Textbook of Sociology for Physiotherapy Students PDF

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Dow University of Health Sciences

2005

KP Neeraja

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sociology textbook sociology for physiotherapy health and society social sciences

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This textbook of sociology is written for physiotherapy students. It covers fundamental sociological concepts and examines their relevance to the healthcare profession. The book is intended to provide students with a comprehensive understanding of sociology and its application in physiotherapy.

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Textbook of Sociology for PHYSIOTHERAPY STUDENTS Textbook of Sociology for PHYSIOTHERAPY STUDENTS KP Neeraja BSc BSc(N) BPR MSc(N), MA PhD Principal Navodaya College of Nursing Mantralayam Road Raichur 584103...

Textbook of Sociology for PHYSIOTHERAPY STUDENTS Textbook of Sociology for PHYSIOTHERAPY STUDENTS KP Neeraja BSc BSc(N) BPR MSc(N), MA PhD Principal Navodaya College of Nursing Mantralayam Road Raichur 584103 Karnataka JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd EMCA House, 23/ 23B Ansari Road, Daryaganj New Delhi 110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672 Fax: +91-11-23276490, +91-11-23245683 e-mail: [email protected] Visit our website: www.jaypeebrothers.com Branches 202 Batavia Chambers, 8 Kumara Krupa Road, Kumara Park East, Bangalore 560 001, Phones: +91-80-22285971, +91-80-22382956, +91-80-30614073 Tele Fax: +91-80-22281761 e-mail: [email protected] 282 IIIrd Floor, Khaleel Shirazi Estate, Fountain Plaza Pantheon Road, Chennai 600 008, Phones: +91-44-28262665, +91-44-28269897 Fax: +91-44-28262331 e-mail: [email protected] 4-2-1067/1-3, Ist Floor, Balaji Building, Ramkote Cross Road, Hyderabad 500 095, Phones: +91-40-55610020, +91-40-24758498 Fax: +91-40-24758499 e-mail: [email protected] 1A Indian Mirror Street, Wellington Square Kolkata 700 013, Phone: +91-33-22451926 Fax: +91-33-22456075 e-mail: [email protected] 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital Parel, Mumbai 400 012, Phones: +91-22-24124863, +91-22-24104532, +91-22-30926896 Fax: +91-22-24160828 e-mail: [email protected] Textbook of Sociology for Physiotherapy Students © 2005, KP Neeraja All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher. This book has been published in good faith and belief that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only. First Edition : 2005 ISBN 81-8061-464-6 Typeset at JPBMP typesetting unit Printed at Gopsons Papers Ltd., A-14, Sector 60,Noida to My sisters, Dr KP Sailaja and Mrs K P Thriveni, who are motivating force to build up my career Acknowledgements This work is made possible under the inspiration of my well wishers, I am thankful to Dr K Srinivasa Reddy, Social Scientist, who is the guiding force for me. And I am most grateful to resource persons. Mrs Ghousia, Mr Veerendra Patil and Dr Lakshmi Narayanan and various friends, who helped me to gather the required materials. I am indebted to all the staffs of M/s Jaypee Brothers Medical Publishers Pvt Ltd, who helped to produce this book in time. Mr Ravi Kumar of Jaypee has initiated me to take up this great task. Foreword The author deserves to be congratulated for preparing ‘Text book of Sociology for Physiotherapy Students’. I have immense pleasure in presenting the foreword to this book for pro- fessional students brought out by my student, Dr KP Neeraja. The increased application of Sociology in the health profession has necessitated a right kind of textbook applied to the profession and the author has made an attempt to fulfil such a need. A practicing sociologist with the credit of authorizing several books, Dr KP Neeraja has brought into this book various practical points not only in dealing with client, his family and social factors related to client, his family and community as well, to provide total client care with the knowledge of sociology. This book is aimed at the students of Physiotherapy in undergraduation courses, who are studying in various colleges in the country, since it conforms to the syllabus of undergraduates, I am confident that this book would benefit them to acquire knowledge and skills in a broader social outlook. Dr KP Neeraja’s vast knowledge and rich experience in the profession of Nursing and Teaching are definitely, an asset in writing this textbook. It comprehensively covers the basic and introductory concepts in sociology as related to the health care profession and help the students to understand the subject in an easy manner. I am delighted that this book is published at a right time when the student need it most. It is of great value in its own right and should guide the student to develop greater insight into the sociological concepts. I am confident that this book will go through many more editions in future. Kurnool Dr K Sreenivasa Reddy 01.09.04 (Social Scientist) Preface During my teaching experience I came across several students asking for relevant notes and material for the various abstract concepts of sociology and in particular its relevance to physiotherapy. It is observed that there is no comprehensive textbook on sociology written with an eye on the syllabus. I hope this book will help the students to fulfil their needs and to develop better understanding and insight into the subject of sociology. A sincere effort is made to stimulate and motivate the physiotherapy students to identify significant relevant social factors in the occurrence of diseases and their role in management of clients. The concepts are presented in a comprehensive manner to benefit the students. I am confident that this book will also be welcomed by the teachers as well as students inview of increased importance and application of sociology in various fields. KP Neeraja Contents 1. Introduction......................................................................... 1 Definition, Nature, Scope, uses, methods of sociological investigations—Social survey, Case study, Opinion poll, Questionnaire, Observation, Interview, Importance of its study with special reference to health care professionals, Application of knowledge of sociology to physiotherapy, Occupational therapy; relationship of sociology with other disciplines. 2. Sociology and Health...................................................... 55 Concept of health and disease, Social consciousness, Perception of illness, Social factors affecting health status and illness, Decision-making in taking treatment, Individualisation, Society, Relationship between individual and society, Role of physiotherapist in Indian society, Role of heredity and environment. 3. Social System.................................................................... 93 Definition, Meaning, Elements, Types, Characteristics, Social values socialisation, Definition, Concept, Meaning, Aims, Characteristics, Importance, Process, factors, role, Theories, Types, Agencies, elements of socialisation, Influence of social factors in personality development, Socialisation in hospitals, Socialisation in the rehabilitation of the clients. 4. Social Groups.................................................................. 123 Definition, Characteristics of group life, Group structure, Classification, Primary and secondary group, Religious group, Influence of formal and informal groups on health and sickness, The role of primary and secondary groups in hospitals and rehabilitation centres. 5. Family............................................................................... 140 Definition, Characteristics/features of families, Importance, Functions, Types-modern, joint family; Basic needs, Changes in functions of a family, Impact of sickness in family, family planning, Psychosomatic illness. xiv Textbook of Sociology for Physiotherapy Students 6. Community...................................................................... 162 Definition, Meaning, Elements, Benefits of community life, Types, Rural community—definition, Meaning, Characteristics, Hazards of ruralities and remedial measures, Rural development programmes, Urban community- definition, meaning, Features, Hazards of urbanites and remedial measures, Differences between rural and urban communities, Role of rural and urban communities in public health, Role of community in determining beliefs, practices and home remedies in treatment, Tribal community-definition, characteristics, tribal problems and welfare activities 7. Culture and Health........................................................ 196 Definition, Meaning, Characteristics, Types, Functions, Organisation, Cultural variation, Subculture of medical workers, Components of culture, Culture induced symptoms and diseases, Cultural lag, Civilisation, Differences between civilisation and culture, Cultural factors affecting health and disease. 8. Social Stratification....................................................... 221 Definition, Types, Caste system, Difference between class and caste. 9. Social Change................................................................. 230 Definition, Nature, Factors, Effects of social change, Process, Social evaluation, Social progress, Social deviation, Social welfare planning in India, Human adaptation and social change, Social change and stress, Social change and health programs, The role of social planning in the improvement of health and in rehabilitation. 10. Social Control................................................................. 262 Definition, Meaning, Need, Types, Agencies. 11. Social Problems.............................................................. 274 Definition, Nature, Classification: Juvenile delinquency, Unemployment, Prostitution, Poverty, Beggary, Alcoholism, Problems of women in modern India, Over population, Unmarried mothers, Solvation of social problems and social planning. Contents xv 12. Social Security................................................................ 354 Insurance schemes for industrial workers ESI Act, Workmen Compensation Act, Social legislation in relation to disabled, Merits and Demerits of social legislation. 13. Social Work..................................................................... 376 Definition, Meaning, Nature, Scope, Factors affecting social work, Characteristics, Principles, Requisites for social work, Methods, Field, Role of Medical Social Worker. 14. Evaluation........................................................................ 397 Definition, Meaning, Scope, Characteristics, Principles, Purposes, Functions, Types, Methods, Steps, Elements. 15. Leadership....................................................................... 435 Definition, meaning, nature, elements, types, principles, origin and development, importance, emergence as a leader, functions, techniques, competencies of leadership. Bibliography........................................................................ 461 Index................................................................................... 