建構以生物心理心靈社會面向於疾病之壓力－資源－調適模型圖：SRC BPS模型

Construct the Stress-Resource-Coping Model on Illness by Using Biopsychospiritsocial Aspects: SRC BPS Model

蔡崇煌(Chung-Huang Tsai) ； 黃素雲(Su-Yun Huang) ； 胡月娟(Yueh-Juen Hwu) ； 李孟智(Meng-Chih Lee)

《醫學與健康期刊》 3卷1期 (2014/03) Pp. 11-24

摘要

生物心理社會（Biopsychosocial; BPS）模型同時考量不同面向，但從字面上看，無法完全解釋相似壓力下，引致疾病的個別化差異；家庭壓力模型（ABCX）或健康照護模型（ABCDX），多加調適策略，則可解釋之，且改變生活型態亦可由此呈現，是比BPS模型更完整的呈現模式，但ABCD個別代表的意義，無法直接由其字母判定，致不易理解，且由字面上看亦未包含心理（靈）面向。因此，本文以蹺蹺板圖型，將以上模型做一整合，提出以BPS面向於疾病的壓力－資源－調適模型理論，是更完整的呈現模型。此模型有幾個特徵，1.以圖示呈現模型，將個人外形、內臟器官系統及心理（靈）代表一個完整個體，以蹺蹺板及BPS表示之，2.將ABCDX之壓力與資源、Double ABCX之時間考量及BPS融入模型中，位蹺蹺板兩側，3.支點代表面對壓力的調適策略，亦受BPS因素影響，進而改變支點不同位置及形狀，4.以SRC BPS命名之，字義分別代表壓力（stress）、資源（resource）、調適（coping）策略及生物心理心靈社會。本模型可供醫療人員的臨床應用，及畢業後一般醫學訓練全人醫療之醫學教育參考。

關鍵字

調適策略 ； 個別化 ； 醫學教育 ； 壓力

並列摘要

The biopsychosocial (BPS) model comprehensively explains the causes of illness, but it cannot interpret differences in individuals suffering similar stresses as well as ABCX the ABCDX models, which incorporate coping strategies. The latter two models also reveal modifications in lifestyle modification, making them more comprehensive than the BPS model. However, it is difficult to understand and interpret the different dimension of the ABC or ABCD of these models as their definitions of biomedical status do not include the psycho and spiritual dimensions. Therefore, the seesaw model was developed by integrating both models. In this model, first, the whole body with personal appearance, internal organ and psychology/spirit is displayed along with the traditional BPS. Second, the stress and resource dimentions of ABCX or ABCDX and the time sequence of Double ABCX are integrated with aspects of BPS, and located at either side of the seesaw. Third, the dynamic fulcrum, which denotes the coping strategy affected by BPS factors resulting in the different site and shape, is used to indicate the individualized differences. Fourth, SRC BPS is used to denote stress, resource, coping strategy and biopsychospiritsocial dimensions, respectively. Together, these make it possible for the model to serve as a reference for family physicians, other medical sub-specialties, and post-graduate students receiving further general medical education.

並列關鍵字

Coping strategy ； Individualized ； Medical education ； Stress