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Sociology and Nursing

1. INTRODUCTION

Sociology is the science of human relationships. It studies man as a social animal. It deals with human groups, and tracks the evolution of customs and behavioural patterns that are handed down from generation to generation through personal contacts.

The primary goal of sociology in nursing is promotion of health and prevention of illness and injury. Health promotion and illness prevention in the population may be achieved through interventions directed at the total population or at the individuals, families, and groups, which constitute its members.

Public health nursing is the practice of promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences. The practice is population focused with the goals of promoting health and preventing disease and disability among all people through the creation of conditions in which people can be healthy. Community health nurse is a partner in a health team, who provides nursing care, treatment to the sick, health counselling, and works in different places such as homes, schools, and health centres. He or she is also responsible for family-centred care.

During the Middle Ages, nursing was carried out by religious or military groups, whose primary function was not nursing care, but they cared for the poor and destitute. The nursing needs of the sick were met by the members of the family at home. It was the evolution of medicine, surgery, and public health into complicated technical dimensions, which led to the requirement of many procedures to be performed by specialized persons. The Crimean War made the establishment of nursing collectively organized and institutional resources were linked to its military basis. However, the war and other social changes in the middle of the 19th century also brought the nurse into close association with the physician, giving him or her control and jurisdiction over nursing activities—not only over curative actions but also over those which involved the patients’ comfort, sanitary needs, and all other conditions associated with his or her patients’ status.

2. SOCIOLOGICAL ASPECTS OF NURSING

Sociology has several branches such as social psychology, industrial sociology, sociology and medicine, sociology of religion, sociology of education, sociology of family, rural sociology, and so on. Similarly, the importance of sociology in nursing is widely accepted. Sociology demystifies the nature of health and illness, highlights the social causes of disease and death, exposes power factors and ethical dilemmas in the production of health care, and either directly or indirectly helps to create a discerning practitioner, who then becomes capable of more focused and competent decision making. There has to be a fair and realistic balance between how much of social science, biological science, and pure nursing is accommodated in the education of nurses.

Considering the patient as a person is a precept given as the introduction to the special aspects of nursing care and nursing education. The relationship between the social conditions and the factors that influence health or development of disease is now established. Health problems tend to be accepted from the perspective of particular societies and cultures and, as a result, people have usually responded to the threat of disease in predictable ways. The knowledge about norms, values, beliefs, social structures, and lifestyles has provided insight not only about the social organization and human resources designed to cope with health problems, but also about the very nature and cause of illness. The knowledge of sociology will help nursing students understand and appreciate the social factors of health and illness, mortality, and fertility; problems of the aged; the social milieu of the most vulnerable groups in the society; children and expectant mothers; the social functions of health institutions; the relationship of systems of healthcare delivery to other social systems; and the social behaviour of the health personnel and of those people who are the users of the healthcare systems.

Individuals are composed of bio-physical, psychological, spiritual, and socio-cultural elements. They develop through life cycles and stages. They have varying abilities to meet hierarchical needs as they strive towards health, growth, and self-actualization. Culture is viewed as the context within which self-care behaviour is learned. Society is composed of individuals, groups, and communities. It is dynamic and shares a reciprocal relationship with integrated patterns of human behaviour. Nursing is a dynamic practice discipline and its focus is on caring for individuals, groups, and communities. Using a holistic approach, social education provides the foundation for the nurse to understand the bio-physical, psychological, spiritual, and socio-cultural aspects of individuals, groups, or communities. Nursing is composed of actions and roles involving human services, interpersonal processes, and technology. Actions and roles are deliberately selected and performed by nurses to help individuals, groups, or communities under their care maintain or change their self-care practices.

3. NEED FOR SOCIOLOGY IN NURSING

Sociology is a body of thought about man’s inter-human life. To know how sociology illuminates human experiences, one must first understand what it is. It studies the general characteristics common to all classes of social phenomena, of the relationship between these classes, and of the relationship between social and non-social phenomena. It chooses interaction as the unit into which the phenomena should be analysed. The diseases and cures differ according to habits, social and economic, climatic variations and ways of life. Those concerned with health care must reckon both the general importance of human biology and socio-economic and environmental diversities of health problems, such as constant and unavoidable exposure to the stimuli of urban and industrial civilizations, the impact of technological advancement, physiological disturbances, emotional trauma, and the disruption of set patterns of community and society.

Figure 2.1 Need for Sociology in Nursing

Sociology is concerned with the study of human relationships, and more specifically, with the formulation and perpetration of these relationships and of the individuals who enact them, within the broad context of human society. Sociology seeks to explain how it is that human system and organizations exist over time in a recognizable and ordered fashion. Nursing services meet the needs of the society and any major change in social structure and dynamics will bring about changes in nursing too (Table 2.1).

