MSN-TFN

Victor Angelo Vera

Activity: Theory Analysis

Biopsychosocial-spiritual Model

Are concepts theoretically and operationally defined?

YES

• Biological = component of the model refers to the fact that pathogens like germs and toxins
precipitate illness.

• Psychological = component looks for potential psychological causes for a health problem
such lack of self-control, emotional turmoil, and negative thinking.

• The Social part of the BPS model explains how different social factors such as socioeconomic
status, culture, poverty, technology, and religion can influence health.

• Spirituality the search for ultimate meaning, purpose and significance, in relation to oneself,
family, others, community, nature, and the sacred, expressed through beliefs, values,
traditions and practices

Are statements theoretically and operationally defined?

YES

ASSUMPTIONS:

• This model states mind, body, and environment interact in causing disease.

• Psychological well-being and resilience have been found to play a protective role in the
dynamic balance between health and disease

• Affective disturbances, such as depression and anxiety, as well as illness behavior (the ways
in which individuals experience, perceive, evaluate, and respond to their own health status),
may affect the course, therapeutic response, and outcome of any given illness episode

• believed that to understand and respond adequately to patients' suffering—and to give

them a sense of being understood—clinicians must attend simultaneously to the biological,
psychological, social & spiritual dimensions of illness

Are linkages explicit?

YES

• Person as the patient or the center of service, considering the 4 aspects of BPSS to create a
proper management plan to promote health and well-being. Health clearly defined “as state
of complete physical, mental and social well-being, and not merely the absence of disease or
infirmity” and well-being as a dynamic state of completeness in the 4 aspects and cannot be
 attained if one aspect is ignored or unattended. Environment must be conducive to promote
patients health, manipulation of it to promote health is necessary biologically, psycho-social,
and spiritually. Neglect one of the BPSS aspects signifies the need for Nursing intervention.
Focusing, planning, establishing patient-centered care holistically carefully assessing any
factors related to patients feeling of being unwell.

Is the theory logically organized?

YES – as the origin of the theory stated, existed 400 b.c but do not have a dominant form until 1800s
many experts and researchers polished the theory to its current model, used by various medical
professional as guide to their approach to health. Logically organized in a way the theory states that
relative health and disease is dependent on the interactions between these four factors. Their
interplay thus determines the cause, manifestation and resolution of illness

Is there a model/diagram? Does the model contribute to clarifying the theory?

YES

As what is shown in the diagram, the interrelation and connection of one aspects to another.
Persons can be considered beings-in-relationship, and illness can be considered a disruption in
biological relationships that in turn affects all the other relational aspects of a person

Are the concepts, statements, and assumptions used consistently?

YES - became a guide to numerous researches and theories, used commonly by medical doctors,
non-nursing theories, and nursing theories.

Are outcomes or consequences stated or predicted?

YES

BPSS model is widely used as a medical approach, not explicitly defined due to the theories
generalizability, but it is stated that negligence to one aspects could lead to lack of holistic approach.
For example, focusing only to disease or biological aspects could not guarantee that the patient
could attain faster recovery but considering what the patient thinks about his/her
illness(psychological), considering the coping(social), and beliefs(spiritual) could improve nurse-
patient relationship leading to cooperation and increase energy to recover
Is the theory congruent with current nursing standards?

YES

Even though BPSS is commonly used by medical practitioner as it is a non-nursing theory, but could
still be adapted or applied to nursing practices. Nursing theories used terms like Patient-centered
approach, transcultural nursing, therapeutic communication approach and etc. proves that it is
congruent to nursing standards

Is the theory congruent with current nursing interventions and therapeutics?

YES - nursing can be described as having an important role in patient’s care plan, the healing
professions should serve the needs of patients as whole persons, such as identifying factors causing
pain, sign & symptoms, establishing goals and outcomes, nursing assessment identifying (patients
perception to pain, pain experience, religious beliefs, ability to perform ADL, spirituality that might
influence decision-making), and nursing interventions using independent, interdependent,
dependent management ( pharmacologic to nonpharmacologic ) focusing biological, psychological,
sociological, and spiritual concepts of the patient.

Has the theory tested empirically? Is it supported by research? Does it appear to be accurate/valid?

