, subjective support, support utilization, and social support in the intervention group were higher than those in the control group (P < 0.05). After the intervention, the intervention group had higher positive coping scores and lower negative coping scores than the control group (P < 0.05). Continuing care based on the biopsychosocial model of medicine is effective in people with abnormal tumor markers on medical screening. It can improve the knowledge about the disease, increase the compliance rate, improve negative emotions, psychological status, and social support, and promote a more positive way of responding.


Assuntos
Ansiedade , Modelos Biopsicossociais , Ansiedade/psicologia , Biomarcadores Tumorais , Humanos , Exame Físico
9.
Pan Afr Med J ; 41: 166, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35655671

RESUMO

Adolescents (10 to 19 years) living with HIV (ALHIV) experience disproportionately poor adherence to antiretroviral treatment (ART) compared to other age groups. Several barriers, including psychosocial challenges, contribute to this observation. Psychosocial support (PSS) interventions show promising results as a strategy to deal with the biological and psychosocial challenges faced by ALHIV. However, there is dearth of information on how psychosocial support interventions designed to improve treatment adherence and retention in care among ALHIV are effective. In this commentary, we used the biopsychosocial model to formulate hypotheses on how the components of a PSS intervention could improve adherence and retention in ART care. Psychological wellbeing, coping strategies, social support, self-efficacy, and disclosure are key components in the intervention designed to improve ART adherence and retention in care. The management of ALHIV for improved ART adherence and retention requires recognising and addressing the complex biological, psychological and social issues peculiar to them.


Assuntos
Infecções por HIV , Modelos Biopsicossociais , Adolescente , Antirretrovirais , Infecções por HIV/tratamento farmacológico , Humanos , Sistemas de Apoio Psicossocial , África do Sul , Resultado do Tratamento
12.
Rev. Bras. Saúde Mater. Infant. (Online) ; 22(1): 11-22, Jan.-Mar. 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1376206

RESUMO

Abstract Objectives: a systematic review study with the objective of estimating the effect on the practice of the kangaroo method (KM) on the formation and strengthening of the mother-baby bond (MBB). Methods: independent searches were performed in three international databases in the United States National Library of Medicine - PubMed, Scientific Electronic Library Online - Scielo and Web of Science databases. Searches were made without limit on languages and year of publication. Results: the final selection consisted of 27 studies, 14 of a quantitative nature (nine clinical trials and five observational) and 13 qualitative. All qualitative articles and most quantitative ones (n=10) indicated the practice of the KM as favorable to the formation and strengthening of the MBB. Other quantitative studies did not show statistically significant differences in the comparisons made between groups. None of the 27 studies found unfavorable effects resulting from the practice of KM on the MBB. Conclusion: the results suggest that the KM favors the formation and strengthening of the MBB regardless of the weight and gestational age of the newborns or the place of measurement (hospital or residence). Thus, encouraging the execution of this biopsychosocial intervention of qualified and humanized care is recommended for the promotion of children's health.


Resumo Objetivos: estudo de revisão sistemática com objetivo de estimar o efeito da prática do método canguru (MC) na formação e fortalecimento do vínculo mãe-bebê (VMB). Métodos: foram realizadas buscas independentes em três bases de dados internacionais nas bases de dados United States National Library of Medicine - PubMed, Scientific Electronic Library Online - Scielo e Web of Science. As buscas foram feitas sem limite para idioma e ano de publicação. Resultados: a seleção final foi composta por 27 estudos, 14 de caráter quantitativo (nove ensaios clínicos e cinco observacionais) e 13 qualitativos. Todos os artigos qualitativos e a maioria dos quantitativos (n=10) apontaram a prática do MC como favorável à formação e ao fortalecimento do VMB. Os demais estudos quantitativos não apresentaram diferenças estatisticamente significantes nas comparações realizadas entre grupos. Nenhum dos 27 estudos encontrou efeitos desfavoráveis resultantes da prática do MC sobre o VMB. Conclusão: os resultados sugerem que o MC favorece a formação e o fortalecimento do VMB independentemente do peso e idade gestacional dos recém-nascidos e do ambiente de medição (hospital ou domicílio). Assim, o incentivo a execução desta intervenção biopsicossocial de atenção qualificada e humanizada é recomendada para a promoção de saúde da criança.


