Discussion Response #2: Applying Biopsychosocial Science to Improve Patient Quality of Care

Respond to the discussion #2 below using the following approach:

Ask a probing question, substantiated with additional background information, evidence, or research.

Share an insight from having read your colleagues' postings, synthesizing the information to provide new perspectives.

Validate an idea with your own experience and additional research.

According to Engel (2012), the "BPS [Biopsychosocial] model is an interdisciplinary model that assumes that health and wellness are caused by a complex interaction of biological, psychological, and sociocultural factors" (para. 1). Psychological factors of health include issues with self control or emotions while social factors include socioeconomic status, culture, and poverty, and biological components of health include pathogens that cause illness (Engel, 2012).

Healthcare providers must consider all three components of health when caring for their patients in order to provide high quality care. Throughout this discussion, biopsychosocial strategies to improve the quality of care for patients, the family, and the community will be discussed.

Strategy for the patient

A strategy to improve the quality of care for the patient includes providing patient-centered care. According to Sanders, Foster, Bishop, and Nio Ong (2013), healthcare providers must care for the whole person in context of their values and position in the community. These authors further state that it is imperative for healthcare providers to make decisions collaboratively with patients and consider a range of therapeutic interventions that align with the patient's social and psychological factors as well as the biological factors of their health.

Providing patient-centered care requires the health care provider to identify the patient's psychosocial obstacles to recovery, acknowledge the patient's concerns, and structure communication with patients in a manner that aligns with the patient's values (Sanders et al., 2013). For example, medication use is affected by the patient's emotions, self-regulation skills, how their practitioner supports them, and the patient's perceived ability to pay for them (Suls, Krantz, & Williams, 2013). Medications are only effective for as long as a patient takes them. Therefore, healthcare providers must collaborate with the patient when choosing the appropriate treatment for each patient considering the patient's biological, psychological, and social components of health.

In my practicum setting, a patient presented to the clinic for a follow-up appointment regarding her diabetes. She had been seen by an endocrinologist because her blood sugars were out of control and she was at the maximum dosage of metformin. The endocrinologist prescribed trulicity for this patient. When my preceptor asked if the patient was taking this medication, the patient replied that she was not taking it because she did not know how to use it, and her insurance sent her a letter stating the company was no longer going to pay for this particular medication.

My preceptor provided patient-centered care in understanding the patient's comfort level with giving herself injections by providing the patient education in how to use the medication. My preceptor then told her that if she had any additional questions, she could call the clinic or report to her pharmacy. My preceptor also addressed the patient's perceived ability to pay for the medication by instructing the patient to call the endocrinologist to see if there was a similar medication that could be used in the place of trulicity.

Strategy for the family

Another biopsychosocial strategy that can be used to improve the quality of care a patient receives is providing family-centered care. According to Rawson and Moretz (2016), family is identified as close blood relatives, a spouse or same-sex partner, and/or a group of friends. Family is considered a social component of a patient's health and can have a great influence on the health of the patient. Family members have valuable input and can be educated to be effective partners in the care of the patient (Rawson & Moretz, 2016).

Health care providers must consider the family member's values, beliefs, and needs in the context of the patient's care. According to Harrison Dening and Hibberd (2016), providing family-centered care can help clarify issues and provide structure to help unite families while still recognizing the patient's individual values. This helps reduce conflict and improve relationships within the family, which according to the biopsychosocial model, improves the health of the patient.

In the clinic in which I am completing my practicum, a young adult with a history of hypoplastic heart syndrome and asthma presented to the clinic with his mother. My preceptor provided family-centered care by acknowledging the patient's mother and allowing both the patient and his mother to provide input throughout the appointment. In doing this, she maintained high quality relationships between all involved, which in turn, helps improve the health of the patient.

Strategy for the community

In regards to the community, a biopsychosocial strategy that can be used to improve the health of the community is ensuring there are spaces for community members to gather where health information and biopsychosocial support can be provided to them at the community level (Maylan, Carey, Blackburn, Hayes, & Robinson, 2013). According to Maylan et al. (2013), such community gathering spaces are areas in which community members can gather to meet and enjoy each other's company, provide a sense of belonging, and provide a place to go to be occupied.

