中華心理衛生協會

Purpose: The bio-psychosocial (BPS) model has been a central concept in medical care and an important clinical technique in the treatment of illness for the past three decades. The aims of this study is to explore the enabling and barrier factors for medical residents in applying the BPS model at clinical settings and to discover the best training strategies for applying the BPS model. Methods: We organized 44 residents (mean age = 29.56) into 7 focus groups. Participants were asked to report how they used the BPS model in their clinical work. We used a qualitative approach for data analysis, which included the following steps: 1. Gain consensus among experts for categorizing utilization-related BPS themes and content using transcripts of the video-recorded focus groups. 2. Based on each theme, we elicited and conceptualized the enabling and barrier factors contained in the participants’ dialogue records. Results: 1. Although the BPS model was endorsed by residents of different years, we found a discrepancy in the definition of BPS and in comprehension and application of the model. 2. The benefits of implementing BPS medical care encompass the concepts of an integrative future-oriented approach, and involvement and cooperation with interdisciplinary, patient-centered care in the resident’s communication. Relationship skills and assessment or case conceptualization are important techniques for physicians. Barriers to implementing BPS can be caused by overemphasizing medical problems, a decline in patients’ satisfaction, and reduced efficiency with this type of care. A deficit in training or competence can cause residents to resist using this approach. Conclusions: Both cognitive knowledge and affectivevolitional attitudes are important components of the BPS approach. If they are supported with proficiency in techniques, the impact of the approach can be enhanced. Results supported the need for multiple methods and multi-levels of training in physicians’ education. Suggestions for important points related to BPS that require particular attention in a clinical setting are highlighted.