PSYC3020 : Psychology Factors and Health : Bio-Psycho-Social Model of
This module is essential for student development as it is a student-centred module. It will help you take ownership of your learning and recognise the importance of psychosocial context and the effects on health and wellbeing. You will not only develop independent learning skills but also team skills as you will work in groups and present three different triggers throughout the course of the module. By the end of the module you should be confident in presenting and working as part of a group. These skills will be crucial for second and third year.
JIM IS 70 YEARS OLD. He lives on a hOUSING ESTATE IN GLASGOW. He has not worked since the local factory closed thirty years ago. He is a heavy smoker and a regular drinker at his local pub. Yesterday one of his neighbour, a close friend of jim's recently decreased wife, phone social Services to say was worried about him, as his dog was wandering around scavenging for food, and he had not been seen for about a week. He was not answering his door. He has now been admitted to the hospital with an acute chest infection- dirty, smelling of stale cigarettes and whisky, and swearing at everybody .
What is the psycho social issues that may affect jim and influence his current feelings and behaviour? What can you you contribute in your small group discussion on how best to understand jim, and how to help him?
Answer:
Introduction:
In the present generation, the subject of social epidemiology has gained importance in the healthcare industry. The recent shift of treatment approach from the biomedical model of treatment to that of the bio-psycho-social model of treatment has been the main driving force for the application of the subject in health research. Until few years back, healthcare professionals mainly adopted biomedical model of care to develop treatment plan the patients. Here the treatment interventions were only planned focusing mainly on the symptoms so that the patient can overcome the physical disorders. However, in the past decade, biomedical model of care is severely criticised by the researchers as they believe that it results in half hearted treatment and care for the patients. Present day professionals are advised to follow the bio-psycho-social model of care. This model of care not only looks on the biological determinant of health but also takes in consideration of the social as well as psychological determinants of health (Wilkinson and Pickett 2010). This is mainly because all these types of determinants can affect the life equally and therefore only caring about biological determinants may not ensure better quality lives of patients. In the case study, Jim is seen to be severely affected by poor psychological factors that had a massive impact on his health and well-being. The different psychological factors would be discussed in details to understand their impact on the health as well as on healthy aging.
The relationship between unemployment as well as poor health has been seen to be positively correlated with the occurrence of ill health as well as poor quality life. Unemployed individuals are mainly seen to have higher levels of impaired mental health. This includes depression, anxiety, stress as well as higher levels of mental health hospital admissions. They are also seen to suffer from different types of physical and chronic disorders like hypertensions, musco-skeletal disorder as well as cardiovascular disorders. Researchers have conducted studies where they have seen that depression and unemployment are not only correlated but that the higher levels of depression are indeed the result of the unemployment (Jasper 2013). One of the most interest finding of the study has revealed that all unemployed individuals with either less or greater than one year of employment had reported significantly worse perceived mental health scores. When the researchers had taken income, age, gender, education as the different covariates, it was seen that individuals who were unemployed for more than one year had significantly worse scores on mental health. This study has therefore revealed that there is an interconnection between the work status of an individual and that of mental health. This has helped to understand that individuals indeed attach at least some of their self-worth to being productive as well as working members of the society (Levi et al. 2011). One of the most significant effects of unemployment is that it results in development of depression and anxiety among the patients. Such mental health conditions affect the quality of lives of individuals resulting them to suffer hugely in their personal lives. In the case study as well, it can be seen that Jim had remained unemployed for more than 30 years without involving himself into nay productivity activity throughout the years to engage in societal contributions. Therefore, Jim can be considered to be suffering from depression throughout the years where he might have not being able to feel productive to the society and might have felt worthless as an individual. Such feelings might have affected his self-esteem and self-confidence that had in turn made him suffers from different substance abuse disorders. When researchers wanted to examine the main reason for the occurrence of depression due to unemployment, a number of rationales came up in the studies. One of the participants in the study was seen to state boredom to be the main reason for depression while on the other hand there were many individuals who stated that stigmatisation, feeling of rejection and worthlessness were the main reason that would result in development of depression. Many of the participants stated that they felt depressed about how people judged and were worried about future. Therefore, Jim is also expected to have gone through severe phases of depression that had made him to live poor quality life.
