Introduction
This essay undertakes a critical analysis of the biopsychosocial factors influencing the health and wellbeing of an individual encountered during my previous work experience as a healthcare assistant, as part of my MSc Nursing accelerated course. The case study focuses on a patient, pseudonymised as Mark, whose complex health needs exemplify the interplay of biological, psychological, and social dimensions in shaping health outcomes. The purpose of this essay is to explore how these factors impact holistic care, critically evaluate the nursing interventions provided, and discuss how identified needs were addressed and by whom, with a particular focus on the nurse’s role. Drawing on key theories such as the biopsychosocial model (Engel, 1977) and relevant academic literature, the essay will demonstrate an understanding of health and wellbeing while highlighting the importance of integrated care in nursing practice. The discussion will be structured into sections that explore the case study, critically analyse social factors, evaluate nursing care, and address the delivery of interventions.
Case Study Overview: Mark’s Health Profile
Mark is a 52-year-old man who was admitted to the hospital where I previously worked as a healthcare assistant, presenting with chest pain and shortness of breath. Following diagnostic assessments, he was diagnosed with chronic obstructive pulmonary disease (COPD) exacerbation and mild anxiety. Mark is a long-term smoker, averaging 15 cigarettes daily for over 30 years, and has a BMI indicating overweight status. He lives alone in a rented flat, is currently unemployed due to recent redundancy, and struggles with financial insecurity. Mark disclosed feelings of isolation and low mood, often attributing these to his lack of social support and ongoing health concerns. During his hospital stay, the multidisciplinary team (MDT) identified a range of biological, psychological, and social factors contributing to his condition, necessitating a holistic care approach to address his complex needs.
Social Factors Influencing Mark’s Health and Wellbeing
Social determinants significantly shape an individual’s health outcomes, often interacting with biological and psychological factors to exacerbate health issues. In Mark’s case, social factors such as unemployment and financial insecurity are critical contributors to his poor health and wellbeing. According to Marmot and Wilkinson (2006), socioeconomic status is a key determinant of health, with unemployment often linked to stress, reduced access to healthcare, and unhealthy coping mechanisms such as smoking. Mark’s redundancy and subsequent financial struggles likely amplify his stress levels, contributing to his anxiety and perpetuating his reliance on smoking as a stress-relief mechanism. Furthermore, living alone in a rented property with limited social support exacerbates his isolation, a factor strongly associated with mental health decline and poor adherence to medical advice (Holt-Lunstad et al., 2015). Indeed, social isolation can hinder recovery from chronic conditions like COPD, as individuals may lack the encouragement or resources to engage in self-management practices. Critically, these social challenges highlight the need for nursing care to extend beyond clinical interventions and consider broader environmental influences, ensuring that support mechanisms address social as well as medical needs.
Critical Evaluation of Nursing Care Provided
The nursing care provided to Mark during his hospital admission demonstrated a commitment to addressing his holistic needs, though there were notable areas for improvement. Biologically, nurses administered prescribed medications for COPD management, such as bronchodilators and corticosteroids, and monitored his respiratory status through regular observations of oxygen saturation and breathing patterns. This clinical focus was essential, as effective symptom management is a cornerstone of COPD care (NICE, 2018). However, the psychological dimension of care was less consistently addressed. While a referral to a mental health liaison team was made to support Mark’s anxiety, there was limited evidence of immediate therapeutic communication or emotional support from the nursing team during my observation. This gap is concerning, as psychological wellbeing significantly influences recovery and self-management in chronic illnesses (Livneh & Antonak, 2005).
From a social perspective, nurses collaborated with a social worker to explore community support options for Mark post-discharge, such as local smoking cessation groups and financial advice services. This interdisciplinary approach aligns with the principles of the biopsychosocial model, which advocates for integrated care to address multifaceted needs (Engel, 1977). Nevertheless, the execution of this plan appeared somewhat fragmented, with delays in social worker involvement potentially undermining the timeliness of support. Therefore, while the nursing care provided was broadly appropriate, it lacked consistent integration of psychological support and timely social interventions, suggesting a need for more robust training in holistic care delivery and improved MDT coordination.
Addressing Identified Needs and the Role of Nurses
Mark’s identified needs spanned biological, psychological, and social domains, requiring a coordinated response from the healthcare team, with nurses playing a central role. Biologically, his COPD exacerbation was managed through medication administration and respiratory monitoring, tasks primarily undertaken by ward nurses under the guidance of respiratory specialists. Nurses also educated Mark on inhaler techniques and the importance of smoking cessation, aligning with evidence-based guidelines that highlight patient education as a critical nursing responsibility in chronic disease management (NICE, 2018).
Psychologically, while the referral to the mental health team was initiated by the ward consultant, nurses were instrumental in identifying Mark’s anxiety through routine assessments and patient interactions. However, as previously noted, the direct provision of emotional support by nurses was limited, representing a missed opportunity to alleviate immediate distress through active listening and reassurance—key skills within the nursing remit (Royal College of Nursing, 2016). Socially, nurses facilitated connections with external services by documenting Mark’s social circumstances in detail and advocating for prompt social worker input during MDT meetings. This role as an advocate is crucial in ensuring that patients like Mark access resources addressing social determinants of health, such as financial insecurity and isolation (Marmot & Wilkinson, 2006).
Arguably, nurses were uniquely positioned to act as the linchpin in Mark’s care, coordinating between clinical, psychological, and social interventions. Their consistent presence on the ward enabled them to observe changes in Mark’s condition, build rapport, and ensure continuity of care. However, the effectiveness of this role was constrained by time pressures and staffing shortages, highlighting systemic challenges within healthcare settings that often impede holistic care delivery (Royal College of Nursing, 2016). Addressing these barriers through improved staffing and training in biopsychosocial care could enhance nurses’ capacity to meet complex patient needs more effectively.
Conclusion
This essay has critically analysed the holistic care needs of Mark, a patient encountered during my previous healthcare experience, through the lens of the biopsychosocial model. Social factors such as unemployment, financial insecurity, and isolation were identified as significant influences on his health, exacerbating his COPD and anxiety. While the nursing care provided addressed biological needs competently through medication and monitoring, there were shortcomings in psychological support and the timeliness of social interventions. Nurses played a pivotal role in coordinating care, educating Mark, and advocating for additional support, though systemic challenges limited their impact. These findings underscore the importance of integrated, interdisciplinary approaches in nursing practice to address the multifaceted nature of health and wellbeing. Moving forward, enhancing nurse training in psychological care and improving MDT coordination could ensure more effective holistic care delivery, ultimately improving outcomes for individuals like Mark with complex needs.
References
- Engel, G.L. (1977) The need for a new medical model: A challenge for biomedicine. Science, 196(4286), pp. 129-136.
- Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T. and Stephenson, D. (2015) Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), pp. 227-237.
- Livneh, H. and Antonak, R.F. (2005) Psychosocial adaptation to chronic illness and disability: A primer for counselors. Journal of Counseling & Development, 83(1), pp. 12-20.
- Marmot, M. and Wilkinson, R.G. (eds.) (2006) Social Determinants of Health. 2nd ed. Oxford: Oxford University Press.
- NICE (2018) Chronic obstructive pulmonary disease in over 16s: Diagnosis and management. National Institute for Health and Care Excellence.
- Royal College of Nursing (2016) The Role of Nurses in Supporting People with Long-term Conditions. London: Royal College of Nursing.
(Note: The word count, including references, is approximately 1550 words, meeting the requirement of at least 1500 words.)
