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B991 Health And Social Care Question: Explore and evaluate the utility of different models of health for understanding health and health care and the experience of illness Communicate effectively and appropriately in writing, producing a clearly articulated account of an informed argument supported by evidence Manage your own learning through identifying learning needs, which includes identifying strengths and weaknesses and where there is a need to improve; and responding to feedback and reflecting on your own work. Answer: Introduction Health is defined as a state of overall mental, physical and social well-being apart from the absence of diseases (Habersack and Luschin 2013). Health models can be described as the conceptual frameworks that are used to assess the health concerns that provide necessary health outcomes. There are three different models of health. These are the Biomedical model of health, the Social model of health and the Ottawa Charter for Health Promotion.  Biomedical model is practiced by doctors, social model is practiced by various individuals including doctors, while the Ottawa Charter for Health Promotion involves the building of health policies and community actions (Ogden 2012; Fertonani et al. 2015). This essay describes the case studies of two individuals Mary and Jane. Both of them suffer from Osteoarthritis. The Mary lives alone and was diagnosed with osteoarthritis five years ago. Previously, she did not experience in problems and was able to cope with her condition, however, she was suffering from pain in her knees for the last six months. She takes pain killers and is unable to sleep at night, thereby making her feeling lethargic. She is a working home and used to walk to her office, but due to the pain she is unable to walk or carry out daily activities. She is concerned about staying alone and coping with her pain. Jane on the other hand is trying to adjust to living alone. She was diagnosed with osteoarthritis ten years ago and has suffered throughout. It affected her hands and hips. She used to live an active life but due to the severity of the pain in her hands, she is unable to carry out her work. She is anxious of walking because of pain in her hips. Inspite of all this she wants to maintain her independence and live alone. She does not take any medication. This essay describes the case studies, determines the models of health demonstrated for each, describes the nature of the evidence and the values that defines the approaches used by the healthcare professionals.   Models Of Health There are three different models of health. These are the Biomedical models of health, Social models of health and Ottawa Charter for health promotion (Www.cdhn.org, 2017). The Biomedical model of health is an approach that deals with diagnosis, treatment and cure, but it does not involve the use of preventative measures to stop the disease from arising in the future. It involves the use of diagnostic measures for disease assessments, use of antibiotics for treatment and the use of technologies like latest surgical procedures to remove or treat the disease. It does not involve identification of the determinants responsible for the occurrence of the disease. The advantages of biomedical model of health is that it causes advances in both technology and research. This model of health focuses on diagnosis and treatment and as a result can stop the further spread of the disease. It decreases the mortality rates of patients and provides an overall favorable patient outcome. However, there are several disadvantages to the biomedical model of health. These are dependence on healthcare professionals as well as technology, thereby making this health model highly costly for providing patients relief from their disease states. It does not encourage the individuals to lead a healthy life and does not determine the effects of the environmental, social and economic determinants on patient health. Some diseases cannot be cured with advances in technologies and treatments (Hanney et al. 2015). The Social model of health helps to determine the social, environmental and economic determinants that affect health of an individual (Bircher and Kuruvilla 2014). It focuses on disease prevention rather than diagnosis and cure. It involves the application of educational and health promotion programs to bring about changes in the lifestyle of individuals, thereby helping in prevention of the disease in the future. The advantages associated with this health model is that it helps in addressing the determinants of health of the individuals, it helps to empower individuals through education, it helps to reduce social inequalities, provides access to healthcare systems and involves a co-ordinated approach to health by involving healthcare professionals from different sectors. This health model is not limited to use by doctors only and involves the use by other healthcare professionals. The disadvantages associated with this health model is that the education is limited to only the patient and does not address an entire population, lifestyle changes are difficult to be carried out, every disease cannot be prevented and it is difficult to measure the effectiveness of this model as the results obtained are not instantaneous and requires a long time in order to observe the effects (Www.atsdr.cdc.gov, 2017). The World Health Organization developed the Ottawa Charter of Health Promotion. It involves the building of health policies, supportive environments, development of skills, reorientation of health services and development of community actions in order to provide a stable ecosystem that enables individuals to improve their health and lifestyle (Fry and Zask 2016; Lee 2015). Model Of Health In Case Study 1 The model of health demonstrated by case