 

TABLE 2.1 The Needs of Nurses to Study Sociology

Concepts	Areas
Cultural values	Nurses need to know the cultural aspects of health services, health institutions, health problems, and prevailing health practices
Prediction	Nurses should be aware of modes of prediction
Social structure	Nurses need to know the social structure of the society, based on which they can plan the nursing process
Distribution of power	Nurses should provide care to the community effectively by utilizing and distributing their power equally
Political organizations	Nurses should be aware of various political organizations existing within the community and the nation in order to help the people avail healthcare facilities
Mobilization	Nurse should know mobilization of resources and pattern of their uses within the community in the context of cultural perception and cultural meaning of the health problems

4. IMPORTANCE OF SOCIOLOGY IN NURSING

Sociology plays an important role in the area of health sciences. Medicine and nursing have the common goal of prevention and restoration of health. However, the primary role of medicine comprises diagnosis and treatment, that is, the cure process. In contrast, the primary role of nursing lies in the care process—consisting of caring, comforting, and guiding. Nurses play a significant role in health-care profession. They are the key persons, who have significant influence over the members of the society. They have to work for the maintenance of healthier lifestyles and high standards of living.

Sociology is closely related to personal and community health. Specialized branches of sociology, such as medical sociology and hospital sociology, have come into existence, and these emphasize the importance of sociology in the area of health.

The study of sociology is important for nurses due to the following reasons:

• Sociology helps understand those forces and pressures which affect patients adversely.
• It helps the nurses understand the behaviour, conflicts, interpersonal relationships, hierarchy, groups, adaptation, and so on, of different people working in hospitals or health institutions.
• Through sociology, the nurse gets information about the socio-cultural life of the patient.

Figure 2.2 Importance of Sociology in Nursing

• With the help of sociology, we can study the structure of family, community, and society, on the basis of which health organizations are made and services distributed. Thus, medical sociology is useful for comprehensive health services.
• With the help of sociology, the nurses can understand the characteristics of social relationship, its complexities, and its impact on health care.
• Sociology helps in the understanding and eradication of social problems.
• By the study of sociology, the nurses learn the techniques of adjustment that can be used in nursing.

5. SCOPE OF SOCIOLOGY IN NURSING

The knowledge of sociology is essential for the nurses to apply it in nursing care. Understanding about the importance of sociology will help the nurses to carry out their functions smoothly since everyday they handle patients with different issues, and communication skills play an important role in binding the relationship with society and the nurses. Scope of sociology towards nursing has widened in the areas such as hospitals, community health centres, hospice care, industries, jails, counselling centres, geriatric homes, orphanages, palliative centres, juvenile homes, mental health centres, and rehabilitation centres. As the quality nursing care has been improved, the demands and the needs of the people are increased, and expectations on the nurses are also high in provision of quality nursing care. Scope of sociology applies in this following areas:

• hospitals
• community health centres
• hospice care
• industries
• jails
• counselling centres
• geriatric homes
• orphanages
• palliative centres
• juvenile homes
• mental health centres
• rehabilitation centres

5.1. Hospitals

Hospital is a place where the patients are assessed, diagnosed, and treated as per there actual and potential problems. Nurses play an important role in socializing the needs of the patients. Care is given not only in the main hospitals, but also in nursing clinics, where a team of doctors, nurses, anaesthetists, physiotherapists, occupational therapists, sociologists, psychologists, lab and X-ray technicians, dieticians, all join their hands to give complete care to patients.

Figure 2.3 Scope of Sociology

5.2. Community Health Centres

Each community has an attached health centre. One primary health centre covers every 50,000 to 1,00,000 population. A sub-centre covers 3000 to 5000 population; each centre has its own staff appointed by the government. Staff nurses are dedicated to give immediate care to the people since immediate source for the people in the community are the health workers in the primary health centre. The main function of nurses is to train all health workers to socialize with people in the community and help them create awareness about the health needs and illness and the need to approach the health centre when there is any illness in their families.

5.3. Hospice Care

Hospice is a health institution in the middle of the community health centre and the hospital, which provides extended health services to the people after discharge from the hospital, especially for old age people with terminal illnesses, poor people who cannot afford the health care, and orphans. Staff nurses are trained to socialize with people with such illnesses and promote their health.

5.4. Occupational or Industrial Health-care Services

This is to handle the workers in the factories to treat their illnesses, or any accidents or injuries happened during their work. Hence, it is important for the nurses to have the basic understanding about the occupational hazards, and communicate with the industrial owners to protect the workers in the industries. Nurses should represent the workers and create awareness among them to wear protective devices, keep emergency equipments to protect them from fire or other disasters.