Assuntos
Feminino , Gravidez , Recém-Nascido , Saúde da Criança , Saúde Materno-Infantil , Humanização da Assistência , Método Canguru/psicologia , Relações Mãe-Filho/psicologia , Modelos Biopsicossociais
13.
Rev. bras. med. fam. comunidade ; 17(44): 3052, 20220304. ilus
Artigo em Inglês | LILACS, Coleciona SUS | ID: biblio-1379763

RESUMO

Hipertensão arterial leve é uma condição assintomática caracterizada por pressão arterial entre 14/9 e 16/10 mmHG e baixo risco de problemas cardiovasculares. É a condição de aproximadamente dois terços das pessoas diagnosticadas com alguma forma de hipertensão. A melhor evidência disponível não apoia o tratamento farmacológico desse grupo para a redução de mortalidade cardiovascular. Além disso, a sobredetecção de hipertensão ocorre e essa prática é apoiada por campanhas de conscientização ao público, rastreamento, acesso fácil ao teste e má prática clínica, que aumentam potencialmente o sobrediagnóstico. Poucas pesquisas qualitativas orientadas para os pacientes mostram que diagnosticar hipertensão pode ter também consequências negativas. Diante disso, são necessárias evidências sobre o potencial de efeitos psicossociais não esperados no diagnóstico de hipertensão. Objetivo: Investigar se o diagnóstico de pessoas de baixo risco com hipertensão leve tem consequências psicossociais indesejadas. Métodos: Onze entrevistas semiestruturadas e quatro grupos focais foram conduzidos em São Paulo, Brasil, com pessoas que relataram hipertensão arterial leve, sem comorbidades, com ou sem uso de medicação. Informantes foram selecionados da população geral por meio de lista de pacientes de unidades de atenção primária e também recrutados por redes sociais. Os participantes tiveram variedade em termos de sexo, idade, nível educacional, cor de pele e tempo de diagnóstico. Os dados foram submetidos à análise qualitativa de conteúdo temático por três dos autores independentemente, o que foi seguido de discussões para gerar categorias e temas. Resultados: os informantes confirmaram que o diagnóstico de hipertensão foi tomado como um rótulo para reações psicossomáticas ao estresse, medicalizou situações difíceis e causadoras de estresse, nomeando-as como doença, e foi um marco biográfico. Nós observamos consequências não intencionais do diagnóstico em uma ampla gama de dimensões psicossociais, por exemplo, medo de morte, doença e envelhecimento; pressão e controle por parte de pessoas próximas; e culpa, vergonha e ansiedade em relação ao trabalho e ao lazer. Apesar das diferentes características dos informantes, todos compartilharam histórias e sentimentos semelhantes relacionados ao rótulo. Conclusão: O diagnóstico de hipertensão é um evento significativo que afeta o dia a dia. A maior parte do impacto é considerada como consequências psicossocias negativas; porém, às vezes, o impacto pode ser ambíguo ou mesmo positivo. Os modelos explanatórios das pessoas são elementos-chave para entender e abordar as consequências psicossociais do diagnóstico, e profissionais de saúde e formuladores de políticas públicas devem estar atentos a esses potenciais consequências negativas na avaliação de risco/benefício das estratégias de diagnóstico desses casos.