Finances is one of the important aspect that has the huge capacity to affect the quality of living of individuals in a society. Lack of finances makes it difficult for the individuals to live healthily both mentally as well as physically. Unemployment may lead to lack of finance in the family that affects different aspects of healthy living. People are seen to fail miserably in eating well and buying basic food as well as household items. Not only that, lack of money and poverty brings stress and worries that create huge pressure on the individuals. Many of the participants had stated that they had to struggle immensely to allocate food for the family and maintain the necessities. Many of the individuals are often seen to take debts that they cannot return and that in turn leads to humiliation in the society or legal obligation (Alcock 2006). All these result in poor mental health condition as well as well-being. Researchers have also found that the poor a financial condition often makes the individuals to stop themselves from socialising that in turn leads them to social exclusion. This tends to affect the mental health condition making them develop depression. Therefore, in case of Jim, it can be stated that lack of employment had made him deprived of financial power. They did not have money to buy food and this could be well understood from the fact that even his dog had been found wandering in search of food. Moreover, he had also excluded himself socially within his house and were not socialising with anyone for past week. This might be due to lack of finance to buy food and other essential necessities of his house (Alcock, Daly and Griggs 2008). Moreover, he might also have the fear of stigmatisation as he had been of low socioeconomic status or many days. Researchers are of the opinion that poverty can be described as the condition that is mainly characterised by the severe deprivation of basic needs like safe drinking water, food, health, shelter, sanitation, information, shelter, education and others. When people do not have access to these different types of essential requirements, they are considered to be living in poverty. This definition can be applied in case of Jim, where it may be related that Jim was found to be dirty which states that he has no proper amenities in his house to maintain personal hygiene. Food could be considered to be absent as this was found wandering in search of food (Barry and Yuill 2012). He has not been out for one entire week that implies he had no fresh fruits, vegetables and other food at his home. Even if he had food, they must have been stale and this could also had negative impacts on his health.
Stress is yet another important aspect of psychosocial trait that remains intricately associated with that of unemployment as well as lack of finance and poverty. Many of the researchers have found out that many of the job centres created stress in the individuals by asking them to do things that were seen to be irrelevant as well as not helpful. Many of the individuals also stated that severe stress occurred when they tried to make financial planning or when they had no money to but urgent necessities of life (Burtis and Turman 2006). Many of the researchers also stated that sitting at homes made many individuals develop stress as they became hopeless that they had no ways to modify their life towards betterment. It might have happened that Jim’s wife would have been supporting him mentally, emotionally as well as financially to an extent and that after her death, there was no one to provide him support. The feeling of loneliness could have also triggered stress in him besides his situation of unemployment and lack of finance. Researchers have found out that burden as well as exertions of a living on a low finance or in unemployed situation, results in various types of biological changes in the body (Cottrell 2016). Researchers are of the opinion that during the times of high wage, bodies of individuals are seen to react by the triggering of different of different stress hormones. These stress hormones can be seen to affect the immune system as well as the cardiovascular systems. This mainly helps the human body to deal with different forms of immediate threats by mainly increasing the heart rate, redirection of blood to the muscles at the same time of heightening anxiety as well as alertness. Similar situations might have also occurred with Jim that had resulted in severe effects on his physical health. Researchers have stated that stress management procedure is a normal procedure by which body reacts to stress but repeated occurrence of such phenomena for too long may damage health (Graham 2009). Symptoms of prolonged and chronic stress may expose individuals to different types of symptoms. This may include depression, diabetes, and increased susceptibility to infection, high cholesterol, and greater risk of heart attack, high blood pressure and even stroke. Researchers have stated that when individuals suffers from co-morbid situations like stress associated living conditions along with poor financial situation, with a bad diet, poor living conditions, individuals become more prone to experience ill health and poor quality life (Jasper 2013). All these symptoms were seen to be present in the case study of Jim that not only shows Jim to be highly stressed but also shows that Jim were living with all the aspects that could expose him to threatening disorders in the future.
Researchers have shown that unemployment is also closely associated with that of excessive substance abuse. The main reason that they have depicted for up taking of such lifestyle and habit is depression and severe stress. Most of the individuals stated that drugs and alcohol helped them to cope with the present situation and to overcome the feeling of excessive pressure and burden on their mental health (Johnson and Johnson 2012). They have stated that they are well aware of the fact that substance misuse had negative effects on their health and hygiene but they were not being able to control themselves and felt helpless. Other individual stated that boredeom, loneliness, isolation as well as feeling worthless were the main reasons for participants who were using substances. Unemployed people are indeed seen to develop the propensity to for consuming higher amount of substance that in deed may have negative impacts on their health. Many of the researchers have found participants stating that drinking of alcohol and addiction to different types of drugs and smoking of cigarettes help in development of “alternate reality” where they become free from any form of stresses (Levi 2011). Substance abuse has been found to have both long terms and short-term effects on the patients. Short-term effects can include different types of changes in appetite, heart rate, wakefulness, mood to heart attack, blood pressure, stroke, overdose, psychosis as well as even death. Long-term effects can include heart as well as lung disorders, mental illness, cancer, hepatitis and many others. Researchers also say that such disorders have the capability to make changes in the brain that ultimately makes this habit to interfere with the how individuals experience normal pleasures in life such as food, sex, ability to learn as well as remember, ability to control stress level as well as their decision making ability (Marmott and Wilkinson 2006). Impulsivity, risk of trauma, violence, injury and many others also can take place. In case of Jim, it can be seen that excessive depression and stress resulting from unemployment, financial insecurity, death of his wife and other factors had made him to take up alcohol disorder as well as excessive smoking.
