Education and demonstration – Psychology
Reexamination Certificate
2001-02-09
2003-11-18
Hughes, S. Thomas (Department: 3714)
Education and demonstration
Psychology
C434S118000, C600S300000, C600S301000, C705S002000, C705S003000
Reexamination Certificate
active
06648649
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to a device and method for analysis involving at least two factors, with at least two of the factors related to each other.
BACKGROUND OF THE INVENTION
When multi-factor analysis of interrelated factors is attempted, the individual often has difficulty keeping track of which factors may have already been considered and what the relationship of those factors might be for a particular set of circumstances or facts. The same problem exists when two or more persons analyze such related factors, and may even be more complex and confusing depending on the role and contributions of those persons. Exemplary types of multi-factor analysis of related factors include, but are not limited to, those of biopsychosocial analysis and the analysis of the assets or capital of a business entity. Each of these examples is discussed in greater detail herein to assist in understanding the complexities associated with such analysis.
The dominant model of health care for health and illness is the “biomedical model”, also referred to as the “medical model”. This model is based on the assumption that illness results from physical causes, such as trauma or infection, for example. Therefore, psychosocial processes are not factors that cause disease under the biomedical model, as a person's illness or sickness must result from a disordered part of the body or from a pathological disease process. Problems with mood, emotion, thought or behavior are frequently categorized and analyzed as mental disorders or psychological disorders under the biomedical model.
Although there are limitations to the biomedical model, other models have had less widespread acceptance or use. The biopsychosocial model is one of those alternative models. The biopsychosocial model posits that health involves the interaction of biological psychological, and social/environmental factors in a person's life. In other words, health depends upon: (a) biological factors like structural defects (e.g., heart valve), weak function (e.g., inability to fight infection), or overactive function (e.g., allergy); (b) psychological factors including cognitive activities such as learning, remembering, analyzing, and emotional factors such as joy, anger, fear or sadness; and (c) social factors, including the closest social relationship (e.g., family) as well as reciprocal interactions with other individuals and institutions in the community.
Although the role of biological, psychological and social/environmental factors in health and disease is increasingly acknowledged, there is extreme lack of understanding about how these components interplay in wellness and illness. Such lack of understanding is due, in part, to the complex processes involved in analyzing linkages between personal, biological, psychological, and social/environmental data, and the increasingly limited contact time of a patient with health care professionals, including physicians. These problems may be expressed in other ways:
(a) Widespread physician beliefs and practices reinforce and perpetuate the overwhelmingly prevalent biomedical model. Consider, for example, the fact that very few physician-patient interactions include a balance of biomedical and psychosocial topics. Many such interactions do not result in an understanding of how these factors interplay or are used in effective, focused, joint decision-making. Physicians are more likely to perceive patients with psychosocial problems like depression or anxiety as “difficult”; such patients experience poorer functional status, unmet health expectations, reduced satisfaction, and greater use of health care services. Most patients are willing to confide psychosocial information to their physician, but rarely do unless a physician has previously expressed a specific interest. Thus, life events and social difficulties tend to merge indirectly as a part of a description of physical symptoms. Gynecologists are the de facto primary care physicians for many women, but a gynecologist's training emphasizes surgery, office procedures, infection, and metabolic disease treatment. Thus, such training provides little exposure to management of psychosocial problems. Referring patients with psychosocial problems to psychiatrists is inconvenient and expensive. For many patients with physical complaints, no organic cause can be found. One study showed that a psychiatrist evaluation and analysis improved subsequent treatment by the primary physician, but this also added greater complexity, cost, and inconvenience to the care process.
(b) The lack of biopsychosocial information leads to unnecessary suffering and expense. The most dramatic examples of this lack of information occur with syndromes such as chronic fatigue, chronic whiplash, repetition stress injury, and fibromyalgia. All these syndromes include a cycle in which a person connects continuing physical symptoms to an underlying serious disease. By thinking the problems will become worse and by expecting disability, a person can easily reinforce and perpetuate symptoms in a vicious cycle; assuming the “sick role” can prevent a person from ever getting well. Often stress remains an unresolved ongoing problem that affects an individual's well being and his or her ability to relate to others in a mutually beneficial manner.
(c) By not identifying and understanding the effect of life stressors, individuals confuse and confound the care process. The tendency in many instances to only address physical symptoms may lead people to cease seeking further medical advice if their needs are not met. Alternatively, an individual may frequently change physicians or see multiple physicians. These activities increase overall medical expenses, especially as people get older. Not understanding the biological, psychological, and social changes of an individual situation can increase distress and exacerbate the discomfort of chronic illness.
(d) Major health problems must have an integrated biopsychosocial approach for effective management and treatment. Such an integrated approach may be more expensive and is inherently more complex. The previously narrow biological paradigm of asthmatic disease is evolving in a way that gives scientific credibility to such an approach. The field of psychoneuroimmunology links psychosocial stress, the central nervous system, and changes in immune and endocrine function. This field describes biological paths by which stress affects respiratory function. Stress affects autonomic control of airways. Stressors such as living near a nuclear plant accident, being an Alzheimer's Disease caregiver, or taking difficult school exams have all been scientifically shown to affect the number and function of white blood cells. Stress triggers release of hormones that affect immune cells and increase susceptibility to viral respiratory infections. Management of asthma is a paradigmatic example of how the effects of family function, social support, thinking, personality, self-concept, stress, and coping ability are all important factors associated with favorable or unfavorable outcomes.
(e) Opportunities to improve one's physical condition are missed by not understanding one's psychological experience. People with even moderately severe asthma or rheumatoid arthritis who write about their stressful life experiences have significant clinical improvement. Depressive symptoms or lack of social support have been shown to affect cholesterol levels. Feelings of anger and hassle influence insulin and glucose metabolism in non-diabetic adults. Such findings occur not only in the United States, but throughout the world. Gastrointestinal diseases have exemplified the impact of psychological factors. Psychological factors impact diseases such as gastroesophageal reflux disease, chronic abdominal pain, Crohn's Disease, and Irritable Bowel Syndrome.
(f) Health professionals are not in a position to make the biopsychosocial model part of their practice. Such professionals continue to be trained using the biomedi
Agewell, P.C.
Gridley Doreen J.
Harris Chanda
Hughes S. Thomas
Ice Miller
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