Introduction: Mild hypertension is a common asymptomatic condition present in people at low risk of future cardiovascular events. These people represent approximately two-thirds of those diagnosed with hypertension. The best available evidence does not support pharmacological treatment for mild hypertension to reduce cardiovascular mortality. Additionally, overdetection of hypertension also occurs, and this practice is supported by public awareness campaigns, screening, easy access to testing, and poor clinical practice, enhancing the overdiagnosis potential. Moreover, sparse qualitative patient-oriented evidence that diagnosing hypertension has harmful consequences is observed. Therefore, evidence regarding the potential for unintended psychosocial effects of diagnosing mild hypertension is required. Objective: The aim of this study was to investigate if diagnosing low-risk people with mild hypertension has unintended psychosocial consequences. Methods: Eleven semi-structured single interviews and four focus groups were conducted in São Paulo, Brazil, among people diagnosed with mild hypertension without comorbidities. Informants were selected among the general population from a list of patients, a primary healthcare clinic, or a social network. The informants had a broad range of characteristics, including sex, age, education level, race/skin colour, and time from diagnosis. Data were subjected to qualitative thematic content analysis by three of the authors independently, followed by discussions, to generate categories and themes. Results: The informants confirmed that the hypertension diagnosis was a label for psychosomatic reactions to stress, medicalised illness experiences, and set a biographical milestone. We observed unintended consequences of the diagnosis in a broad range of psychosocial dimensions, for example, fear of death, disabilities, or ageing; pressure and control from significant others; and guilt, shame, and anxiety regarding work and leisure. Although informants had a broad range of characteristics, they shared similar stories, understandings, and labelling effects of the diagnosis. Conclusion: The diagnosis of hypertension is a significant event and affects daily life. Most of the impact is regarded as negative psychosocial consequences or harm; however, sometimes the impact might be ambiguous. Patients' explanatory models are key elements in understanding and changing the psychosocial consequences of the diagnosis, and healthcare providers must be aware of explanatory models and psychosocial consequences when evaluating blood pressure elevations.


Introducción: La hipertensión leve es una condición asintomática común presente en personas con bajo riesgo de eventos cardiovasculares futuros. Estas personas representan aproximadamente dos tercios de las personas diagnosticadas con hipertensión. La mejor evidencia disponible no respalda el tratamiento farmacológico de la hipertensión leve para reducir la mortalidad cardiovascular. Además, también se produce la sobre detección de hipertensión, y esta práctica está respaldada por campañas de concienciación pública, cribados, fácil acceso a las pruebas y mala práctica clínica, lo que aumenta el potencial de sobrediagnóstico. Además, se observa escasa evidencia cualitativa orientada al paciente de que el diagnóstico de hipertensión tiene consecuencias nocivas. Por lo tanto, se requiere evidencia con respecto al potencial de efectos psicosociales no deseados del diagnóstico de hipertensión leve. Objetivo: investigar si el diagnóstico de personas de bajo riesgo con hipertensión leve tiene consecuencias psicosociales no deseadas. Métodos: Se realizaron once entrevistas semiestructuradas y cuatro grupos focales en São Paulo, Brasil, entre personas diagnosticadas con hipertensión leve sin comorbilidades. Los informantes fueron seleccionados entre la población general de una lista de pacientes, de una clínica de atención primaria o de una red social. Los informantes tenían una amplia gama de características que incluían sexo, edad, nivel de educación, origen étnico, color de piel y tiempo desde el diagnóstico. Los datos fueron sometidos a un análisis de contenido temático cualitativo por tres de los autores de forma independiente, seguido de discusiones, para generar categorías y temas. Resultados: Los informantes confirmaron que el diagnóstico de hipertensión era una etiqueta para reacciones psicosomáticas al estrés, experiencias de enfermedad medicalizadas y marcaba un hito biográfico. Observamos consecuencias no deseadas del diagnóstico en una amplia gama de dimensiones psicosociales, por ejemplo, miedo a la muerte, discapacidades o envejecimiento; presión y control de otras personas significativas y culpa, vergüenza y ansiedad en relación con el trabajo y el ocio. Aunque los informantes tenían una amplia gama de características, compartían histórias, entendimientos y efectos de etiquetado similares del diagnóstico. Conclusión: el diagnóstico de hipertensión es un evento significativo y afecta la vida diaria. La mayor parte del impacto se considera como consecuencias o daños psicosociales negativos; sin embargo, a veces el impacto puede ser ambiguo. Los modelos explicativos de los pacientes son elementos clave para comprender y cambiar las consecuencias psicosociales del diagnóstico, y los proveedores de atención médica deben conocer los modelos explicativos y las consecuencias psicosociales al evaluar las elevaciones de la presión arterial, comunicarse y tratar.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Sobremedicalização , Modelos Biopsicossociais , Hipertensão , Pesquisa Qualitativa , Erros de Diagnóstico
14.
PLoS One ; 17(2): e0264357, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35226661