463 Introduction 1 1 Introduction Sociology is the youngest of all social sciences. The history of sociology is as old as society. Systematic studies of society started long back in Greece, i.e. in 427-347 B.C. Plato and his disciple Aristotle (384-322 B.C) laid foundation for systematic study. In India, king Manu laid foundation for sociology. He divided people into four varnas. Epics in India reflect the behaviour and various aspects how to live in a society. Manu referred to customs, social affairs in his book, ‘Manu Smruthi’. In 1839, Auguste Comte, a French Philosopher, (1798-1857)- coined the term, ‘Sociology’. He is considered as, ‘Father of Sociology’. Sociology is derived from two words, ‘societus’ means society, (Latin word) and ‘logos’ (Greek word) means study of. Definition ‘The science of social phenomenon subjected to natural laws, the discovery of which is the objective of investigations’— Auguste Comte ‘The scientific study of society’—Gidding and Gidding ‘Study of relationship between man and his environment’— H.P. Fair Child ‘The study of interactions arising from the association of living beings’—Gillin and Gillin 2 Textbook of Sociology for Physiotherapy Students ‘The study of human interactions and interrelations, their conditions and consequences’—M Ginsberg ‘The science which attempts the interpretive understandings of social being’—Max Weber ‘The scientific study of social relationships, their variety, their forms whatever affects them and whatever they affect’. ‘Sociology is the scientific study of patterns of human behaviour as they emerge and crystallise out of the interactions of human beings in the groups, which comprise the society’— George Shankar ‘It is the study of social aggregates and groups in their institu- tional organisation and the causes and the consequences of changes in institutions and social organisation’—International Encyclopedia of social sciences. ‘It is an academic discipline that utilises the scientific method in accumulating knowledge about man’s social behaviour. It studies the patterned, shared human behaviour, the way in which people act towards one another—Prasad, 1977 The above definitions are based on the following factors: Human beings have a propensity to organise their behaviour in groups in order to satisfy their needs and wants to fulfill necessary social function. Human beings have the capacity to know how to organise their behaviour in a wide range of groups. The behaviours, thoughts and attitudes of human beings are determined to a large extent by the quality of the learned ways of interacting in groups. The social interaction in which one person influence the attitudes, thoughts, opinions and behaviour of another. Interaction pattern occurs within the large social systems in societies, groups, crowds, social classes, social institu- tions, neighbourhood and community. Introduction 3 From all the definitions of sociology, we can list out the following views: The sociology is science of society. It studies the social relationships. It is the study of social life. It is the study of human behaviour in group situation. It deals with social actions. It studies social systems. Nature of Sociology Sociology as a science: It emerged as a special discipline among the social sciences, considered as sciences of society. The concept was first developed by Emile Durkheim. As it uses scientific methods, investigation, and different bodies of knowledge. 1. It studies social phenomenon: It is known as, ‘Mother of all social sciences’. It uses scientific method. It is a systematic way of dealing with ideas, careful observation and recording of the factual data, which is classified, analysed and organised in a systematic fashion by logical basis through which generalisations can be made. 2. Sociology is factual: It deals with facts only, uses scientific principles to solve the problems. 3. Sociology frames laws and attempts to predict: Science can make prediction on the basis of universal and valued laws relating to the problem solving approach. 4. Principles of sociology are universal: The laws of sociology proved to be true at all times and places, as long as the conditions do not vary. The laws are devoid of any exceptions. 5. It discovers the cause and effect relationship: It structures for the cause and effect relationship in its subject matter and in this connection, it provides universal and valid laws. 4 Textbook of Sociology for Physiotherapy Students 6. Sociological principles are veridical: The laws of sociology prove true at every verification and re-verification. Any one can examine their validity. The Opposite Views about the Nature of Sociology Some critics who deny sociology to be regarded as science, sociology is a social science it cannot be regarded as science. 1. It lacks experimentation: Sociology deals with human relationship, which can be neither measured, weighted nor see or analyse. 2. Lack of objectivity: The sociologists cannot maintain complete its objectivity in order to understand its external action. 3. Lack of exactivity: The laws and conclusions cannot be expressed in precise terms. The prediction might not be true. Findings are often limited in time and space. 4. Inability to measure subject matter. 5. It lacks perfect exactness. 6. It cannot make predictions correctly. Scope of Sociology There is no one opinion about the scope of sociology. Calberten describes, since sociology is a elastic science it is difficult to determine just where its boundaries begin and ends. It is impossible to divide as it studies human interactions, interrelations, their conditions and consequences. There are two main schools of thoughts: One group of sociologists headed by Simmel formulated specialistic or Formulastic School. They thought that it is pure science and systematic one. It is independent science. Specialistic/Formalistic School Simmel’s View It classifies, analyses and delimits the forms of social relationships. Introduction 5 Small’s View It does not understand to study all the actions of society. It studies genetic forms of social relationship behaviour and activities. Verkendent’s View It is a specialised branch of knowledge concerned with ultimate forms of psychic relationship, which link men to men in the society. Max Weber’s View It studies interpretation and understanding of behaviour and it is concerned with analysis and classification and types of social relationship. Vonwiese’s View The sociology studies all forms of social relationship. Tonnie’s View He has differentiated the society and the community on the basis of forms of social relationship. Criticism It has narrowed the scope of sociology. Abstract form is separate from concrete form. The construction of pure sociology is impractical. Sociology alone does not study social relationship. Synthetic School Durkem’s View Sociology was divided into 3 branches: a. Social morphology: Concerned with geographical basis of the life, its relationship to types of social organisation and the problems of population. 6 Textbook of Sociology for Physiotherapy Students b. Social physiology: It is divided into number of branches like sociology of religion, sociology of morals. Sociology of laws, sociology of economic life, sociology of language, etc. c. General sociology: It discovers the social facts. Hobhouse’s View The interconnections of social relations and the results; social life as a whole will be studied. Karl Mannheim’s View Sociology is divided into systematic and general sociology. It describes how the individual will react social changes in a given society. Ginsberg’s View It studies the types and forms of social relationship. It determines the relation between different factors of social life, social change, persistence and to discover sociological principles governing social life. Thus the scope of sociology is very wide. It studies the various aspects of society, e.g. social processes, traditions, morphology, social control and social pathology. Uses of Study of Sociology It makes scientific study of society. It studies the role of institutions, through the knowledge of sociology the individual can understand and establish relationship with the social environment like family, religion, school, governmental policies and working situations. The study of sociology is indispensable for understanding and planning of society. Introduction 7 It helps in solvation of social problems. It draws our attention to the institutional worth and dignity of men. It contributes to understand human culture, to make good citizens. It keeps us update information on modern institutions. It adds to the knowledge of society. It identifies good government with community. Technical function. To construct society by observing existing problems, customs, traditions, institutions, etc. it can make the people to understand the changing situations. Introductory function: It supplies the information about the elements of social system to facilitate the introduction of any desirable changes. It explains different methods, which can introduce this change into various parts of it. Informative function: It possesses some important information based on theoretical knowledge with practical experience. It makes the individual to organise society by solving certain social problems. It provides guidance in practical reforms. Tolerative function: In India, each individual comes across different religions and cultures. We have to understand all the social institutions to develop a feeling of universal brotherhood. Democratic function: To develop a selfless tendency and understands the society in a well-planned manner. SOCIOLOGICAL INVESTIGATION ‘Critical examination into a situation to discover new facts about a particular or specified social phenomenon to discover intellectual and practical answers to problems through the application of scientific methods in the universe’ is called social investigation. It is a careful, critical enquiry or examination in 8 Textbook of Sociology for Physiotherapy Students seeking facts or principles diligent investigation in order to ascertain something. It is a critical in the light of newly discovered facts. It is the study of activities undertaken to search a solution for the social problems. The society has to march on its present form with the help of constant research and investigation. Long march from stone age to computer age has been the result of research. Today society is facing several social problems of formidable in nature. They demand solutions and any attempt to solve the problems must be through scientific enquiry. It aims at increasing our knowledge about society and strategies involved solvation of social problems. Definition ‘Systematic investigation to gain knowledge about social phenomena and social problems’—Moses CA ‘It is the investigation of the underlying process operating in the lives of persons who are in association‘—Bogardus E ‘It is a study of human group relationships‘—Whitney FL ‘It is the systematic study of discovering the new facts or verifying old facts, their sequences, interrelationship, casual explanations and the natural laws, which govern them‘— PV Young ‘Systematised effort to gain new knowledge or new mode or orientation of new knowledge’—Redman and Money ‘The manipulation of things, concepts or symbols for the purpose of generalising to extend, correct or verify knowledge; whether that knowledge aids in construction of theory or in the practice of an art’—M Stephen From the above definitions, it is clear that it is concerned with pure social phenomena, answering meaningful questions Introduction 9 and finding out the old or new facts through scientific method, which is based on logic and systematic means. To collect and analyses the data more or less within the exiting framework and establishes the exploration techniques. Theoretically, social