NUR015-1 Health And Well-Being

Introduction:

In this essay, Schizophrenia is being discussed based on the biopsychosocial model. Schizophrenic patient Mr. A usually is not aware of the reality. Schizophrenic patient like Mr. A is associated with distorted mind, disorganized perceptions, or withdrawn emotions which indicates bizarre behaviour. Schizophrenic patient Mr. A exhibits both positive and negative symptoms and it include hallucinations, delusions, disorganization, abnormal movements, restricted emotional expression, avolition, impaired cognition, depression, and mania. Biological characteristics can be helpful in partial prognosis of the Schizophrenia. Comprehensive prognosis can be achieved by considering nature of the disorder, psychological and psychosocial characteristics. Biopsychosocial model is not only a conceptual model but it is also helpful in providing care to the Schizophrenia at each level (Seidman et al., 2012).

Phrenologists, 200 years ago raised question regarding localization of functions of brain. Later, research established localization of function of cortex. Studies established that Schizophrenia and related mental disorders can occur dur to abnormal functioning and abnormal structures of localized units of brain (Murakami et al., 2011). From the research studies in past ten years, it is evident that structural abnormalities of the brain are mainly responsible for the Schizophrenia. Structural abnormalities are mainly responsible for the occurrence of negative symptoms of Schizophrenia. Ventricles are the brain cavities which contain cerebrospinal fluid. In patients with Schizophrenia, these ventricles get enlarged. In another studies, it is evident that Schizophrenia is associated with the abnormal structures of other brain regions like hippocampus, amygdala, and thalamus. There can also be physiological changes in nervous system in Mr. A. Murakami et al. (2011) established that Schizophrenic patients had significantly reduced hippocampal volume in comparison to the healthy individuals. This reduced hippocampal volume occurs in only earlier stage of the disease and not in the chronic stage of the disease (Comer, 2010). Pinkham (2012) demonstrated that in Schizophrenia there is altered and aberrant brain response to the neural network associated with the cognition-emotion interaction. Impairment and alteration in the goal-directed behaviour of the Mr. A occurs due to neurophysiological alterations in brain networks related to the cognitive procession over emotional processing. Even though, Schizophrenia is associated with physical and physiological alterations of the identified brain regions, Schizophrenia research should not be restricted to these regions. Other regions need to be explored to establish altered brain region and behavioural variability of Mr. A. More research need to be carried out to understand psychological phenomenon of Schizophrenia from the point of view of alterations in the whole brain disturbances (van den Heuvel and Fornito, 2014).

Biomedical model used to study Mr.A include study of Schizophrenia by emphasizing person’s biological factors which include genetic materials and physiological functions and structure. Risk factors of the Mr. A need to be studied based on the different factors like history, social association, lifestyle, personality, mental status and biological alterations. Hence, biopsychosocial model established as the replacement for the biomedical model for addressing holistic aspects of biological, psychological, and social systems. All these holistic aspects are interconnected with each other and these can influence functioning of each other (Solli and Barbosa, 2012).

According to the biopsychosocial model, aspects of Schizophrenia like abnormal behaviour and mental disorder can be studied and understood by considering combined biological, psychological, and sociocultural aspects of Schizophrenia patient instead of considering these aspects in isolation. Biopsychosocial model also states that for the treatment of these Mr. A also all these aspects need to be considered in combination. Biopsychosocial theories were developed and were being implemented based on this integration concept of biopsychosocial model. From the studies, it is evident that physical, physiological, mental and psychological abnormality develop in Mr. A due to interaction among different factors like genetic, biological, developmental, emotional, behavioral, cognitive, social, cultural, and societal influences (Toates, 2011).

According to biopsychosocial model, interplay and interaction of biological, psychological, and social aspects of people’s day to day life can produce adverse effect on the health of the person and consequently it can lead to illness. Biopsychological model can be considered as the extension of the biomedical model. In biopsychological model, individual’s background need to be added to the biomedical perspective. Hence, it can be helpful in understanding different and broader picture of individual’s health and illness with link of biological factors to psychological and social factors. In biopsychosocial model all three factors like biological, psychological and social have importance and these factors can interact with individual’s health and interact with it (Sarafino and Smith, 2012).

Psychology deals with the study of people, mind and behaviour. Based on the capability to think, feel and interact on individual basis or in group, psychology can be helpful in the developing solutions for the social issues. According to public health theory and practice, both heath psychology and social psychology are relevant to Mr. A. Health psychology deals with the individual’s altered attitudes, beliefs and behaviours about health and social psychology is associated with the behaviour of individuals and groups in relation to the broader societies. Health psychology also include models and theories to predict and enable behaviour change (Pomerantz, 2011). Health and illness of an individual depends on capability to cope with stresses necessary for stability and cooperation within the modern society. Society comprises of biological organism which is made up of interconnected and integrated parts. This integration mainly occurs due to core values and norms. Structuring of the human behaviour is essential for establishing sick role and associated issue of illness behaviour. Hence, illness can be considered as the social phenomenon instead of merely physical condition.