RESUMO

INTRODUCTION: COVID-19 is a respiratory infection that causes not only somatic health issues, but also frequently psychosocial burdens. The aims of this study were to investigate biopsychosocial factors that might further aggravate fear of COVID-19, and to establish a biopsychosocial model of severe fear of COVID-19. METHODS: 368 participants were included in this study. Biopsychosocial factors observed comprised biological factors (somatic risk), psychological factors (state/trait anxiety, physical symptoms of anxiety, severe health anxiety, specific phobias, depression), and psychosocial factors (social support, financial losses, social media consumption, social contacts with COVID-19 infected people). Psychometric questionnaires included State-Trait Anxiety Inventory, Beck's Anxiety Inventory, Whiteley-Index / Illness Attitude Scales, Specific Phobia Questionnaire, WHO-5 and Social Support Survey. RESULTS: 162/368 (44.0%) participants had almost no fear, 170/368 (46.2%) participants had moderate fear, and 45/368 (12.2%) participants had severe fear of COVID-19. Female participants showed higher levels of fear of COVID-19 than male participants (gender: χ2 = 18.47, p<0.001). However, the level of fear of COVID-19 increased in male participants when they had contact with people who were infected with COVID-19, while in contrast the level of fear of COVID-19 decreased in female participants when they had such contacts [ANCOVA: fear of COVID-19 (contact x gender): F(1,363) = 5.596, p = .019]. Moreover, participants without relationships showed higher levels of fear of COVID-19 (marital status: χ2 = 14.582, p = 0.024). Furthermore, financial losses due to the COVID-19 were associated with higher levels of fear of COVID-19 [ANCOVA: fear of COVID-19(financial loss x gender): F(1, 363) = 22.853, p< .001]. Multiple regression analysis revealed female gender, severe health anxiety (WI-IAS) and state /trait anxiety (STAI) as significant predictors of severe fear of COVID-19. CONCLUSION: In this study significant predictors of severe fear of COVID-19 were female gender, pre-existing state and trait anxiety, as well as severe health anxiety. The finding of significant predictors of fear of COVID-19 might contribute to detect people who might suffer most from severe, overwhelming fear of COVID-19 at an early stage.


Assuntos
Ansiedade , COVID-19 , Modelos Biopsicossociais , Transtornos Fóbicos , SARS-CoV-2 , Inquéritos e Questionários , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , COVID-19/epidemiologia , COVID-19/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Psicometria
15.
Semin Neurol ; 42(2): 80-87, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35114695

RESUMO

The biopsychosocial model was defined by George L. Engel to propose a holistic approach to patient care. Through this model, physicians can understand patients in their context to aid the development of tailored, individualized treatment plans that consider relevant biological, psychological, and social-cultural-spiritual factors impacting health and longitudinal care. In this article, we advocate for the use of the biopsychosocial model in neurology practice across outpatient and inpatient clinical settings. To do so, we first present the history of the biopsychosocial model, and its relationships to precision medicine and deep phenotyping. Then, we bring the neurologist up-to-date information on the components of the biopsychosocial clinical formulation, including predisposing, precipitating, perpetuating, and protective factors. We conclude by detailing illustrative neurological case examples using the biopsychosocial model, emphasizing the importance of considering relevant psychological and social factors to aid the delivery of patient-centered clinical care in neurology.


