BP103T Unit 1 – Fundamentals of Communication in Healthcare
Unit 1 explores the behavioral and psychological determinants of human health. It contrasts the traditional reductionist Biomedical Model with Engel's holistic Biopsychosocial Model, analyzes Talcott Parsons' Sick Role concept, explores illness perceptions, and details the Health Belief Model (HBM) for predicting medication adherence.
📋 Prescribed Syllabus Topics
📖 Detailed Lecture Notes & Solved Examples
11. The Biomedical Model vs. Engel's Biopsychosocial Model
Dedicated Webpage➔The traditional Biomedical Model viewed human disease purely through a mechanistic, reductionist lens — defining illness solely as biological pathology, pathogen invasion, or biochemical malfunction treatable strictly with physical interventions. In 1977, psychiatrist George Engel introduced the Biopsychosocial Model, recognizing that health and recovery result from dynamic, reciprocal interactions among three distinct domains: Biological factors (genetics, viruses, neurochemistry), Psychological factors (emotions, coping styles, health beliefs, stress levels), and Social factors (socioeconomic status, family dynamics, cultural background, healthcare access). In pharmacy, understanding this model explains why two patients with identical hypertension diagnoses may have vastly different medication compliance rates based on psychological anxiety or economic constraints.Purana Biomedical model sirf bimari, bacteria aur organs ke kharab hone ko dekhta tha. 1977 me George Engel ne Biopsychosocial Model diya jo batata hai ki bimari aur ilaaj me 3 cheezein judi hain: (1) Biological (shareer aur genes), (2) Psychological (marij ka darr, stress, aur vishwas), aur (3) Social (garibi, parivar, aur paise ki kami). Is model se pharmacist samajh pata hai ki sugar ka marij dawai kyu miss kar raha hai.
▶Clinical Application: Managing a Non-Compliant Diabetic Patient
Evaluating a 52-year-old patient with uncontrolled HbA1c (9.2%) using both models.
| Dimension | Biomedical Model | Biopsychosocial Model (Holistic) |
|---|---|---|
| Etiology of Disease | Purely biological (bacteria, biochemical lesions, gene mutations) | Complex interplay of biological, cognitive, behavioral, and social factors |
| Role of Patient | Passive recipient of curative treatments | Active partner in disease self-management and decision making |
| Treatment Focus | Targeted drugs, surgery, physical eradication of symptoms | Pharmacotherapy combined with behavioral lifestyle modification and psychological support |
| Health Definition | Mere absence of biological disease or infirmity | Complete state of physical, mental, and social well-being (WHO standard) |
- •Biomedical Model: Reductionist, dualistic (separates mind and body), views patient as passive recipient of medical interventions.
- •Biopsychosocial Model: Holistic, systems-based, emphasizes patient-centered care and psychological resilience.
- •Health Psychology: Investigates how cognitive beliefs, emotions, and behavioral habits influence physical wellness and disease progression.
22. Illness Behaviour & Talcott Parsons' Sick Role Concept
Dedicated Webpage➔Illness Behaviour describes the manner in which individuals monitor their physiological states, interpret bodily symptoms, give them cognitive meaning, and decide whether to take remedial action or seek professional medical advice. Sociologist Talcott Parsons formulated the sociological concept of the 'Sick Role' (1951), asserting that being ill is not just a physiological condition, but a socially sanctioned social role carrying specific institutionalized rights (exemptions) and obligations (duties).Talcott Parsons ka 'Sick Role' batata hai ki bimaar insaan ko samaj me 2 adhikaar milte hain: (1) Rozmarra ke kaam ya office se chhutti milna, aur (2) Bimaari ke liye use doshi na thehrana. Lekin uske 2 kartavya bhi hain: (1) Jaldi theek hone ki ichha rakhna, aur (2) Doctor aur Pharmacist ki salah manna aur poori dawai lena.
▶The Four Tenets of Talcott Parsons' Sick Role
Structural rights and duties governing patient behavior in society.
- •Secondary Gain: Unconscious psychological or financial benefits derived from remaining in the sick role (e.g., disability compensation, increased family attention).
- •Malingering: Conscious, intentional fabrication of physical symptoms for tangible external gain.
- •Factors influencing symptom appraisal: Symptom visibility, perceived severity, fear of diagnosis, and socioeconomic cost of seeking care.
33. The Health Belief Model (HBM) & Predicting Medication Adherence
Dedicated Webpage➔Developed in the 1950s by social psychologists at the US Public Health Service (Rosenstock, Becker), the Health Belief Model (HBM) is a psychological cognitive framework used to explain and predict individual health-related behaviors and medication compliance. It posits that a patient will engage in health-promoting actions (e.g., taking antihypertensive pills daily) if they perceive themselves as vulnerable to a severe condition and believe the benefits of treatment outweigh barriers.Health Belief Model (HBM) se pata chalta hai ki patient dawai kyu khayega. Jab use lagega ki: (1) Use bimari ho sakti hai (Susceptibility), (2) Bimari bohot khatarnaak hai (Severity), (3) Dawai khane se jaan bachegi (Benefits), aur (4) Dawai ke kharche/side effects se bachne ke upaay hain (Overcoming Barriers), tabhi wo regular dawai lega.
▶Deconstruction of HBM Core Constructs in Chronic Hypertension
How a pharmacist uses HBM constructs to guide patient adherence.
| HBM Construct | Psychological Definition | Pharmacy Counseling Strategy |
|---|---|---|
| Perceived Susceptibility | Belief regarding vulnerability to contracting a disease | Explain asymptomatic progression of chronic disorders (e.g. silent hypertension) |
| Perceived Severity | Belief regarding seriousness of consequences if untreated | Explain long-term risks (e.g., diabetic retinopathy, nephropathy, myocardial infarction) |
| Perceived Benefits | Belief in efficacy of prescribed drug therapy | Present clinical trial evidence showing reduced hospitalization and extended longevity |
| Perceived Barriers | Belief about tangible costs, side effects, and hassles | Suggest lower-cost generic alternatives, manage side effects, simplify dosing regimens |
| Self-Efficacy | Confidence in one's personal ability to follow instructions | Provide step-by-step demonstrations for inhalers/insulin pens to build patient mastery |
- •Perceived Threat = Perceived Susceptibility $\times$ Perceived Severity.
- •Net Behavioral Likelihood = Perceived Benefits $-$ Perceived Barriers.
- •Self-Efficacy (Bandura): The conviction that one can successfully execute the behavior required to produce desired outcomes.
- •Cues to Action: Internal bodily triggers (chest pain) or external reminders (prescription refill alerts) that activate the health behavior.
- In university 10-mark questions, draw the complete schematic diagram of the Health Belief Model showing Perceived Threat, Modifying Factors, Cues to Action, and Likelihood of Action.
- State the 2 rights and 2 duties of Talcott Parsons' Sick Role.