The Role of Sociology in Human Physical and Spiritual Health (Part.2)

CHAPTER II

STUDY

A. Definition of Sociology in Health

According to Willson, sociology of health is observation and analysis by taking a distance, which is mainly motivated by a problem of sociology, while sociology in health is research and teaching that is more characterized by intimacy, applied and togetherness which is mainly driven by health problems.

Medical sociology is a branch of sociology that focuses on the preservation of medical science in modern society. This subject has developed so rapidly since the 1950s that it is now one of the largest areas of specialization in sociology. This development cannot be denied, it is caused by the awareness that many issues contained in modern health care are social problems. However, this also reflects an increasing interest in treatment itself in the social aspects of illness (illness), particularly concerning psychiatry, pediatrics, general practice (or family support) and community medicine.

According to Solita Sarwono, medical sociology includes the study of social factors in etiology (causes), prevalence (incidence), and interpretation (interpretation) of diseases about the medical profession itself as well as the relationship between media personnel and society in general.

Sociology of health also discusses health behavior, the influence of social norms on health behavior, and interactions between health workers and the community.

The basic principle of the discipline of health sociology is the application of the concepts and methods of the sociology discipline in describing, analyzing, and solving health problems. In other words, health sociology is the application of social science in studying health problems.

The scope of applied sociology studies depends on the scope of the object of study itself. Thus, the sociology of nursing is the science of sociology in studying nursing service and communication problems, as well as other fields of health studies.

Sociology of health as a science because it does have scientific properties such as:

1. Empirical means that health sociology learns what happens in society and what is learned can be proven in daily life.
2. Theoretical means that health sociology uses theories in its study where it is put forward by experts based on what is happening in society.
3. Comulative means that the health sociology that is now studied is nothing but the development of the health sociology that teah there sabelumnnya. So that the sociology of health is dynamic in the sense that it can change according to the social conditions that occur today.
4. It is not judged to mean that health sociology cannot justify and blame the actions or behaviors of individuals/groups of people because each region has its norms so that what is considered wrong in one area can be considered right in another area, so vice versa.

The development of health sociology begins from the moment the human being realizes that health is not only limited to the physical, but also the mental and social condition of a person. Therefore came the so-called Sociology of Medicine which later evolved into Sociology in Medicine.

Studies on health sociology can be problems experienced by sociological objects, be it society, society or community. To understand and analyze these problems, various approaches are needed either based on the perpetrator’s point of view or using an ethical approach based on the views and opinions of pera experts and then comparing them to cultures from other regions.

B. The role of sociology and sociologists in health practices

In theory, some of the general role of sociologists in the development of science and public health services.

• Sociologist as a research expert

As a scientist, a sociologist has a responsibility to conduct scientific research, scientific socialization, and also to foster a mindset towards society. In connection with this problem, the role of a sociologist’s research expertise is obliged to search, collect, analyze, and infer social facts from existing data so that sociological knowledge arises that is beneficial for the continuation of the process of understanding sociology as well as engineering or social analysis.

In this role as a research expert, sociologists are also obliged to straighten out the opinions of ordinary people or certain circles that are more due to misinformation or superstitions that can destroy the human mindset. For example, about the effect of the lunar eclipse on the health of the conceived child.

No less important, sociologists can also show the role to provide sociological predictions of statistical data or trends of social change so that it can be considered in formulating public policy.

• Sociologist as a kindness consultant

Sociologists can analyze social factors, social dynamics, and process trends, as well as social changes. On a long-term scale, sociology can foresee the influence of a policy on social life.

Social development trends–as shown in social statistics–can analyze social forecasts that may occur in the future. Therefore, in this case, the sociologist can demonstrate his role not only as a research expert but as a kindness consultant.

• Sociologist as technician

A sociologist can engage in the planning and implementation of community activity programs to advise on moral issues, public relations, inter-employee relationships, intergroup relationships within an organization, and solving various problems regarding interhuman relationships. Sociologists often take special expertise in social psychology, industrial sociology, rural sociology, urban sociology, or organizational sociology.

One of the roles of technicians that can be shown is the emergence of clinical sociology. This term is a mention of past sociologists’ habits in conducting studies on health problems. However, in today clinical sociology is more likely to show its role in applied sociology in analyzing health problems.

• Assisting and enhancing the role of teacher/health educator

By studying sociology, healthcare can understand the nature, character, or norms of the prevailing society. So that in the end a health promotion program or health development agenda in a community will be able to run effectively. Our missingness in understanding the character or values and norms of society can lead to resistance from society to health development programs. Therefore, sociology can contribute insight and understanding to health workers or policymakers in the field of health.

