Introduction
This topic covers the patient's social history (the personal, family, occupational and social background that can be clinically significant) and the family anamnesis (family history of disease, with its advantages and limits).
Social history
The portion of the medical history addressing familial, marital status, occupational and recreational aspects of a patient's personal life. It has the potential to be clinically significant.
Enquiries cover:
- Substance usage: alcohol, tobacco, illicit drugs
- Occupation
- Sexual preference: increased risk of infection in prostitutes and gay men
- Prison: especially if TB needs to be ruled out
- Travel
- Exercise
- Diet
- Pets
Family anamnesis (general history in 7 parts)
- Patient characteristics: name, marital status, sex, age, location (address), adaptability, working capacity, education, interests, behaviour.
- Patient's family background (family relationships / living conditions). Types of family:
- Nuclear family: traditional family with mum and dad with children; the male is the breadwinner.
- Extended / three-generation family: includes grandparents, their children and their children.
- Single-parent family.
- Reconstituted family: one or more parents have been married previously and bring children from their previous marriage.
- Symmetrical family: the roles of husband and wife are equal.
- Occupational environment: occupation, position, salary, shift, overwork, working conditions.
- Patient's social environment: availability of social support inside/outside the family; membership of any informal organisation; ecological problems (noise, pollution).
- Health services of the patient: character of contact (sporadic/regular); hospitalisation and treatment; the patient's attitude to health services; health services' attitude to the patient.
- Socio-medical conclusion: patient's risk factors and needs.
- Reason for medico-social help to the patient.