Biopsychological model can be used as teaching model to teach both biological and psychological aspects of Mr. A. It can be helpful in eliminating stigma associated with the mental health. Usually mentally ill patients, doesn’t consider mental illness as pathological event. In such scenario, biopsychosocial model can be helpful in convincing patient about pathological manifestations of the psychological issues. It can be helpful in improving willingness of Mr. A to seek medical advice. Society also doesn’t consider abnormal behaviour as the disease and doesn’t realize its impact on the society. Social awareness can be improved about the impact of abnormal behaviour of Mr. A on society. Both social setting and medical setting need to be implemented for promoting and providing intervention to the Mr. A (Lalla and Arshoff, 2013).

Awareness need to be improved for the impact of geosocial, religiosoical and econosocial aspects on the severity of the Schizophrenia. Also, awareness need to be improved about impact of  geosocial, religiosoical and econosocial aspects on outcome of biopsychosocial intervention implemented for Mr. A. Psychosocial history need to be effectively used for severity of Schizophrenia and providing relevant intervention. Biopsychosocioculturogeoethnicspiritual model can be effectively used for the health promotion to individual patient like Mr. A, group or society associated with the Schizophrenia (Tavakoli, 2009). For the promotion of the psychiatric conditions, psychiatry need to be considered similar to the other medical condition and all the steps need to be followed effectively. These steps include use of historical data, medical examination, diagnosis and treatment plan (O’Brien et al., 2014). Health promotion for the Schizophrenia patient like Mr. A can be achieved by different perspectives like The disease perspective: what a patient has; The dimensional perspective: what a patient is; The life story perspective: what a patient encounters and The behavioral perspective: what a patient does. Consideration of these different perspectives is important because these perspectives changes for each patient. Schizophrenia patients, their family members and society members need to learn about the schizophrenia, coping with symptoms of schizophrenia, and communication and social relationships. Health education programme for Mr. A and family members need to be developed based on different aspects like degree of family relationship, educational level and income level. Physical health need to be promoted in Mr. A to prevent other complications like cardiometabolic risk factors. Counselling need to be given to the Mr. A to avoid development of stigma related to mental illness. Advice regarding medication consumption need to be given Schizophrenic patient because most of the anti-psychotic drugs are associated with the adverse drug events (Smeerdijk et al., 2015; Smeerdijk et al., 2014).

From the research, it is evident that prevalence of mental illness is higher in physically ill patients and vice versa. In indicate, there is strong interaction between physical and psychological aspects. In recent times, there is increase in the gap between people with mental and physical illness and people without illness. Absence of either physical, psychological or both illness can improve overall health and wellbeing of the Schizophrenia patient (Soundy et al., 2014). Interaction between the physical and psychological health depends on the relationship between the lifestyle choices and social interaction. Unhealthy lifestyle can lead to stress which can adversely affect physiology and physical health. In turn, it leads to social isolation and it adversely affects overall wellbeing of the Schizophrenia patient. Physical activity and physical health are most important aspects for psychological health and its most prominent effect is evident in patients with older age. Even though, there is strong link between the physical and psychological health, specific pathways were not being established between physical and psychological. Hence, more research need to be carried out to establish pathway directed relationship between the physical and psychological health (Rastad et al., 2014).

Assessment of physical and psychological health need to be carried out simultaneously. Physical health can be assessed using activities of daily living (ADL) and psychological health can be assessed using depression and behavioural scale. Simultaneous assessment can be helpful in the assessing interaction between physical and psychological health. Social interaction can have positive effect on both physical and psychological health of the patient. Social interaction can establish positive social ties, good health behaviours and good life experiences. It is evident that, people with mental illness were less likely to receive intervention for physical illness and vice versa. Hence, either conditions can exaggerate due to improper assessment and diagnosis of Mr. A. Lifestyle factors like exercise, smoking and diet need to be considered while studying interaction of physical and psychological health. Life experience can play important role in managing physical illness through psychological health and manging psychological illness through physical health in Mr. A (Roberts and Bailey, 2011; Roberts and Bailey, 2013).  

Conclusion:

Schizophrenia is a chronic mental illness. Schizophrenia can be considered as multifactorial disorder because it causes due to more than one factors. By application of biopsychosocial model, scientists studied biological, psychological, and social factors and their interactions which can influence Schizophrenia pathology and it onset. Anatomical studies indicated that Schizophrenia can occur due to abnormality in certain brain regions. Physiological studies indicted that reduction in hippocampal volume can lead to development of Schizophrenia in Mr. A. Instead of purely biomedical models, biopsychosocial models need to be considered for the study of Schizophrenia. In biopsychological model biological, psychological and social aspects need to be considered in integration. Intervention for Schizophrenia need to be provided both at medical and social facilities. Health psychology and social psychology need to be considered for providing management for the Mr. A. Health promotion for the management of Schizophrenia need to be provided by considering both biological and psychological aspects. Biopsychosocioculturogeoethnicspiritual model can be effectively used for health promotion in Schizophrenia patient. Health education and counselling need to be provided to the Schizophrenia patient. Interaction exists between physical and mental illness and this interaction need to be considered while providing intervention to the Schizophrenia patient. ADL and depression and behavioural scale need to be considered for studying interaction between the physical and mental illness respectively.

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