The benefits of studying sociology for health are as follows,

• • Learn how people ask for help-seeking
  • Provide an analysis of the relationship between medical personnel and clients
  • Know the socio-economic background of the society in the utilization of health services
  • Analyzing social factors about disease etiology,
  • Sociological analysis of social issues concerning pain, physical disabilities, and the like which is a social fact.

In analyzing health situations, health sociology is useful for learning how people seek medical help. Also, sociological attention to sick behavior is generally centered on the population’s understanding of the symptoms of the disease as well as actions that are considered appropriate according to the prevailing values and norms in society. Another health sociological benefit is analyzing social factors in conjunction with disease etiology. Another aspect that makes sociology useful for medical practice is that sick and physical disabilities in addition to social facts as well as medical facts. Health sociology also provides an analysis of the relationships between medical personnel and clients. In the development of this health sociology, a medical professional can develop a “verstehen” attitude that is the ability to dive into what the patient or society itself feels. To then, after understanding what the patient is experiencing, it is only at a later stage analyzed based on the health sciences that he already has. Thus, the application of health sociology can be referred to as an effort to build a unified approach between ethics and ethics, so that health services are more beneficial to society in general. According to Fauzi Muzaham, the purpose of applying sociology in the field of medicine and health is among others to increase the ability of doctors to conduct clinical assessments more rationally, increase the ability to address the problems experienced in practice, be able to understand and appreciate the behavior of patients, colleagues, and organizations, and increase the ability and confidence of doctors in dealing with the social and emotional integrity of patients, as well as their ability to have and deal with disease disorders suffered by patients.

In health sociology, several terms indicate the contribution or role of sociology in the health sector, namely:

• Sosiology in medicine

Sociologists who work directly with doctors and other health staff in studying social factors that are relevant to the occurrence of health problems or sociologists trying to deal directly with patient care or to solve public health problems. This shows that social phenomena can be a determining factor or affect their health or other behavior when they are sick or after the illness..

• Sosiology of medicine

Related to the organization, values, trust in medical practice as a form of human behavior that is within the scope of health services, human resources to build health and training for health workers.

• Sosiology for medicine

Related to the methodological strategies developed by sociology for the benefit of the health service sector. For example, the Thurstone, Likert, Guttman measurement scale technique helps identify or measure attitude scales. This role also includes multivariate systematic procedures as well as factor analysis and network analysis which sociologists commonly use to collect data or explain research results.

• Sosiology from medicine

Analyze the medical environment from a social perspective. For example, how to pattern education, behavior, lifestyle, doctors, or socialization of medical students during health education.

• Sosiology at medicine

It is more of a part of observing the political orientation and ideology associated with health. For example, how a western structure will affect changes in treatment patterns while changing the pattern of community interaction.

• Sociology around medicine

Shows how sociology becomes part or interacts with other sciences such as anthropology, economics, ethnology, legal philosophy, and language.

The importance of the application of sociology in nursing

Nursing care is an important factor in client survival and the aspects of maintenance, rehabilitative, and preventive health care. To arrive at this point, the nursing profession has identified the following problem-solving processes.

• Basic patient data, including assessment, includes data collected through interviews, medical history collection, physical assessment of diagnostic laboratory examinations, and previous record reviews
• The priority of nursing diagnosis, to facilitate the sequencing of nursing diagnosis as a guideline for nursing plans.
• Client repatriation in accordance with expected health conditions.

Nurses as members of the health team use nursing diagnoses in providing nursing care. The nursing diagnosis is grouped based on the level of basic human needs which is a combination of several theories, the main hierarchies of Maslow’s needs, and the philosophy of early care. In addition, nurses also need knowledge expertise in other fields in applying nursing care, such as medicine, pharmacy, nutrition, environmental health, and socio-cultural economic-political ideology.

A preliminary study of the doctor-patient relationship in sociology was pioneered by Henderson. Among the various sociological themes he reviewed, we found themes of the concept of social systems and systems as well as themes of medical sociology. Henderson’s thinking was further developed by Talcott Parsons, among others, in his paper on modern medical practice.

One of Parsons’s most influential writings in health sociology is published in the book The Social System. For him, medical practice is a mechanism in the social system to deal with the diseases of members of the community. One of Parsons’ important mind donations to sociology is the five pairs of variables he named pattern variables. Parsons also discussed the role of pain. For him, illness is a social role, and a sick person has some social rights and obligations.

