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

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.

Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia

“…On the other hand, avoidance/delay in seeking treatment has been related to dislike or distrust in practitioners and general dislike of medical treatment,29 while greater adherence to treatment is related to clinicians who provide clear information, emotional support and empathy, and treat patients as partners in the process 30 31. Despite the benefits of such a model of physician–patient partnership, within some contexts (especially non-Western Educated Industrialised Rich and Democratic, that is, non-WEIRD), adherence is positively related to obedience and treatment satisfaction 32 33. This suggests that, in certain contexts, patients’ passivity is normalised or even expected, thus making the relation with adherence less clear.…”

“… 30 31 Despite the benefits of such a model of physician–patient partnership, within some contexts (especially non-Western Educated Industrialised Rich and Democratic, that is, non-WEIRD), adherence is positively related to obedience and treatment satisfaction. 32 33 This suggests that, in certain contexts, patients’ passivity is normalised or even expected, thus making the relation with adherence less clear. Furthermore, adherence is consistently related to patients’ trust in the healthcare system and healthcare providers: trusting patients are more likely to adhere to treatment and follow public health recommendations (see Chandra et al 34 for a review).…”

Qualitative research methods in psychiatry in India

“…Most had a mixed-methods approach and limited articles had a purely qualitative methods. [ 13 14 15 16 17 ] Similarly, the papers presented at ANCIPS had few researches using qualitative methodology (1.3%). Analyzing further, it was found that the published articles and conference abstracts showed a rising trend when those from the second half of the decade are compared with the first half.…”

Mental Health and Quality of Life in Patients with Chronic Liver Disease: A Single-Center Structural Equation Model

“…Globally, there is great concern about the lack of support for mental health in patients suffering from CLD [6], and their quality of life [7]. In Pakistan speci cally, there is even greater concern as mental health is not a priority area for the health sector [8], and the 'bio-psycho-social-spiritual model' [9] which is important to secure the quality of life in patients is less understood or integrated in the health system [10]. It is thus that patients holistic care with regard to integrated and multidimensional care including clinical attention, social support, and spiritual wellbeing are less considered.…”