3. Biopsychosocial model
Context: Relationships, perceptions, personality, level of
education; previous experiences; beliefs and
expectations are determinants of health behaviour.
Health behaviour includes: The understanding and
development of disease and illness; health maintenance;
sick-role behaviour; risk behaviour; help-seeking
behaviour; doctor-patient relationship and responses to
treatment (adherence).
See Pretorius et al, 2010
4. How is it possible?
Physiological and neurological response to
personality and environmental factors.
• Circuit of Papez
• Stress response
5. Define health
• Absence of disease…
• State of complete physical, social and
mental well-being (WHO)
• Context specific
• Age and development dependent
• Education and lifestyle dependent
• Meaning of health and illness (Jung)
6. Define disease
• DISEASE: Medical term – genetics; pathogens;
environmental causes (pollutants & allergens); system-
organ-molecular level
• DISEASE: cultural perspectives (humoral theory and
balance – laxatives etc); lifestyle choice versus disease -
homosexualism and alcoholism; medical advancement
(heart attack not cause of death until this century)
• Signs and symptoms as defined by science (label)
8. Define illness
• This is the subjective experience of the
disease and is defined and responded to
differently by different people
• Determinants:
– Own understanding
– Previous experiences
– Culture and belief system
– Medical literacy
9. Define health, illness and disease
(Alder et al, 2009:39 and Pretorius et al, 2010)
Public account
of illness
(lay perceptions)
Normal illness
due to disease
e.g. otitis media
Real illness
e.g. Major life
threatening disease
e.g. MI
Health problems
that are not illness
e.g. Conditions
associated
with age
Psychological e.g.
Stress related and/or
Psychiatric conditions
21. Individual
• R - Reason for consultation
• I - Ideas
• C - Concerns
• E - Expectations
• F - Feelings
• F - Fears
22. Reason for the consultation/
encounter /presenting at health
care
• Limit of tolerance
• Limit of anxiety
• Problems of living presenting as
symptoms
• Administrative reasons
• Preventative
35. Contextual
• Behaviour is contextual
• Defined by systems – informal and formal
• Defined by culture and sub-culture
• Dynamic
• Social determinants of health
36. Ideology
• Political ideology: form of government
(e.g. democracy, theocracy etc.) Political
ideologies are concerned with many different aspects of a society,
some of which are: the economy, education, health care, labor law,
criminal law, the justice system, the provision of social security and
social welfare, trade, the environment, minors, immigration, race,
use of the military, patriotism, and established religion.
• economic system (e.g. capitalism,
socialism, etc.)
• Rights based (feminism, etc)
38. Families
• Nuclear Family (have a husband, wife and
one or more biological or adopted
children.)
• Single Parent Family
• Extended Family
• Childless Family
• ??Gay family- people of the same sex
having a marriage
39. On the basis of marriage:
Family has been classified into three major types:
• Polygamous or polygynous family- the
practice of having more than one wife at the same time
• Polyandrous family - having more than one
husband at a time
• Monogamous family - having one mate
40. Western Kinship
• Mother: a female
parent
• Father: a male parent
• Son: a male child of
the parent(s)
• Daughter: a female
child of the parent(s)
• Brother: a male child
of the same parent(s)
• Sister: a female child
of the same parent(s)
• Grandfather: father of
a father or mother
• Grandmother: mother
of a mother or father
• Cousins: two people
that share the same
grandparent(s)
41. For collateral relatives within the nuclear
family:
• Grandfather: a
parent's father
• Grandmother: a
parent's mother
• Grandson: a child's
son
• Granddaughter: a
child's daughter
• Uncle: father's brother, mother's
brother, father's sister's husband,
mother's sister's husband
• Aunt: father's sister, mother's sister,
father's brother's wife, mother's
brother's wife
• Nephew: sister's son, brother's son,
wife's brother's son, wife's sister's son,
husband's brother's son, husband's
sister's son
• Niece: sister's daughter, brother's
daughter, wife's brother's daughter,
wife's sister's daughter, husband's
brother's daughter, husband's sister's
daughter
• Cousin: the most classificatory term;
the children of aunts or uncles
68. Natural resources
Arum lily- The leaves are also traditionally used as a poultice for aching
inflamed wounds and a treatment for headaches
69. Fever tree: grow in swampy areas
and the early settlers realised that
they get fever in those areas (later
we knew it was malaria due to
mosquitoes in swampy areas)
Willow tree: Hippocrates referred
to their use of salicylic tea to
reduce fevers around 400 BCE
(acetylsalicylic acid – aspirin)
70. Jackal Berry - The fruit, leaves, bark and roots contain tannin - an astringent
substance that helps stop bleeding. The tree also contains substances with antibiotic
properties. Bark extracts and crushed young shoots are applied to wounds and
bruises to promote healing. A decoction of the roots is ingested to fight internal
parasites such as ringworm and to help people recover from dysentery and fever.
Sometimes pieces of bark are placed on a grid above burning coals and people who
suffer from coughing fits or sinus problems inhale the steam coming from it
71. Two alkoloids in the leaves of the plant have been found beneficial in the
treatment of some types of cancer (Leukemia, Lymphoma). This led to the
development of Vincristine and Vinblastine
Madagascar Periwinkle
