The psychosocial history is important in any assessment that considers a holistic view of the patient, especially in a community or long-term care setting. The psychosocial history involves the patient's relationship to others, such as family members, friends, neighbors, church groups, colleagues at work, and friends in social and civic organizations in the community. Assessing factual data about the patient's social network and needs is essential, but determining feelings about those contacts and needs is also important. Expression of feelings is more difficult for some patients than others, but the skillful nurse who communicates well will more likely set an environment where important feelings will be expressed.

Inquire about and document the following:

• Significant others, relationship, proximity
• Support systems needed and available:
  • Informal: Family, friends, neighbors
  • Formal: Temporary Aid to Needy Families (TANF); Medicaid: Medicare: Special Supplementary Food Program for Women, Infants, and Children (WIC): Food Stamps: Supplemental Security Income (SSI)
  • Semiformal: School, church, clubs
• Satisfaction with social contacts
• Typical 24-hour weekday and weekend day:
  • Satisfaction with employment
  • Recreational activities enjoyed
  • Leisure time activities pursued
  • Sports enjoyed as a participant or observer
• Living arrangements:
  • Alone, with family members, or with others
  • Number of rooms
  • Number and ages of other individuals in home
  • Feelings about home arrangements
• Significant stressors
• Coping ability
• Feelings about self: Self-concept, functional status, adaptations, independence, body image, marital status, sexuality, sexual orientation
• History of interpersonal trauma: Rape, incest, abuse as child or spouse, other personal tragedies. Note ability to discuss, current stage in resolution (denial, fear, anger, adaptation), and resources.
• Periods of grief and current status
• Understanding of and feelings about current illness(es)
• Feelings about retirement (past, present, or future)
• Psychological problems and conflicts
• Feelings about past, present, or future caregiver roles (care for children, disabled adults, older family members)
• Spiritual concerns and needs:
  • Concept of God
  • Source of strength
  • Value placed on religious practices and rituals
  • Perceived relationship between religious beliefs and patient's current state of health
  • Spiritual adviser
  • Role and relationship with an organized religious group