PART ONE．SOCIOLOGICAL ORIENTATION 1
Chapter 1 FOUNDATIONS FOR UNDERSTANDING SOCIETY 3
Nursing School—＂New World＂of Experience 3
Quest for Basic Understanding of Experience 4
Behavior Influenced by Social Experience 5
All Knowledge Is Relative 5
Determining Facts of Illness 6
Facts Interpreted by Reference to Systems of Analysis 7
Continuous Expansion of Bases for Medical Interpretation 8
More Understanding of Human Relations Needed 8
Puzzling Nature of＂Human Nature＂ 10
The Case of＂Understanding＂Fatigue 11
Nurses in Changing Social Situation 13
Nursing Responsibilities Are Changing 14
Goals and Functions of Nursing 15
Educational Changes Demanded 16
The Challenge of this Book 17
For Investigation and Discussion 19
Bibliography 19
Chapter 2 ANALYZING THE BASIC STRUCTURE OF SOCIETY 20
Comparison with Dissection and Study of Human Anatomy 20
Communication，＂Correct＂Forms 20
All Parts Have Functions 22
Culture，the Total Way of Life 23
Tools for Detailed Study of Culture 24
Trait，Complex，Pattern，and System 24
Social Norms：Folkways，Mores，Laws 25
Social Institutions 28
Defects and Disorders May Develop in Changing Social Institutions 29
Summary View of Social Structure 30
How Culture and Society Are Related 30
For Investigation and Discussion 31
Bibliography 31
Chapter 3 SOCIAL LIFE OCCURS IN GROUPS 32
Informal Group Formation 32
Chief Characteristics of Human Groups 33
Aggregations and Classifications Are Not Groups 35
Classification of Social Groups 35
Primary Groups 36
Primary Group Experience May Be Limited or Absent 39
Secondary Group Life May Become Dominant 40
Bureaucracy 42
Groups Related Vertically or Horizontally 43
Stratification of Groups 45
Mobility 46
In-Groups and Out-Groups 47
Ethnocentrism Produced Experimentally 50
Ethnocentrism and Professional Groups 52
For Investigation and Discussion 52
Bibliography 53
Chapter 4 HUMAN NATURE AND PERSONALITY 54
Why We Look into Mirrors 54
Infants at Birth 55
Original Helplessness Plus Flexibility 56
＂Not Born Human＂ 57
Anticipation of Infant＇s Birth 57
Socialization 59
Idea of Self Develops 59
Development of Self Words and Speech 61
Development of Moral Responsibility 63
Learning To＂Play the Game of Life＂ 64
Personal Organization 65
Focus of Social Pressure on Person 66
Determinants of Personality 68
Significance of Social Isolation 69
Examples of Cultivation and Guidance 70
Personalities of Parents Influence Child 72
Getting Acquainted with Personalities 72
For Investigation and Discussion 74
Bibliography 75
Chapter 5 SOCIETY IS CHANGING IN MANY WAYS 76
＂What＇s New？＂ 76
People on the Move 77
There Is a＂Battle for Men＇s Minds＂ 77
Perspective May Come from History 78
Critical Periods Have Occurred in the Past 79
Why Social Changes Occur 80
Deviations May Get Acceptance 80
Trial and Error 80
Research and Invention 82
Borrowing and Diffusion 82
Limitations on Social Change 83
The Culture Base 83
Communication 83
Intergroup Relations 84
Resistance to Social Change 84
Some Major Current Changes 85
Technological Revolution 86
Changes along Whole Cultural Front 87
Social Changes and Social Stability 89
Social Disorganization 89
Social Problems 90
Culture Lag 90
Social Values 91
For Investigation and Discussion 92
Bibliography 92
Chapter 6 SOCIAL HEALTH AND SOCIAL PROBLEMS 94
Social Defects and Disorders 94
＂Hospital World＂as Model Society 95
Physical Structure 95
Diversification and Stratification 95
Interdependence and Organization of All Parts 97
Problems in＂Hospital Society＂ 97
Problems of Doctors 98
Problems of Nurses 99
Hospital，Part of Whole Society 100
The Health of All the People 101
Revolutionary Improvements 101
Organization and Support of Health Services 102
