Each of the three monographs in this series onNewer Dimensions of Patient Careis concerned with how individualized attention to patients can be increased, particularly in large hospitals. Each focuses consideration upon a different facet of various possible solutions. Part I began by recalling patients’ frequent complaints about anxiety, frustration, loneliness, boredom, and uselessness. It was suggested that changes, of an almost obvious kind, might be made in the physical and social environment of the wards that would reduce the sense of strangeness and the cold, impersonal atmosphere that exacerbate these discomforts. It was suggested specifically that hospitals attempt...

The foregoing discussion has attempted to indicate the importance of expanding the scope of the information obtained about all patients. In this chapter, therefore, additional items will be suggested that should probably be included in the face-sheet data if staff are to be able even to begin an assessment of patients as persons. Factual information concerning most of these items could be acquired routinely by the admitting office merely by adding a few additional questions. Elaboration of this information would have to be obtained through conversation with and observation of patients and their visitors.

Quite as important, however, as the...

An international health education team, sponsored by the World Health Organization, was attempting a demonstration of how malaria might be eradicated in one of the countries of southeast Asia. It decided to make a simple film strip that could be shown widely. Hence it sketched the story of a boy of fourteen who runs to the doctor’s office, reports that his little sister is sick, and escorts the doctor to the home. There the boy asks many questions about his sister’s malady; the doctor explains in Ianguage an adolescent would understand the cause and treatment of malaria, and how it...

A Polish-American patient, who was suffermg intractable pain, had taken it for granted that if he were very sick he would be given massive doses of individualized attention, including a nurse’s hand on his forehead or an arm around his shoulder. (Although he was born in the United States, this expectation was apparently in accord with practices in the part of the country from which his parents had come.) When he received no such attention in the particular hospital, he concluded that all the staff disliked him. As a result, said he to the social scientist interviewing him, he knew...

In this chapter we turn from our discussion of the diverse ethnic groups that comprise America to a consideration of the diverse socioeconomic backgrounds to be found within the population. Thus further opportunity is provided to think about diversity—but again diversity within group regularities that can be fairly readily recognized and thus utilized for practical purposes. Because references to “patients” in a generic sense, as if they were all primarily alike, are so frequent, repeated emphasis has to be placed on the fact that various groups of patients, like the groups in the population at large from which they...

Before the appearance of recent studies of the relation of cultural factors to medical and health services, the late Dr. Alan Gregg, then vice president of the Rockefeller Foundation, discovered what he considered to be the large potential importance for the clinical practice of medicine of an understanding of social class. His discovery resulted from reading theYankee City Series,which the Yale University Press had begun to publish in 1941 under the authorship of W. Lloyd Warner and his colleagues. With nothing more than these volumes for systematic background, Dr. Gregg decided to make an informal investigation of what...

After a long digression we now return to the discussion begun in the first two chapters about the desirability, if not necessity, of obtaining more than the customary social data concerning each patient for whom comprehensive care is to be provided. Of several additional categories of data that were suggested for inclusion only two have been examined in any detail—ethnic and socioeconomic or social class background. An attempt has been made additionally to look at the concept of culture because all the nonbiological determinants of human behavior are embedded in its matrix.

The reason a disproportionate amount of attention...

In chapter 2 it was suggested that the admitting office of the hospital enlarge the number of items concerning which social information is sought, and that all data collected be forwarded to the nursing unit at the earliest possible moment so that both medical house staff and nursing personnel could examine them before visiting the patient. If the persons responsible for treatment and care have some profile of the patient in mind, the initial contact—the importance of which can scarcely be exaggerated—ought to be easier and more comfortable for staff and patient alike.

Observation of how strangers, who...