Engel GL, a professor of psychiatry and internal medicine at the Medical College of the University of Rochester in the United States, published in the journal Science 1977 entitled "Need for a new medical model; The challenge to biomedicine "criticizes the limitations of modern medicine, that is, biomedical model, and points out that this model has gained dogmatic status and cannot explain and solve all medical problems.
To this end, he proposed a new medical model, that is, biological-psychological-social medical model. Engel: "In order to understand the determinants of disease and realize a reasonable treatment and medical care model, the medical care model must take into account the patients, the living environment of the patients and the supplementary systems designed by society to cope with the devastating effects of diseases, namely the roles of doctors and medical care systems."
The changes of disease spectrum and death spectrum highlight the role of psychological and social factors;
The structure of human diseases and causes of death has changed. Heart disease, cerebrovascular disease and malignant tumor have a tendency to occupy the main position in the disease spectrum and cause of death spectrum of all countries in the world. For example, the main diseases affecting people's health in China have gradually changed from infectious diseases to non-infectious diseases.
The content of bio-psychological-social medical model;
Generally speaking, the comprehensive health medical model developed on the basis of environmental health medical model can be regarded as the representative of bio-psychological social medical model.
1, blooming.
In 1974, Blum pointed out that there are four factors that affect human health: environment, biology, behavior and lifestyle, and health services. Among them, environmental factors include natural environment and social environment, especially social environment has an important impact on health.
2. Comprehensive health model.
Lalonde and Dev revised and supplemented the environmental health medical model, and put forward a comprehensive health medical model, which provided a theoretical basis for formulating health policies and guiding health care work. This model holds that each of the four categories of factors that affect human health can be divided into three factors, and then twelve factors are counted.
Various factors have different effects on different diseases. For example, cardiovascular and cerebrovascular diseases are mainly behavioral lifestyle and biological factors, accidental deaths are mainly environmental factors, and infectious diseases are mainly health services.