Some Highlights and Shadows in the Picture 102
Physical Examinations of Inductees 103
Leading Causes of Death 104
Death Rate Due to Accidents 105
Disability 106
Mental Health 107
Problems of Health and Our Way of Life 109
＂Total＂and＂Positive＂Health 110
The Price Required 112
Quasi Health Problems 112
Vice and Crime 113
Alcohol and Social Problems 113
Juvenile Delinquency 116
For Investigation and Discussion 118
Bibliography 119
Chapter 7 SOCIAL PROBLEMS(continued) 120
State Pride 120
＂States＇Rights＂and Obligations 121
The Problem of Intergroup Relations 121
Religious，Racial，and Class Groups 122
The Negro Is a Minority Group 123
Under Slavery 123
Humanitarian Developments and Legal Emancipation 123
Advancement Despite Social Inertia 124
Race and Group Consciousness 124
Significant Changes 125
The Problem Remains 125
Impact of Prejudice on Self and Personality 125
Biological Differences Are Social Symbols 126
Japanese，Indians，Mexicans 126
Marginal Persons 127
Some Problems of Jewish-Gentile Groups 128
Long History of Separation and Persecution 128
High Status of Many Jews 129
Stereotyped Image 129
Some Cooperation and Friendship 129
Most Serious Aspect of Problem 130
Religious Conflict May Disorganize Society 131
Fractional Strife in Communities 131
Labor-Management Relations 132
Emergence of Modern Economic Groups 132
Labor Organization 132
Important Facts and Issues 133
Light May Be Dawning 133
The Basic Problem of Social Intelligence 134
Behavior Rests on Consent 134
Children Must＂Know the Game＂Being Played 134
The＂Hospital World＂Once More 134
Complexity of Informed Public Opinion 135
Some Underlying Difficulties 136
Static Learning and Dynamic Living 136
Fear of Inquiry and Understanding 136
Propaganda 137
Control through Advertising 137
Propaganda Is Subtle 137
Extreme Results in Germany 138
Protection against Propaganda 138
For Investigation and Discussion 139
Bibliography 140
Chapter 8 FAMILY RELATIONSHIPS ARE CHANGING 141
Variability among Families 141
Similarities by Habitats and Classes 141
Changing Bases of Family Structure 142
The Traditional American Family 144
Patriarchal in Form 144
Primary Goals 145
Agricultural Interest 145
Functions of the Traditional Family 146
Changes in Economic Relations and Functions 147
Technological Revolution 147
New Things Become Necessities 148
Work Pattern of Family Changes 148
Changes Associated with Reproductive Function 149
Children—Economic Assets or Liabilities 150
Emphasis on Individualism 151
Happiness—By-Product or Goal 151
Changes in Protection and Maintenance Functions 152
Welfare，Health，and Educational Services 152
Family as Consumption Unit 153
Transmission of Property，Status，and Name 153
Arts and Crafts Instruction Declines 154
Creative and Recreative Activities 155
Limited Function of Mass Amusements 156
Determination of Vocation or Vocational Preference 156
Chapter 9 FAMILY RELATIONSHIPS(continued) 158
Determination of Conceptions of Self and Personality 158
Mastery of Language 159
Children May Learn More Than Parents 160
Training in Manners and Morals 160
Child Training and Reactions to Illness 161
Cross-Cultural Differences in Early Training 161
Relative Length of Complete Dependence 162
Family Continues as Chief Source of Early Training 163
Community Shares More Training 163
Guidance from＂The Lonely Crowd＂ 163
Provision of Affection and Security 164
Essential Family Function 164
Effects of Institutional Life on Personality 165
Report of Case Study 166
＂Explanation＂of Love 168
Completeness of Self in Others 168
Complementarity in Courtship and Marriage 169
Possible Clue to Divorce 170
