Other part of the
medical interview that's quite lengthy at times and probably fairly sensitive is the social history. Now, I always think that most
interviews are difficult sometimes depending
on the patient and what you're
trying to ask them, but the social history
does carry with it some risky things to
ask a patient to make sure that they understand why you're asking them
these questions, and what it is you
want to know for. What we try to assess
with the social history is health habits,
health behaviors. Other behaviors
that may or may not put a patient at risk
for different things. So I'm going to
proceed now by asking the patient here about
her social history. Miss Smith, time
of this interview now is with the social history. And by that, I want
to try to get to know you a little bit in a
different way as a patient. Some things about your past, some things about
your health habits, some things about your
lifestyle that can tell me if there's any
risk perhaps that we need to assess in
terms of your health. What I need you to
know about it is where some questions are very simple
and very easy to answer, some questions are
very personal. As I ask them, you may
wonder why I'm asking them, and I hope that I tell
you why I'm asking them. If not, please ask me. Also too, if you
say, you know what? That's not anything
I want to discuss with you, please tell me so. Everything is your choice as to whether or not you
wish to answer it. Is that right with you? Yeah. I want to start out
with some things now, just your living situation.
Where were you born? I was originally
born in Selma, Alabama. And so how did
you get to Madison? I came here for school. And you live in Madison now? Yes. And may I ask, who
do you live with? Who lives in your household? My husband. How long have
you been married? We've been married
about three years now. Three years.
Anyone else live in the household other than
you and your husband? No. One of the things I
would like to know about people just to get a sense for what support systems
they have available is if you and your husband
needed help with something, or you needed help or you
got sick or somebody had to go and get gas for you if you ran out of gas or
you broke your leg, who would be available
to help you? Probably maybe our friends. Anybody else is
useful in terms of support to you and your husband that even don't live here? Our parents, of course. There's one
thing I always like to make sure that I know also. You've told me about who you
could depend on for support. Is there anybody that depends on you for support
that relies on you? My husband. Your husband. So you guys sound like you take
care of each other? We do. Children? No children. So typical day for you. Tell me what a typical
day is for you? For the most part, I
usually get up and go to work. I usually work out at
some point in the day. And then go home enjoy dinner. Do you work during the day? Yes. Tell me about the
type of work you do? I'm a teller at Anchor Bank. I see and you work
routine daytime hours? Yeah. What do you do for fun? We like to go out.
We like to dance. Go out to eat,
movies, simple stuff. What I want to know about, and the next two things I'm
going to bring up to do, you have to do specifically
with your healthcare. And what I need to know is
culturally or spiritually, are there any
activities that you engage in or communities
that you belong to, or beliefs that you
have that affect your healthcare that as your practitioner I
should know about? No. The last thing that I
want to talk to you in this category is about is what they call advanced directives. And advanced directives
is a term that's used for instructions
that are given. Should you and I not be able to talk about
your healthcare? Should you not be able to
tell me what you want? Most times the subject
is addressed a someone becomes very ill or
someone becomes older, but it's always a good
idea I think to as patients once they're
of legal adult, to ask, do you have what they
call advanced directives? I don't have any. This would be something
I would like to talk with you a little bit
more to make it a little more formalized
because there is some legality to it and
there are forms to it. It's important that
you think about it, talk to your husband about it or other family
members about it. So I'd like to bring this up to you again at another
time if that's okay. Yes. The next thing that
I want to talk about is more specifically health
habits that you have. And we're going to talk about
things like exercise, diet, tobacco use, things like that habits that people have when it comes to their health. So what I'm thinking
about with that is, first of all, let's talk about the one thing we do every
day we sleep every day. Everybody we sleep every day. So tell me a little
bit about your sleep. I usually get about
eight hours a day. And I'm assuming you sleep at night because
you work during the day. As we think of at night. And you sleep how long? About eight hours. About eight hours. And
what I want to know more specifically is do you feel
rested when you wake up? Yes. The next thing I'd like
to go to is your nutrition. Is your weight something that
you feel comfortable with? Are you satisfied with
your current weight? Yes. Can you be a little more specific about your eating plan? Tell me what a typical day
eating plan looks like. And what I want to know
is things about fruits, vegetables, if you eat
them or you tell me. I usually try to
have three meals a day. For breakfast, I try to
do something like a fruit or yogurt and maybe
something with whole grain, so like a bagel or a bowl of oatmeal or
something like that. For lunch sometimes, we'll eat out in the office. But mostly, I try to
do a lean cuisine and a yogurt or some
vegetables or something. And then for dinner, we try to have more
of a balanced meal, something with
lots of vegetables and usually some
meat in a grain. We try to eat red meat
about twice a week. So how many servings of fruits and vegetables would
you say you have a day? I don't know. But I
try to have quite a bit. How many would you say
quite a bit is for you? I'm hoping at least 5-6 maybe more than that, probably. Are there any food groups
you think you eat more of or less of than you
want to or should? I love potatoes, so I probably eat
too much potatoes. Any foods that
don't agree with you? None that I can think of. Tell me about
your caffeine use. I usually drink about
two cups of coffee a day. And any colas? I try to stay
away from those. Teas? Sometimes I have
a glass of tea. Any problems with
caffeine keeping you up? No. Exercise. Tell
me about exercise. I try to walk every day. And how far do
you walk every day? Usually 2-3 miles, sometimes longer, just
depending on the day. And when you walk
two or three miles, how much time does
it take you to walk? Not too long. Maybe if we do two miles
maybe about a half an hour. So you're walking
at a pretty good clip. And how many days a
week do you do this? I try to do it every day. So maybe on average
six days a week. You mentioned that
you dance. Do you dance for exercise also, or is that mostly for
pleasure and enjoyment? Mostly for pleasure. We talked about sleep first. You start your day that way. What I'd like to know
about is safety. And when I talk about
safety with people, what I'm talking about
are some simple things like do you have smoke
detectors in your house? Yes. Do you have carbon
monoxide detectors? Yeah. And you check those regularly with changing the
batteries and whatnot? Yes. I think it's recommended if you're changing at
least once a year. If you engage in things
like biking, skiing, snowboarding,
behaviors that require a helmet. Do you wear a helmet? Usually. Tell me about seat
belts in your car. I always wear a seat belt. In the environment
many times, depending either through
leisure or through work, sometimes we can be
exposed to things. And the types of things
I'm talking about is, are you exposed to
smoke in any capacity, or second hand smoke? No. Can you tell me, are you
exposed to things like dust, chemicals, excessive noise, excessive temperatures,
hot or cold? Maybe some dust. And that would be when? It's everywhere,
but not a whole lot. Probably nothing outside
of the ordinary. Anything you know
environmentally that you think impacts
your health at all? No. I want to move on
to another subject now that sometimes is difficult
for people to talk about, but it's important
that we have some idea of what is the status of things. And the first thing I
want to ask you about is your tobacco use.
