Psychosocial Determinants

Patients have social and behavioral factors that may have not only contributed to the clinical condition, they may have caused it. These social and behavioral factors may need to be addressed for the clinical treatments to be effective. The social and behavioral factors include being willingness to change, depressed, stress as someone else's care giver, physical activity, nutrition and patient activation.(See: Improving Clinical Outcomes By Addressing Social And Basic Needs)

These Psychosocial Determinants can decisively affect patient well-being and patient recovery.

Patient (About)

This is about how to understand and relate to the patient. Patient (About) are elements of the Psychosocial Determinants can decisively affect patient well-being and patient recovery.

About

• Narrative/Story
• Photos
• Language Speaking and literacy
• History of each determinant

Family & Friends

• Marital Status
• Family Members - Their regular interaction, role in care or monitoring, where they live in proximate
• Friends - Their regular interaction, role in care or monitoring, where they live in proximate
• Photos
• Level of social interaction with family and friends

Career & Education

• Education Level
• Job History

Passions

• Sports Teams, Television, reading, social media
• Physical Activities - Walking, shopping, etc.

Patient Activation

Patient activation factors are elements of the psychosocial factors in patient recovery.

Activation Level

• Patient Activation Measures - understands conditions, understands treatment, understand how to care for conditions, understands how to manage symptoms
• Activation History

Condition Management Aptitude

• Diabetic monitoring glucose and injecting insulin
• Self-care

Education

• Diagnosis
• Prognosis
• Treatments
• Understand Options and onboard with the treatment plan

Treatment Adherence

• Medication Adherence
• Nutrition
• Therapy, Physician Visits
• Recommended Activity levels

Intervention Activation

• Know when to ask for help
• Comfortable asking for help
• Know who to ask for help

Device Aptitude

• Use of remote monitoring devices (Blood Pressure cuff)
• Use of remote diagnostic devices (ecg app)
• Use of tablet, computer or smartphone

Technology Aptitude

• Using Internet to find information
• Education Videos
• Patient Portal Usage
• Ability to use Secure Texting, Video Conferencing, email

Online Personal Health Record

• Online Electronic Health Record
• Access Authorization (Recovery Team access)
• Patient Input History (Patient answer questions or inputs data into Personal Health Record)

Technology Usage

• Broadband Internet, Wifi & Telecom Network (AT&T, Verizon)
• Devices - Computer, Smartphone or Tablet
• Remote Monitoring Devices (Blood pressure cuff, blood glucose monitoring)
• Remote Diagnostic Devices (ECG app)
• Accessing patient history via Blue Button

Behavior & Lifestyle

Patient behavior factors are elements of the psychosocial factors in patient recovery.

Physical Activity

• Exercise and Activity Levels
• Transportation (Always walks, always drive, always buses or subways)
• Work (how active)
• Sports Participation (Golf)
• Sporting Events (enjoy race track, kids sporting events, etc.)
• Home maintenance

Nutrition

• Diet and Nutrition
• Nutrition (Fast Food, Take Out, Home cooked meals)

Social Interactions

• Engagement with others
• Engagement with Caregivers, others
• Organized Communities - like PatientsLikeMe
• Socially Isolated

Adverse Behaviors

• Adverse Behaviors (use of alcohol, drugs, gambling, unprotected sex, smoking)

Activities (Social)

• Family Activities (dinners, youth sports)
• Social Activities (Social Organizations, frequent bars, etc.)

Activities (Sedentary)

• Television (Watch Baseball, Drama series, News - Favorite programs)
• Read, knit,etc.
• Hobbies

Volunteering

• Youth Coaching
• Social Service

Home and Travel

• Snowbird (summers in the North, winters in the South)
• Travel

Jail Involved

• History of jail or prison time

Goals & Preferences

Patient preferences factors are elements of the psychosocial factors in patient recovery.

Authorizations

• Privacy and HIPAA
• Advanced Beneficiary Notice
• Recovery Team Access to Electronic Medical Records

Change Acceptance and Determination

• Acceptance to change to Behavior, Lifestyle, address Problem (Stress), Patient Activation, Patient Technology Adoption
• Determination to make change happen
• University of Rhode Island Change Assessment Scale (URICA)(URICA)

Living Will

• Advanced Patient Directives

Treatment Preferences

• Home Based
• Recovery Team
• Technology Use
• Palliative Care and End of Life preferences

Perspectives

• politics
• lifestyle,
• culture

Spirituality

• Religion
• Religious beliefs
• Yoga, etc.

Resilience & Stress

Stress Factors

• Recent Stressful Events
• Ongoing Stressful Challenges
• Potential Stressful Events

Sentiment

• Upbeat, depressed

Support

• Care Giver
• Emotional and physical Support from family and friends
• Trust in peoples opinions
• Influencers (people) that could impact patient decisions

Responsibilities & Purpose

Care Giver Roles

• Kids, parents, friends

Support

• Support received from family and friends
• Support provided to family and friends