investigations aims at finding solutions of a problem as a part of social system and behaviour of the individuals under different situations and on utilitarian aspect, it helps in reducing social conflicts and tensions as well as in rectification and removal of social evils. Social phenomena are complex. Therefore different methods and approaches have to be followed to study the social aspects of the individuals. Social phenomena can be indirectly studied through observation of traditions, customs, values and vested interests, which are prevailed in the society. To have the objectivity in studying social phenomena is difficult. The scope of social investigation depends upon several factors such as money, time available to the investigator, availability of the sample, accessibility of the investigator to the respondents, the amount of time the respondent can spare for the investigation, etc. METHODS OF SOCIAL INVESTIGATIONS Social Survey Approach It is a common method used to diagnose and solve the social problem. The survey design is the non-experimental type of research in which, the researcher investigates a community or a group of people. The researcher gathers the data from a relatively large number of cases at a particular time. It involves clearly defined problem or objectives. It requires expert, imaginative planning, careful analysis, interpretation of data gathered, logical and skillful reporting of the findings. It may be done by: By questioning Interview Observation 10 Textbook of Sociology for Physiotherapy Students Social survey is one of the important methods of social investigation and helps in solving the group problems. The researcher investigates new situation, organisation or a group and be clear about the nature of enquiry, objectives, nature and scope of study. Researcher formulates questions for the larger study and pursues general overall description of the situation. Definition ‘It is a process by which qualitative facts are collected about the social aspects of a community composition and activities’— Mark Abram ‘Collection of data concerning the living and working condi- tions, broadly speaking the people in a given community’— Bogardus ES ‘It is the scientific study of conditions and needs of a com- munity for the purpose of presenting a constructive programme and social advance’—EW Burgers ‘It is a process by which quantitative facts are collected about the social aspects of a community, composition and activities’— SM Harison ‘Fact finding study dealing chiefly with working class and with the nature and problems of community’—AF Wells Social survey are connected with: The formation of constructive programme of social reform and amelioration of social problem. Current or immediate conditions of social pathological nature which have definite geographic limits and definite social implications and significance—PV Young Introduction 11 Characteristics Done in a large scale and gains a lot of material To find out the basic facts of life Quality is maintained Scientific and well planned Conducted regularly, e.g. census, market surveys, etc. Costly affair, needs both human as well as economic resources to complete Unnecessary data should not be collected Trained personnel are required to collect the information and capable of adjusting themselves to the nature of work To collect the detailed information about a social problem under investigation or social aspect of community To test hypothesis Practical and utilitarian view point. Subject Matter of Social Survey Demographic characteristics Social environment Activities of community members Opinions and attitudes. Uses of Survey Method To obtain demographic data, information about people’s behaviour (attitudes, opinions, interests) To discover casual relationship in a specific area or precise qualitative description of some phase of the universe. Advantages of Survey Approach It can give information about the possibilities of understanding different types of research methods It provides an insight into a situation suggests kinds of questions to ask and the methods to adapt 12 Textbook of Sociology for Physiotherapy Students It provides hypothesis and helps to test the hypothesis Provides data about present situation It studies the problems thoroughly and deeply in all aspects Guides the researcher about confounding, intervening, independent and dependent variables Useful for policy makers and administrators to make a decision Specific goals will be obtained Changes in society, pressures of public opinion can be obtained Provides an opportunity to use researcher’s creativity Factual information related to life experiences will be gathered It has high degree of representation in the reality Broad generalisation can be done Greater deal of information will be obtained Easy, less time consuming Disadvantages To get resources both human (trained investigators, field workers) and economic (huge fund is required) is problem Low degree of control over extraneous variables No uniformity in data collection Lack of manipulation of independent variables Each researcher will try to use their own bias in the study One cannot progressively investigate one aspect after another of the independent variable to get closer to the real world Time consuming Statistical devices are not always able to separate the effects of several independent variables. Introduction 13 Types of Survey Descriptive Survey Simplest survey with in the social discipline. To describe objectively the nature of the situation under study and conclusions also drawn. Evaluation Survey The researcher looks back to see what has been accomplished with a critical eye and evaluates the results. The researcher is interested in finding out the results of some procedure or methods already in operation. This method is used on small sample atleast initially. To find, if this method in operation meets the criteria stated in the purpose of the original project. It should not be done by the investigators, who have a particular benefit or gain to be made from the results. Comparative Survey When two different groups or techniques are compared this technique is used. It should be based on an important professional problem, so the resulting data will be significant to the profession. Significant elements will be considered, each element is representative within itself. Activity Analysis The analysis of the activities or processes that an individual is called upon to perform. This method may yield information that would prove useful in establishing: The requirements for a particular job or position A programme for the preparation or training of individuals for various jobs or positions An in-service programme for improvement in job competence Equitable wage or salary schedules for various jobs or positions 14 Textbook of Sociology for Physiotherapy Students Trend Studies It is based upon a longitudinal consideration of recorded data indicating what has been happening in the past, what the present situation reveals and on the basis of these data, what is likely to happen in the future. Short-term Survey Data is collected over short time (days to months) no control over the sample. Long-term Survey Data is collected more than five years. Exploratory Survey Oriented towards the discovery of relationships between variables where phenomena of interest, but pursues the question: What factor or factors influence, affect, cause or relate to this phenomena? When a new area or topic is being studied it is useful to estimate the feasibility and cost of undertaking. Developmental Studies a. Longitudinal studies Short-term Long-term b. Trend studies Cohort studies Panel studies Follow-up studies Psychologists, anthropologists many times uses this method. The researcher repeatedly collects data on the same group of individuals over a period of time. He makes repeated observations on the same group of subjects. Introduction 15 To understand any stage of life in terms of his develop- mental origin. It provides useful perspective of the orderly and coherent developmental sequence and the elements of both change and continuity that human development involves It serves as a data collection device, source of hypothesis. A. Trend studies: Sample from a general population are studied over time with respect to some phenomenon. Different samples are selected at repeated intervals, but the samples are always drawn from the same population. To examine patterns and rates of change over time and to make predictions about future directions. B. Cohort studies: Specific populations are examined over a period of time. Different samples are selected at different points in time, but the samples are drawn from specific sub-groups that are often age related. C. Panel studies: The same subjects are used to supply the data at two or more points in time. Panel is used in the longitudinal survey projects, refers to the sample of subjects involved in the study. In this the investigator reveals pattern of change and reasons for the change. Since the same individuals are contacted at two or more points in time, the researcher can identify the subjects who did and did not change and then isolate the characteristics of the sub-groups in which changes occurred. D. Follow-up investigations: To determine the subsequent development of individuals with a specified condition or who have received a specified intervention to ascertain its long-term effects. Cross-sectional Studies It involves the collection of data at one point in time or it observes at only one point in time. The phenomena under 16 Textbook of Sociology for Physiotherapy Students investigation are captured as they manifest themselves during the one static time period of data collection. They are easy to manage and are economically advantageous, majority of health-care professional studies are cross-sectional. Regular or Adhoc Survey When a body or an individual organisation conducts the same survey at regular intervals, e.g. Economic survey of RBI; census survey. The survey is conducted with a view to find out some information required for a particular purpose. Official Survey Which will be conducted by the government to find out certain facts for official or philanthropic purpose. Non-official Survey Individuals without the help of official agencies will be conducting survey to collect the data for research purpose. Direct Survey (Personal/Primary Survey) The researcher himself will collect the data by means of observation or interview for research purpose. Indirect Survey/Secondary Survey The collected information will be analysed, the researcher does not start the survey but spends on the work, which has already been done by somebody else. Postal Survey Through mailed questionnaire the researcher will obtain the information. Introduction 17 Initial Survey When a survey is carried out in a particular area or particular subject for the first time. Repetitive Survey The researcher carries out the work several times on the same sample. Open Survey When the nature and result of survey are open to the public or organisation is called ‘open survey’. Confidential Survey The results or information gathered through survey are kept confidential. Comprehensive Survey The survey covers vast field, variety information and wide range is covered. Limited Survey The field covered is comparatively limited. The Process of Survey Research Statement of research problem Determination that the problem is