Burkett G L
Department of Family Medicine, East Tennessee State University, Johnson City 37614.
Fam Med. 1991 May-Jun;23(4):287-91.
Family medicine has appropriated the biopsychosocial model as a conceptualization of the systemic interrelationships among the biological, the psychological, and the social in health and illness. For all its strengths, it is questionable whether this model adequately depicts the centrality of culture to the human experience of illness. Culture (as meaning system) is not an optional factor that only sometimes influences health and illness; it is prerequisite for all meaningful human experience, including that of being ill. A more adequate model of the relationship between culture and illness would demonstrate the preeminence of culture in the experience of illness among all people, not just members of "exotic" cultures; would view healers as well as patients as dwellers in culture; would incorporate the role of culture as meaning system in linking body, mind, and world; and would promote the significance of the cultural context as a resource for research and therapy.
家庭医学采用了生物心理社会模型,将其作为对健康与疾病中生物、心理和社会之间系统相互关系的一种概念化表述。尽管该模型有诸多优点,但它是否充分描绘了文化在人类疾病体验中的核心地位仍值得质疑。文化(作为意义系统)并非只是有时影响健康与疾病的一个可选因素;它是包括患病体验在内的所有有意义的人类体验的先决条件。一个更恰当的文化与疾病关系模型将表明,文化在所有人(而非仅仅“异域”文化成员)的疾病体验中具有首要地位;将视治疗者和患者同为文化中的参与者;将纳入文化作为意义系统在连接身体、心理和世界方面的作用;并将提升文化背景作为研究和治疗资源的重要性。