Family System Becomes Unstable and Families Disorganized 171
Summary of Changes in Family 171
The Family System in Transition 172
Significance of Complementarity Reviewed 173
For Investigation and Discussion 173
Bibliography 174
Chapter 10 WE ARE AT HOME IN COMMUNITIES 175
Help from Community in Getting Job 175
The Community Is a Social Group 175
Experience in Community 176
What We Know about Our Community 176
Better Acquaintance with Communities 177
What We Need To Know 177
Geographical and Regional Location 178
Reasons for Community Location 179
Regional Connections among Communities 179
Value of Historical Sketch 179
Extent，Size，and Layout of Communities 180
Legal and Sociological Boundaries 180
Rapid Expansion Quite Disturbing 181
Variability in Size of Communities 181
Need for a Base Map 182
Population 182
Variation in Sex and Age Ratios 183
Natural Areas 183
In Smaller Places Such as Jonesville 184
In Larger Cities 184
Value of Area Analysis 187
Class Structure 187
In Jonesville 187
Variations in Class Structure 188
Economic Base and Division of Labor 189
Competition and Cooperation 190
Family Life 191
Religious Organizations 191
Some Points of Difference 191
Systems of Control and Government 192
Control Related to Freedom 192
Making Community Decisions 192
Why＂Political Machines＂ 193
One-Family Domination 193
Power Structure 194
If Informed People May Rule 194
Communication 195
The Local Newspaper 195
Informal Communication 196
Holding Together 196
Habitual Patterns for Living 196
Special Occasions and Interests 196
Distinctive Character of Each Community 197
Calls for Particular Study 197
For Investigation and Discussion 197
Bibliography 198
Chapter 11 COMMUNITY ORGANIZATION AND PROFESSIONAL SERVICES 199
American Ideal of Progress 199
Many Organizations for Improvement 199
Efforts To Eliminate Undesirable Conditions 200
Trial and Error Lead to Establishing Agencies 200
Health Organization 201
Historical Perspective Needed 202
Antecedents of Medicine 202
Recognition of Environmental Factors in Disease 203
Discoveries Essential to Advent of Public Health 203
Evolutionary View of Hospital Services 204
Nursing Becomes Essential to Coherent Health Service 205
Chief Reasons for Revolutionary Gains in Health 205
Chronic Diseases Illustrate Future Challenges 206
Welfare Organization 207
Some Forerunners of Welfare Organization 208
Case Work—New Rationale and Method 209
Discoveries in St．Paul Indicate Major Need in Welfare Organizations 209
Recreational Organization 211
Recency of Many Recreational Demands 211
Recreation Gives Rise to Problems of Regulation 212
Recreation for All 213
Communities Vary Widely in Recreational Organization 214
Therapeutic Values of Recreation Uncertain 214
Educational Organization 214
Cabinet Post Combines Health，Education，and Welfare 214
Educational Functions Widely Diffused 215
Education Broader than Schooling 215
Average Educational Level Rising 216
Historically and Currently Schools Lack Integration 216
Investigation and Experimentation Needed 216
Toward Positive Community Organization 217
Health Organization Points the Way 217
Lag in Welfare Organization 217
Public Support and Participation Crucial 218
Economy and Efficiency Required 219
Two Types of Competence for Professional Service Personnel 219
For Investigation and Discussion 220
Bibliography 220
PART TWO．SOCIOLOGY APPLIED TO NURSING INTRODUCTION TO PART TWO 224
Chapter 12 CHANGING ORGANIZATION AND FUNCTION OF HEALTH SERVICES 225
Emergence of Present-Day Health Services from a Disorganized Pattern of Care for the Sick 225
The Family Primarily Self-Sufficient in Most Illness Situations 226
Changes in Medical Care and Medical Practice 226
