Biosocial History Assessment (Nursing)

00:01 So, oftentimes you'll hear people talk about biopsychosocial histories, and how the biopsychosocial history is going to affect a person's current mental status.

00:13 So what are we talking about? Well, we're going to talk about bio - the biological, psycho - their psychological, and social.

00:22 And we just put it together in one word, biopsychosocial history.

00:26 So what are we going to be looking at? We're going to be looking at lifetime functioning levels.

00:32 And that includes their demographics, as well as their chief complaint.

00:38 So what is their demographics? This is a word oftentimes used, that sometimes people are afraid to ask, what do you mean by demographic? Well, a demographic tells us some information about: Where they grew up? What is their educational status? What is their employment status? What is their marital status? Do they have a job? Do they have an income? These are the demographics on our patients? Where do they live? Do they live with their family? Are they living alone? Are they homeless? And you can see how those different demographics can impact our recovery plan for a patient.

01:20 We want to be able to also describe the history of the present illness.

01:27 How did this problem present itself this time? As well as, are there any other things that you are dealing with right now? A person might be coming in for one thing, but they also might have a history of depression and anxiety.

01:44 But maybe they're coming in because they just were in a car accident, and they're dealing with the trauma of the car accident.

01:55 It's extremely important to ask every patient, every single patient about their alcohol, or other substance use history.

02:06 Another thing that is very, very important, when we are talking to patients, and respecting them who they are individually, is to ask them, what their pronouns are.

02:20 And to be able to remember those pronouns and utilize their pronouns of choice.

02:28 We might be able to also ask their sexual identity, versus their gender: their birth, sexuality, and who they are today.

02:40 These things represent our ability to see an individual for who they are, and respect them and give them the respect that they require in order to help them in their recovery from mental illness.

02:57 We want to also ask them, in the past, where their specific coping mechanisms that you might have used that helped.

03:05 And in the present, what are your best coping mechanisms? What can I do to help you be able to cope? These are really important questions.

03:16 Because this gives us a sense of who this person is, and where they're coming from.

03:22 It also lets them know that we respect them individually, who they are, and we are going to demonstrate that respect.

03:31 Oftentimes, I will ask someone, "What would you like me to call you?" There are very frequently times that I will hear someone call a patient mommy because she's old.

03:44 And I'll have to go over and say, "Is that something you want me to call you?" Or how would you like me to address you?" And that older elderly woman who's in her 80 might say, "Please call me Dr. Brown." And when I look at her chart, yes, indeed, she has a PhD in physics.

04:04 And her whole life has been spent with people respecting her.

04:08 And now in her 80s, she has some young person, or a nurse, or a resident saying, "Hey Mommy, how you doing today, mommy?" We are not helping this person towards recovery.

04:20 We are not demonstrating respect for the individual.

04:24 So before we even start thinking about what we are seeing in front of us, we have to find out who they are.