appropriate for the survey approach Selection of appropriate type of survey Objectives, hypothesis, delimitations should be formulated Select sampling technique, identification of sources of information Plan for data collection 18 Textbook of Sociology for Physiotherapy Students Examination of all documentary sources; field work Coding, recording, analyses and reporting the project, interpretation of findings Communicating the findings with the help of graphs. CASE STUDY Introduction The case study is a way of organising social data for the purpose of viewing social reality. It examines a social unit as a whole. The unit may be a person, a family, a social institution or a community. It is often used for descriptive research. It is a longitudinal approach showing development over a period of time. It studies or understands life cycle or an important part of the life cycle of the unit. It is in-depth investigation of social unit. It tests hypothesis but not directed towards broad generalisation. The method can be used to analyse the interaction between factors bringing about change usually over a period of time. Consent must be taken from the social unit to get cooperation. Researcher may use past history or may report on current events. Verbal description between interviewer and client or may use artifacts, records, questionnaires. The nursing or medical professions case studies will be used more often. Evaluation and Scope The case study method is a widely used systematic field research technique in these days. The credit for introducing this method in the field of social investigation goes to Frederic Le Play, who used it as a handmaiden statistics in his studies of family budgets. Herbert Spencer was first used case material in his comparative study of different cultures. Dr William Healy resorted to this method considered it as a better method over Introduction 19 and alone the mere use of statistical data. Similarly, anthropologists, historians, novelists and dramatists have used this method concerning problems pertaining to their areas of interests. Even management experts use case study methods for getting clues to several management problems. Objects of Case Study Individuals suffering with social problems like drug addicts, alcoholics, juvenile delinquents, interested events. Definition ‘It is a form of qualitative analysis involving very careful and complete observation of a person, a situation or an institution’— Biesanz and Biesanz ‘All inclusive and intensive study of an individual, in which the investigator brings to bear all his skill and methods or as a systematic gathering of enough information about a person to pursue one to understand how he or she functions as a unit of society’—Young ‘It is a way of organising social data so as to preserve the unitary character of the social object being studied’—Goode and Hat ‘It is a technique by which individual factor whether it is an institution or just an episode in the life of an individual or a group is analysed in the relationship to any other in the group’—H Odum ‘A comprehensive study of a social unit’—PV Young Meaning It is a form of qualitative analysis where in careful and complete observation of an individual or a social situation or a social unit. It is an in depth study. It analyses limited number 20 Textbook of Sociology for Physiotherapy Students of events or conditions and their interrelations. It is an intensive investigation of a particular unit under consideration. Characteristics of Case Study Method The researcher can take single social unit for their study purpose Intensive study of selected unit covering all facets Qualitative approach It deepens the perception and gives a clear insight in life It studies mutual interrelationship of casual factors Generalisation may not be possible. Methods of Data Collection Observation Interviews Questionnaires Government voluntary or private agencies Co-opinionaires Psychological tests and inventories Recorded data. Assumptions The case study method is based on several factors: 1. The assumption of uniformity in the basic human nature inspite of the fact that human behaviour may vary according to situations. 2. Assumption of studying the natural history of the unit concerned. 3. Assumption of comprehensive study of the unit concerned. Phases Involved in Case Study 1. Recognition and determination of the status of the phenomenon to be investigated or the unit of attention Introduction 21 2. Collection of data, examination and history of the given phenomenon 3. Diagnosis and identification of casual factors as in basis for residual or developmental treatment 4. Application of remedial measures like treatment and therapy 5. Follow-up programmes to determine effectiveness of the treatment given. Advantages It enables us to understand total behaviour pattern of the concerned unit, as case study method is exhaustive Researcher can obtain real record of personal experience, which would reveal man’s inner strivings, tensions, motivations that drive them to action or to adopt certain pattern of behaviour Natural history of social unit and its relationship with the social factors and the forces involved in its surrounding environment is possible Formulation of relevant hypothesis is possible Facilitates intensive study of social unit Enhance the experience of the researcher, which in turn increases analysing ability and skills To study social change Useful for therapeutic and administrative purposes; to take decisions regarding management problems Critical and reflective thinking will be promoted Researcher may begin or stop at any time Detail information will be obtained More suitable to Paramedical and medical profession Perceives whole situations Opportunity of having an intimate knowledge of subject’s conditions, thought, feelings, actions, intentions and environment Great number of interesting insights can be observed. 22 Textbook of Sociology for Physiotherapy Students Disadvantages Limited approach Generalisation and comparison may not possible Expensive Time consuming Subjective biased Difficult to check accuracy and objectivity. OPINION POLL METHOD To gather the information about a specific social phenomenon from a huge sample at a given time in different areas of a region, opinion poll method of survey is used. Public aware- ness of a specified event will be collected through this poll. The researcher will take assistance from field investigators, structured questionnaire is formulated to gather the data. The survey conducting areas usually be a common meeting/ gathering place of the public. Eg: At the time of election, opinion poll is conducted to know the public’s view about who will win the election and form the Government. QUESTIONNAIRE A good deal of information can be gathered by direct questioning of sample, who have specified characteristics through the use of formal instrument (i.e, questionnaire). If the informants are spread over a vast or in accessible areas, the information is sought with the help of questionnaire. Definition Questionnaire (Survey Instrument) ‘Any written document, which is used to instruct one or more readers or listeners to answer one or more questions.’ Introduction 23 A list of questions/items are compiled by the researcher based on different aspects of the problem. Certain times mailed questionnaires will be sent to the respondents to give the reply. In structured interview with the help of structured question- naire. Items Questions in the questionnaire. Respondents The person who answers the items in a questionnaire. Interviewer A person who conducts the study, who is having training in interviewing techniques and administering the questionnaire in the study projects. Characteristics of Questionnaire The heart of the questionnaire method is ‘question’ itself. It acts as an effective stimuli. It is a device securing answers to questions using a form, which the respondent fills. Analytical Questions Questions should be capable of analysing the entire problem. Clarity and Concise/Precise Items should be clear, complete; questions should be worded simply, as possible to provide an opportunity for easy, accurate and unambiguous responses. Questions should be in limited number to avoid disinterest, tiredness and boring. It should be free from suggestions or leading. 24 Textbook of Sociology for Physiotherapy Students Linguistic, Completeness and Grammatical Consistency It is a verbal interaction between researcher and respondent and care should be taken to the linguistic quality of question unit. Phrases, which are not commonly understood by the respondents, have to be avoided. Singleness of purpose. Avoid emotional questions. Questions should be present in good psychological order to organise their own way of thinking. Proper planning and listing of questions are done. Encourage inter-validated questions. Physical form of questions attracts, encourages and stimulates the respondents; proper spacing, clarity and sequence in the arrangement of the questions then only the respondent will be encouraged to come out with correct answers. Questions should be objective in nature. Logical in order. Advisable to pre-construct a tabulation sheet anticipating how the data will be tabulated and interpreted before the final form of the questions is decided upon to avoid ambiguity in question form. Questions should be relevant, diplomatically worded. The length of the question be pertained to collect essential data. General to specific logical manner be followed in arranging items in questions. Carefully worded questions, so that the ego of the respondent is not injured in any manner. Steps in Questionnaire Construction Based on objectives the needed information will be assessed Break-up the whole information into sub-areas Introduction 25 In each area, clear the mind and decide what question to ask, identify major area where information has to be gathered Read out the questions to experts and consultants Pre-test the questions for validity and reliability Administer the tool to the reference population Apply statistical tests for reliability and validity Internal consistency and internal coordination Introduction/Instruction The interviewer read the introductory comments in face-to- face interview or in telephonic interview; the cover letter contains introductory letter. It used to introduce the study the potential respondent and should not exceed one page, thus each sentence should serve a distinct purpose. The content of letter will be divided into four paragraphs: 1st Paragraph: Explain the purpose of the study Convince the respondent that the study is useful Avoid any hint of bias. 2nd Paragraph Make respondent to feel the importance to the success of the study. 3rd Paragraph The confidentiality and anonymity of respondents will be maintained. 4th Paragraph Re-emphasize the basic justification for study. Availability of study results, offering a copy of it to the respondent. Introduce each section to the respondent with a brief preface to clarify them, why the questions are being asked. 