5.5. Prisons

Nursing care has no limit and it has penetrated even into the jail in order to care for the prisoners, who are emotionally unstable. Counselling cells are always active to tackle the prisoners to calm their mind. Adequate training and knowledge on social problems is important to handle the prisoners.

5.6. Counselling Units

Counselling units are always available in hospitals, community health centres, mental health hospitals, colleges, schools, industries, and also in all the different professional institutions and companies, where social workers, psychologists, and nurses are trained to support the people and provide guidance and counselling to them.

5.7. Old Age Homes

Geriatric homes are increasing, where both old males and females are pushed into. Nurses create a milieu therapy by providing the love and affection to this age group. Socializing with them and understanding their problems and meeting their needs is always a big challenge and it needs lots of training and patience, especially knowledge on problems of the family and its structure.

5.8. Orphanages

Our country has many orphanages, where the children are cared and protected. Since they are orphans they have serious emotional and the social problems and definitely need help and support to come up in their lives, and nurses are there always to counsel them and train the caregivers to treat the children of all ages.

5.9. Palliative Centres

These centres are established to care patients with incurable illnesses, for example, cancer, AIDS, neuromuscular degenerative illnesses. Nurses are trained to treat and support such patients. Diversional therapies, such as role plays, dramas, puppet shows by nurses are provided to rehabilitate the minds of such patients.

5.10. Juvenile Homes

This is the prison for the child prisoners who are arrested and admitted in the jail having involving in social evils. They need lot of emotional support and encouragement to bring back their normal lives. As the society does not accept such children quickly as others when they come out of the jails, so the children should be taught with alternative therapies to stabilize their minds to prevent them from repeating the social evils. These therapies include yoga, exercise, positive lifestyle, peer-group support, organizational encouragement, spirituality, social and community-oriented monitoring and guidance. Nurses are trained to handle such children. They also create awareness among the society and respective families to support them and accept as normal human beings.

5.11. Mental Health Centres

Every mental health hospital has its own guidance and counselling unit with social workers, psychologists, and nurses to handle the unsound patients since their opinion is very important for the psychiatrists to judge their mental health illnesses.

5.12. Rehabilitation Centres

Rehabilitation centres mean special homes for children who are physically, mentally unaided, for example, autistic centre, spastic centre, deaf and dumb schools, where the candidates are specially trained and made functional to the maximum to earn their daily wages.

Other important areas where the scope of sociology in the hospital setting extends to are as follows:

• Social structure of the hospital—understanding the infrastructure and needs
• Medical and nursing professionals
• Hospital and nursing (as an industry)
• Specialization in medical services
• Patient–doctor, nurse–patient, nurse–doctor, nurse–patient’s relatives, and other interpersonal relations within the hospital
• Medico-social work
• Consumer Protection Act
• Medical ethics, nursing code of conduct, and social etiquettes
• Role of patients and their relatives in the hospital

6. USES OF SOCIOLOGY IN NURSING

Sociology is a very useful science, especially for the nursing profession. It helps the nurses know the cultures and social lives of their patients. In countries like India, where people have affiliations with different religions, castes, tribes, and communities, it is essential to know the culture of these groups. The customs, traditions, folks, mores, and values of the patients must be known before treating them, so as to make the medical and nursing services more effective. For all these, the study of sociology is necessary. The treatment of diseases, mental or physical, is a cooperative venture in which a united effort of various medical, paramedical, and even non-medical personnel is required.

Usually, it is the nurse who acts as a key person in the hospital scenario. The knowledge of sociology helps her maintain a congenial relationship between different personnel at different levels.

Nurses work not only within the hospitals, but also outside. In programmes, such as public health, industrial health, school health, and military nursing, nurses have to work in very close proximity with different sections of the society. The knowledge he or she has of the society is extremely useful. Technological progress has successfully eliminated many diseases, but it has brought new problems and challenges to the nurses: the problems of the aged, those of patients suffering from AIDS, and those of persons suffering from permanent disabilities due to industrial or other types of accidents. A deep understanding of human behaviour relationships and sociology can be very useful in handling such situations.

Nursing care is the primary and essential component of a nurse’s job. To meet the needs of his or her patient adequately, it is essential that the nurse develops self-understanding. He or she must strive constantly to become emotionally, mentally, morally, and socially mature. The study of sociology along with sociological and religious training is very useful in this process. Today, nursing is not employed simply in curing illness. Preventive services and promotion of health are equally important aspects of nursing. To be an effective agent of health promotion, knowledge of the community and the facilities and resources available therein is essential.

