Question

You are to write an essay, including an introduction and conclusion, using the sections
below as a guide with a word count of 1250 words (+/- 10%).

Case Study
Andrew is a 69 year old gentleman of Italian heritage, who has come into hospital for a
below knee amputation due to complications from his Type 2 Diabetes (18 years post
diagnosis). He is retired and lives with his wife of 40 years and his daughter, son in law
and their three young children in a three bedroom house in the outer suburbs of
Sydney. He has failing eyesight and has not had a job for the past 15 years due to his
health problems. He is currently taking medication to help manage his blood sugar
(Metformin), however his blood sugars continue to be very high. Andrew does not like
taking his medication as he finds it expensive and does not believe it helps him maintain
his blood sugars within a healthy range. He believes there is nothing he can do to
manage his blood sugar levels and that the amputation was a natural progression of the
disease state. He infrequently takes his blood sugars, and does not see the point in
attending frequent doctor appointments again due to the cost.
Andrew’s son in law is the only one who brings an income into his household, and this
must support Andrew, Andrew’s wife, his daughter and their children. With limited
resources, it is important that Andrew keeps his medical bills as low as possible. The
family does enjoy spending time together and enjoy celebrating and connecting over
meals. His son-in-law usually joins Andrew in an evening after the family meal to drink
wine and smoke cigars. Both men find this an important time to connect and relax after
a long day. Andrew socialises very infrequently with anyone else outside of his family,
as his failing health and eyesight prevents him from being able to drive anymore.
Use the case study provided to answer Section A and Section B.
Section A explores the dimensions of patient centred care and Section B is a
comparative discussion about biomedical and social model of care in relation to the case
study supported by scholarly references.

Introduction: (125 words)

Section A: (500 words)
Referring to the case study, identify the seven dimensions of patient centred care and
how you could utilise the dimension/s to provide holistic, therapeutic care to Andrew.

Section B: (500 words)
Compare and contrast to the biomedical model of health and explain how Andrew’s
psychosocial health could benefit applying a social model of health care.
Conclusion: (125 words)

Answer 1

Section A

The seven attributes of patient-centered primary care are

1. Access to care

2. Patient engagement in care

3. Information systems

4. Care coordination

5. Continuity and transition

6. Respect for patient’s preference

7. Emotional support and alleviation of fear and anxiety

1. Access to care- Patients need to know they can access care when it is needed which could be access to hospitals, availability of transportation, easily available appointments and access to medical specialists as well. In the mentioned scenario due lack of finances Andrew’s health is getting bad day by day. However, the state offers health schemes where care for such individuals can be taken place and he should have access to these facilities to improve his quality of life.

2. Patient engagement in care- This principle addresses the role of family and friends in the patient’s care. This includes providing care and accommodation to the patient, involving family and getting support by family in decisions and recognizing his needs. In this scenario, Andrew’s needs are well met as this is a very close-knit family with his son-in-law being the sole bread earner. They eat and talk everyday which provides a very good platform to allay any depression and also provide support to the patient. The family nurturing is the best sort of care anyone can get

3. Information systems- Sometimes, patients express their worries that they were not being completely informed about their condition. So to counter this, they provide patient information with clinical status, progress of disease, information on care and health promotion. Here, Andrew knows about his condition very well as the health care professionals have shared their assessment with him and the family. He is very well aware of his deteriorating health and hence not taking medicine to avoid being a burden on his family. Ultimately, he and his family might be at peace as they understand the inevitable.

4. Care coordination- Patients express feeling vulnerable and powerless in the face of illness. Proper coordination of care can alleviate those feelings. These include coordination of care, support services and patient care. Here Andrew due to proper care and coordination does not feel vulnerable as he is very aware of his disease condition and its outcome.

5. Continuity and transition- Patients are concerned about their ability to care for themselves after discharge. These include understanding schedule for medications, date for follow-up, dietary requirements, planning treatment and providing information regarding access to clinical, social, physical and financial support on a continuing basis. In this scenario, Andrew’s family take care of him by providing him with medications and care as well as finances to meet those needs, however its Andrew who does not want to deplete their resources further.

6. Respect for patient’s preference- This Involves patients in decision-making, recognizing they are individuals with their own unique values and preferences. Here Andrew prefers not taking medicines as his own decision and preference and it is for the family and doctors to respect that decision.

7. Emotional support and alleviation of fear and anxiety- Fear and anxiety associated with illness can be as debilitating as the physical effects. Its very important for the family to provide emotional support in such a scenario which Andrew’s family readily does.

Section B

The biomedical model of health focuses on purely biological factors and excludes psychological, environmental, and social influences. It is considered to be the leading modern way for health care professionals to diagnose and treat a condition in most Western countries.

Firstly, the social model of health is a conceptual framework that can be practiced by a wide range of individuals, for example the care can be provided by the participation of family and as well as the community whereas the biomedical model of health is practiced only by doctors and health professionals. Secondly, the social model of health considers preventative measures, whereas the biomedical model considers only diagnosis, cure and treatment of disease. This results in the social model of health placing less of a burden on the healthcare system.

In addition to this the biomedical model focuses only on the physical and biological aspects of disease and illness, whereas the social model considers a wide range of determinants which include providing patient care, support and adhering to his preference.

The biomedical model is practiced by doctors and health professionals, whereas the social model can be practiced by a community

The biomedical model is associated with the diagnoses, cure and treatment of disease, whereas the social model also considers prevention;

The biomedical model of health placed a considerable burden on the healthcare system, whereas the social model of health prevents some of that burden;

And, finally, the social model of health is in practice today, whereas the biomedical model of health ended a long time ago.

Andrew’s psychosocial health could benefit applying a social model of health care.

Social models of health recognise that our health is influenced by a wide range of individual, interpersonal, organisation, social, environmental and economic factors. They encourage us to have a deeper understanding of health. Applying a social modal of health will have a better outcome of Andrew’s psychosocial health as it would provide a more holistic approach to his quality of life. The diagnosis has been made already by the biomedical model and now what is left is an elderly patient with chronic diseases and deteriorating health. In such a scenario, it is imperative that family provides all kind of support to the patient which would ultimately have a positive impact on the patient’s health and could thereby prolong his life and also improve quality as well. As discussed earlier knowing about your prognosis is also very helpful as then the person would know his medical condition and then not prove a financial burden to his family. This is of particular importance is low-socio economic families who don’t have full access to resources.

Conclusion

Each and every modal of health care is important. Where the biological model is focused on diagnosis and treatment, the patient care model focusses on a holistic approach to health care management. Referring to the case study Andrew’s emotional needs are very well met by his family and his family in engaged in his care. They also respect his preference in not taking the treatment as it would prove a financial constraint on their family. They sit, eat and talk together and provide him with adequate psychosocial support which is required at this stage.

So in summary the patient care model provides a more holistic approach towards treatment rather than the traditional model. However, the role of traditional model cannot be excluded and still is very important for patients