NCP 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, i.e., auditory, visual, kinesthetic

Patient’s dominant language/literacy; knowledge and use of other languages; style of speech

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Behavior when anxious, afraid, impatient, withdrawn, or angry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 home), retired

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)


Employment; finances

Environmental factors: residence, work, and recreation; out of usual environment (on vacation, visiting)

Social class; value system

Social acceptability of disease/condition (e.g., sexually transmitted diseases [STDs], HIV, obesity, substance abuse)


Ethnic background; heritage and residence/locale

Beliefs regarding caring and curing

Health-seeking behaviors; illness referral system

Values related to health and treatment

Cultural factors related to illness in general and to pain response


Kind/cause of illness; how has it been treated, how should it be treated? Anticipated response to treatment; patient’s/SO’s expectations

Is this an acute or a chronic illness? Is it inherited? What is the threat to self/others?

If terminal illness, what do patient and SO know and anticipate?

Is the condition “appropriate” to the afflicted individual, e.g., multiple sclerosis, diabetes mellitus (DM), cancer?

(Note: Some theories suggest certain personalities are prone to certain illnesses.)

Illness related to personality factors, such as type A (may be myth or valid relative to management of stressors); highrisk behaviors


Basic knowledge of human responses and how the current situation is related to response of the individual

Basic knowledge of biological, psychological, social, and cultural issues

Knowledge and use of therapeutic communication skills

Knowledge of own value and belief systems, including prejudices, biases

Willingness to look at own behavior in relation to interaction with others and make changes as necessary

Respect of patient’s privacy; confidentiality; human needs


1. Reduce anxiety/fear.
2. Support grieving process.
3. Facilitate integration of self-concept and body-image changes.
4. Encourage effective coping skills of patient/SO.
5. Promote safe environment/patient well-being.


1. Reports/anxiety/fear manageable.
2. Progressing through stages of grieving.
3. Patient/family dealing realistically with current situation.
4. Safe environment maintained.
5. Plan in place to meet needs after discharge.