Teori Pendekatan
Biopsikososiokultural
di Layanan
Kesehatan Primer
D H A N A S A R I V I D I AWAT I D E P. I K K F K U I
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AGENDA
•Sejarah berkembangnya pendekatan bio-psiko-sosial
•Model bio-psiko-sosial dari George Engel
• Berbagai perkembangan model bio-psiko-sosial
• Konsep ‘patient centered’
• Aplikasi model bio-psiko-sosial dalam pelayanan dengan pendekatan
‘patient-centered’
Setiap pasien yang datang, adalah manusia.
Manusia tidak hanya terdiri atas raga (body/neurobiology),
tapi juga jiwa (psycho), memiliki spirit, emosi, health beliefs, dan pemikiran, serta
bagian dari lingkungan sosial dan budayanya
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Holistic approach
Holistik (menyeluruh)
yaitu peduli bahwa pasien adalah seorang manusia seutuhnya yang terdiri dari fisik, mental, sosial dan
spiritual, serta berkehidupan di tengah lingkungan fisik dan sosialnya.
Buku Standar Pelayanan Dokter Keluarga , PDKI 2004
Community Med Clinic & Surgery
Biomed
''''''''''''''''''''''''''''''''''''''''''''''''''
Hirarki sistim pada manusia
Bio-psycho-social model, by George L. Engel in 1977, source:
https://www.ncbi.nlm.nih.gov.
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Rethinking the biopsychosocial model of health:
Understanding health as a dynamic system
Social & Personality Psych, Volume: 11, Issue: 8, First published:
03 August 2017, DOI: (10.1111/spc3.12328)
Lane Fischer, Mental Health and Spirituality: The
Biopsychosocial Spiritual Model, APR 23, 2021
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Saad M, de Medeiros R. Spirituality and Healthcare—
Common Grounds for the Secular and Religious Worlds and Its Clinical Implications. Religions. 2021; 12(1):22.
https://doi.org/10.3390/rel12010022
The Mandala of Health
A model of human ecosystem
Determinan kesehatan individu
The Mandala of Health:
A model of Human Ecosystem
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Beberapa model pendekatan biopsikososiokultural pada masalah kesehatan tertentu
MODEL DICIPTAKAN BERDASARKAN TEMUAN RISET
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https://delphis.org.uk/mental-
health/the-biopsychosocial-
model-of-mental-health/
Figure Fillingim 2017, https://cor- kinetic.com/have-we-ballsed-up- the-biopsychosocial-model/
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Human Givens Institute (2020) Biopsychosocial Model [Infographic]. East Sussex: UK.
https://arttherapytrainingandstudiogroups.word press.com/2020/04/14/biopsychosocial- model-2/
Biopsychosocial Model
Biopsychosocial holistic model of cardiovascular health
Chapa, Deborah & Akintade, Bimbola & Son, Heesook & Woltz, Patricia & Hunt, Dennis &
Friedmann, Erika & Hartung, Mary & Thomas, Sue. (2014). Pathophysiological Relationships Between Heart Failure and Depression and Anxiety. Critical care nurse. 34. 14-25.
10.4037/ccn2014938.
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Conceptual framework of the biopsychosocial
impact of end stage renal disease (ESRD) and
coping mechanisms of elderly ESRD patients
Han, Emeline & Shiraz, Farah & Haldane, Victoria & Koh, Joel & Quek, Rina & Ozdemir, Semra & Finkelstein, Eric & Jafar, Tazeen &
Choong, Huilin & Gan, Sheryl & Lim, Lydia &
Legido-Quigley, Helena. (2019).
Biopsychosocial experiences and coping strategies of elderly ESRD patients: A
qualitative study to inform the development of more holistic and person-centred health services in Singapore. BMC Public Health. 19.
1107. 10.1186/s12889-019-7433-6.
The cyclic effects of biopsychosocial
factors on metabolic control for type 1 diabetes.
Jack, Leonard. (2003). Biopsychosocial Factors Affecting Metabolic Control Among Female Adolescents With Type 1 Diabetes. Diabetes Spectrum. 16. 154- 159. 10.2337/diaspect.16.3.154.
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Biopsychosocioc ultural model of recovery of
mental distress
Mental Health and Social Work Di Bailey, in International
Encyclopedia of the Social &
Behavioral Sciences (Second
Edition), 2015
Contoh kasus
biopsychosociocultural factors pada pasien
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Patient Centered Care
PENDEKATAN PELAYANAN BERPUSAT PADA PASIEN
Medical Evidence
Health care constraints Patient
preferences
1 Garrison GM, Dupras DM,Merry SP, Smith A. Clinical Decision Making. In: Rakel RE, editor. Textbook of Family Medicine. 7th ed. USA: Saunders Elsevier Inc; 2007.
