Chronic pain is at epidemic levels and has become the highest-cost condition in health care. This course uses evidence-based science with creative and experiential learning to better understand chronic pain conditions and how they can be prevented through self-management in our cognitive, behavioral, physical, emotional, spiritual, social, and environmental realms. The goal of this course is to blend creative, experiential, and evidence-based teaching strategies to help participants understand chronic pain conditions and how a human systems approach can be applied to self-management strategies to reduce risk factors, enhance protective factors, and prevent chronic pain. There are four major objectives to the course; 1. Describe the prevalence, personal impact, and health care dilemma associated with chronic pain. 2. Recognize the clinical characteristics and underlying etiology of several common pain conditions and the peripheral, central, and genetic mechanisms of chronic pain 3. Based on the literature associated with risk and protective factors in the seven realms of our lives, learn specific strategies in each realm that can be employed daily to prevent chronic pain and enhance wellness. 4. Appreciate the value of a human systems approach to health care and how it can provide a basis for integrative, interdisciplinary, and individualized care to preventing pain and enhancing wellness. CONTINUING EDUCATION CREDIT Health Care Professionals Health care professionals who participate in this CE activity may submit this certificate statement of participation to their appropriate accrediting organizations or state boards for consideration of credit. The participant is responsible for determining whether this activity meets the requirements for acceptable continuing education. Email your Coursera certificate statement of completion to your appropriate organization.
1 The Biomedical Model versus a Human Systems Approach
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來自 University of Minnesota 的課程
Preventing Chronic Pain: A Human Systems Approach
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從本節課中
The Problem of Chronic Pain (Week 2)
與講師見面
Dr. James Fricton, DDS, MSProfessor and Pain Specialist
University of Minnesota, HealthPartners Institute, and Minnesota Head and Neck Pain Clinic
Hi, I'm James Fricton, and I'm back to teach the
next module on prevention of chronic pain, a human systems approach.
And I'm presenting from the University of Minnesota.
The title of this module is called The Balance Between Health and Illness.
And it has six parts.
We're going to discuss and compare and contrast
the biomedical model versus the human systems model.
We'll also look at the several concepts, between, for the human systems model.
Including holism: seeing the big picture of risk and protective factors.
Cybernetics: what comes around goes around.
Chaos theory: knowing that small changes in your
life can make a big impact later on.
And then a self assessment: that is not who you are, but how do you want to be.
So by the end of this module you'll be
able to articulate the differences between these two models.
Identify risk and protective factors in the seven realms.
Be able to explain cybernetics and how it really impacts your life.
And it also includes some discussion on
chaos theory to explain the small lifestyle changes.
And finally, to conduct a self-referential analysis of how you want to be.
So the first part is entitled, The
Biomedical Model versus the Human Systems Approach.
And this module is really about ideas.
As Eleanor Roosevelt, quoted: great minds discuss ideas,
average minds discuss events, and small minds discuss people.
This module is clearly about ideas.
And first we'll discuss the Biomedical Model.
And it views disease in this way.
One, the focus is really identifying
pathophysiology and restoring health by curing disease.
In addition, the cause of the illness is really
something that's external to the body, that invades the body.
Or it's related to some involuntary internal changes that occur in the body.
And thus the responsibility is really not with the person, but the
individual is really not to blame,
it's something else that's causing this illness.
And the treatment, then, is really with the medical profession, they
are responsible for correcting whatever the problem is that's invading the body.
Now this model is a reductionist model.
As Rene Descartes stated: divide each difficulty into as
many parts as is feasible and necessary to resolve it.
So it's really about making the, evaluating the system in such a way.
That you look at each individual part, and not necessarily the whole.
As he continues to state: each problem that I solved
became a rule, which served afterwards to solve other problems.
So, this model is very mechanistic.
The body is like a machine, with many, many different parts.
All the way down to the molecular level,
to the individual tissues and organs and cells.
If there's something wrong, we need to fix it.
Thus, the role of the health care provider is to fix the problem.
And, our tools, include primarily medications and surgery.
[BLANK_AUDIO].
But the biomedical model has its limits also.
The American Medical Association stated that about $0.25 of every dollar in
healthcare goes to treating diseases that result from changeable behaviors.
This is under the responsibility of the person.
And the Dean at the Goldman School of Public Health in University of
California stated that the medical system affects only 10% of the indices of health.
The rest of it is impacted by lifestyle.
So let's contrast the biomedical model with
a different, broader model of health and disease.
As Hippocrates stated: it is more important to know what kind of person
has a disease than to know what kind of disease a person has.
[BLANK_AUDIO].
Now, 2000 years later, the World Health Organization agrees.
That health is a state of complete, physical, mental and
social well-being; and not merely the absence of disease or infirmity.
So, the human systems approach really looks at the whole person.
Its focus is understanding the whole person and identifying risk
and protective factors that can enhance health and prevent disease.
The cause of illness, then, is not a external agent that invades the body, but
it's the attitude, lifestyles, emotions, and the interaction
we have with our social and physical environment.
Responsibility then comes with the individual.
They need to accept responsibility for their health and
the conditions since the causes are within their control.
And finally, the treatment is the responsibility of the medical profession.
Is to provide care and training, the patient in self management
to improve their health and wellness, and not solely treating disease.
So each model does have its pros and cons.
Whereas the biomedical model offers single treatments for acute conditions.
With single static ideologies like an infectious agent and use of antibiotics.
Whereas a human system model really
offers understanding of complex dynamic chronic illnesses.
The biomedical model relies on objective findings and
thus is easy to apply the scientific method.
Whereas the human systems model includes both objective and subjective findings.
But it is difficult to measure and apply scientific
paradigms, because there's too many factors that are going on.
The biomedical model is based on the underlying pathophysiology.
Whereas in the human systems approach, it's based on not only the
physical problem, but also the contributing
factors in each of the seven realms.
The biomedical model thus provides a
weak framework for explaining and predicting and
influencing chronic disease, and the multiple
factors that are involved in its etiology.
Whereas human system models relies less
rigorous and less controlled pragmatic clinical trials.
What works in real life.
The biomedical model is uni-dimentional,
and thus, encourages single, sequential treatments.
It's very easy to implement.
Whereas, the human systems model, it's
multi-dimentional, and thus, is complex to implement.
It really requires a broad systems view.
By all the participants, all the healthcare
providers, and a team approach is typically appropriate.
And then the biomedical model is reductionistic mechanistic
and thus is somewhat inflexible in it's approach.
Whereas the human systems model is much more holistic, spontaneous, and flexible.
And then finally, the implementation of the biomedical
model is really occurs in a more fragmented approach.
It's very difficult to coordinate all the different
things that are going on within a particular, system.
But it is well supported by the economic system.
Whereas the human systems model is contrary to the
current healthcare economics system, which rewards procedures over process.
And it's more difficult to be reimbursed and rewarded within this system.
So the question really is, do we take the red pill.
Or do we take the blue pill?
Is it really an either/or decision that we need to make?
Well I believe that it's both.
That human system theory can combine both understanding and treatment of
the path of physiology, as well as intervention with the etiology.
And so the next part of this module
has really discussed several principles that reflect human systems.
One is the concept of Holism: looking at the whole body.
Number two is Cybernetics and how the different positive
and negative feedback cycles impact our health and wellness.
And the third one is Change, and how theories on chaos
affect our understanding of how we can change to improve our conditions.
So thank you.
