Family Medicine, Preventive Medicine, Uncomfortable life saving questions

Doctors are not gossiping: Psychosocial History.

 

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This is the part of your medical history that is more uncomfortable to register, for you and for the practitioner. Sometimes physicians don’t complete this section until there is an established and fairly good doctor patient relationship.

Filled with very personal questions, the Psychosocial History collect those parts of your social, sexual, family, educational and work life that might be having an influence, for good or for bad, in your current physical and mental health condition.

Variables of the content of the psychosocial history.

· Socioeconomic characterization. Age, sex, marital status, family life, schooling, occupation, sexuality…

· Assessment of your illness or current physical status.

· Presence of acute and chronic stressors.

· Perception of social support.

· Emotional state and coping with the disease.

The physician may gather this information following a questionnaire including:

1. Patient identification:
Name, age, genetic sex, gendeethnicity, marital status, number of children, school level (last grade reached), occupation, type of job or retiree (job you did and how long you have been retired). If she is a housewife, find out if she worked, what activity made her reasons for leaving the job.

2. Conditions of the interview: where we interview you, who is with you, your attitude after asking you permission for making more personal questions.

3. Birth and development: Where  were you born, occupation of the parents, social extraction. Example”He was born in normal, domiciliary or hospital delivery”. Psychomotor development: age at which he walked and spoke; conditions of importance in childhood, Example: seizures, serious illnesses, accidents, loss of consciousness, oneurological psychiatric treatment, among others.

4. Family environment:
Family stability, divorced parents, arguments, aggressiveness, number of siblings, patient relationships with these or other family members.

5. School History:
Age when school started, how it adapted, school performance at each level, whether it failed or dropped out of school.

6. Labor History:
Age at which he started working, where, why he did it, how he behaved, what development he has had until now.

7. Psychosexual and Marriage History:
Age of first knowledge about sexuality, through who obtained it, what were these, conflicts related to masturbation or variants of sexuality, age of first sexual relationships, whether or not they were satisfactory, dating relationships, marriages, children, divorces and current situation (if you are satisfied or have any disorder or difficulty).

8. Interests, philosophical and political attitude: Preferences, interests, what he spends his free time, religion he professes and if he is interested in politics.

9. Assessment of the current disease:
What do you know about your disease, do you think you know enough about it? Has it interrupted important activities or plans? If your illness has caused limitations or sequelae

The history gives an idea of 2 important aspects of your health process:

Affectation.  Your illness or condition or risk factor and any expression of repercussion of your disease and medical care in the life of relationships in the spheres: couple, family, work or student, activities of daily life, self-care.

Suffering: How do you feel about your health status. Any expression of emotional and sentimental response to illness and medical care. Ipinions about the causes of your illness, concerns about your life and expectations about the solution of your problem.

When the psychosocial history is not collected, your doctor is missing important information that could be the base of your stress, lack of recovery, lack of compliance with the indications that you did receive…

Modern medicine should be patient centred and personalized. If your practitioner doesn’t know your social and psychological background, he can’t help you to keep nor to recover your health because he will be missing a significant component of the equation.

 

Art from:

Secrets

 

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