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评估发展中国家公立部门医院医患互动中生物心理社会模型的应用程度。

Assessing the extent of utilization of biopsychosocial model in doctor-patient interaction in public sector hospitals of a developing country.

作者信息

Nadir Maha, Hamza Muhammad, Mehmood Nadir

机构信息

Department of Surgery, Rawalpindi Medical College, Rawalpindi Medical College, Rawalpindi, Pakistan.

Department of Surgery, Benazir Bhutto Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan.

出版信息

Indian J Psychiatry. 2018 Jan-Mar;60(1):103-108. doi: 10.4103/psychiatry.IndianJPsychiatry_153_17.

Abstract

BACKGROUND

Biopsychosocial (BPS) model has been a mainstay in the ideal practice of modern medicine. It is attributed to improve patient care, compliance, and satisfaction and to reduce doctor-patient conflict. The study aimed to understand the importance given to BPS model while conducting routine doctor-patient interactions in public sector hospitals of a developing country where health resources are limited. The study was conducted in Rawalpindi, Pakistan.

MATERIALS AND METHODS

The study design is qualitative. Structured interviews were conducted from 44 patients from surgical and medical units of Benazir Bhutto Hospital and Holy Family Hospital. The questions were formulated based on patient-centered interviewing methods by reviewing the literature on BPS model. The analysis was done thematically using the software NVivo 11 for qualitative data.

RESULTS

The study revealed four emerging themes: (1) Lack of doctor-patient rapport. (2) Utilization of a paternalistic approach during treatment. (3) Utilization of a reductionist biomedical approach during treatment. (4) Patients' concern with their improvement in health and doctor's demeanor.

CONCLUSION

The study highlights the fact that BPS is not given considerable importance while taking routine medical history. This process remains doctor centered and paternalistic. However, patients are more concerned with their improvement in health rather than whether or not they are being provided informational care. Sequential studies will have to be conducted to determine whether this significantly affects patient care and compliance and whether BPS is a workable model in the healthcare system in the third world.

摘要

背景

生物心理社会(BPS)模型一直是现代医学理想实践的支柱。它被认为有助于改善患者护理、依从性和满意度,并减少医患冲突。该研究旨在了解在一个卫生资源有限的发展中国家的公立部门医院进行常规医患互动时,BPS模型所受到的重视程度。该研究在巴基斯坦拉瓦尔品第进行。

材料与方法

该研究设计为定性研究。对来自贝娜齐尔·布托医院和圣家医院外科和内科的44名患者进行了结构化访谈。通过回顾有关BPS模型的文献,基于以患者为中心的访谈方法制定了问题。使用NVivo 11软件对定性数据进行了主题分析。

结果

该研究揭示了四个新出现的主题:(1)医患关系融洽度欠缺。(2)治疗过程中采用家长式方法。(3)治疗过程中采用简化论的生物医学方法。(4)患者对自身健康改善和医生态度的关注。

结论

该研究突出了这样一个事实,即在进行常规病史采集时,BPS模型未得到足够重视。这个过程仍然以医生为中心且具有家长式作风。然而,患者更关心自身健康的改善,而非是否得到了信息性护理。必须进行后续研究,以确定这是否会显著影响患者护理和依从性,以及BPS模型在第三世界医疗保健系统中是否可行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce35/5914237/1711a356121c/IJPsy-60-103-g002.jpg

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