Xiao Xiaohua, Song Haidong, Sang Tian, Wu Zhihua, Xie Ying, Yang Qian
School of Public Health, The Children's Hospital, and National Clinical Research Center for Child Health, School of Medicine, Zhejiang University, Hangzhou, China.
Affiliated Mental Health Center Zhejiang University School of Medicine (Hangzhou Seventh People's Hospital), The 4th Clinical College of Zhejiang Chinese Medical University, Hangzhou, China.
Front Psychiatry. 2021 Oct 26;12:725596. doi: 10.3389/fpsyt.2021.725596. eCollection 2021.
The modern medical model has been transformed into a biopsychosocial model. The integration of the biopsychosocial approach in healthcare can help improve the effectiveness of diagnosis and treatment. This study explored the actual application of the biopsychosocial approach in healthcare and provides a basis for targeted interventions to promote the biopsychosocial approach in healthcare. Study 1 involved one-on-one interviews with 30 medical staff and focus group interviews with 16 recent patients. Study 2 was a cross-sectional survey of 13,105 medical staff in Hangzhou, China that analyzed the status quo implementation of the biopsychosocial approach in healthcare. Study 1 found that medical staff did not welcome patients to report information unrelated to their disease, hoping patients did not express their emotions. In the treatment process, patients believed that medical staff refused to attend to or did not encourage reporting of any information other than the disease, and that patients should have reasonable expectations for medical staff. Study 2 found that medical staff had a 37.5% probability of actively paying attention to the patient's psychosocial status. Female medical staff (38.5%) were actively concerned about the patient's psychosocial status significantly more than male medical staff (34.2%) ( < 0.01). The medical staff in the psychiatric department (58.4%) paid more active attention to the patient's psychosocial status than staff in the non-psychiatric departments (37.2%). Gender, department, hospital level, and professional title were the factors associated with the medical staff's attention to the patient's psychosocial status ( < 0.05). The influence of age on the probability of medical staff actively paying attention to the psychosocial status of patients increased with the number of years of employment. Participants that were 31-40 years old, had an intermediate professional title, and 11-15 years of employment were the least likely to actively pay attention to patients' psychosocial status. Although the biopsychosocial approach has been popularized for many years, it has not been widely used in medical care. Medical staff pay more attention to patients' physical symptoms and less attention to patients' psychosocial status. It is recommended that training will be provided to medical personnel on implementing a biopsychosocial approach with particular attention to the sociodemographic characteristics of medical personnel. Additionally, we propose helping patients set reasonable expectations, and formulating guidelines for implementing the biopsychosocial approach.
现代医学模式已转变为生物心理社会模式。将生物心理社会方法融入医疗保健中有助于提高诊断和治疗的有效性。本研究探讨了生物心理社会方法在医疗保健中的实际应用，并为有针对性的干预措施提供依据，以促进生物心理社会方法在医疗保健中的应用。研究1对30名医务人员进行了一对一访谈，并对16名近期患者进行了焦点小组访谈。研究2是对中国杭州13105名医务人员的横断面调查，分析了生物心理社会方法在医疗保健中的实施现状。研究1发现，医务人员不欢迎患者报告与疾病无关的信息，希望患者不要表达情绪。在治疗过程中，患者认为医务人员拒绝关注或不鼓励报告除疾病之外的任何信息，并且患者应该对医务人员有合理的期望。研究2发现，医务人员主动关注患者心理社会状况的概率为37.5%。女性医务人员（38.5%）比男性医务人员（34.2%）更积极关注患者的心理社会状况（<0.01）。精神科医务人员（58.4%）比非精神科医务人员（37.2%）更积极关注患者的心理社会状况。性别、科室、医院级别和职称是与医务人员对患者心理社会状况的关注相关的因素（<0.05）。年龄对医务人员主动关注患者心理社会状况概率的影响随着工作年限的增加而增加。31至40岁、具有中级职称且工作11至15年的参与者最不可能主动关注患者的心理社会状况。尽管生物心理社会方法已经推广多年，但在医疗护理中尚未得到广泛应用。医务人员更关注患者的身体症状，而对患者的心理社会状况关注较少。建议针对医务人员实施生物心理社会方法提供培训，尤其要关注医务人员的社会人口学特征。此外，我们建议帮助患者设定合理期望，并制定实施生物心理社会方法的指南。