The interaction amongst community members addresses both social and psychological components of health, which according to the biopsychosocial model, improves the biological health of people as well. Healthcare providers can take advantage of these community gathering areas to provide health information about common health issues and needs within the community (Bath, Trask, McCrosky, & Lawson, 2014).

Conclusion

According to the biopsychosocial model, all three components of health- the biological, psychological, and social- contribute to the overall health of an individual. As healthcare providers, it is important to consider all of these components when providing care to patients. Many strategies can be used to improve the quality of health for patients, families, and the community. Such strategies include patient-centered care, family-centered care, and providing gathering places in the community where community members can meet and receive health information. Employing such strategies not only improves the health of individuals but the community in which the care is provided as well.

Resources

Bath, B., Trask, C., McCrosky, J., & Lawson, J. (2014). A biopsychosocial profile of adult Canadians with and without chronic back disorders: A population-based analysis of the 2009-2010 Canadian community health surveys. BioMed Research International, 2014, 1-11. doi: 10.1155/2014/919621

Engel, G.L. (2012). Biopsychosocial model. Retrieved January 1, 2017, fromhttp://nursingplanet.com/theory/biopsychosocial_model.html

Harrison Dening, K. & Hibberd, P. (2016). Exploring the community nurse role in family-centred care for patients with dementia. British Journal of Community Nursing, 21(4), 198-202. Retrieved from http://www.magonlinelibrary.com/journal/bjcn

Maylan, M.M., Carey, L.B., Blackburn, R., Hayes, R., Robinson, P. (2013). The men's shed: Providing biopsychosocial spiritual support. Journal of Religious Health, 54, 221-234. doi: 10.1007/s10943-013-9804-0

Rawson, J.V. & Moretz, J. (2016). Patinet- and family-centered care: A primer. Journal of the American College of Radiology, 13(12), 1544-1549. doi: 10.1016/j.jacr.2016.09.003

Sanders, T., Foster, N.E., Bishop, A., & Nio Ong, B. (2013). Biopsychosocial care and the physiotherapy encounter: Physiotherapists' accounts of back pain consultations. BMC Musculoskeletal Disorders, 14(1), 65. doi:10.1186/1471-2474-14-65

Suls, J., Krantz, D.S., & Williams, G.C. (2013). Three strategies for bridging different levels of analysis and embracing the biopsychosocial model. Health Psychology, 32(5), 597-601. doi: 10.1037/a0031197

Reminder:

1. 1 page only

2. Put Citations in APA format and at least 3 references... Articles must be 2011 to 2016.

Required Readings

Benner, P., Tanner, C., & Chesla, C. (2009). Expertise in nursing practice: Caring, clinical judgment, and ethics (2nd ed.). New York, NY: Springer.
· Chapter 4, "Proficiency: A Transition to Expertise" (pp. 103-135)

The authors continue to present the stages of nursing practice development by outlining the characteristics of proficiency and how the leap from competent to proficient nursing is transformative in six major ways. As with the previous stages, consider this process from your own experience and observation of nurses in your practicum setting.

· Chapter 5, "Expert Practice" (pp. 137-169)

This chapter completes the presentation of the stages of nursing practice. As you read, bring to mind expert nurses in your specialty area of interest and characteristics of their skilled performance.

Dreyfus, H. L., & Dreyfus, S. E. (2009). The relationship of theory and practice in the acquisition of skill. In P. Benner, C. Tanner, & C Chesla, Expertise in nursing practice: Caring, clinical judgment, and ethics (2nd ed., pp. 1-23). New York, NY: Springer.

· Chapter 1 is one of three chapters in Expertise in Nursing Practice written by contributors other than the authors. Hubert and Stuart Dreyfus are brothers who have developed a model of skill acquisition. In this chapter they explain their model and its five stages-novice, advanced beginner, competence, proficient, and expert- and its application and implications for development of nursing practice.

Note the conclusion that experiential learning is essential for progressing from novice to expert in any field and consider how this practicum may advance your nursing practice.

Engel, G. L. (2012). Biopsychosocial model. Retrieved from

http://nursingplanet.com/theory/biopsychosocial_model.html

This brief presentation explains the concept of the biopsychosocial model-how physical, psychological, and social factors interplay in both the development and treatment of disease.