Key Contexts for Foundations of Health and Social Care by Robert Adams
Chapters 21-30
Chapter 21
Hand hygiene is a matter which relates primarily to microbiology and medical research and
practice. Although this topic is driven by essentially practical concerns, there are social
implications, depending on the setting it takes place, as we mention in the next chapter, which
is closely related to this one.
Chapter 22
The control and prevention of infection is rooted in the context of microbiological theories,
research and practice. It is affected by the social context in which it takes place and this
chapter relates particularly to healthcare settings such as the hospital, as the primary site
where the risks of infection are great. There are other similar settings, such as residential care
and nursing homes for older people. These settings ensure that there is an organisational
dimension to this chapter, which relates, therefore, to organisational psychology and
sociology as well as to theories and research into management and quality assurance.
Chapter 23
The primary context of this chapter on nutrition is knowledge informed by research into the
biological needs of the body and how they are best met. Biological knowledge is the basis of
the immediate knowledge base of physiology in which nutritional and dietary needs are
managed.
Chapter 24
The context for research and practice into bowel and bladder health is biological and
physiological. Medical research in this area is rooted in these areas of knowledge. It would be
a mistake to see this as the sole or even the main context for this chapter. There is a strong
sociological and psychological dimension to this area of work, in that the health and social
care practitioner is one of a multi-disciplinary group of staff who need to engage with the
person, to try to overcome personal feelings of shame and lack of confidence and build up
social skills associated with the management of incontinence and constipation.
Chapter 25
The key contexts of this chapter are medical research and pathology (ie. the study of the
causes, processes and consequences of disease) of the body, insofar as they focus on illnesses
Key Contexts for Foundations of Health and Social Care by Robert Adams
and conditions. The chapter takes a very general approach, focusing attention briefly on a few
of the main illnesses and conditions the basic health and social care practitioner is likely to
encounter.
Chapter 26
The study of pain is not straightforward. As the definition of pain in the chapter indicates,
pain itself is somewhat problematic as a concept, because there is no necessary physical proof
of what a person experiences. Pain, therefore, is what you say you feel, rather than what you
feel, that can be corroborated independently by a physical test. So we have to say that the
major contexts for this chapter should be both the physical pathology and the
psychopathology (psychology of disease) of pain. Pain could have mental as well as physical
origins.
We have started with the more complicated and difficult to grasp context for pain. The most
obvious and immediately accessible one is based in the physical diseases and conditions
which produce immediately obvious and verifiable signs – such as swellings over a broken
bone – the origins of which lie in the anatomy and physiology of the body.
Chapter 27
The key contexts for this chapter are biological, specifically in the physiology of the human
body and the medical research which has enabled the practice of wound management to make
advances.
Chapter 28
This chapter is located in the largely medical and biological context of the process of dying
and the psychological context of theories, research and practice concerning bereavement
processes. Dying is more than a physical process located in medical practice, of course. It is a
complex social and psychological event, usually associated with a variety of often major and
traumatic psychological and spiritual consequences for relatives and friends. Sometimes the
death is so traumatic that medical and health and social care staff are affected. The process of
bereavement has a social dimension, in that funerals and mourning in many ethnic groups,
cultures and faith communities are associated with prolonged rituals of transition and have an
anthropological dimension.
Part IV
This deals with the process of practice. It discusses the idea of process in Chapter 29 and the
following four chapters go through the stages of the work.
Key Contexts for Foundations of Health and Social Care by Robert Adams
Chapter 29
This chapter relates to frameworks of ideas about processes in health/nursing and social
care/social work. Most of the literature on the health side is rooted in nursing and midwifery,
whilst that on the social care side is drawn from social work.
The similarities between the nursing and social work processes are far greater than the
differences. The differences are mainly in emphasis, reflected in the slightly different
language used as headings for the four stages.
Chapter 30
The main contexts for this chapter on assessment are the social sciences which inform the
assessment process. Chiefly, these are psychological and sociological, with some social
policy perspectives having relevance. These disciplines enable the practitioner to draw on
knowledge of the problems which afflict a particular vulnerable person at their stage in the
life course, in their geographical locality, given their ethnic, gender and cultural and religious
background, and contribute to the local environmental and family factors which interact with
their personal history and development and lead them to express the wants and needs they
have today.