Assuntos
Modelos Biopsicossociais , Médicos , Humanos , Assistência Centrada no Paciente
16.
Appl Psychol Health Well Being ; 14(2): 626-644, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34866337

RESUMO

The increase in the prevalence of gastrointestinal (GI) conditions is an emerging global health concern. Studies of the impact on the lives of individuals living with GI conditions such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) typically focus on biological elements, such as symptomology and treatment efficacy. Comparatively fewer studies have explored the psychological and social aspects of GI conditions, which could provide key information needed to better understand the impact of GI conditions on people and their lived experiences. In this review, existing literature concerning the psychosocial factors and well-being outcomes associated with GI conditions was reviewed using a scoping methodology. Sixty-eight studies were selected for inclusion. Of these studies, the well-being outcomes most frequently addressed, for both IBS and IBD, were quality of life and health-related quality of life, and the most frequently addressed psychosocial factors were social support and coping. These outcomes are largely consistent with those identified for other medical conditions explored using the biopsychosocial model of health, with some exploration of the lived experiences of those with a GI condition.


Assuntos
Doenças Inflamatórias Intestinais , Síndrome do Intestino Irritável , Adaptação Psicológica , Humanos , Doenças Inflamatórias Intestinais/psicologia , Síndrome do Intestino Irritável/psicologia , Modelos Biopsicossociais , Qualidade de Vida/psicologia
17.
Australas Psychiatry ; 30(1): 55-59, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34748708

RESUMO

OBJECTIVE: The biopsychosocial (BPS) model remains the predominant theoretical framework underpinning contemporary psychiatric training and practice. Like all models, it has its limitations and its critics. In light of recent censure, The purpose of this article was to (a) review key aspects of the history, development and contemporary utility of the BPS model and, (b) review key contributions of George Engel. CONCLUSION: An aetiological model for mental disorders that involves psychological, biological and sociocultural factors has existed since at least the 1940s. The term "biopsychosocial" was arguably first coined by Roy Grinker in 1952. Spurred on by his interest in systems theory, Engel expanded upon the model in 1977 and used it to hypothesise about the integration of mind and body. Despite its shortcomings, the BPS model remains relevant and useful.


Assuntos
Educação Médica , Transtornos Mentais , Humanos , Modelos Biopsicossociais
18.
Appetite ; 169: 105833, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34863795

RESUMO

BACKGROUND: Recent research among postpartum women has considered body image and eating attitudes as well as exclusive breastfeeding within common theoretical models. However, these efforts have so far neglected to include partner-related constructs, which constitutes an important gap. Thus, the aim of this study was to examine an integrated model of body image and eating concerns, and exclusive breastfeeding among mothers of infants six months and younger, that included partner appearance influences as well as general postpartum support. METHODS: A sample of new mothers (N = 156), aged 20-47 years, mean = 32.7 (SD = 4.7) years, reported on postpartum partner support and appearance pressures, thin-ideal internalization and body dissatisfaction, symptoms of disordered eating, depression, breastfeeding self-efficacy and exclusive breastfeeding. Path analyses were conducted to test the hypothetical model. RESULTS: Findings revealed that the final model was a good fit to these data. Postpartum partner support was associated with lower depression and higher breastfeeding self-efficacy, through which it was related to higher reports of exclusive breastfeeding and lower eating disorder symptoms. In addition, partner appearance pressures and thin-ideal internalization were associated with higher body dissatisfaction, and thin-ideal internalization was also related to lower breastfeeding self-efficacy. CONCLUSIONS: Partner influences may be important to account for in models of body image and eating concerns among postpartum women, and exclusive breastfeeding, and further research on ways in which they can support mothers of young infants is warranted.