Do you use tobacco? I do smoke on occasion. You smoke cigarettes? Yeah. And tell me when
did you start smoking? Maybe about 10 years ago. And do you smoke every day? Yeah, for the most part. How many cigarettes a day? I tried to have
more than three. Have you ever tried to quit? Yes. Is quitting something you want to talk a
little bit more about, or you're interested
in pursuing? Yeah, but maybe
not right now. May I have the permission
to bring it up to you again at another
visit, is that okay? Yes. The second thing I want to
talk about is alcohol use. Tell me about how often
you drink alcohol? Maybe 1-2 times a week. One to two times a
week. And what type of alcohol do you
drink when you drink? I like wine. You like wine. And
how many drinks do you have when you drink alcohol? Probably a glass, maybe two at the most. Can you show me how
big the glass usually looks or is it a
typical wine glass? It's a typical wine glass and probably a typical servant
of about half the glass. The third category is drugs. And with illicit drugs, I mean, anything that is not
prescribed for you or anything recreational
that you may take. So do you ever use
anybody else's medications that were
not prescribed for you? No. Any drugs such as
marijuana, cocaine, ecstasy, heroin, drugs that we typically call street drugs
or recreational drugs. Any use of those now? No. One of the last things
that I want to talk to you about is
something that I talked to all patients
about to make sure that there's nothing here that we would need to
talk about any further, but what I want to talk about
is your sexual behavior. And what I need to know is, are you in a sexual
relationship now? Yes. You are. And may I
ask who that's with? My husband. Your husband. Are your
partners male, female, or both? Male. Any partners outside of
your marriage now for you? No. To the best of
your knowledge, are there any partners outside of your marriage
for your husband? I hope not. Do you have any concerns
about STIs at all? No. Any concerns about
your sexual health or your sexual satisfaction? No. If there would
be, please know that you could come and
talk to us about that. The last thing that
I really want to talk to you about
in greater detail is some things about
stress and violence, and some simpler things more about economic
risks for one thing. And with our economy
and people losing their jobs and losing
their insurances, do you have any
economic stressors as you think it
affects your health? None that I can think of. If I could ask, how is
your health care paid for? How is it taken care of? We both get insurance
through my employer. Any stressors in your life that you think
affect your health? No, I really can't
think of anything. That effect. The last
thing that I want to close with is the
subject of violence. And it's a very difficult subject for
people to talk about. It's a very private
subject and sometimes, people just are not
comfortable with it. I would hope that our office
is someplace that you could always talk to us if
this was to happen for you. And I talked to everybody about. What I'd like to ask you
more specifically is, are you in any relationship now, be it at home or anywhere
else where you feel that you were ever
hit or slapped, or kicked, or pushed or shoved? No. Or physically
assaulted in any way? No. Are you in a
relationship now that where you are emotionally abused in any way or to feel
disrespected, or put down? No. Are there any places where someone forces you
to participate in sexual behavior
against your will? No. Has anyone ever
touched you in an inappropriate way or touched you sexually in a way
that you did not want? No. Is there any place where
someone speaks to you in a disrespectful manner or a harassing manner
that you don't want? No. Anyway, is there any
place where someone controls your behavior either
by controlling your money, controlling who you
spend time with, or what behavior or activities
you participate in? No. I thank you very much for
talking to me about this. This is a very sensitive
subject as are most of the things
that I've talked to you about in the
social history. And I just want you to
know that this office is someplace that you can
come and talk about issue should you have concerns. Thank you. The last thing that I want to close this interview with is that is there anything going on in your
life that affects your social relationships or
your legal relationships, or your work relationships, that anything that I
should know about? No. I can't
think of anything. Anything else you
want to tell me that I haven't brought up or I
haven't asked you about? No. This concludes the social history part of the interview. Thank you for talking
with me today. Thank you.