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循证、以患者为中心的方法使心理社会生物医学模式具有科学性。

An evidence-based patient-centered method makes the biopsychosocial model scientific.

机构信息

Departments of Medicine and Psychiatry, Michigan State University College of Human Medicine, East Lansing, MI, USA.

出版信息

Patient Educ Couns. 2013 Jun;91(3):265-70. doi: 10.1016/j.pec.2012.12.010. Epub 2013 Jan 23.

Abstract

OBJECTIVE

To review the scientific status of the biopsychosocial (BPS) model and to propose a way to improve it.

DISCUSSION

Engel's BPS model added patients' psychological and social health concerns to the highly successful biomedical model. He proposed that the BPS model could make medicine more scientific, but its use in education, clinical care, and, especially, research remains minimal. Many aver correctly that the present model cannot be defined in a consistent way for the individual patient, making it untestable and non-scientific. This stems from not obtaining relevant BPS data systematically, where one interviewer obtains the same information another would. Recent research by two of the authors has produced similar patient-centered interviewing methods that are repeatable and elicit just the relevant patient information needed to define the model at each visit. We propose that the field adopt these evidence-based methods as the standard for identifying the BPS model.

CONCLUSION

Identifying a scientific BPS model in each patient with an agreed-upon, evidence-based patient-centered interviewing method can produce a quantum leap ahead in both research and teaching.

PRACTICE IMPLICATIONS

A scientific BPS model can give us more confidence in being humanistic. In research, we can conduct more rigorous studies to inform better practices.

摘要

目的

回顾生物心理社会(BPS)模型的科学现状,并提出改进方法。

讨论

恩格尔的 BPS 模型将患者的心理和社会健康问题纳入到高度成功的生物医学模型中。他提出 BPS 模型可以使医学更科学,但它在教育、临床护理,特别是研究中的应用仍然很少。许多人正确地指出,目前的模型不能以一致的方式为个体患者定义,使其无法测试和不科学。这源于没有系统地获得相关的 BPS 数据,同一个访谈者获得的信息与另一个访谈者获得的信息不同。作者中的两位最近的研究提出了类似的以患者为中心的访谈方法,这些方法具有可重复性,并能引出每次就诊时定义模型所需的相关患者信息。我们建议该领域采用这些基于证据的方法作为识别 BPS 模型的标准。

结论

使用经过验证的、以患者为中心的访谈方法为每个患者确定科学的 BPS 模型,可以在研究和教学方面取得巨大飞跃。

实践意义

科学的 BPS 模型可以使我们对人文关怀更有信心。在研究中,我们可以进行更严格的研究,以提供更好的实践指导。

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