A Biopsychosocial Model to Complement a Biomedical Model: Patient Questionnaire Data and Socioeconomic Status Usually Are More Significant than Laboratory Tests and Imaging Studies in Prognosis of Rheumatoid Arthritis

McCollum, Lauren; Pincus, Theodore

doi:10.1016/j.rdc.2009.10.003

Cited by 37 publications

(31 citation statements)

References 28 publications

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“…Lower SEP confers increased risk of morbidity and mortality. Subsequent studies have also associated SEP with poorer outcomes in cancer, autoimmune disease, and psychological disease [88][89][90][91].…”

Section: Socioeconomic Positionmentioning

confidence: 99%

Systematic Review of the Evidence of a Relationship Between Chronic Psychosocial Stress and C-Reactive Protein

2013

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Section: Socioeconomic Positionmentioning

confidence: 99%

Systematic Review of the Evidence of a Relationship Between Chronic Psychosocial Stress and C-Reactive Protein

2013

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“…Grace [9] To investigate the nature of diagnosisrelated problems and treatmentrelated problems that women with CPP experience at health care facilities Women with endometriosis and CPP, with or without other associated diseases…”

Section: Studymentioning

confidence: 99%

“…This ineffectiveness in treating CPP seems to be partially responsible for the dissatisfaction and frustration of patients and health professionals, as well as for conflicts between them. In addition, although several countries have adopted the biopsychosocial model and the psychosomatic approach, modern medical care is still based largely on a paradigm known as the biomedical model [9], on which medical training in Brazil is currently based. This has dichotomized the physical and psychological aspects of health care.…”

Section: Introductionmentioning

confidence: 99%

Qualitative research as the basis for a biopsychosocial approach to women with chronic pelvic pain

Souza

Romão

Silva

et al. 2011

Journal of Psychosomatic Obstetrics & Gynecology

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Chronic pelvic pain (CPP) is a highly prevalent clinical condition and is recognized as a public health problem. Although the number of qualitative studies related to the topic is increasing, it is essential that this knowledge be presented in a synthesized manner, grounded in the context of the care provided to patients with CPP, in order to increase the clinical and research applicability of the findings. Little attention is given to CPP in undergraduate courses and in meetings for the continuing education of health professionals, the approach to CPP typically being based on the biomedical model. We believe that qualitative research can provide insights into CPP and form the basis for a biopsychosocial approach to the condition, which can in turn lead to better results, including resolution of the pain and greater patient/health professional satisfaction. Therefore, we conducted a metasynthesis of seven qualitative studies of CPP, the principal themes of which were as follows: (a) coping with CPP versus secondary gain; (b) the great importance of determining the cause of the pain; (c) expectations regarding the doctor-patient relationship; and (d) gender issues. We hope that the present study can aid in restoring the humanistic aspects of CPP treatment.

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“…A complementary "biopsychosocial model" to overcome some limitations of a biomedical model A "biopsychosocial model" provides a complementary view of health and disease to a biomedical model (Table 1) [1,5]. In a biopsychosocial model, disease etiology and severity are regarded as multifactorial, resulting from external pathogens, toxins, host genes, dysregulatory processes, psycho-socio-economic variables, behaviors, and social support, rather than a "reductionist" single "cause."…”

Section: ) Some Limitations Of Clinical Trials In Ramentioning

confidence: 99%

“…This review article updates evidence concerning the value of a biopsychosocial model to complement a traditional biomedical model in care of patients with RA, with emphasis on "scientific" data from patient self-report questionnaires, particularly a multidimensional health assessment questionnaire (MDHAQ) [3][4][5][6][7][8][9]. The article is divided into three sections concerning: a) limitations of a biomedical model in RA; b) a biopsychosocial model in RA, incorporating patient history data recorded on an MDHAQ and other patient questionnaires as complementary to a biomedical model; c) patient questionnaire data which support a biopsychosocial model concerning prognosis, course and outcomes of RA.…”

Section: Introductionmentioning

confidence: 99%

Evidence from a Multidimensional Health Assessment Questionnaire (MDHAQ) of the Value of a Biopsychosocial Model to Complement a Traditional Biomedical Model in Care of Patients with Rheumatoid Arthritis

2016

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Patient self-report questionnaires such as a multidimensional health assessment questionnaire (MDHAQ) have advanced knowledge concerning prognosis, care, course and outcomes of rheumatoid arthritis (RA). The MDHAQ may overcome some limitations of a "biomedical model," the dominant paradigm of contemporary medical services, including limitations of laboratory tests, radiographs, joint counts, and clinical trials, to predict and depict the long-term course and outcomes of RA. A complementary "biopsychosocial model" captures components of a patient medical history on patient questionnaires as quantitative, standard, "scientific" scores for physical function, pain, fatigue, and other problems, rather than as "subjective" narrative descriptions. A rationale for a biopsychosocial model in RA includes the importance of a patient history in diagnosis and management compared to biomarkers in many chronic diseases such as hypertension and diabetes. Some important observations which support a biopsychosocial model in RA based on patient questionnaires include that MDHAQ physical function scores are far more significant than radiographs or laboratory tests to predict severe RA outcomes such as work disability and premature death; patient self-report measures are more efficient than tender joint counts and laboratory tests to distinguish active from control treatments in RA clinical trials involving biological agents; and MDHAQ scores are more likely than laboratory tests to be abnormal at presentation and to document incomplete responses to methotrexate at initiation of biological agents.

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A Biopsychosocial Model to Complement a Biomedical Model: Patient Questionnaire Data and Socioeconomic Status Usually Are More Significant than Laboratory Tests and Imaging Studies in Prognosis of Rheumatoid Arthritis

Cited by 37 publications

References 28 publications

Systematic Review of the Evidence of a Relationship Between Chronic Psychosocial Stress and C-Reactive Protein

Systematic Review of the Evidence of a Relationship Between Chronic Psychosocial Stress and C-Reactive Protein

Qualitative research as the basis for a biopsychosocial approach to women with chronic pelvic pain

Evidence from a Multidimensional Health Assessment Questionnaire (MDHAQ) of the Value of a Biopsychosocial Model to Complement a Traditional Biomedical Model in Care of Patients with Rheumatoid Arthritis

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