study 1 is the Biomedical model of health. This is because Dr. Collins assessed the range of movement of Mary’s shoulders and kher knees as well. For assessing the range of movement, the doctor must have carried out diagnostic test, which involves the use of a Goniometer that helps to measure the angle at the joints. The Goniometers show degrees ranging from 0 to 180 or 360 degrees (Sarac, Yalcinkaya and Unver 2017). The doctor also recommended her the use of analgesic medication in order to reduce her pain, which were affecting her daily activities. He also explained the effective of this medication for providing pain relief to people suffering from osteoarthritis. He also suggested Mary to consume slipping pills, as she was not able to sleep at night. He advised her to get hold of the latest developments and research that are being carried out for treatment of osteoarthritis. Moreover, he also referred her to an orthopedic consultant at a hospital in the locality and informed her about the various surgical procedures and joint injections available for the treatment of osteoarthritis. Biomedical model of health promotes disease diagnosis and treatment. In this case study, also Dr. Collins carried out necessary assessments and provided medications to treat her pain. However, he did not recommend her to carry out any preventative measures like exercises that can prevent the disease to occur in the future. Moreover, he also provided her treatment options in the form of surgeries that use the latest technologies and research. He also provided her options relating to joint injections that are known to treat osteoarthritis (Jo et al. 2014). Thus, the treatment options that he provided her made her dependent on healthcare professionals and no such role for her with respect to disease prevention and control. Moreover, the latest surgeries recommended by him are highly expensive and will be a great financial burden for her. Additionally, he did not determine the social, economic and environmental determinants associated with her current medical condition. Thus, even though she understood that her pain will be treated but the prospects of surgery raised many questions in her mind regarding future decisions. Model Of Health In Case Study 2 The model of health demonstrated by case study 2 is the Social model of health. This is because Dr. Salter examined and assessed Jane’s condition regarding her pain in the hands and hips as a result of osteoarthritis, which she had been suffering for the last 10 years. He also listened to her concerns regarding her health and also understood her determination to remain independent. He provided her with medications that can relieve her pain. He also suggested her to get her X-Ray done, so that he can refer her to specialist treatments. He advised her about the importance of exercise programs in the treatment of osteoarthritis and also provided her with information about other exercise forms like swimming, which might also help her to prevent such occurrences of pain in the future (Bartels et al. 2016). He also referred her to a physiotherapist at the medical center and to an occupational therapist, who can give her information about the use of equipments or gadgets that might be useful to her. Thus, in this case the doctor assessed her social and other determinants that contributed to her current medical condition. Moreover, he helped her to increase her knowledge about osteoarthritis and local self-help groups by providing her with leaflets. He noted her wish to remain independent and as a result offered her advice about consulting the self-help groups. He provided her with prevention strategies in the form of exercises and swimming that would help her to prevent the recurrence of pain and discomfort. He also involved other healthcare professionals like physiotherapists and occupational therapists to address her problem and provide pain relief to her (Jansen, Hendrick, and Ellis 2017). Moreover, the approaches provided by him to prevent osteoarthritis were comparatively less expensive than the latest surgical procedures that were recommended for the treatment of osteoarthritis as described in the first case study. Thus, all these approaches followed by Dr. Salter helped Jane to be reassured about her future. Thus, Dr. Salter followed the social model of health in order to provide long-term relief to his patient Jane. Nature Of Evidence The nature of evidence based on which healthcare advice was provided by the doctor  in the first case study involved proper assessments of range of motion involving specific diagnostic techniques. The healthcare advice provided by the doctor involved the recommendation of evidence-based medication (Greenhalgh, Howick and Maskrey 2014). The doctor’s advice regarding the treatments was also based on the reports in leading journals that have provided descriptions about the latest surgeries, research and technologies. Thus, the nature of the evidence in the first case study is highly specific and supported by latest research published in reputed journal articles. The nature of the evidence in the second case study was not specific as it did not involve the use of diagnostic procedures and was essentially based on observational assessments, since the doctor just assessed the way the patient walked. His choice of medication was not supported by evidence. He provided her with pain relieving medication before assessing the extent of her medical condition. Moreover, the effectiveness of the prevention and treatment strategies recommended by the doctor like exercises and swimming were also not supported by evidences. The nature of the evidence was based on the descriptions provided by the patient about the ongoing medical condition, rather than on medical tests as was in the first case study. Values In Healthcare Value in healthcare represents