The Family Doctor 226
Contrasts in Cost of Medical Services 227
The Advent of the Specialist 227
Specialization in Medical Practice 227
Access to Clinics and Hospitals 228
Early Hospitals 228
Attitude toward Hospitalization 229
Personnel Involved in Care of the Patient 229
Modern Hospitals 229
Changing Role of the Hospital 229
Changes in Hospital Environment 229
Length of Hospital Stay 230
Change in Attitude about Hospitalization 230
Increasing Complexity of Relationships of Hospital Personnel 230
Team Concept of Care 231
Hospital Facilities More Readily Available to All 231
Health Services and the Consumer 231
The Consumer 231
Demand for Adequate Health Services 232
Public Relations 232
Broadening Concept of Health 233
Nurses＇Training Gives Way to Education for Nursing 233
Nursing Education 234
Nursing Service 235
Change in Concept of Nursing 235
Status and Role of the Nurse 236
Variations in the Community 239
Variations in the Work Environment 241
Summary 245
For Investigation and Discussion 246
Bibliography 247
Chapter 13 STRUCTURE OF NURSING SITUATIONS 248
Basic Understandings 248
Physical Aspects 248
Social Institutions in the Community 248
Population Characteristics 249
Differences in Urban and Rural Communities 249
Religion 250
Family Size 250
Income，Occupation，and Economic Status 251
Housing 252
Marriage Establishes the Family 254
Health Requirements for Marriage 254
Common-Law Marriage 254
Family Life 255
Establishing a Home 255
Class Differentiation in Families 256
Class Structure 256
Family Disintegration 256
Annulment 257
Desertion 257
Divorce 257
Separation 257
Family Relationships 259
Democracy in the Family 259
Autocracy in the Family 259
Effects on Planning 259
Other Assets of the Family Group 260
Educational Attainment 260
Intelligence 260
Skill of the Homemaker 261
Health Information 261
Health Status 261
Summary 262
For Investigation and Discussion 263
Bibliography 264
Chapter 14 NURSING SITUATIONS RELATING TO MATERNAL AND NEWBORN HEALTH 266
Cycle of Nurse＇s Contacts during This Period 266
Family Relationships 267
The Woman Who Is To Become a Mother 268
Family Customs 270
Family Attitudes 270
Relationships 271
Fears of Pregnancy 271
Admission to the Maternity Ward 273
Maternal and Newborn Mortality 273
Postnatal Period 275
Rooming-In 277
The Newborn 277
The Midwife 278
The Incomplete Family 279
The Unmarried Mother 279
Community Resources 282
Specialized Institutions That Aid Families in the Maternal and Newborn Period 282
National Institutions 282
Children＇s Bureau 282
Aid to Dependent Children of Social Security Act 283
State Institutions 283
Division of Child Hygiene，State Department of Health 283
Local Institutions 284
County Health Department 284
Hospitals 284
Maternity Homes 284
Homemaker Service 285
Temporary Home Placement in Foster Homes or Boarding Homes 285
Planned Parenthood 286
Summary 287
For Investigation and Discussion 288
Bibliography 288
Chapter 15 NURSING SITUATIONS IN THE INFANT PERIOD OF LIFE 290
The Infant 290
Early Contacts 290
A Look at the Picture 291
The Place of the Infant in the Population 291
Mortality and Morbidity in the First Year of Life 291
The Infant and His Family 291
Family Structure 292
Husband-Father and Wife-Mother in Their New Roles 294
Housing 294
Family Economic Resources 294
Cultural Heritage Influences Parents 295
Orientation of Infant＇s Basic Sense of Emotional Security and Dependence 295
Attitude of Parents 296
Communication Early in Infancy 296
The Infant Begins Social Interaction 296
Control as Part of Interactive Process 297
Improved Care as a Result of Teaching 297
Culture and Satisfaction of Infant Needs 298