According to Parsons, a patient’s situation is characterized by a state of helplessness and the need to be helped, a lack of technical competence, and emotional engagement.

According to Parsons, the doctor’s role centers on his responsibility to the welfare of the patient, which is to encourage the healing of his disease within the limits of his ability. To carry out his responsibilities, doctors are expected to master and use high technical competencies in medical science and techniques based on him. For the benefit of healing patients, it is not uncommon for doctor-patient relationships to involve highly personal things. In addition to physical contact with patients, the doctor can also ask very personal things that are not usually disclosed to others. Another source of tension parsons has suggested is an emotional dependence on doctors.

Theoretical Approach and Empirical Studies

According to the symbolic interactionism approach, both doctors and patients have their picture of social reality, which affects the interaction between them. The study of symbolic interactionism of physician-patient relationships emphasizes gaps in expectations and the possibility of conflict. Parsons’ views on the role of pain have received the response of some sociologists. The four things that sociologists are concerned about are disease type, diversity in individual and group responses, health officer relationships with patients, and middle-class orientation. In line with time travel began to develop work-related to assistance to the doctor in the implementation of his duties.

The work of these non-physician health workers in literature is often referred to as pre-profession. The main feature that distinguishes the status of the profession from the work is the lack of autonomy. Because non-physician health workers do not have professional autonomy but are dominated and controlled by doctors, their work is classified into occupations, not professions

Another difference between the group of professions and the doctor profession is that non-physician health workers are more responsive to patients and more oriented towards them than doctors. Nurses are the most recognizable professions. The history of nursing work can be divided into two periods: the days before and after Florence Nightingale. Before Florence Nightingale nurses were considered surrogate mothers. Afterward, Florence Nightingale transformed the nurse’s image from surrogate mother to professional nurse.

C. HEALTH AND DISEASE FROM SOCIAL VIEW

• Understanding and Concept of Disease

In health sociology, there is a difference between the concept of disease and illness. For Conrad and Kern, the disease is a symptom of bio physiology affecting the body. According to Field disease (disease) is a medical concept regarding an abnormal state of the body that experts think can be known from certain signs and symptoms. Sarwono formulates disease as a disorder of the physiological function of the organism as a result of infection or environmental pressure, for which the disease is objective.

For Conrad and Kern, illness is a social symptom that accompanies or surrounds the disease. For Field, illness is the personal feelings of someone who feels his health is impaired. Sarwono formulates illness as an individual’s assessment of the experience of suffering from the disease; for him and Field illness is subjective.

Muzaham translates the term disease into disease, and illness becomes a sick-state, while Sarwono translates the term disease into disease, but translates the term illness into illness.

In every society, there is a medical system. By Foster’s definition, the medical system includes all beliefs about improving health and action as well as the scientific knowledge and skills of the group members who support the system. Foster also identified some universal elements in the various medical systems.

The disease is a product of culture. According to Geest in different societies, the disease is expressed differently, explained differently, and constructed differently.

• Social Construction on Disease

Some observers of health issues suggest that the disease is a social construction. Examples of this disease as a social construct include Conrad and Kern, who discuss the social construction of women as weak and irrational beings who are held back by typical female factors such as reproductive organs and their mental state, and a tendency to construct premenstrual and menopausal syndromes as health disorders that require special therapy. The following examples are presented by Diederiks, Joosten, and Vlaskamp, who specialize in their discussions on the social construction of physical and mental disabilities. Another example was presented by Brumberg, who discussed To deepen your understanding of the above study, work out the following exercises! social construction symptoms of anorexia nervosa among Western women. The latest example is based on Nijhof’s writings, which are based on the autobiography of people with chronic diseases.

• Health and Social Factors

Healthy Relationships with Social Class, Lifestyle, and Gender

The disease is not evenly distributed among the population. The problem of which group suffers from what disease is a field of study called epidemiology. Data from various countries reveals a link between health and social class. Differences in mortality between classes are caused by a variety of factors, such as heart disease ischemia, lung cancer, cerebrovascular disease, bronchitis, motor vehicle accidents, pneumonia, and suicide.

Although between the two neighboring U.S. states, Utah and Nevada, there were not many differences in income per capita, the percentage of the population living in urban areas, the number of doctors per 100,000 residents, the average level of formal education of the population, the age structure of the population, the composition of race, the comparison of men and women and the physical environment, but between the two found stark differences in various areas of health. His explanation was sought on the lifestyle differences of the residents of the two states. From this case, it is concluded that the availability of health facilities and high income does not in itself guarantee public health.