The study of sociology helps nurses identify the psycho-social problems of patients, which helps improve the quality of treatment. Sociology training in this subject also helps nurses support the government in various schemes of social planning. For example, the family planning programme run by the government can be successfully implemented only with the active participation of the nurses. The study of sociology helps the nurses improve the quality of family welfare programme and the community health services of the government. It also helps the nurses interact with a wide spectrum of persons whose behaviours are varied, for example, patients, doctors, family members, management, government, and society at large. The study of sociology will assist in understanding these behavioural patterns, which will in turn help improve health care. Table 2.2 helps you understand how sociology is useful for the nurses.

 

TABLE 2.2 How Sociology Is Useful for the Nurses

Concepts	Areas
Quality care	To provide total patient care in a comprehensive manner and render loving care to meet the total needs of the clients either in tile hospitals or in the community
Holistic care	To understand and meet the needs of the individuals, families, and social needs in a holistic manner whereby the development of the nation can be achieved
Understanding human behaviour	To broaden the view of the nursing students to understand human behaviour in relation to the society
Planning nursing process	To understand the cause and meaning of many kinds of patient behaviour to make the patients comfortable and treat them all alike to improve diem care
Continuity of care	To suggest ways to work with families, community agencies, and groups of persons to provide health counselling in planning for continuity of care
Interpersonal relationship	To provide right motivation, right treatment, and physical, medical, vocational, and psycho-social rehabilitation based on attitudes and responses of others by understanding their behaviour through good interpersonal relationships
Professional development	To understand emotional reaction pattern (e.g. level of perception, attitudes of people towards medical care, barriers of communication, individual differences. social distance, prejudice, change, emotional and interpersonal components of the disease process, the growth and decline of population in a special area, and socio-psychological factors); to understand self and others; and to make more effective use of their professional skills
Understanding human problems	To gain greater insight into the human problems related to illnesses
Cultural value identifications	To identity some of the socio-cultural barriers and promote the activities related to treatment and prevention of diseases, and promotion of health
Community promotion	To develop plans of operation by involving local people and others engaged in community development, keeping in mind the social realities
Innovative health care	To analyse health conditions of people and bring about changes and innovation in health care based on research
Social interactions	To plan social interactions and to establish good interpersonal relationships with superiors, subordinates, class IV employees, diems, students, visitors, and community
Preventive and remedial approaches	To study social problems related to behaviour and suggest preventive remedial approaches to tackle the problematic situations in the community in an efficient manner
Analysing social situations	To identify and analyse different social situations responsible for the incidence and prevention of morbidity and mortality
Effective liaison	To act as an effective liaison between themselves, clients, and the health team members

7. NURSING APPLICATION OF SOCIOLOGY IN DIFFERENT FIELDS: OTHER FIELDS OF SOCIOLOGY

7.1. Sociology and Family

Sociology deals in depth about family and its structure. It helps us know about different types of families and the social and economic needs of families. A nurse encounters different types of patients, who come from different backgrounds and cultures. Hence, this concept will be applied by learning sociology.

7.2. Sociology and Community

The knowledge about the community and its needs is important for a nurse to care for the people belonging to that community. Each community has diverse cultures, traditions, and taboos, therefore, a nurse needs to respect every community and care for them equally.

7.3. Sociology and Demography

Carrying out epidemiological investigations can create understanding about the population in each areas, spread of illness in each population, distribution and frequencies of diseases in each year, which is important to care for the community people and prevent them from acquiring such diseases that regularly attack them.

7.4. Sociology and Education

Basic knowledge of sociology is important to understand the entire community; therefore, all nurses should have through knowledge of sociology. Updating the knowledge is very important as everyday new problems arrive, and nurses should improve there knowledge by participating in workshops, conferences, seminars, and so on.

7.5. Sociology and Religion

Sociology helps understand about different religions. Every nurse needs to know about different religions and their activities, which can help them give good care to the community. He or she should support every religion and provide a fair care to all.

7.6. Sociology and Economics

Sociology helps understand money management as it plays vital role in fulfilling the needs, and demands a basic knowledge in budgeting.

7.7. Sociology and Politics

Sociology helps understand the politics. There is a need for nurses to have knowledge on the ruling people, who exercise powers, so that they can demand for the health needs of the society.

7.8. Sociology and Social Stratification

Nurses should have the understanding of the different divisions in the community, that is, social stratifications, in order to prevent conflicts in the society and promote peace and happiness in the society.

7.9. Sociology and Anthropology

Anthropology is the study of old and ancient culture. As different families follow old cultures and traditions, nurses need to check whether the old practices affect the health of people.