26 Textbook of Sociology for Physiotherapy Students Elements of Questioning Method Content of the questioning The question Provision for answering Content of Questioning It is useful to develop a blue print of various aspects of situation about which questions might be asked Researcher should decide how much time is allotted for every item The selection of content is based on researcher’s knowledge of situation, the literature available in the problem area; objectives of study and needs of the researcher Facts about the respondent, behaviour, persons known to the respondent, events and conditions known to the patient Beliefs, attitudes, feelings, opinion of respondents Reasons for or influences of other person’s behaviour Level of knowledge about policies, practices, conditions or situations Intention for future action Order/Sequence of Questions Open ended questions should be written first to provide an opportunity to conceptualise the issues in their own words rather than formulating their answers based on the responses they have seen in the closed ended questionnaires The general questions should be placed first followed by specific questions to avoid putting ideas into people’s heads The schedule begin with questions that arouse the respondent’s interest and motivation to cooperate Personal, sensitive, threatening nature questions should not be placed at the beginning as it arouse suspicious about the purpose of the study Introduction 27 The items bearing on one issue or topic should be in close proximate Don’t formulate too many questions in the small space Every item in the question should relate to the topic under the study Logical progression in the question order is necessary Identify the information by factual data and subject matter of the survey Scrutinisation of question during pretest Colleagues, experts assess how well the question will accomplish the study objectives Potential users of the information for accuracy, back of bias and ignorance of items Problems in Construction of Questionnaire 1. Problem with clarity of question Clarify in the mind regarding what information is to be obtained for that questions. Avoid long sentences or phrases double barreled questions; non-specific items. State the questions in affirmative order than negative. 2. Ability of respondents to give response Use simple language, short statements. 3. Memory The researcher should not take for granted that the respondents will be able to recall the events, situations or previous activities. 4. Bias Avoid leading questions that suggest a particular kind of answer. State a range of alternatives within the question itself. 5. Handling a sensitive or personal information Politeness and encouragement helps to motivate the respondent to cooperate. 28 Textbook of Sociology for Physiotherapy Students 6. Response alternatives Significant alternatives should be used. Mutually should be there in ordering of questions and responses. Avoid too long questions. Advantages of Questionnaire Simple method of obtaining data Items can be constructed easily by beginning researchers Less time is consumed in using this method of gathering information thus it saves time, energy and money. Thus it is more economical and sufficient Able to gather data from a widely scattered sample in a limited period Provides an opportunity to establish rapport to explain the purpose of the study and the items which are not clear Reduces interaction between research and respondent Provides sufficient time to the respondent to think and give his response Complete anonymity of the respondent will be maintained Ensures anonymity and kept the information confidential Disadvantages It lacks depth: To ensure rate of response from questions is difficult as it depends upon the method of administration The researcher may omit or disregard any item without giving any explanation Some items may force the subject to select responses that are not actual choice Respondent may take their own time, which may hamper the research progress Creates artificial situation as researcher is asking for verbal response not for action Mailed questions are limited to literate respondents and to get good response from them only when they have research conscious Introduction 29 Types Structured Question The items which pose definite, concrete and pre-ordained questions, i.e. prepared in advance and not constructed on the spot during the question period. Pictorial Question To promote interests in answering the questions; this type will be used to study the social attitudes, prejudices and for studies related to children. Open Ended Question Calls for a free response in the respondent’s own words Provides a greater depth of response Respondents reveal their frame of reference and possibly the reasons for their responses since it requires greater effort on the part of the respondents Involves the respondent’s attitudes or feelings expressed in their own words Respondents must create their own answers and state them in their own words Advantages Stimulates free thought, solicit suggestions Probe respondent’s memories Disadvantages Respondent must recall past experience, create and articulate new answers Difficult to construct responses Illegible hand writing pose difficult in mail questions Closed Ended Question The respondent’s answer is limited to the choices offered, short in form, limited responses. They provide chance for 30 Textbook of Sociology for Physiotherapy Students marking alternatives. It is easy to fill out, requires little time, objective, fairly easy to tabulate and analyse. Close-ended questions offer a number of alternative replies from which the respondents must choose closely approximate answer. Difficulties Difficult to construct but easy to administer Possibility of neglecting or over-looking the important responses, the omission possible alternatives can lead to inadequate understanding of the issues If the area of the research is completely new, this type is not advisable Pre-testing of the schedule is immensely helpful Too superficial questions may be considered Types of Closed Questionnaire Dichotomous Items It requires the respondent to make a choice between two alternatives. Too restrictive, the respondents may be forced to say within two alternatives. Eg: Do you like to have: (a) Coffee (b) Tea Multiple-choice Questions A range of alternatives provides more information; one can measure intensity of feeling and direction. Most commonly offer 3 or 5 alternatives. Eg: Psychosocial aspect. Liking sweets: (a) with every meal (b) once a while (c) always Cafeteria Questions Which is put forth to the respondents to select a response that most adequately states their view, used in qualitative surveys. Introduction 31 Closed Ended with Ordered Choice or Objective Type Answer choices are provided; each is a graduation of a single dimension of some thought or behaviour. Eg: How did you get along with the doctor in the emergency room? a) strongly agree b) mildly agree c) neither agree nor disagree d) mildly disagree e) strongly disagree Closed Ended with Unordered Response Choices Answer choices are provided but no single dimension underlines them. The respondent must choose discrete, unordered categories by independently evaluate each choice and select the one that best reflects the situation. Eg: The food item I like best a) samosa b) sandwich c) dosa d) idly Partially Closed Ended Questions It provides a compromise response although answer choices are provided; respondents have to option of creating their own response. Unordered or ordered choices are seen within this structure. Eg: Which of the following areas of expenditures do you want to have the highest priority for improvement in this hospital? a) emergency dept. b) X-ray dept. c) laboratories d) others (please specify) Step Ladder/Rank Order Questions Questions to rank order their responses along a continuum from most favourable to least favourable can be useful; carefully handled because respondents often misunderstand them. Eg: Attitude of job preferences of physiotherapy students after course completion. a) working in teaching institution b) working in hospital setup. The respondents should rank the answers in the order of preference. Checklist or Matrix Questions It encompasses several questions on a topic and requires the same response format. 32 Textbook of Sociology for Physiotherapy Students Graphic Rating Scale It assigns numerical score in order to place the individual along a continuum with respect to the attribute being measured. Respondents are asked to give a judgment of something along an ordered dimension. The specified two opposite ends of a continuum is referred as bipolar in nature. Eg: How friendly are you with your classmates? Least friendly 1 2 3 4 5 Most friendly Direct Vs Indirect Approach or Coming in Front Door vs Coming in Back Door A check can be made as to the value of the responses by asking a direct or indirect question and then comparing the answers. Eg: Physiotherapy education in India. a) high image b) low image c) no image d) cheap image OBSERVATION It is one of the basic and oldest research methods to gather data. It is a normal part of daily life and becomes a research method if it is systematically planned and recorded and checked for their validity and reliability. The basis for observation is curiosity. Meaning Planned, methodical watching that involves constraints to improve accuracy. Definition ‘It is a technique used for collecting all the data or acquiring information through occurrences that can be observed through senses with or without mechanical devices.’ Introduction 33 ‘Systematic viewing coupled with consideration of social phenomena’—PV Young ‘Accurate watching of social phenomena as they occur in nature with regard to cause and effect relationship or natural relationship’—Oxford Dictionary It involves interpretation of phenomena in the environment. Two process are involved: 1. Someone is observing—observer 2. Something to observe—observed Observation can be done in natural setting (field research) or in laboratory setting. Four Broad Questions that Confront the Researcher What should be observed? How should observation be recorded? What procedures should be used to try to assure the accuracy of observation? What relationship should exist between the observer and the observed and how can such relationship be established. Features It is an eye affair. Observer has to observe the situation very closely and clearly. Observation implies the use of eyes rather than that of ears and voice Observation should be definite aim. It is clearly determined (for scientific enquiry) before starting the process Proper planning is required, before starting observation necessary equipment and instrument have to be arranged After observatory process the events has to be noted down Cause and effect relationship will make the whole study useful and purposeful 34 Textbook of Sociology for Physiotherapy Students Phenomena Amenable to Observation Characteristics and conditions of individuals. Eg: Physiological conditions and characteristics through sense or aided by observation apparatus. Eg: Effect of yoga on lung function of patients with pleural effusion (M Prakasamma, 1981) using spirometer several readings of FEV1, FVC, MVV, X-ray chest is used to see lung expansion before giving treatment. Verbal communication behaviour; a) Linguistic behaviour b) Content and structure of people’s conversation c) Social interaction. Eg: Interaction pattern between teachers and students in clinical setting using Flanders’s interaction analysis category system (Vasta, 1978, Madanlal, 1980) Non-verbal communication behaviour. Eg: Facial expression, touch, posture, gesture, body movements, extra linguistic behaviour. Activities (overt state of an individual many activities can be observed) Eg: Physical and mental functioning of an individual. Skill attainment and performance. Eg: Aseptic techniques used by nursing students during nursing procedures. Environmental characteristics. Eg: Noise level, cleanliness, ventilation, odour, water supply, mosquito breeding places. Units of Observation 1. Molar approach: Observation of large units of behaviour and treating them as a whole. 