Patient preferences;
Reasons for encounter, concern, hope, perception, socio- cultural background
Medical Evidence;
Clinically relevant
research, often from the basic sciences of
medicine, but especially from patient centered clinical research
Health care constraints;
Doctor as manager of resources; in
accordance with the health system, facilities, local rules and
regulation.
2. Nirwani N. Diagnosis Holistik. 2nd ed. Jakarta: Departemen Kedokteran Komunitas FKUI;
2010
Clinical Decision Making
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Simpulan
Pendekatan biopsikososiokultural adalah cikalbakal pendekatan yang berpusat pada pasien,
baik dalam segi medical evidence, patient preferred, maupun healthcare constrain.
Referensi
1. White Peter. Biopsychosocial Medicine. An integrated approach to understanding illness. Oxford University Press.2005.
2. Hutchinson Tom A. Whole Person Care. A new paradigm for the 21st century. Springer Science+Business Media, LLC 2011.DOI 10.1007/978-1-4419-9440-03.
3. Catherine Hudon, Martin Fortin, Jeannie L. Haggerty, Mireille Lambert, Marie-Eve Poitras. Measuring Patients’ Perceptions of Patient-Centered Care: A Systematic Review of Tools for Family Medicine. The Annals of Family Medicine Mar 2011, 9 (2) 155-164; DOI: 10.1370/afm.1226
4. Textbook of Family Medicine, Ian Mc Whinney
5. Bio-psycho-social model, by George L. Engel in 1977, source: https://www.ncbi.nlm.nih.gov.
6. Social & Personality Psych, Volume: 11, Issue: 8, First published: 03 August 2017, DOI: (10.1111/spc3.12328) 7. Lane Fischer, Mental Health and Spirituality: The Biopsychosocial Spiritual Model, APR 23, 2021
8. Saad M, de Medeiros R. Spirituality and Healthcare—Common Grounds for the Secular and Religious Worlds and Its Clinical Implications.Religions. 2021; 12(1):22.
https://doi.org/10.3390/rel12010022
9. HNCOCKand Perkins Health Education. Summer 1985 pps10
10.https://delphis.org.uk/mental-health/the-biopsychosocial-model-of-mental-health/
11.Figure Fillingim 2017, https://cor-kinetic.com/have-we-ballsed-up-the-biopsychosocial-model/
12.Human Givens Institute (2020) Biopsychosocial Model [Infographic]. East Sussex: UK. https://arttherapytrainingandstudiogroups.wordpress.com/2020/04/14/biopsychosocial-model-2/
13. Chapa, Deborah & Akintade, Bimbola & Son, Heesook & Woltz, Patricia & Hunt, Dennis & Friedmann, Erika & Hartung, Mary & Thomas, Sue. (2014). Pathophysiological Relationships Between Heart Failure and Depression and Anxiety. Critical care nurse. 34. 14-25. 10.4037/ccn2014938.
14. Han, Emeline & Shiraz, Farah & Haldane, Victoria & Koh, Joel & Quek, Rina & Ozdemir, Semra & Finkelstein, Eric & Jafar, Tazeen & Choong, Huilin & Gan, Sheryl & Lim, Lydia & Legido-Quigley, Helena. (2019). Biopsychosocial experiences and coping strategies of elderly ESRD patients: A qualitative study to inform the development of more holistic and person-centred health services in Singapore. BMC Public Health. 19. 1107. 10.1186/s12889-019-7433-6
15. Jack, Leonard. (2003). Biopsychosocial Factors Affecting Metabolic Control Among Female Adolescents With Type 1 Diabetes. Diabetes Spectrum. 16. 154-159. 10.2337/diaspect.16.3.15 16.Garrison GM, Dupras DM,Merry SP, Smith A. Clinical Decision Making. In: Rakel RE, editor. Textbook of Family Medicine. 7th ed. USA: Saunders Elsevier Inc; 2007.
17. Nirwani N. Diagnosis Holistik. 2nd ed. Jakarta: Departemen Kedokteran Komunitas FKUI; 2010
18. Mental Health and Social WorkDi Bailey, in International Encyclopedia of the Social & Behavioral Sciences (Second Edition), 2015
