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Part of the FMGE study roadmap. Botany topic psm-005 of Botany.

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Sociology, Psychology, and Communication in Health

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Sociology, Psychology, and Communication in Health — Key Facts for FMGE Core concept: Health behaviors are influenced by social, cultural, and psychological factors; effective communication improves patient outcomes High-yield point: Health belief model, stages of change model, and social determinants of health are important conceptual frameworks ⚡ Exam tip: The doctor-patient relationship, counseling skills, and health education techniques are frequently tested

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Sociology, Psychology, and Communication in Health — FMGE Study Guide

Sociology in Health

Social Determinants of Health

  • Economic status: Poverty limits access to health care, nutritious food, safe housing
  • Education: Higher education associated with better health-seeking behavior
  • Employment: Job security, occupational hazards
  • Social support: Family, community networks
  • Gender: Women face barriers to health care access in some settings
  • Caste and ethnicity: Discrimination affects health access
  • Environment: Clean water, sanitation, pollution

Social Classification in India

  • Caste: Traditional hierarchical system; affects health access
  • Class: Based on education, occupation, income (Brahmin, Kshatriya, Vaishya, Shudra, SC/ST)
  • Family structure: Nuclear vs joint; patriarchal vs matriarchal
  • Urban/rural divide: Urban areas have better health infrastructure

Culture and Health

  • Health beliefs: What is considered healthy/sick varies by culture
  • Healing practices: Traditional healers, home remedies
  • Dietary beliefs: Some foods avoided during illness/pregnancy
  • Rituals around birth/death: Affect health-seeking behavior

Communication Barriers

  • Language: Regional languages vs Hindi/English
  • Literacy: Understanding health information
  • Cultural norms: Gender interactions, stigma

Psychology in Health

Health Behavior Models

Health Belief Model:

  • Perceived susceptibility: Belief about getting disease
  • Perceived severity: Belief about seriousness
  • Perceived benefits: Belief that action will reduce threat
  • Perceived barriers: Belief about obstacles to action
  • Cues to action: Trigger for action
  • Self-efficacy: Confidence in ability to take action

Theory of Planned Behavior:

  • Behavioral intention: Most important predictor
  • Attitudes toward behavior: Outcome expectations
  • Subjective norms: Social pressures
  • Perceived behavioral control: Ease/difficulty

Transtheoretical Model (Stages of Change):

  1. Precontemplation: No intention to change
  2. Contemplation: Thinking about change
  3. Preparation: Planning to change
  4. Action: Actively changing
  5. Maintenance: Sustaining change

Sick Role Behavior

  • Sick role: Rights (care, sympathy) and obligations (trying to get well)
  • Labeling: Being “patient” changes behavior
  • Non-compliance: Important issue in chronic disease

Psychological Aspects of Illness

Adaptation to illness:

  • Denial, anger, bargaining, depression, acceptance (Kübler-Ross)
  • Coping strategies: Problem-focused vs emotion-focused

Stress and Health:

  • General Adaptation Syndrome (Selye): Alarm → Resistance → Exhaustion
  • Psychosomatic diseases: Hypertension, peptic ulcer, asthma
  • Immune function: Stress suppresses immune system

Behavioral Sciences in Medicine

Patient-centered care:

  • Understand patient’s perspective
  • Shared decision-making
  • Empathy and rapport

Motivational interviewing:

  • Non-confrontational approach
  • Explore ambivalence
  • Elicit change talk

Health Communication

Principles of Effective Communication

In patient care:

  • Silence: Allow patient to speak
  • Reflection: Mirror patient’s words
  • Open-ended questions: Encourage narrative
  • Summarization: Confirm understanding
  • Non-verbal cues: Eye contact, posture, tone

Barriers to Communication

Health care provider barriers:

  • Lack of time, language, cultural competence
  • Medical jargon, patronizing attitude

Patient barriers:

  • Fear, anxiety, low health literacy
  • Cultural beliefs, stigma

Health Education

Methods:

  • Individual: Bedside counseling
  • Group: Health talks, demonstrations
  • Mass media: TV, radio, social media

Approaches:

  • Medical approach: Focus on disease
  • Educational approach: Knowledge and skills
  • Social mobilization: Community participation

IEC (Information, Education, Communication):

  • Print materials (posters, pamphlets)
  • Electronic media (radio, TV spots)
  • Interpersonal communication (counseling)

Counseling

Definition: Systematic process of helping people change

Process:

  1. Rapport building: Trust, empathy
  2. Assessment: Explore problem
  3. Goal setting: What change is wanted
  4. Intervention: Strategies for change
  5. Follow-up: Monitor progress

Skills:

  • SOLER: Squarely facing, Open posture, Lean toward, Eye contact, Relaxed
  • OARS: Open questions, Affirmations, Reflections, Summaries

Doctor-Patient Relationship

Models:

  • Paternalistic: Doctor decides
  • Informative (scientific): Doctor provides information, patient decides
  • Interpretive: Doctor clarifies values
  • Deliberative: Doctor helps patient decide

Types:

  • Active: Doctor takes initiative
  • Collaborative: Joint effort
  • Passive: Patient as recipient

Breaking Bad News

SPIKES Protocol:

  • S: Set up the interview
  • P: Assess Perception
  • I: Obtain Invitation (if patient wants to know)
  • K: Deliver Knowledge
  • E: Explore Emotion
  • S: Summarize and plan next steps

Health Behavior Change

Communication for Health

Behavior Change Communication (BCC):

  • Promotes positive behaviors
  • Addresses barriers
  • Uses multiple channels

Social Marketing:

  • Commercial marketing techniques for social good
  • Example: Condom promotion campaigns

Community Participation

Approaches:

  • RCH (Reproductive and Child Health): Involves community
  • VHSNC (Village Health Sanitation and Nutrition Committee): Local planning
  • Self-help groups: Women’s empowerment

Barriers to Behavior Change

  • Fatalism: Belief that health is determined by fate
  • Stigma: Diseases like TB, HIV, mental illness carry stigma
  • Misconceptions: Traditional beliefs oppose modern medicine
  • Side effects: Fear of treatment effects
  • Cost: Direct and indirect costs of care

Health Promotion Strategies

  • Lifestyle modification: Diet, exercise, smoking cessation
  • Risk factor modification: Control BP, blood sugar, cholesterol
  • Screening: Early detection of disease
  • Vaccination: Prevention of infectious diseases
  • Environmental modification: Safe water, sanitation

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