PSYCHOSOCIAL ASPECTS OF CARE
The emotional response of the patient during illness is of extreme importance. The mind-body-spirit connection is well
established; it is known, for example, that when a physiological response occurs, there is a corresponding psychological
response. Also, there are physiological conditions that have a psychological component, for example, the emotional
instability associated with steroid therapy or Cushing’s syndrome or the irritability of hypoglycemia. Rapid growth in
the field of psychoneuroimmunology is regularly providing new information about these issues.
With expanding technology in healthcare, ethical issues are hotly debated. Although the stress of illness is well
recognized, the effect on the individual is unpredictable. It is not necessarily the event that creates problems, but rather
the patient’s perception of and response to the event, which may result in unmet psychological needs that drain energy
resources needed for healing. The caregivers’, patients’, and significant others’ (SOs) values, sensitivity to different
cultures, and language barriers (including difficulties that people have in talking about their bodies) affect the care a
patient expects and receives.
Any setting in which nursing contact occurs/care is provided.
This is an aspect of all care and plans of care.
Assessment Factors to Be Considered
Age and gender
Religious affiliation: church attendance, importance of religion in patient’s life, belief in
life after death
Level of knowledge/education; how the individual accesses and incorporates information,
e.g., auditory, visual, kinesthetic
Patient’s dominant language/literacy? Knowledge and use of other languages? Style of
Patterns of communication with SOs, with healthcare givers?
Perception of body and its functions: In health, illness, this illness?
How does patient define and perceive illness?
How is patient experiencing illness versus what illness actually is?
Emotional response to current treatment/hospitalization
Past experience with illness, hospitalization, and healthcare systems
Emotional reactions in feeling (sensory) terms: e.g., states, “I feel scared.”
Behavior when anxious, afraid, impatient, withdrawn, or angry
Marital status; SOs, nuclear family, extended family. Recurring or patterned relationships
Family development cycle: Just married, children (young, adolescent, leaving/returning
What are the interaction processes within the family?
Patient’s role in family tasks and functions
How are SOs affected by the illness and prognosis?
Lifestyle differences that need to be considered: Dietary, spiritual, sexual preference, other
community (e.g., religious order, commune, retirement center)