2. Molecular approach: Observation of small and highly specific behaviour. Eg: Each movement, gesture, action. Steps in Observation schedule 1. Selecting the aspect of behaviour to be observed: To carry out systematic observations; one must select certain aspects or categories of behaviour to be observed. Introduction 35 2. Defining the behaviour that fall within a category. 3. Training observer. Observational methods are more vulnerable to perceptual errors than any other data collection. To minimise the bias and maximise the accuracy and objectivity of the observation, training of observer is essential. Observer’s manual with detailed instructions can be used. Training sessions are useful for clarifying doubts. Once the observers are fully oriented with the instrument, they should use the observation schedule on a group that demonstrates the same phenomena as under study. Their difficulties can be resolved through discussions and practice sessions. Quantifying Observation When the behaviours specified have to provide certain measurement then some form of quantification is required. The qualification usually takes the form of counting. The count may be of number of times that a subject shows a particular form of behaviour during a period of observation. Here observer should be sure of when one act ends, and the next begin. Break the period of observation into short segments and observer can then watch occurrence or non-occurrence of particular behaviour under specified category. Recording To have adequate account of what was observed during observation, recording is needed. Eg: Motion pictures, films, video tapes. Testing To ascertain the adequacy of content being put to measure the variable under study. 36 Textbook of Sociology for Physiotherapy Students A. Interrater reliability: Two or more raters observing the same behaviour/events and their percentage of agreement obtained establishes the reliability of the schedule. B. Intrarater reliability: When a rater observes same behaviour/events on two or more occasions. Multiple observations extending over days/weeks/years. Advantages Important technique for studying human behaviour specially where interventions are used Provides variety and depth of information Researcher is not dependent on subjects who consent to answer, all subjects are potential respondents Subjects are usually available It allows view of complete situation, first hand and sequence of events All the data obtained by the observation are usable Open to use of recording devices. Eg: Tape recorders and cameras May be stopped and begin at any time May be recorded at the time of occurrence, eliminating bias during recall Inexpensive Useful in healthcare profession. Disadvantages Observation and interpretation is a demanding task which requires attention, sensation, perception, conception Lack of consent to being observed Time and duration of event can’t be predicted usually observer may wait until an event happens Data obtained is vulnerable to many distortions and bias. Eg: Cultural background, personal interpretation, and influence Introduction 37 Lack of qualified, trained observer Chances of wrong interpretation. Aids to Observation Checklist Rating scale Score cards Observation sheets Photographs Line diagram Sketches. Observational Sampling a. Time sampling method: It involves the selection of time periods during which the observations will take place. b. Event sampling method: It selects integral behaviour or events of a pre-specified type for observation. Observational Methods Unstructured Observation Participant observation: It is a technique where researcher participates in the functioning of the social group that is under investigation. The researcher will not interpret their views and meaning into the social situations under observation. It provides deep understanding of human behaviour. Observer usually has three types of records: a. Logos: It is a record of events and conversations usually maintained on a daily basis by field worker. b. Field notes: It is much broader, more analytic, more interpretation and represents participants observer’s effort to record, inform, synthesis and understands the data. c. Anecdotes: It focuses on behaviour of particular interest. It selects specific kind of events and behaviour for 38 Textbook of Sociology for Physiotherapy Students observation before hand. The observer objectively and accurately records the observation. Structured Observation It involves indicates of presence or absence of pre-specified behaviour or attributes. a. Checklists: Phenomena are recorded by putting a tally against a particular behaviour, event or characteristics depending upon its presence or absence. Researcher must list all the expected behaviour related to the variable being measured, so that all relevant behaviour in the subjects will correctly be identified. Basic format of observation checklist contains i. Sign system: List categories of behaviours that may or may not be manifested by the subjects. The observer watch for instances of the behaviour on the list and puts a check off beside the appropriate behaviour when it occurs. Researcher identifies the occurrence and frequency of particular behaviour. ii. Analysis of ongoing and discrete elements of behaviour: The observer places behaviour in only one category for each unit of behaviour. b. Rating scales: Observation can also be rated in terms of qualitative points along a descriptive continuum. It usually is quantified during the subsequent analysis of the observation data. Here either the observer is required to make ratings of behaviour or events at frequent intervals throughout the observational period or he may make use of rating scale to summarise an entire event or transaction after the observation is completed where a more des- criptive method has been used for maintaining observation record. c. Category system: Construction of category system to which observed behaviours or characteristics could be assigned. Introduction 39 Types A. Non-concealment and participant: The observer will not attempt to alter the social setting, i.e. being studied and does not make the observation covertly. The observer is a part of the social setting. The subjects are aware of researcher’s presence but may or may not be aware of the underlying motive. Drawback: The interaction between the observer and the observed alters the behaviour of the subject. Ethical issues, as observer will not take consent of subjects. B. Concealment and participant: The observer observes the behaviour of people in their natural setting, where the observed are unaware of being observed; passive role will be maintained with minimum intervention and records. C. Concealment and non-participant: Observer makes the observation from the peripherally of a social setting and does not interact with others. D. Non-concealment and non-participant: The researcher is interested in observing the effects of some specific intervention introduced for scientific purpose. The subjects are aware of their participation in the study. This method is very much useful in nursing research studies. THE INTERVIEW The interview is an oral questionnaire, the interviewee gives the needed information verbally in a face-to-face relationship. It is an important method of data collection where one can know the views and ideas of other persons. The interviewer gains rapport or establishes a friendly, secure relationship with the subject and obtains some confidential information that the subject might be reluctant to put in writing. The interviewer can explain the purpose of the investigation and can explain more clearly just what information he or she wants. 40 Textbook of Sociology for Physiotherapy Students Definition ‘The interview is not only the conversation between an investigator and informant but also interviewer will try to understand the gestures, glances, facial expressions and reveals subtle feelings’—PV Young ‘It is a fundamental process of social interaction’—Goode and Hatt ‘It is face-to-face interpersonal situation in which one person, the interviewer asks a person being interviewed and the respondent will answer or gives the responses; the items are designed to obtain answers pertinent to research problem’— Fred N Kerlinger Characteristics Close contact or interaction between two or more persons Define object to know the views and ideas of others Face-to-face relationship between individuals Data will be collected related to social problem Objectives Information will be obtained from unknown facts through face-to-face interaction Investigator and respondent has to know each other by means of research needs and requirements Gives an opportunity to formulate hypothesis, which are based on personal and social behaviour Collecting additional information about different situations in qualitative facts. Eg: Ideas, feelings, views, faith and conclusion, etc. Gives an opportunity to observe the things which are not under study. Introduction 41 Instrument for Interview a. Interview schedule: A questionnaire is read to the respondent and formed about facts and situations involved. b. Interview guide: It provides ideas but allows the interviewer freedom to pursue relevant topics in depth. To use interview guide or not depends upon the policy and attitudes of the interviewer. Preparatory Process on Technique of Interview Based on scientific knowledge Understands the problem which are under study Preparing interview schedule and interview guide Training of field workers Selection of informants, appointment with respondents Seeking and providing information about respondents. Process of Interview Get cooperation from the leader and the community Select proper time and place Introduction with respondents Put systematic, clear and unambiguous questions Precautions to be taken regarding emotional point of view. Technique of Interview Establish contacts and rapport with the informants Start the interview in a scientific and attractive manner Help the respondents to recall things correctly and encourage to come out with proper information Ask probing questions Encourage and guide the informants in proper line. Qualities of Good Interviewer Attractive personality 42 Textbook of Sociology for Physiotherapy Students Pleasing manners Tactful Initiative Should win the confident of the informant Objective observer Avoid too much inquisitiveness. Types On the basis of objectives and qualities: i. Clinical interview: To know the cause of certain abnormality thereby remedy can be sorted out. It studies individual’s life experiences. ii. Selection interview: To select a person on the basis of certain traits and qualities. Eg: Job interview iii. Diagnostic interview: To find out certain serious causes of some social events or problems. iv. Research interview: To find out the cause of problem, a comprehensive study of social problems in detail. v. Directive interview: Predetermined questions, which the interviewer will ask the respondent. On the basis of functions and methodology 1. Non-directed interview: Uncontrolled interview asked through conversation. The informant is encouraged to exhibit and express his knowledge and views. The interviewer collects the information. 