7.10. Medical Sociology

Understanding medical sociology helps nurses to estimate the health status of the individuals and the community, and also to find out the social factors that result in spread of communicable diseases, such as sexually transmitted diseases, tuberculosis, AIDS, and so on; to learn the customs, traditions, beliefs, and other cultural patterns that affect the health of a particular community; to establish the interdependence of medical and social sciences; and to understand the meaning of social pathology, which is learning about the conditions, such as poverty, crime, beggary, and so on. The study and survey of accidents, communicable diseases, such as heart diseases, diabetes, asthma, cancer, and so on, come under the subject matter of social medicine.

7.11. Sociology of Law

Understanding the law, Indian Penal Code, medico-legal issues and aspects are important for the nurses to handle legal and the ethical issues, to make ethical decisions, and solve ethical dilemma while providing nursing care.

7.12. Military Sociology

Military sociology deals with adaptation of the military people to understand about different communities and adjustment to various climatic conditions, social taboos, cultures, and so on. Military nurses are trained to adapt to different areas especially war fields, borders, areas affected by manmade disasters, for example, bio-terrorism, terrorist attacks, bomb blasts, and natural disasters like earthquakes, floods, and volcano eruptions.

7.13. Sociology of Criminology

Sociology of criminology involves learning about criminal attitude and minds and the behaviours of the criminals, corrective behaviours, and helping them to adapt to the changes and surroundings. This involves support of voluntary social groups in order to accept them as members of society.

7.14. Social Psychology

Social psychology studies about man, family, and environment. Psychology and sociology are two sides of the same coin, that is, they cannot be separated. Hence, nurses need to learn psychosocial aspects.

7.15. Social Disorganization

Social conflicts and social problems are wide in the society, for example, beggary, poverty, dowry, crime, juvenile delinquency, prostitution, child abuse, alcoholism, drug addiction, and abuse. Nurses should learn about these problems as handling them efficiently is an important function when encountered.

7.16. Sociology of Ecology

Ecology is learning about the relationships between plants, animals, people and their environment, and the balances between these relationships.

7.17. Sociology of Rural and Urban Society

Understanding the functions of urban and the rural society is important as nurses have to give care for all people. Hence, nurses need to analyse where the people live, what facilities they have or not have, and what they actually need.

7.18. Cultural Sociology

People live with different cultures, and India is respected for its rich cultural heritage. Hence, learning the cultural taboos and traditions are important for nurses to get cooperation from people while providing care.

• Sociological aspects of nursing
• Need for sociology in nursing
• Importance of sociology in nursing
• Scope of sociology in nursing
• Uses of sociology in nursing
• Nursing application of sociology in different fields

I. LONG ESSAY

• Explain the sociological aspects in nursing.
• Describe the uses of sociology.
• Illustrate the applications of sociology in different fields in nursing.

II. SHORT ESSAY

• Explain the need for sociology in nursing.
• Illustrate the scope of sociology in nursing.
• Describe the importance of sociology.

III. MULTIPLE CHOICE QUESTIONS

1. Sociology is the study of:
   1. socio-political institutions
   2. political system
   3. human behaviour
   4. society
2. Which of the following can be a suitable area of study in the scope of sociology:
   1. trade
   2. community
   3. education
   4. individual
3. A social relationship in a society involves:
   1. presence of institutions
   2. complications of social and political problems
   3. reciprocal awareness
   4. consciousness of the existences of other individual
4. Society exists only when:
   1. the members know each other
   2. the members possess common interests
   3. the members know each other and possess common interests
   4. the members are at the same place at the same time
5. The term society in sociology is used to refer to:
   1. the persons living in an area
   2. the persons possessing the same religion
   3. the system of social relationships
   4. the organized relation between individuals
6. Man is a social animal because
   1. his nature and need makes him so
   2. he has been living in society since the birth of civilization
   3. society was born with him
   4. his forefathers have lived in society
7. Socialization is a process of converting a biological organism into:
   1. a human being
   2. a super human being
   3. a modern man
   4. a civilized person
8. Hospice care concern about the patients suffering with
   1. acute illness
   2. chronic illness
   3. severally ill
   4. terminal illness
9. The primary goal of sociology in nursing is:
   1. promotion of health
   2. prevention of morbidity
   3. prevention of mortality
   4. all of these
10. The primary role of nursing concerns with:
    1. diagnosis and treatment
    2. care process
    3. research and utilization
    4. technology and advancement

ANSWERS

1. d 2. b 3. c 4. a 5. c 6. a 7. a 8. d 9. a 10. b

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