In the early days of nursing, the profession was thought of as anything but intellectual. Doctors argued that they were the ones equipped to make serious decisions and that all nurses needed to know was how to perform the tasks appointed to them. However, this has changed a great deal over time, and nursing is now a respected discipline in its own right, contributing to patient health in a way that is often independent of what doctors do and that can get results even where their efforts fail.
Its focus is on the promotion of health and looking after a person on a holistic level. To succeed, however, nurses need to take more than just medical or biological factors into account, and that’s where developing a solid understanding of aspects of psychology and sociology proves useful.
If you’ve been looking at accelerated nursing programs online, you’ve undoubtedly noticed the focus on studying these areas to develop a better understanding of the complexities of patient care. The BSN program at Baylor University’s Louise Herrington School of Nursing is an intensive full-time program with a combination of teaching methodologies including online courses, clinical and lab experiences, and hybrid interactive learning courses.
The complexity of patient care wasn’t always a part of nurses’ education; it emerged following the development of the biopsychosocial model of health in the late 1970s. Contentious at the time but now widely accepted, this model holds that biological factors are not the only contributors to illness (although they may be the primary ones in some cases), and that psychological and sociological factors also need to be taken into account.
In other words, the condition of the individual patient’s mind and the condition of the society from which that patient has emerged should also be considered when reflecting on what is necessary to improve the patient’s overall health.
Psychological factors in illness
Understanding the way that psychology affects health goes well beyond looking at factors like the links between stress and heart health or concerns about patients malingering when they might benefit from taking a more positive attitude. It focuses heavily on behavioral aspects and helps nurses to determine what additional support individual patients might need and what communication strategies might be most effective for engaging with them.
In this context, psychology looks not just at the innate characteristics of the mind but also at acquired characteristics, the most important being education. Knowing a patient’s educational level and whether or not they have undergone any medical or scientific training is tremendously useful when determining how to explain things to them and establishing the degree to which they are capable of making fully informed decisions about complex aspects of their treatment.
It is also useful to know if a patient is neurodivergent (and if so, how) in order to figure out how to work around any apparent stumbling blocks in communication.
In addition, patients’ motivation and general attitude to treatment must be taken into account. Will they actually stick to a diet or exercise plan? If not, can it be adjusted to increase the likelihood that they will do so? Can they be relied upon to take medication properly? If not, do they need support to do so, or could they receive treatment in a different way? How capable are they of following hygiene protocols, and is their behavior likely to differ in different social environments? Do they have phobias that might affect their ability to comply?
Understanding a patient’s lifestyle is also important. For example, a shift worker may be unable to stick to a regular pattern of sleeping and eating, no matter how beneficial it might be. Nurses need to be realistic about risk-taking behaviors and ensure that patients trust them enough to be honest about them. They also need to look for ways in which lifestyle can be advantageous – for example, a patient who isn’t interested in formal exercise might be happy to go out dancing more often.
Sociological factors in illness
Illness is often caused by social factors over which patients have limited control. However, it is still important to be aware of these because interventions may be possible, often through referrals to social services. In cases where this is not the case, there may be ways to mitigate the problem. For example, exposure to mold and fungus in low-quality housing has a massive deleterious effect on the health of US citizens, but if they are made fully aware of the risks and taught effective methods of treating infestations, individuals can reduce their exposure. They can also be made aware of the symptoms of related illnesses and advised on when to seek help.
The biggest single factor affecting general health and life expectancy is poverty, and this is very hard to tackle at an individual level. Nevertheless, advice on topics such as how to eat more healthily on a tight budget can still be useful. For many people, the problems associated with poverty are becoming harder to deal with because they are changing as a result of climate change, creating a need for new strategies and solutions. Heat waves disproportionately affect people in poor-quality housing who can’t afford air conditioning, but they can at least be given advice on staying hydrated without upsetting their electrolyte balance. As familiar foods become too expensive, they might need help to find suitable substitutes. Where they are exposed to flooding, they need to know how to manage risk.
Nurses also need to take cultural factors into account. A patient’s religion may affect which treatments they are willing to undergo. Exposure to misinformation may lead to risky behaviors, such as ceasing to take essential medication.
The informed nurse
Nurses who are properly informed about the psychological and sociological factors affecting their patients are better at anticipating their needs and reactions and at planning approaches to treatment that will work for them, in addition to helping them to improve their general health. They can also help to advocate for communities facing health crises, either on their own or in partnership with social workers, and they can feed into public health policy in a way that helps to reduce illness in the general population.