the favorable health outcomes achieved by the patients or customers with respect to the amount of money spent by them. The value of the healthcare system is based on providing patient satisfaction with regard to health and finance. The value should always be centered around the patient as well as involving the rewards for other healthcare sectors, which were working as a team to provide benefits to the patient (Mitchell et al. 2012). The value of healthcare in the first case study involved the use or recommendation of a single intervention that is surgery. Moreover, as value in healthcare is based on providing benefit to patients at both the physical and financial level, the recommendations of intervention strategies in the first case study were not associated with providing favorable financial outcome for the patient. Moreover, the recommendations of treatment interventions did not involve the engagements of healthcare workers from other interrelated sectors. Thus, it did not involve the use of services provided by other healthcare sectors that could have provided favorable patient outcome. Thus, integrated care units were not utilized in order to address the total care that can be provided to treat the medical condition. The value of health defined in the second case study involved a compatible patient doctor relationship, where the doctor understands all aspects of the patient’s situation not just the addressed medical condition and provides intervention strategies that would provide a sustainable recovery for the patient. The second case study also involved healthcare workers of interrelated sectors like the physiotherapists, occupational therapists, among others to address the medical condition of the patient and provide long-term relief. The value of health also looked after the financial outcome of the patient by providing interventions that are highly patient friendly with respect to favorable health and financial outcome (Robert et al. 2015). Conclusion Thus, it can be concluded that the essay describes two different models of health utilized in the two case studies described. The first case study involved the biomedical model, which is highly specific as it is based on diagnosis and specific evidence based treatments. The second case study involved the use of the social model of health, which is based on assessments of health with respect to socio-economic determinants. Moreover, it is more pocket friendly for the patients and involves the use of services provided by different healthcare workers in order to provide sustainable treatment and long-term prevention. It also helps in educating the patients about their medical condition and allows the patient to take responsibility of their own health. Reference List Bartels, E.M., Juhl, C.B., Christensen, R., Hagen, K.B., Danneskiold?Samsøe, B., Dagfinrud, H. and Lund, H., 2016. Aquatic exercise for the treatment of knee and hip osteoarthritis. The Cochrane Library. Bircher, J. and Kuruvilla, S., 2014. Defining health by addressing individual, social, and environmental determinants: New opportunities for health care and public health. Journal of public health policy, 35(3), pp.363-386. Fertonani, HP, Pires, DEPD, Biff, D. and Scherer, MDDA, 2015. The health care model: concepts and challenges for primary health care in Brazil. Science & collective health , 20(6), pp.1869-1878. Fry, D. and Zask, A., 2016. Applying the Ottawa Charter to inform health promotion programme design. Health promotion international, p.daw022. Greenhalgh, T., Howick, J. and Maskrey, N., 2014. Evidence based medicine: a movement in crisis?. Bmj, 348, p.g3725. Habersack, M. and Luschin, G., 2013. WHO-definition of health must be enforced by national law: a debate. BMC medical ethics, 14(1), p.24. Hanney, S.R., Castle-Clarke, S., Grant, J., Guthrie, S., Henshall, C., Mestre-Ferrandiz, J., Pistollato, M., Pollitt, A., Sussex, J. and Wooding, S., 2015. How long does biomedical research take? Studying the time taken between biomedical and health research and its translation into products, policy and practice. Jansen, V., Hendrick, P. and Ellis, J., 2017. Therapy management of thumb carpometacarpal osteoarthritis: Exploring UK therapists’ perceptions of joint instability. Hand Therapy, p.1758998317698099. Jo, C.H., Lee, Y.G., Shin, W.H., Kim, H., Chai, J.W., Jeong, E.C., Kim, J.E., Shim, H., Shin, J.S., Shin, I.S. and Ra, J.C., 2014. Intra?articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof?of?concept clinical trial. Stem cells, 32(5), pp.1254-1266. Lee, M.S., 2015. The principles and values of health promotion: building upon the Ottawa charter and related WHO documents. Korean Journal of Health Education and Promotion, 32(4), pp.1-11. Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C.E., Rohrbach, V. and Von Kohorn, I., 2012. Core principles & values of effective team-based health care. Washington, DC: Institute of Medicine. Ogden, J., 2012. Health psychology. McGraw-Hill Education (UK). Robert, G., Cornwell, J., Locock, L., Purushotham, A., Sturmey, G. and Gager, M., 2015. Patients and staff as codesigners of healthcare services. Bmj, 350, p.g7714. Sarac, D.C., Yalcinkaya, G. and Unver, B., 2017. AB1197-HPR Validity and reliability of a smartphone goniometer application for measuring hip range of motion in patients with hip osteoarthritis: a pilot study. Www.atsdr.cdc.gov, A. (2017). Chapter 1: Models and Frameworks | Principles of Community Engagement | ATSDR. [online] Atsdr.cdc.gov. Available at: https://www.atsdr.cdc.gov/communityengagement/pce_models.html#Ecological [Accessed 4 Dec. 2017]. Www.cdhn.org (2017). Cite a Website – Cite This For Me. [online] Cdhn.org. Available at: https://www.cdhn.org/sites/default/files/oldwebsite/FACTSHEETS%201_Screen%20View%281%29.pdf [Accessed 4 Dec. 2017].

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