2. Focused interview (Controlled interview): To test a particular or specific experience hypothesis. The questions are predetermined and preplanned, which are formed on the basis of behaviour of respondent. 3. Repeated interview: To study the dynamic functions and attitudes that influence, guide and determine the behaviour of certain individuals. These interviews are carried out after certain interviews in repeated manner. Introduction 43 4. Respondent interview: To study the specific development of a social or psychological process. 5. Depth interview: The respondent will be fully encouraged to respond. The interviewer must be perfectly trained. On the basis of number of informants or respondents 1. Individual interview: Information will be gathered from an individual. 2. Group interview: Collecting information from the group of respondents. 3. Structured/Formal/Standardised interview: Interviewer cannot adopt questions for a specific situation, the interview is not permitted to change the specific wording of the questions. 4. Unstructured /Informal/Non-standardised interview: The interviewer will have freedom to develop each questions in the most appropriate manner for the situation. 5. Semi-standardised interview: The interviewer may be required to ask a number of specific major questions, beyond which any number of further questions may be asked. Advantages Possible to study the events that are not open to observation (hidden factors), e.g. feelings, attitudes, fear, emotions, reactions Complete answers are possible Clarification can be made if respondents had done so that misunderstanding can be minimised Questions can be pursued in depth A higher response is possible and the reliable information can be obtained Inflow and outflow of ideas can be possible between interviewer and respondent. 44 Textbook of Sociology for Physiotherapy Students Disadvantages The data collected are of a doubtful character Costly method Validity measurement problem due to difference in social characteristics. Eg: Race, ethnicity, perceived status differences Too much dependency of the memory of the respondent Possibility of change in meaning Lot of subjectivity, individual feelings, inferiority complex. Importance of Study of Sociology with Special Reference to Health Care Professionals In recent times, the field of sociology has extended towards medical sciences and the sub-field of ‘Health sociology/ medical sociology’ has been evolved. It describes medicine and allied disciplines as social science. There is a dire need to integrate the knowledge of behaviour sciences is essential along with medical sciences and it has to be included in the curriculum of health care professional in order to prepare professionals adequately to practice the science of medicine and the art of professional in varying socio-cultural context coexisting health care systems. The institutions, which integrate the behavioural sciences in their programme of health care education, those are on the path of progress by keeping scientific pace with proper understanding of the structural realities in contemporary society. The study of social relationship between health phenomena and social factors in medical/health context. A sociological approach in medical field gives a better understanding and develops an integral knowledge relate the life processes to the existing social phenomena and health in a comprehensive manner. It provides a unique way of viewing the disease and the client as well. It enables the practitioners with information about medical Introduction 45 institutions. The study of distribution of health and disease, cultural perspectives, attitudes, values emerging from social organisation. It also deals with study of various socio-cultural, economic, political, geographical, anthropological groups that shapes the health services as a system of country at macro- level and at micro-level. The health care professional will act as behavioural scientist or health social scientist in the medical field. A holistic approach is needed to understand health and illness in a comprehensive manner. Cultural influences the roles, statuses, institutional net works are believed to help in the health enhancing process and helps to identify cross cultural similarities and variations in the patterning of such behaviour. Preventive, promotive and rehabilitative health aspects of health care services are closer to the people of the society. Health care professionals has to assume the responsibility specially for the provision of first level care in the community and thus act as changing agents in bringing about good quality- of-life to the people at large. It calls for reorientation of training programmes to understand structural realities in our contemporary Indian society. It moves in the direction towards caring for people in their everyday life in the community. The health care professionals have to be sensitive to the health needs of the people in the context of broader social change. The interest of sociology in health was heightened owing mainly to the great strides achieved through improvement in the standard of living health status. The scope of social science application to medicine and health care broadened with the inclusion in analysis socio-cultural and environmental condition that cause diseases or create predispositions for them or influence their causes. Much of the medical activity whether in research, clinical practice or preventive work requires an understanding of the cultural and social pressures that influence an individual’s recognition who needs help in decision making. For community health maintenance altering of socio- 46 Textbook of Sociology for Physiotherapy Students cultural patterns may be needed. Awareness of social and behavioural processes on the part of the training of health workers and which will aid in delivering of care to the clients is required. Medical sociology is concerned with the social causes and consequences of health and illness. Medical sociology is the study of the social facets of health and illness. It applies sociological principles to the study of topics such as the organisation of health care, the socialisation of health professionals, socio-cultural responses to illness- Delhi, ICSSR, 1974. Medial sociologists will study the social facets of health and diseases, the functions of health organisations, the relationship of health care delivery system with other social systems, the social behaviour of health personnel and consumers of health care delivery system and international patterns of health services—Advani, Mohan, 1980. Relationship of Sociology with other Social Disciplines The knowledge of human behaviour with an interdisciplinary approach to understand the human needs in the context of Relationship between Sociology and Psychology Sociology Psychology Society is the basic unit Individual is the basic unit It studies the relationship of It is a science of human experience and individual to the society behaviour It studies man as a part of It studies man as an individual and his societal system and social interaction with heredity and institutions and social processes environment. The psychic and mental will be used in social interaction processes Difference of attitudes in regard Individualistic attitude can be studied to common material can be studied Introduction 47 wider social problems. It is a total system approach to understand human behaviour. It views man as a product of socio-psychological and cultural factors. It analyses man’s behaviour in relation to psychological framework, interpersonal orientation and group influence. It helps to find solutions to problems, which are arising due to man’s complex nature. Sociology and psychology are having much common under- standing and intimate relationship without understanding human psychology, it is impossible to understand interrelations and activities of individual in relation to society, thus sociology and psychology are complement with each other. Sociology and Social Psychology Both are closely related as many areas of the study are overlapping. The social psychology is a science that deals with the behaviour of the individual in society, focuses upon the individual behaviour understands the factors that shapes the behavioural activities and thoughts of the individual within the social settings. Social Psychology Sociology It studies the behaviour of an Group behaviour can be studied individual in society It studies the mental processes of It studies social processes, social laws the individual or values related to attitudes It is the study of individual attitude Sociology discuss concrete form of towards cultural and social values society, its structure and functions and the laws related to these attitudes It analyses the frame work of social It studies the interaction of the human relationships being with the environment 48 Textbook of Sociology for Physiotherapy Students Sociology and Economics Economics Sociology It is the study of man’s activity Comprehensive and studies the whole devoted in obtaining the material, society in its scope means for the satisfaction of his wants and restricted way of behaviour of the individual It studies economic relationship It studies social relationship from societal and economic point of view only point of view The unit is the individual with Individual behaviour in relation to the economic activity group and environment Mainly it deals with production, The social relationships can be studied distribution and uses addition, by various methods eg: interview, subtraction, induction, deduction observation, questionnaire as the methods of study The scope is restricted It comprehends the whole society in its scope It studies relations and activities Comprehensive view point related to economic view point Sociology and Anthropology Social anthropology deals with physical, cultural, social, medical factors, which determine health status and behaviour of the individual in society. Sociology Anthropology It studies modern communities and It studies ancient communities and the social problems and suggest solutions problems existed It studies various aspects and It studies as a whole problems of society and guides for change It studies social relationship It studies anatomical characteristics and its influence upon the behavioural change It makes suggestions concerning It is pure understanding and past to the future relationship It makes use of documents, surveys It makes use of functional method Introduction 49 History and sociology History Sociology It studies past and it is concrete It is abstract, deals with present, past and future It presents a chronological It studies the human experience and description of incidence of human nature. It attempts to discover events and its culture their causes and general principles It studies those incidence which It studies those incidence which are are peculiar or unusual frequently repeated It describes incidence taking place It studies to discover universal laws and at a definite place and time. It is not related to particular incidence. emphasises the doings of the Social groups is the unit of sociological individual study Sociology and Political sociology Sociology Political sociology It is science of society It is the science of government of