Chest infections are also associated with the increased habits of smoking as well as drinking. Smoking cigarettes and drinking alcohol increases the risk for getting pneumonia as well as other lung infections. Researchers are of the opinion that drinking of alcohol makes it easier for the bacteria to get into the lungs from the upper tract portion of the nose of individuals. Smoking of cigarettes is also seen to increase the severity of the bacterial penetration. Therefore, researchers are of the opinion that alcoholics who are also seen to smoke are at a higher risk of developing infections of the different types of respiratory tract and consequently many other parts of the body (Marmot 2010). Alcoholics who are also cigarette smokers are seen to be particularly susceptible to pulmonary infections that are caused by S. Pneumonia. Consumption of alcohol is seen to increase the movement of the microorganism towards the lungs and at the same time exposure of smoke is seen to exacerbate the alcohol-induced use of bacterial penetration (Morrison and Benett 2012). Therefore, in case of Jim, it can be stated that he had been an alcoholic and smoker throughout his life and therefore excessive smoking and drinking along with poor hygiene, lack of food, improper maintenance and others have made him exposed to chest infection.
Community based care centres should mainly focus on the different symptoms of substance abuse disorders so that he can come back to normal life overcoming the habits of substance abuse. The first priority would be to develop his ineffective coping abilities with his present situation. Therefore, Jim would be taught to encourage verbalisation of the feelings, fears as well as anxiety and thereby explore different types of coping strategies. Jim should be assisted in learning and thereby encouraging the use of relaxation skills that can be guided by imagery as well as visualisation. The patient should be encouraged involvement in different types of therapeutic writing and many other activities that would help him to overcome his boredom and associate with society effectively (Ogden 2012). The patient may be also suffering from lack of nutrition as he did not have the capability to buy nutritious food and therefore he may lack nutrients as well in his body. Therefore, the professionals should assess the need of specific nutrients in the patient and accordingly develop diet chart plan that would help in developing his physical condition, develop his health and strengthen the immunity system so that infections fail to attack him resulting in poor quality life. The patients may also suffer from low self-esteem due to the different tragedies that had occurred with him. Hence, the professionals can counsel him properly, helping him to verbalise his shame, fear, anger, disappointment and others. In therapeutic communication and relationship, the professionals can empower him and help him to indulge in different social activities so that he can develop his self-esteem (Taylor and Field 2007). Cognitive behavioural therapy can be also applied to him through the help of an expert as this therapy in helpful in treating depression as well as substance abuse disorder and stress. This therapy helps in addressing the harmful thought patterns that help clients to recognise the ability to practice alternative ways of thinking and thereby regulating distressing emotions and harmful behaviour.
From the entire discussion, it s seen from the case study that psychosocial factors like unemployment, poverty, lack of money, loneliness, depression, stress and many other factors can result in poor quality lives. They may lead to taking up of habits like alcohol drinking as well as excessive smoking which altogether can lead to different ill health like chest infections. Therefore, social care workers can help such patients in community-based settings by making capable to cope with situations, develop self-esteem, develop nutrition, and many others. Cognitive behavioural therapy is also helpful.
References:
Alcock, P. (2006) Understanding Poverty. 3rd edn. Basingstoke: Macmillan.
Alcock, C., Daly, G. and Griggs, E. (2008) Introducing Social Policy. 2nd edn. Harlow: Pearson Longman.
Barry, A. and Yuill, C. (2012) Understanding the Sociology of Health. 3rd edn. London: Sage Publications.
Burtis, J. O., and Turman, P. D. (2006) Group communication pitfalls: overcoming barriers to an effective group experience. Thousand Oaks, CA: Sage.
Cottrell, S. (2011) Critical thinking skills: developing effective analysis and argument. Basingstoke: Palgrave Macmillan.
Graham, H. (Ed.) (2009) Understanding Health Inequalities. 2nd edn. Buckingham: Open University Press.
Jasper, M. (2013) Beginning reflective practice. 2nd edn. Nelson Thornes Ltd.
Johnson, D. W. & Johnson, F. P. (2012) Joining together: group theory and group skills. 11th edn. London: Pearson.
Levi, D. (2011) Group Dynamics for Teams. 3rd edn. London: Sage.
Marmot, M. & Wilkinson, R. (2006) Social determinants of health. 2nd edn. Oxford: Oxford University Press.
Marmot, M. (2010) Fair society, health lives: The Marmot Review. London: UCL Institute of Health Equity.
Morrison, V. and Bennett, P. (2012) An introduction to health psychology. Harlow: Pearson Education Ltd.
Ogden, J. (2012) Health Psychology. 5th edn. Maidenhead: Open University Press (This is also available as an EBook).
Taylor, S, and Field, D. (2007) Sociology of Health and Health Care. Blackwell.
Wilkinson, R. & Pickett, K. (2010) The Spirit Level: why greater equality makes societies stronger. New York: Bloomsbury Press. [R]
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