Assuntos
Imagem Corporal , Transtornos da Alimentação e da Ingestão de Alimentos , Adulto , Imagem Corporal/psicologia , Aleitamento Materno/psicologia , Feminino , Humanos , Lactente , Pessoa de Meia-Idade , Modelos Biopsicossociais , Mães/psicologia , Período Pós-Parto/psicologia , Adulto Jovem
19.
J Card Fail ; 28(2): 283-315, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34329719

RESUMO

BACKGROUND: Fatigue is a common and distressing symptom of heart failure (HF) and has important implications for patient-reported and clinical outcomes. Despite being a common and bothersome symptom, fatigue has been understudied in HF. We sought to synthesize existing literature on fatigue in HF through a systematic literature review guided by the biopsychosocial model of health. METHODS AND RESULTS: A systematic search of the literature was performed on March 18, 2020, using Pubmed, Embase, and CINAHL. Full-text, primary research articles, written in English, in which fatigue was a primary symptom of interest in adults with a diagnosis of HF, were included. The search yielded 1138 articles; 33 articles that met inclusion criteria were selected for extraction and synthesis. Biological and psychological factors associated with fatigue were New York Heart Association functional class, hemoglobin level, history of stroke, and depression. However, there are limited HF-specific factors linked to fatigue. Social factors related to fatigue included social roles, relationship strain, and loneliness and isolation. Few nonpharmacologic interventions have been tested by show some promise for alleviating fatigue in HF. Studies show conflicting evidence related to the prognostic implications of fatigue. CONCLUSIONS: Important biological correlates of fatigue were identified; however, psychological and social variables were limited to qualitative description. There is need for expanded models to better understand the complex physiologic nature of fatigue in HF. Additionally, more research is needed to (1) define the relationships between fatigue and both psychological and social factors, (2) better describe the prognostic implications of fatigue, and (3) develop more therapeutic approaches to alleviate fatigue with the goal of improving overall quality of life.


Assuntos
Insuficiência Cardíaca , Qualidade de Vida , Adulto , Fadiga/diagnóstico , Fadiga/epidemiologia , Fadiga/etiologia , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Humanos , Modelos Biopsicossociais
20.
Disabil Rehabil ; 44(13): 3270-3284, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33284644

RESUMO

PURPOSE: Low back pain (LBP) is the leading cause of disability worldwide. Clinical research advocates using the biopsychosocial model (BPS) to manage LBP, however there is still no clear consensus regarding the meaning of this model in physiotherapy and how best to apply it. The aim of this study was to investigate how physiotherapy LBP literature enacts the BPS model. MATERIAL AND METHODS: We conducted a critical review using discourse analysis of 66 articles retrieved from the PubMed and Web of Science databases. RESULTS: Analysis suggest that many texts conflated the BPS with the biomedical model [Discourse 1: Conflating the BPS with the biomedical model]. Psychological aspects were almost exclusively conceptualised as cognitive and behavioural [Discourse 2: Cognition, behaviour, yellow flags and rapport]. Social context was rarely mentioned [Discourse 3: Brief and occasional social underpinnings]; and other broader aspects of care such as culture and power dynamics received little attention within the texts [Discourse 4: Expanded aspects of care]. CONCLUSION: Results imply that multiple important factors such as interpersonal or institutional power relations, cultural considerations, ethical, and social aspects of health may not be incorporated into physiotherapy research and practice when working with people with LBP.IMPLICATIONS FOR REHABILITATIONWhen using the biopsychosocial model with patients with low back pain, researchers narrowly focus on biological and cognitive behavioural aspects of the model.Social and broader aspects such as cultural, interpersonal and institutional power dynamics, appear to be neglected by researchers when taking a biopsychosocial approach to the care of patients with low back pain.The biopsychosocial model may be inadequate to address complexities of people with low back pain, and a reworking of the model may be necessary.There is a lack of research conceptualising how physiotherapy applies the biopsychosocial model in research and practice.


Assuntos
Pessoas com Deficiência , Dor Lombar , Humanos , Dor Lombar/psicologia , Dor Lombar/terapia , Modelos Biopsicossociais , Modalidades de Fisioterapia
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