Year: 2026 | Month: October | Volume: 13 | Issue: 10 | Pages: 189-202
DOI: https://doi.org/10.52403/ijrr.20261017
Biopsychosocial Dysfunctions: Insights for Medical Social Work from Exploratory Clinical Case Studies on Pressure Ulcers
R. Vinodh Rajkumar
Medical Anthropologist, Physiotherapist & Gerontologist.
Pursuing Master of Social Work at Tamil Nadu Open University, Chennai.
Corresponding Author: R. Vinodh Rajkumar
ABSTRACT
Many diseases have the inherent potential to force the patients to be in prolonged immobilization accompanied by intractable biopsychosocial dysfunctions. In fact, even short-term immobilization could disturb homeostasis and trigger multiorgan health complications that are explained in research studies on the basis of immobilization timeline. Such critically ill patients also might become fully dependent by losing their ability to perform basic activities of daily living that can be quantified through Barthel Index (feeding, bathing, grooming, dressing, bowel and bladder continence, toileting, bed to chair transfers, mobility on level surface, stair climbing). Though not widely noticeable in the society, individuals under long-term immobilization are at the risk of excruciating pressure ulcers (bed sores) as their Barthel Index score continues to decline or remain very low without any improvements. Preventing pressure ulcers should be one of the primary priorities in the rehabilitation of patients in critical condition (palliative care, hospice care) whose diseases are well-known for their devastating secondary complications arising out of highly restricted physical activity, compounded by unfavorable social determinants of health (SDOH) and substandard health-related social needs (HRSN). Findings of few exploratory clinical case studies are discussed in this article with an aim of inculcating the utilization of early mobility to prevent pressure ulcers including the possibility of healing them through infrared radiation therapy before they grow deeper due to excess loss of tissue. Such interventions must be promptly attempted without missing the best window of opportunity by integrating the family social capital and expertise of medical social workers. Applying ‘satisficing healthcare approach’ based on bounded rationality and limited available resources may bring unexpected positive outcomes even for critically ill patients. Competent medical social workers may also be capable of improving downstream determinants (individual-specific healthcare, lifestyle, family dynamics) by influencing and improving upstream conditions (macro-level policies), eventually minimizing the prevalence of pressure ulcers and improving the quality of palliative or hospice model of healthcare.
Keywords: Pressure ulcers, Bed Sores, Decubitus ulcers, Medical Social Work, Social Determinants of Health, Health-related social needs, Biopsychosocial model, Infrared radiation therapy, Physiotherapy, Barthel index
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