Bio-Psycho-Social Model

As in every branch, there are certain protocols used in the processes that start with the patient examination, make the diagnosis, create the treatment plan and evaluate the results in the field of medicine. These protocols have changed over time under the influence of some concepts. Societies and lifestyles, physical and technological opportunities have necessitated these changes. I want to tell you about these concepts in my article. The concepts in question are; It is very important for the diagnosis and treatment of all patients, not only those who need Physio-Therapy.

From Bio-Medical Concept to Bio-Psycho Social Model

In medical education, the Bio-Medical Concept was predominant; now the Bio-Psycho-Social model is taught.

Bio-Medical model, accepts that diseases occur as a result of cell structure deterioration or disease. This model explains diseases by basing them on cellular and chemical imbalances. It identifies no social or psychological role in diseases. However, later on The bio-medical model is starting to fall short. Because "We Are Human". This is the sentence I emphasize the most in my articles, “WE ARE HUMAN”; We are an entity with adaptation and compensation mechanisms at the environment and cellular level.

We will have attitudes and behaviors towards the treating team and physical conditions; Likewise, the treatment team will also have attitudes and behaviors towards us. While the perceptions and comments formed after these behaviors can take us to a healthy level, they can sometimes have a negative effect. E.g;

• How much can being injected in an environment where you think that the physical conditions are not sterile can improve you?
• Before the dermatologist you are examined sees the itchy area on your arm and does not get up from the table; When he prescribes a cream, how much relief can this treatment give you?

Even if that cream will actually cure you, it cannot contribute enough to you. Because the following thought will always prevail in your mind, “He didn't understand me, he didn't even see what's on my arm, people get up and look for two seconds!”

Bio Psycho Social Rehabilitation Treatment Concept

Bio-Psycho-Social Rehabilitation is the concept I use during my treatments. Physio-Therapy and this is the most important concept that takes Manual Therapy one step further. He is my most important companion in terms of "Understanding My Patient", which is my goal before starting the treatment. It remains patient-based and aims to improve the most important part of life, activities of daily living.

Even if the reason we consult a doctor in the first place is to feel pain, Sometimes we choose to go on with life despite the pain. When pain starts to affect our daily life, then we look for a solution. "Actually, I was able to continue the lessons despite the pain, now I can't lift my arm and write two words on the board because of the pain, I think I tore it up." I hear the phrase all the time. Isn't that the most important breaking point for humans, too?

We want to be functionally well in the moment we live. When we want to move from one place to another, it is enough for us to perform the action. Some people go to the doctor even with a pain that lasts for only two seconds when raising their arm, while others do not come until they say that they have torn it thoroughly. It is certain that the difference between them is not a mechanical or cellular damage. At this point, psychological and social-environmental factors come into play.

What is the Definition of Health?

The World Health Organization defines health not as the absence of disease or infirmity, but as a state of complete physical, mental and social well-being. The expression of well-being defined as being healthy will be different for each individual. Everyone's feeling of well-being is quite different from each other. Diagnosis of our patient; Internal meniscus stage 3 tear and surgically removed. This surgery is performed mechanically in the same way, regardless of and without the need for any demographic and anthropometric factors of the patient. However While some patients can say that they are healthy when they can lift 50 kilograms with their operated leg after knee surgery, others say that it is enough for me not to have pain when going up and down stairs.r. In fact, even if the desires develop due to the same symptoms and diagnosis and the same mechanical surgery is performed, the person will determine the outcome. Even if the surgery is bio-medical (mechanically) 100% successful in both, it will be truly successful only if the patient's well-being and expectations are met. This is the difference between the two concepts. One wants mechanical success, while the other wants real success. Because we do human therapy. We must heal the person, not the knee.

Wilson and Cleary's Definition of Health

I would like to explain through an example injury below.

• The first part will be the same regardless of whoever gets this injury.
• The second part may vary; Because “We are Human”, we can behave differently against these feelings that always occur.

1. - Biological Change: Suppose there is tissue injury, muscle tear.
2. - Symptoms Status: The sensations we feel due to the damaged tissue: pain, swelling, stinging pain that increases with movement, a gap felt when touched (It is felt by the expert.)
3. - Functional Status: Avoidance of movement due to stabbing pain during movement.
4. - General Health Perception: I think there is something wrong with my muscles, why is it torn?
5. - General Quality of Life: The patient thinks that he cannot go to work regularly and cannot continue his activities.

These are standard feelings. The impact of environmental and personal factors is as follows:

– Even if the symptoms are standard for the type of injury, the anxiety triggered by the pain sensation will be at different levels. Having faced the same injury in the past will definitely affect the patient. Some sickThere was a tear in November, so there is some pain and swelling, and it stings while walking.” saying;

Some patients; “Kasım is in very bad shape, it hurts, swells and stings while walking, there is something bad for sure here.' she can say.

– Some patients compensate by compensating from other places without using it to protect the area while continuing to move; some patients prefer to lie down and not move at all.

– For treatment that must continue for a certain period of time and for an injury developed as a result of trauma There are patients who think that their general health is very, very bad.

– While some patients can continue their daily lives close to normal, For some, daily life can become unbearable.

In this section, I touched on personal factors a little. When we add the environmental factors and the people around us, even a simple muscle tear can become very large. For example, the person in question has to work and support his house, but cannot go to work due to injury. Or, the managers who want to transfer the athlete cannot go to the match they want to watch because of a muscle tear.

It is possible to multiply these and similar examples. basically There will be certain symptoms and limitations of movement that occur as a result of every injury. These are the natural physiological processes of injury. Whatever the underlying cause or causes, we must eliminate personal and environmental factors that will alter the course of these normal physiological natural processes. Everyone works to keep their daily life quality at the best level. Don't let injuries or other factors get in the way. We have the power to change these factors, as long as we are aware of it.

Stay Healthy,