The multifactorial model of illness and health holds the view that illness is a result of the interaction of various systems at different levels. These levels include the most basic level, the cellular level, and other higher levels such as tissue, organic, personal and interpersonal, and also the environmental levels (National Research Council, 2001). According to this model when a patient is being treated they should be treated in the context of their surrounding environment in addition to considering the individual’s body. The model fosters a holistic approach to illness that integrates the physical, psychological, social, and environmental factors affecting a person.
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The model lists the factors affecting health as biological, environmental, sociocultural, personality, stressors, and behavior. Among these factors, there are those that the individual has no control over and there are those which the individual can control. An example of biological factors that would affect our susceptibility to illness is genetics or family history, inoculations, history of medication, complications at birth, and exposure to pathogenic organisms.
Sociocultural factors that may influence susceptibility to poor health include access to health care, socioeconomic status, discrimination, and prejudice while environmental factors include water quality, pollution, natural disasters, the workplace, and architectural features. Personality factors include psychological hardiness, depression, pessimism or optimism, health-seeking behavior such as finding out information about health risks and one’s expectations of self-efficacy (Rathus and Nevid, 2005).
Depression generally makes it harder for patients to get better and often a patient with a chronic condition who goes into depression may have a problem managing their condition in terms of complying with the treatment regimen. Behavior is closely related to personality and some of the factors that are included are level of physical activity, diet, patterns of sleep, safety practices, and social skills as well as interpersonal skills.
Conditions like hypertension and heart disease are affected in a major way by the behavior of a person. A patient who fails to maintain some amount of physical activity when they have a heart condition or hypertension will likely get worse since diet and physical activity are important issues in the management of the two conditions. Major stressors that could affect the health of an individual include significantly major life changes, frustration, pain, death of a spouse, and the daily hassles of life. Conditions like schizophrenia and other mental illnesses are exacerbated by stress.
The factors that may be considered to be beyond a person’s control are mainly biological. The other factors such as behavior, personality, the environment can be controlled by the individual. The only problem is that change from behavior, personality, or an environment that predisposes one to poor health may not be easy to achieve. A factor like stressors may not be easy to prevent since some life changes occur without warning but having a social structure that is supportive helps the individual to manage life’s stressors.
Hypertension and heart disease are influenced by the factors mentioned in the multifactorial model. Hypertension is a condition characterized by a blood pressure above 130/90 mm Hg. Primary hypertension has been reported to have a genetic risk factor that is the mutation of sodium channels. The condition is closely associated with diet and physical activity as is coronary heart disease. In some cases, it is also familial in nature. An individual may have genes that predispose them to the condition.
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The same case applies to heart disease. Research shows that some behavior patterns increase the risk of getting hypertension. These include a sedentary lifestyle and high-fat, high-salt foods, and poor health-seeking behavior. Often people diagnosed with hypertension find it difficult to maintain their blood pressures within normal limits. In the initial stages, this is difficult because often what works for one patient may not work for another.
To find the drugs suitable for oneself an individual has to keep trying and testing groups of drugs. They also need to be motivated to keep their weight within the normal limits if they are obese or overweight. In this case, one’s psychological hardiness is really put to the test, and for a patient who may be generally pessimistic, they may be unable to manage the condition well. Further, if the patient does not have health-seeking behavior they are likely to ignore health risks associated with their condition.
Heart disease such as coronary heart disease is also genetic in nature and is affected by behavioral and personality factors as well as socio-cultural factors. Many people with coronary heart disease may have other diseases like hypertension, increasing stress levels further. In addition, individuals suffering from coronary heart disease may not be able to manage shocking news wells such as the death of a spouse or a significant life change. Most heart conditions require lifetime treatment or a long stay in hospital which means that a person whose socioeconomic status is low may not get treatment or if they do, the treatment may be of low quality.
Moreover, most heart conditions and hypertension require a change in lifestyle especially diet, for a person who can only afford fast food, this creates a challenge in adherence to treatment. Research shows that amongst the Americans with hypertension only, about 30 percent of them have their blood pressure under control (Rathus and Nevid, 2005). Various reasons have been cited for this poor compliance rate.
Among these are access to health care, socio-economic reasons, and behavioral as well as personality reasons. Sociocultural factors such as low income and discrimination usually affect people from a low socioeconomic status making management of conditions such as heart diseases and hypertension difficult.
To be able to provide effective and quality health care to an individual with either of the two chronic conditions, it is important to use the multifactorial model in the assessment of the individual. This will yield the information necessary to assist the client in improving their health.
For instance, it is important to know about the history of medication, since this will have a bearing on what medication the patient may get or not get. Further, family history is important since it could result in the detection of other family members who are at risk. This will provide an opportunity for early intervention and therefore better health. Holistic assessment will help generate information that could hinder the patient’s management of their condition.
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Once these challenges have been identified then the patient can be assisted to overcome them. In addition, in dealing with a hypertensive patient or one with a heart condition, it may be necessary to involve the family and friends of the patient where possible.
This provides them with social support to help them deal with their condition especially if it has been newly diagnosed. Sometimes involvement in a support group, for patients who may have other problems like depression, anxiety is helpful in getting the patient to deal with their condition better. Some patients may even benefit from financial help from sponsoring groups. This would be found where the person assessing a patient has conducted a holistic assessment with a multifactorial approach to managing the patient’s condition.
The multi-factorial model provides for diversity in managing a patient’s condition so that there is more inclusion of the person and personal adjustment is promoted and thus their health is improved (Rathus and Nevid, 2005). A combination of psychological, socio-cultural, personality, behavioral and biological factors affect how soon a patient gets back to good health after an illness and how long they can stay in optimum health.
National Research Council, 2001, An Integrative approach to new horizons in health, Future Directions for Social and Behavioral Sciences, National Health Institute, National Academies Press.
Rathus SA and Nevid JS, 2005, Psychology and life’s challenges: Adjustment in the new millennium, Hoboken, John Wiley and Sons, New Jersey.