Progress+ Principle of the Month 5: A biopsychosocial approach is applied at all times

Summary

Dr. Lil Breen, a general and community pediatrician, discusses the importance of the biopsychosocial approach in pediatric care. She highlights the need to consider psychological and social factors in managing children’s health. Breen emphasizes the significance of understanding complex family dynamics, mental health challenges, and the transition from children’s to adult services. She suggests practical strategies for pediatric trainees, such as addressing psychosocial issues in patient encounters, utilizing local resources, and supporting mental health early. The discussion also covers how trainees can assist patients in preparing for the transition to adult healthcare services.

Takeaways

• 😀 A biopsychosocial approach is crucial in paediatric care, as psychological and social factors greatly influence children's health and well-being.
• 😀 Paediatricians should consider the family dynamics and the social challenges faced by each child, as they can significantly affect the child's health and development.
• 😀 Understanding the broader context of a child's life, including their emotional well-being, social life, and school experience, helps provide holistic care.
• 😀 Trainees can develop strategies for psychosocial care by discussing these aspects with patients and the multidisciplinary team (MDT), incorporating factors like home life and education.
• 😀 Important psychosocial factors to consider include family life, activities, mental health risks (e.g., drugs, alcohol, suicidal thoughts), and sexual health.
• 😀 Incorporating questions about psychosocial factors into routine consultations helps paediatricians provide more comprehensive care and make a greater impact.
• 😀 Mental health issues in young people are on the rise, but early intervention can help prevent deterioration by encouraging healthy habits and recommending local resources.
• 😀 Paediatricians should be familiar with available local mental health resources and suggest these to patients in need of support.
• 😀 Trainees can benefit from time spent with child and adolescent mental health services (CAMHS) practitioners to better understand how to manage mental health issues in young patients.
• 😀 Transitioning from children's services to adult services can be a challenging process, and preparing young people and their families for this shift is essential for a smooth transition.
• 😀 Paediatricians should stay informed about adult services and, when possible, participate in joint transition clinics or attend adult specialty clinics to better understand how to prepare patients for adulthood.

Q & A

What is the importance of a biopsychosocial approach in paediatric care?

A biopsychosocial approach is crucial in paediatric care as it takes into account the psychological and social aspects of children's lives, which greatly influence their health and well-being. By addressing these factors, paediatricians can provide a more comprehensive and effective level of care.

How should paediatricians consider the psychosocial factors when reviewing a patient?

Paediatricians should evaluate what might be affecting a child's difficulties by considering the family dynamics, the child's schooling and social life, and emotional well-being. It is important to consider how the diagnosis might impact the child’s experiences in these areas.

What are some strategies for trainees to support psychosocial aspects of patient care?

Trainees can develop strategies by maintaining an awareness of the psychosocial aspects during patient encounters. Discussing these factors with the patient and the multi-disciplinary team, as well as using frameworks like predisposing, precipitating, and perpetuating factors, can help guide their approach.

Why is it important to ask about factors like home life, education, and mental health during patient interviews?

These factors often have a bigger impact on patient management than traditional medical history questions like allergies or birth history. Asking about these topics can reveal underlying issues that influence the patient’s overall health and care plan.

How can paediatricians support children and young people struggling with their mental health?

Paediatricians can support young patients by encouraging healthier lifestyles, such as physical activity and better nutrition, and by recommending local youth groups and resources. Additionally, knowing about mental health apps, websites, and local services can help guide patients towards appropriate support.

What challenges exist in supporting mental health in children and young people?

Mental health services are often overburdened, with resources focused on high-risk patients. Paediatricians can help prevent mental health deterioration by supporting children early and making simple recommendations, even though these services may not always be immediately available.

Why is it beneficial for trainees to have exposure to CAMHS practitioners?

Spending time with Child and Adolescent Mental Health Services (CAMHS) professionals, including psychologists and psychiatrists, can give trainees insight into how mental health issues are assessed and managed. It also helps them learn how to address sensitive questions that may arise during patient care.

What are the key aspects of preparing young patients for the transition from children's to adult services?

Preparing young patients involves discussing the transition well in advance, understanding available adult services, and promoting autonomy. Joint transition clinics with adult specialists and attending adult specialty clinics can also provide valuable insights into the process.

What can paediatricians do if joint transition clinics are not available?

If joint transition clinics with adult specialists aren't possible, paediatricians can attend adult specialty clinics themselves to understand how services are delivered. This knowledge can then be used to prepare young patients for the transition.

Why is good communication between patients and primary care services important during the teen years?

Effective communication between patients and primary care services is essential during the teenage years to ensure continuity of care, particularly as patients transition to adult services. This communication helps to manage expectations and supports the child’s ongoing health management.