Impact of Culture 298
Individualization 298
Feeding Practices 299
Preventive Health Practices for the Infant 299
The Nurse and the Normal Infant 300
The Infant Becomes a Human Individual 301
From Biological Organism to Human Being 301
The Rise of the Self 301
Hospitalization of the Infant and Young Child 301
Admission Data and Uses 302
The Infant with Congenital Anomalies 303
Parents and the Premature 305
The Role of Government in Infant Care 306
Community Resources Offering Specialized Services 307
Summary 307
For Investigation and Discussion 308
Bibliography 309
Chapter 16 NURSING SITUATIONS IN THE PRESCHOOL PERIOD 310
Life Begins To Have Real Meaning 310
Social World Enlarges 311
Play Groups 311
The Neighborhood 312
Development of Communication Skills Gives Impetus to Social Interaction 312
The Self Becomes a Reality 313
Emergence of a Person-ality 314
The Child Becomes a Personality 314
Parents Guide Personality Development 314
Structuring Environment for Optimum Growth and Development 314
Setting Limits for Behavior Maturation 314
Significance of Kinship Group 315
Sibling Group 316
Preparation of an Older Brother or Sister 316
The Child and Religious Influence 318
Bridging the Gap between Home and School 319
Day Care Centers 319
Continuing Preventive Health Practices 320
A Step-Mother or Step-Father 321
Foster Homes 322
Adoption 322
Summary 323
For Investigation and Discussion 324
Bibliography 324
Chapter 17 NURSING SITUATIONS IN THE EARLY SCHOOL YEARS 326
The Niche of the Six-Twelve Year Age Group in Socioeconomic Strata of Society 327
Compendium of Physical Growth，Mental Development，and Acquired Skills 327
The Family 328
Recognition and Acceptance of Differences in Children 329
Responsibilities in an Enlarged Social World 329
Respect for Property Rights 329
Manners 329
Money 330
Communication 330
Personality Development Continues 330
The School Has an Important Role To Play 331
Group Adjustment in School Environment 332
Group Interaction Becomes More Diversified 332
Folkways Continue as a Means of Social Control 333
Mores 334
The Seed of Prejudice Is Sown 334
Meeting the Child＇s Needs for Sex Information 335
Health Needs 336
Remedial Defects 336
Hospitalization for the Older Child 337
Community Resources 338
Summary 338
For Investigation and Discussion 339
Bibliography 340
Chapter 18 NURSING SITUATIONS IN THE TEENS 341
What Is the Child Like in His Teens？ 341
What Are Some of the Needs of the＂Normal＂Adolescent？ 342
The Adolescent and His Family 342
Intra-family Relationships 343
Inter-family Relationships 343
Groups and Their Influence 344
Gangs Come into Being 344
Cliques 344
Youth Organizations 345
Student Nurse Organizations 345
Minority Groups 345
School and the Teen-Ager 346
Sex Development 347
Dating and Courtship 347
Dating 348
Courtship 348
Preparing Young People To Be Parents 348
Marriage Counseling 349
Social Hygiene Association 349
Prejudice 349
Attitudes toward Health 350
Safety 350
Becoming Aware of Public Opinion 350
Child Labor Laws 351
Part-Time Employment 351
Delinquency 351
Choosing a Career 353
The Teen-Ager Becomes Aware of Factors That Limit Social Mobility 354
Culture and the Teen-Ager 354
Summary 355
For Investigation and Discussion 356
Bibliography 357
Chapter 19 NURSING SITUATIONS AND THE YOUNG ADULT 358
Population Changes and Satisfaction of Needs 358
Society＇s Benefits 359
Personal Satisfaction from Life 360
Position in the Social Structure 360
Personality 361
Years of School Completed 361
College Education 362
Employment 362
Career 364
Healthful Living 364
Marriage 364
Inception of Family 365
Cultural Conflicts in Marriage and Family Life 366