The inequality of morbidity distribution and mortality is also found between men and women. One of the social factors associated with differences in male and female mortality is behavioral differences, in part due to differences in role socialization. Smoking that results in susceptibility to certain diseases is a habit that in many societies is more common among men than by women. The same is true for liquor consumption.

Another social factor that causes differences in male and female mortality is the fact that men are more often involved in dangerous activities. Another interesting finding is the difference between male and female mortality in suicide rates. In certain cases, social factors result in higher mortality among women.

• Health Relations with Business and Ethnicity

The health problems of the population increase in line with the increasing age. Elderly people usually suffer from degenerative diseases and chronic diseases. They have the highest morbidity rate so the demand for health care is increasing as well. They are getting harder and more independent and increasingly dependent on others. Various health disorders are not resolved due to social factors, such as ignorance and economic factors. A social factor associated with old ageism, a system of discrimination that contains stereotypes that portray elderly people as sick, poor, and lonely.

Data from different communities often shows that the ethnicity or race of citizens is related to the state of their health. One of the factors that cause health disparities between ethnic and racial majority groups and minority groups is social class.

Social factors that are thought to be the main causes of death problems are severe poverty and scarcity of access to basic health care. Recommended efforts are the transfer of prevention and treatment efforts from hospitals, clinics, and emergency rooms to direct services to the highest-risk communities, and intensive education campaigns. Another finding concerning differences in the distribution of diseases between races is the fact that the number of White youth declared ineligible for conscription for medical reasons is always greater than the number of Black youth. This difference is thought to be because White people are more likely to perform sick roles than Black people.

Data on the health condition of ethnic minority groups living in the UK shows a higher prevalence of morbidity and certain mortality among certain ethnic groups than among locals.

Differences in the medical system between migrants and locals are also one of the factors that cause health differences.

• Health and Social Environment

Health problems can come from the social environment. Humans often live in a social environment that makes them angry, frustrated, or anxious, and such feelings can result in various health problems. House, Landis, and Umberson presented the results of research showing a link between social and health relationships. Among other things, it is expressed on the importance of social support for health.

Environmental threats to health are responded to by citizens with a variety of reactions. Some migrate to other regions. There are also community citizens who are trying to overcome it. The awareness or suspicion of citizens that their physical environment causes the disease is then often followed by various forms of action against those who are held accountable.

• Purpose of Public Health Care Services

• • Supporting the improvement of Community Health centers function as a center for community health development, center for the development of participation and community, and as a health care center in realizing the quality of life. This better quality of life is characterized, among others by:

• • • Declining mortality rates of infants, toddlers, and maternity mothers.
    • The increasing acceptance of the norm of small and prosperous families (NKKBS) by society.
    • The realization of a happy and empowered old age in his family and environment.
• • Helping the community get to know as early as possible health problems and be able to find and establish its countermeasures which in the end the community is able to be independent in addressing its health problems.
  • Helping and encouraging people to participate in efforts to improve their health.

 

• Social Order in Health

In general, the meaning of social order or social institution can be interpreted as an institution, organization, association, or social group. In the life of the community, there is much social order that helps the implementation of the realization of the needs of the community. For example, social order education (schools, colleges, madrassas, academies), economic social order (limited liability companies, cooperatives, KUD), health social order (hospitals, polyclinics, health centers), and others.

According to Talcott Parsons, the function is the meaning of another subsystem in the social system. He explained there are two functions, namely manifest functions, and latent functions. The manifest function is the desired function of kindness, organization, program, institution, or association. For example, schools have a function to improve knowledge. Latent functions are functions that a policy, organization, program, institution, or association do not want. For example, the school turns out to serve as an institution giving birth to people becoming lazy working and slow adults.

In relation to this issue, the function of health social order on the one hand helps the government in carrying out public health development. In the service, social order health (ranging from health office to Posyandu) positioned itself as a health service center, so there is an improvement in the quality or degree of public health. This function is an example of the manifest function of social order health. On the other hand, the birth of health social order is also used as one of the business field or profession for a person.

While the latent function of social order health is to create a human being who is not independent and less able to look after and take care of his own body. In modern society, these symptoms are already seen with cirri too easily humans rely on drugs, thus causing chemical drug addiction. This latter behavior is the effect of social order health function in the community. Another latent function, which is to improve the social status of people in society. As a profession with special expertise, the position as a health professional is a social achievement that is respected in the community. In fact, it is not uncommon for many people to make this profession a target in improving their economic or social status.

Nursing Profession’s Commitment to Responsibility and Trust Given by the Community.