political society, its structure and processes It studies social point of view It studies attitude of authority, policy formulation and execution Studies both organised and Studies purely organised community disorganised communities Studies all kinds of social Studies all forms of societies and its laws, relationship and forms of society economy and the higher powers mainly related to political relationship in political society Biology and Sociology Biology Sociology To understand organisation, The knowledge of the efforts of nature and progress hereditary and environment upon man is studied Describes anatomical, developmental, sexual, personal peculiarities and formulates principles for the adjustments to the environment 50 Textbook of Sociology for Physiotherapy Students Application of Knowledge of Sociology in Physiotherapy Man is a socio-cultural being, gregarious in nature, always needs the company of fellow-beings. The professional like nurses and physiotherapists who spend most of their time with the clients should have through knowledge about society, environmental influences, situational factors, influencing areas, situational support of the client during the needed hour, individual felt needs and demands needs in order to identify the requirements based on the needs of the people, diagnose their health and sickness. The professionals has to understand the clients family back ground, cultural, customary habits, economical benefits so that, necessary interventions with adequate support can be planned and implemented from the family members and as well others members who will help the client. Sociology studies the relationship between human beings. Physiotherapist have to establish good interpersonal relationship, wins the confidentiality of the client so that the client will freely ventilate their feelings, thoughts with the therapist without any inhibitions, prejudice or bias. The process of clients’ care is essentially a social activity. The therapist will get first hand information from the client through sociological investigations methods like the health care professionals to gather the way of approaching the strange person, i.e. client. Family is the basic unit of society. When the client is healthy, automatically the entire family will be benefited thereby the society, in specific and community at large for the total welfare of the state and nation. Nearly 75% of physiotherapy activities is performed within the homes of disabled and those who are having physio- therapeutical oriented ailments. The therapist will be having more feasibility to understand the socio-economic, socio- cultural background, nature of family. The knowledge of sociology helps the physiotherapist to get more socialised with Introduction 51 the client’s family members. Hence, the knowledge of sociology helps the therapist to adapt his therapeutic activities according to the need and family’s socio-cultural background and living condition of the patient. The knowledge gained by understanding the sociology, the therapist will able to counsel the client, make the client understand the deficit which he/ she acquired due to some pathology, not only the client but also the clients’ family members are also briefed about the problem of the client and explain to the members about the prognosis or the deficit which are permanent in nature and make the client understand the deficit and to start to live with it. Hence therapist can treat the client in a manner by which the client may be able to recover from his ailment quickly. Application of Knowledge of Sociology in Occupational Therapy The application of goal oriented, purposeful activity in the assessment and treatment of individuals with psychological, physical or developmental disabilities. Occupational therapy (OT) is otherwise called as activity oriented therapy where the therapist will be assisting the individual to perform his daily activities (ADL) in a better manner, by maximum utilisation of functional ability. It is a part of tertiary prevention where the therapist activities are oriented towards prevention of diseases’ complications and disability limitations. Includes rehabilitation of client, promotes recovery and the prognosis of the disease, to bring the client to his own normal activities. The therapist will assess the intelligent quotient levels based on the type of retardation and abilities of the client; the occupational therapist training will be provided to the client to carry out the ADL with minimum effort by the client. The therapist will use the knowledge of sociology in managing the welfare of the client. Bringing the victim to normal 52 Textbook of Sociology for Physiotherapy Students Family Dp gro onda Sec t.H So ups ry cie ian ead CB ty ic R ys Ph iaryPhysiotherapy m icil Surge on Or vt. Do vice Go g ser a Inte N n car u isa rse nsiv e tio s n e Non-Govt. n Organisatio Fig. 1.1 condition requires the socialization process since normalization of victim will not occur suddenly. Review Questions 1. Define sociology and discuss how sociology is related to physiotherapy (15m, NTRUHS, 2000) 2. Define sociology. Explain its relationship with health and other social sciences, viz, economic and politics (5m, NTRUHS, Nov, 1997) 3. Examine the importance of sociology in the field of Physiotherapy and Occupational therapy (15m, NTRUHS, Nov, 1998) 4. Sociology is a science of society. Discuss. (15m, NTRUHS, May, 1999, May, 03) 5. ‘Society is a web of social relationships’—discuss (15m, NTRUHS, Jan, 2002) Introduction 53 6. Describe the role of sociology in Physiotherapy (15m, NTRUHS, May, 2004) 7. Uses of study of sociology (5m, NTRUHS, May, 2004) 8. Define sociology. Explain the uses of sociology (19m, RGUHS, 1999) 9. Define sociology. Discuss its relation to health sciences (10m, RGUHS, 1999) 10. ‘Sociology is the science of society. Explain (10m, RGUHS, 1999) 11. Define sociology and bring out its scope (10m, RGUHS, 2002) 12. Bring out the relationship of sociology and psychology (5m, RGUHS, 2002) 13. What is social survey (2m, RGUHS, 2002) 14. Define sociology and bring out the importance of its study in the field of health (10m, RGUHS, 2002) 15. Explain the ‘case study method’ as a method of sociological investigation (10m, RGUHS, 2002) 16. Write three differences between sociology and anthropology (2m, RGUHS, 2002) 17. Bring out the meaning and scope of sociology (10m, RGUHS, 2003) 18. Explain social survey in the methods of sociological investigation (10m, RGUHS, 2003) 19. Bring-out the relationship of sociology and social psychology (5m, RGUHS, 2003) 20. What is interview (2m, RGUHS, 2003) 21. Social health care professionals (5m, RGUHS, 2003) 22. Social psychology (2m, RGUHS, 2003) 23. Interview method (2m, RGUHS, 2003) 24. Operant conditioning (2m, RGUHS, 2004) 25. Interview technique (2m, RGUHS, 2004) 26. Define sociology (2m, RGUHS, 2004) 27. Sociology is a science of society—discuss (14m, MGRU) 54 Textbook of Sociology for Physiotherapy Students 28. Uses of study of sociology (5m, MGRU) 29. Is sociology an applied science? How far the knowledge of sociology is helpful in the fields of physiotherapy and occupational therapy (14m, MGRU) 30. Define sociology? (2m, MGRU) 31. Features of social survey method (5m, RGUHS, Nov-04) 32. Define social psychology (2m, RGUHS, Nov-04) 33. Opinion poll (2m, RGUHS, Nov-04) 34. Discuss how far medical sociological knowledge is useful to the Physiotherapy students in promotive, curative and rehabilitative aspects of health (15m, RGUHS, Nov-04) Note: NTRUHS—NTR University of Health Science, AP RGUHS—Rajiv Gandhi University of health Sceinces, Karnataka MGR Univ—Dr MGR University, Tamil Nadu. Sociology and Health 55 2 Sociology and Health CONCEPT OF HEALTH Having/possessing a good health is the fundamental human right, each individual has to attain and enjoy it. Attainment of health is a world-wide social goal. It is essential to attain qualitative life for satisfaction of human needs, whereby health permits the individual to lead socially and economically productive life. It is a major instrument of overall socio- economic development and the creation of new social order. Changing Concept of Health Biomedical Concept Health has been viewed as, ‘absence of disease, free from disease’. ‘Biomedical concept’ has the basis in the ‘germ theory of disease’. The medical profession viewed human body as a machine, disease is a consequence of the breakdown of body as a machine and medical professional’s task is to ‘repair the diseased part of the body’. The biomedical model was found to be inadequate to solve the health problems, as health includes many determinants like environmental, social, psychological, cultural, heredity, stan- dards of living, hygiene, economic, availability of health services. Ecological Concept The ecologist viewed, health as a dynamic equilibrium between man and his environment, and disease is maladjustment of the human organism to the environment. 56 Textbook of Sociology for Physiotherapy Students The famous ecologist, Dubos defined health as, ‘health implies the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function’. Two issues has been raised: Imperfect man and imperfect environment. Improvement in human adaptation to natural environment can lead to longer life expectancies and a better quality-of-life. Psychosocial Concept Social phenomenon influences the health, various social factors like economy, culture, education, stress, mental status determines the health status. Holistic Concept It recognises the strength of social, economic, political and environmental influences on health. It is a multi-dimensional process involving the well-being of the person in the context of the environment. Health implies a sound mind, in a sound body, in a sound family, in a sound environment’. The emphasis is on promotion and protection of health where various factors have an effect over health. Eg: agriculture, animal husbandry, information technology. Coordinating Concept Several factors will affect health like cultural, economic, poli- tical and environmental, etc. for preservation and improvement of health, etc. all the factors has to coordinate with each other. Definition of Health ‘Optimum functioning of an individual’ The state of moral, physical, mental well being which enables a person to face any crisis in life with the utmost grace of God and facility—Pericles, 500 BC Sociology and Health 57 ‘A state of soundness in body, mind and spirit with a sense of reserve power’—H Hayman ‘Sound body, mind or spirit especially freedom from physical disease or pain’—Webster Dictionary ‘Soundness of body and where the functions of both are duly filled and efficiently discharged’—English Dictionary ‘Adequate functioning of the organism in given conditions, genetics and environmental’—Report of technical study on health ‘Maintenance of relative equilibrium of body form and function which results from its successful dynamic adjustment to forces tending to disturb it, an active response of body forces working toward readjustment’—Perkins ‘A condition of mental and physical soundness which enables the body to perform its functions timely and effectively’— Oxford Dictionary ‘A state of complete physical, mental, social, spiritual well- being and not merely an absence of disease or infirmity’— WHO (1948) Jerris M an epidemiologist wants to replace certain words in WHO’s definiti

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