Age and Status in the Community 367
Manifestations of Personal Disorganization 367
Social Illnesses 367
Drug Addiction 368
Alcoholism 369
Prostitution 370
Suicide 370
Summary 371
For Investigation and Discussion 372
Bibliography 373
Chapter 20 NURSING SITUATIONS IN THE MIDDLE YEARS 375
The Pattern of Family Life Changes 375
Basic Needs in Middle Life 376
Health Remains a Need 377
Physical and Mental Changes 378
The Nature of the Social World in Middle Years 379
Employment 379
Summary 380
For Investigation and Discussion 381
Bibliography 381
Chapter 21 NURSING SITUATIONS IN THE LATE YEARS OF LIFE 382
The Nurse and the Aged 382
America Is Fast Becoming a Society of Older People 382
Life Expectancy Is Increasing 383
People Spend Longer Years in Retirement 384
When Is a Person Old？ 385
Basic Needs Have Not Changed 385
Philosophy for Living 386
Personality 387
Spiritual Values 387
Education 387
Social Activity 388
Status of Older Persons 388
Recreation 389
Marital Status 389
Family Status 389
Housing and the Aged 390
Health in Old Age 390
Accidents and the Older Worker 391
Economic Status 391
Employment in Later Years 394
Retirement 395
Social Insurance Programs 395
Role and Function of Social Security Programs 396
Indigency in the Aged 396
Custodial Care for Senile Persons 397
The Role of the Community 398
Summary 398
For Investigation and Discussion 399
Bibliography 400
Chapter 22 NURSING SITUATIONS IN ACUTE ILLNESS 401
Application of Sociological Concepts Can Strengthen Comprehensive Nursing 401
Continuity of Care 403
Contrasting Physical Environments in Home and Hospital 404
Hospital Admission 405
Contrasting Social Environments in Health and Illness 406
Acute Illness Threatens Family Security 408
The Nurse-Patient Relationship in Acute Illness 409
Health Education as the Most Effective Tool for Avoiding Illness 410
Socio-economic Status and Incidence of Disease 411
Resources Which May Be Utilized To Cover Cost of Illness 411
Workmen＇s Compensation 412
Prepayment Plans 412
Other Sources 412
Summary 413
For Investigation and Discussion 414
Bibliography 415
Chapter 23 NURSING SITUATIONS IN LONG-TERM ILLNESS 416
Identification of the Major Disabling Diseases 416
Magnitude of the Problem of Chronicity 417
Age Selectivity 417
Prevention 419
Length of Disability Period 420
Personality 420
Housing Facilities 421
Influence on Family Living 422
Social Implications of Long-Term Illness 423
Economic Losses 423
Long-Term Hospitalization 424
Hospitalization for the Child with Long-Term Illness 425
Medically Indigent 426
Contrasts between Acute and Long-Term Illness 427
Chronic Diseases Which Result in Non-Disabling Conditions 427
Sex Differences in Disability 428
Mental Illness 428
Mental Illness as a Problem 429
Increasing Need for Institutional Facilities 429
Environmental Factors in Mental Illness 430
Family Strengths and Weaknesses 430
The Nurse and Mental Illness 431
Social Consequences of Deformities 432
The Role of the Social Case Worker 433
The Role of The Practical Nurse 433
Rehabilitation 434
Occupational Therapy as One of the Components of Rehabilitation 435
Physical Therapy 436
The Community 436
Summary 437
For Investigation and Discussion 438
Bibliography 439
Chapter 24 IN THE PROCESS OF TIME 441
The Framework within Which the Nurse Will Function 441
Responsibilities of Leaders in Nursing 443
Change 443
Democracy 443
Team Relationships and Group Action 444
Communication 445
Working with People 445
Understanding Others 446
Responsibility to Students 446
Evidence of Progress 447
Vital Attributes for the Nurse 449
Problems 452
For Investigation and Discussion 454
Bibliography 455
INDEX 457