1. A nurse doesn’t discriminate against clients. It is the principle of care to provide health care without discrimination. This is under the principle of respecting the individual as it is without distinguishing religion, tribe, race, nation, and so on and being fair to all patients who are tangging his answer. In providing nurse services is not discriminatory, but rather assists fairly following the patient’s ability to achieve optimum health. In this context the principle of fairness is applied, which is not to discriminate against patients and ensure patients get what they should get.
2. Get approval to take action. That principle is the principle of nurses when it comes to taking an action. Before taking action, the nurse informs the patient of the action. This is under the principle of appreciating the patient as a dignified person and being able to determine what is best for himself.
3. Granting the freedom to choose what to do is a moral principle of autonomy and an obligation to respect an individual as an independent person in decision-making because this principle is a core principle in ethics. Freedom is a sign and expression of human dignity. With freedom, man is an independent being who can determine and take his attitude.
4. Recognize the autonomy of the patient. Therefore, a nurse needs to come forward with a confession that the family has the right to reject the action by signing a statement of denial of action. This is under the principle of respect for the person who has autonomy. As individuals, in addition to being free to determine or choose the actions taken, the patient and the family have the right to reject an action that will be taken on him, so it is not permissable to impose an action on another person. Because imposing something on others means ignoring his dignity as a human being who can take his stance. This is the implementation of the principle of autonomy which in its real form is the granting of informed consent. In this infformed consent, the nurse provides a complete explanation in a way and language that can be understood by the patient. The information provided is solely so that the patient or family understands about the procedure of an action, can digest well the information provided, and is finally able to decide as they wish.
5. Prioritise action according to the priority of the issue. This principle is a critical way of thinking to decide which important actions, especially life-threatening, require immediate treatment to save patients. In this way of thinking, nurses can arrange action priorities according to the priority of the problem. By prioritizing action following the priority of the problem, of course the nurse also considers the best course of action for the patient he or she is treating by taking into account the benefits for the patient.
6. The principle of taking action following the priorities of this issue also emphasizes to be fair to the patient by not distinguishing the patient based on the accompanying status, but based on the priority needs of the patient. By prioritizing action appropriately, it can also be detected an early problem to prevent worse conditions or prevent harm.
7. Act for good, avoid harm. This principle is a supportive understanding in nursing action, because the area of nursing services is a human being with a condition that needs help or in a suffering condition.
8. Contained in this principle is to avoid the possibility of loss or damage, take the necessary actions to avoid losses, take actions with a high likelihood of being able to avoid damage, the actions taken will not pose a risk, the profit obtained from the action must be greater than the loss or cost used.

CHAPTER III

Final

Conclusion

• Sociology in health is research and teaching that is more characterized by closeness, applied and togetherness that is mainly driven by health problems. Health sociology also discusses health behaviors, the influence of social norms on health behaviors, as well as interactions between health workers and the public.
• The general role of sociologists in the development of science and public health services, namely Sociologists as research experts, Sociologists as policy consultants, Sociologists as technicians, Helping and increasing the role of teachers /health educators.
• In health sociology there is a difference between the concept of disease and illness. Disease is a symptom of biophysiology that affects the body and is a medical concept regarding abnormal state of the body that illness is a social symptom that accompanies or surrounds the disease. For Field illness is the personal feelings of someone who feels his health is impaired. Illness as an individual’s assessment of the experience of suffering from disease and subjective. While disease is a product of culture. According to Geest in different societies the disease is expressed differently, explained differently, and constructed differently..
• Purpose of Public Health Care Services
  • Supporting the improvement of the function of the Center for Public Health as a center for the development of public health,
  • Helping the community get to know as early as possible health problems and be able to find and establish its countermeasures which in the end the community is able to be independent in addressing its health problems.
  • Helping and encouraging people to participate in efforts to improve their health.
• The function of health social order on the one hand helps the government in carrying out public health development. This function is an example of the manifest function of social order health. While the latent function of social order health is to create a human being who is not independent and less able to look after and take care of his own body.
• The Nursing Profession’s commitment to Responsibility and Trust have given by the Community, namely, a nurse does not discriminate against clients, obtains approval to take action, recognizes the autonomy of the patient, prioritizes actions according to the priorities of the problem, Performs actions for good.

B. Advice

• It is hoped that readers can know the aspects of political sociology and apply it in daily life.
• By studying political sociology it is expected that nurses can pay more attention to the relationship between the nurse and the patient or between the nurse and the patient’s family.
• After reading this paper, it is hoped that the reader can provide feedback so that in the future the author can work better.