Key Points
- A conversation about health shapes beliefs and behaviours: The ways in which we talk about health, known as health discourses, play a significant role in shaping how individuals perceive and manage their health. The traditional biomedical discourse, with its mind-body dichotomy, views the body as a machine that can break down, leading to various diseases. Acknowledging biological, psychological, and social factors is essential for a more comprehensive understanding of health.
- Importance of language in managing osteoarthritis: This article focuses on osteoarthritis as a case study and highlights the prevailing language and misconceptions surrounding the condition. Framing osteoarthritis as a consequence of a “broken body machine” caused by wear and tear over time perpetuates the belief that it is an inevitable part of ageing. “However, evidence supports high-value care involving exercise, weight control, and education to manage symptoms and lead active lives.”
- Shifting to a participatory-based approach: The International Classification of Functioning, Disability and Health (ICF) provides a framework that promotes a participatory-based approach to health. This approach emphasises participation in life situations as the ultimate health outcome, shared across all levels of society. By shifting the way clinicians communicate with individuals with osteoarthritis, focusing on what they can do to improve their health and maintain active bodies, it is possible to promote healthy, engaged lives and encourage uptake of evidence-based interventions.
Synopsis:
A 3-part series delves into the influence of language and communication in shaping health beliefs and behaviours, using osteoarthritis as a case study.
Part 1 introduces the concept of health discourses and their impact, focusing on the mind-body dichotomy prevalent in traditional biomedical discourse. It discusses the importance of acknowledging biological, psychological, and social factors in health, and how the International Classification of Functioning, Disability and Health (ICF) provides a more comprehensive framework for discussing health. The article highlights the prevailing misconceptions and facts about osteoarthritis, emphasising the significance of high-value care through exercise and lifestyle modifications.
Part 2 will explore the impairment-based way of talking about osteoarthritis, while Part 3 will propose strategies for a participatory-based approach that promotes healthy, active lifestyles.
Communicating Health:
Ways of talking about health, also known as health discourses, significantly influence individuals’ health beliefs and actions. This article series raises awareness among clinicians about the impact of their communication on people seeking healthcare, specifically focusing on osteoarthritis as an example.
The Mind-Body Dichotomy:
The biomedical discourse prevalent in medicine stems from Cartesian dualism, treating the mind and body as separate entities. According to this perspective, the body is akin to a machine with various parts that can break down, leading to diseases. Pain is perceived as a symptom of physical damage, and excessive suffering is attributed to a weakness of the mind. This dichotomy can stigmatise individuals with chronic pain and hinder holistic care.
Acknowledging Biological, Psychological, and Social Factors:
Medical science has advanced beyond the mind-body dichotomy, recognising the influence of psychosocial factors on an individual’s health. Health outcomes are not solely dependent on a “broken body machine” but also on the person’s context and choices. However, emphasising individual responsibility for health may disadvantage those impacted by social determinants of health. The World Health Organization’s biopsychosocial framework (ICF) offers an evidence-based way to talk about health, emphasising participation in life situations as the ultimate health goal, shared across all levels of society.
A Case Study – Talking in Orthopaedics:
Osteoarthritis, a prevalent joint condition, is often framed in the context of a broken “body machine” due to wear and tear over time, leading to misconceptions and low adherence to recommended interventions. High-value care, involving exercise, weight control, and education, can help individuals with osteoarthritis manage their symptoms and lead active lives. However, barriers like pain, disability, health literacy, clinician biases, and inadequate services hinder access to such care. Furthermore, the language used by individuals with osteoarthritis and clinicians can perpetuate misunderstandings about the condition, leading to reduced uptake of activity-based interventions.
Effective Communication:
Effective communication about health is crucial in shaping beliefs and behaviours. Part 1 of this series introduces the impact of health discourses and the mind-body dichotomy prevalent in traditional medicine. It emphasises the significance of acknowledging biological, psychological, and social factors in health and introduces the ICF framework as an alternative way of talking about health. The article highlights common misconceptions and important facts about osteoarthritis, stressing the importance of high-value care through exercise and lifestyle modifications.
Next in Part 2, the impairment-based way of talking about osteoarthritis will be explored, followed by Part 3, which will propose a participatory-based approach to support active lifestyles and improve health.
Ref: Broken Machines or Active Bodies? Part 1. Ways of Talking About Health and Why It Matters J Orthop Sports Phys Ther 2023;53(5):236-238. doi:10.2519/jospt.2023.11879
