Psychosocial Health Case Study

An important issue in the management of this case, which I would like to further explore, is the psychosocial care of patients with chronic illnesses, and the relevance of this to primary care. On reflection of this case, it is evident that much of Mr DS’s long-term care is under the management of specialist physicians or other members of the multidisciplinary team. For example, his cardiovascular and respiratory health is under the management of specialist physicians, he has been under the care of orthopaedic surgeons for the management of musculoskeletal problems, and his care has also received extensive involvement from occupational therapy and physiotherapy.

However, the psychosocial health of both the patient and the patient’s family

We must ask, why is it important to provide a patient with psychosocial support? As doctors, is our responsibility solely to the biological needs of the patient, or does our responsibility extend further than this?

Substantial evidence has demonstrated that psychosocial factors affect the onset and course of almost all chronic illnesses[1][2][3]. Psychological, behavioural and social factors interact with disease processes in the development and course of physical disorders[1][2][3][4][5], and they also have a substantial effect on consultations and treatment-compliance[4][5]. Therefore, in treating a disease, we cannot deny the importance of also providing a patient with psychosocial support[2][5].

The World Health Organisation defines health as “a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity”[6]. This statement gives equal influence to the mental and social wellbeing of a person as it does to their physical health. As doctors, our responsibility is to the health of the patient, and as such we do have a responsibility to the psychosocial care of our patients, as well as to their biological

with regards to social isolation) and to the parent (e.g. in regards to the psychological and social burden of being a caregiver).

People with DMD have an increased risk of psychosocial difficulties and medical care is not complete without support for their psychosocial wellbeing[7]8][9]. For many parents the stress caused by the psychosocial problems of their child, and difficulties in getting them recognised and properly treated, exceeds the stress associated with physical aspects of the disease[7][10].

Psychosocial issues associated with DMD include learning problems and increased risk of neurobehavioral disorders (including autism-spectrum disorders, ADHD, and OCD)[7][11]. DMD, as well as almost all other chronic illnesses, involves problems with emotional adjustment, depression, and anxiety[5][7][12]. It has also been well documented that the consequences of DMD (such as physical limitations) may result in social