YES – from being biomedical model biopsychosocial(Engel) biopsychosocial-spiritual(Koenig),

there’s too many researchers supported this study and applied to various medical studies

This was sample studies and theory used BPSS, proving the accuracy & validity:

• Behavioral Medicine - The definition of behavioral medicine implies that it is based on

a biopsychosocial model of health and disease. It follows, that health and disease are best
understood in terms of a combination of biological, psychological, and social factors rather
than purely in biological terms. Aims to include biopsychosocial aspects in research and
treatment, there is often such a breadth of information at the individual (clinical) level that it
is difficult to derive specific action strategies from it.

• Levels of Analysis in Peace Psychology - Psychologists of all stripes appreciate traditional

psychological analyses that draw on the multilevel, biopsychosocial model, in which events
at one level may have multiple determinants within and across levels of analysis

• Gastrointestinal Diseases: Psycho-social Aspects - The interconnection of psychological and

GI functioning is evident in both organic and functional GI disorders, supporting the
applicability of a biopsychosocial model for these chronic conditions. The relationship seems
to be bidirectional, with each able to affect the other, although the etiological role of
psychological distress in GI disease such as IBD remains to be elucidated.

• Geriatric Psychiatry - As subspecialty of psychiatry, geriatric psychiatry follows

the biopsychosocial model ,which emphasizes the contribution of biological, psychological,
and social factors to mental well-being and illness.
Is there evidence that the theory has been used by nursing educators, nursing researchers, or nursing
administrators?

YES

Transcultural Nursing – almost same year developed, but madeleine Leininger uses the concept of
ethnicity, race, and culture in order to understand individuals' perceptions and behaviors. Nurses
must consider these concepts in order to deliver culturally congruent healthcare. We all know this
theory already become a discipline to us nurses, we always consider in every patient interaction
about their cultural belief before an intervention is applied.

Is the theory relevant socially?

YES

• Social Utility - helps primary care doctors to understand interactions among biological and
psychosocial components of illnesses to improve the dyadic relationship between clinicians
and their patients and multidisciplinary approaches in patient care.

• Social Congruence – BPSS model can be used in any of the medical profession concerning
promoting health, Medical, psychological, Human Behavior, Nursing and many more. The
model possesses generalizability and can be applied to any type of patient. Applicability
regardless of time, place and setting( community or hospital )

• Social Significance - encourages clinicians to explain phenomena such as depression by

examining all relevant biological, psychological, social and spiritual factors that might be
contributing to the development or maintenance of the disorder. It also give guidance to all
medical practitioner on how to address patient health in a holistic way. Also part of the
nursing process, determining factors that could affect patients response to management and
decision making whether to accept management or not. It is important to note all of the
areas are interconnected. Strengths in an area can serve to bolster other areas, while
problems in an area can impact and cause issues in other areas.

Is the theory relevant cross-culturally?

YES – as stated BPSS model is widely applied by any medical field, its an approach considering
patients beliefs, religion, culture making it cross-culturally relevant and can be used universally

Does the theory contribute to discipline of nursing?

YES

• BPSS model greatly affects how nurses deal with their patient, considering every aspects in
every moment we interact with the patient.

• From Assessment:

1. full history to determine underlying factors

2. Evaluate factors such as gender, cultural, societal, and religious features that may influence
the patient

3. Assess the patient’s beliefs and expectations

 4. Evaluate the patient’s approach towards pharmacological and nonpharmacological means of
management.

• Developing nursing diagnosis concerning every aspects

• Planning and Implementation

1. Recognize and convey acceptance of the patient’s experience

2. Implement nonpharmacological interventions when discomfort is relatively well controlled

with pharmacological interventions.

3. Validate the patient’s feelings and emotions regarding current health status.

4. Refer the patient and family to community support groups and self-help groups for people
coping

5. Discuss to patient and family the advantages of using nonpharmacological management

strategies

6. Educate the patient and family about the use of pharmacological interventions for
management

• Evaluation – reassessment if the target objectives to improve patient health and well-being
attained, depends on the results, revision and formulation of new management can be done

What are the implications for nursing related to implementation of the theory?

BPSS model became a guide to numerous researches and theories, used commonly by medical
doctors, non-nursing theories, and nursing theories.

A biopsychosocial-spiritual model is a holistic approach that acknowledges the interaction between

physical, psychological, social, and spiritual aspects to patient care and patient well-being. Patients
are considered as beings-in-relationship, and illness is regarded as a disruptive force in the biological
relationships that can impact all other relational aspects of the patient. This holistic model to patient
care focuses on the intrapersonal interactions of the physical body and the mind-body connection
and the patient’s extra-personal relationships with the physical environment, family, friends, and
communities