Reflecting on Health History and Diversity in Health Assessments – Insights from Advanced Practice Nursing

Reflecting on Health History and Diversity in Health Assessments – Insights from Advanced Practice Nursing

Socioeconomic, Spiritual, Lifestyle, and Other Cultural Factors Associated with the Patient

There are significant factors that may affect the health of the patient and can be noted in the patient assigned. Socioeconomic factors are multidimensional constructs that include multiple factors, including employment status, education, income, and others (Centers for Disease Control and Prevention, 2023). Education-wise, SJ is a graduate student which shows a high education level but also possible stress related to academic demands. The patient lives in university housing, which may suggest a living situation that is temporally characterized by possible constraints on comfort and privacy. Financially, SJ may face financial difficulties like tuition, living expenses, and the inability to access financial aid, given that he is an international student.

Social and cultural factors play a significant role. SJ’s religion is Muslim; therefore, it influences her lifestyle, dress code, dietary habits, and daily practices. SJ may experience cultural change issues, including homesickness, language barriers, and unfamiliarity with the healthcare system. Lifestyle factors, including diet, social support, and stress management, are key. The client may follow a halal diet, which may affect her nutritional intake and food choices. Stress management is an issue of concern for graduate schools, which may be stressful in addition to being in a new cultural and country environment.

Issues to be Sensitive About When Interacting with the Patient

Notable issues that one should be sensitive to when interacting with the patient are language, privacy and modesty, and religious practices. First, using a language that the patient is conversant with improves the effectiveness and quality of communication. A nurse should ensure that communication is clear and use simple language, and a translator should be used if necessary (Sharkiya, 2023). Secondly, SJ’s privacy and modesty should be respected during the physical exam, which is in line with her religious and cultural values. Lastly, the nurse should be respectful of the patient’s religious practices by being aware of her prayer times and any religious obligations that might impact her treatment and schedule.

Communication Techniques to Use with this Patient

Several communication techniques that can be used include active listening, respectful inquiry, the use of non-verbal cues, and cultural sensitivity. First, active listening is key in showing empathy, understanding the patients and their personalized needs, expressing respect and warmth, and treating caregivers and patients with compassion and dignity as humans. Showing empathy and understanding encourages SJ to express her concerns (Sharkiya, 2023). Secondly, respectfully inquiring and acknowledging her religious and cultural background is key to avoiding making assumptions about her practices or beliefs. Also, use non-verbal cues including using open body language, appropriate eye contact maintenance, and avoiding inappropriate gestures that might be perceived as disrespectful. Being mindful of body language shows attentiveness and respect (Sharkiya, 2023).

Health History Interview Summary

The first target question is, “Can you tell me about your general health and any concerns you have currently?” This target question aims at gathering information on the general health and well-being of the patient. The open-ended question allows SJ to offer an overview of her health and particular issues she may need to address, setting a base for her health history (Mizumoto et al., 2023). The second question is, “How would you describe your typical diet and any dietary restrictions you follow?”. This question evaluates the dietary habits of the patient. understanding her diet is key given that the Muslim faith has possible dietary restrictions. This helps in coming up with dietary recommendations and ensuring nutritional needs are met (Mizumoto et al., 2023).

The third question would be, “How are you managing graduate school stress and living in a new country?”. This question evaluates her coping mechanism and mental health in response to life changes that are significant to them. It nurtures a conversation about any support that they may require and their emotional well-being (Mizumoto et al., 2023). The fourth question would focus on social support, which would read, “Do you have family or friends here who you can depend on for support?” Identifying her support network helps her comprehend her current social well-being and any need for more support resources. Social connections are significant for mental and emotional health (Mizumoto et al., 2023). The last question would be, “Are there any religious beliefs or practices that you would like us to consider in your healthcare?”. This question assesses religious practices that may affect patient care implementation. This shows respect for her beliefs and ensures her healthcare is in line with her religious practices. It also helps in patient care planning that is culturally respectful and sensitive (Mizumoto et al., 2023).

Risk Assessment Instrument

The most appropriate tool to use for this patient is the Refugee & Immigrant Core Stressors Toolkit. Commonly, immigrant youth encounter four core stressors in resettlement, which include isolation, acculturative, resettlement, and traumatic stress. Interventions that evaluate and address stress across the four domains may significantly improve psychosocial functioning and mental health outcomes among immigrant youths (Davis et al., 2021). According to research, the use of the four core stressors framework in their intervention and prevention programming improves provider confidence, comfort, and effectiveness in serving immigrant and refugee youth and families (Davis et al., 2021). This clearly shows how the appropriateness of using the tool.

References

Centers for Disease Control and Prevention. (2023, September 1). Socioeconomic factors. Centers for Disease Control and Prevention. https://www.cdc.gov/dhdsp/health_equity/socioeconomic.htm

Davis, S. H., Winer, J. P., Gillespie, S. C., & Mulder, L. A. (2021). The Refugee and Immigrant Core Stressors Toolkit (RICST): Understanding the Multifaceted Needs of Refugee and Immigrant Youth and Families Through a Four Core Stressors Framework. Journal of Technology in Behavioral Science, 6(4), 620–630. https://doi.org/10.1007/s41347-021-00218-2

Mizumoto, J., Son, D., Izumiya, M., Horita, S., & Eto, M. (2023). The impact of patients’ social backgrounds assessment on nursing care: Qualitative research. Journal of General and Family Medicine, 24(6), 332–342. https://doi.org/10.1002/jgf2.650

Sharkiya, S. H. (2023). Quality Communication Can Improve patient-centered Health Outcomes among Older Patients: a Rapid Review. BMC Health Services Research, 23(1), 1–14. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-023-09869-8

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For this first Assignment, you will take on the role of an APRN who is building a health history for a particular patient assigned by your Instructor. You will consider how social determinants of health and specific cultural considerations will influence your interview and communication techniques as you work in partnership with the patient to gather data for an accurate health history.

Reflecting on Health History and Diversity in Health Assessments – Insights from Advanced Practice Nursing

Note: You are expected to draw on the resources for both Week 1 and Week 2 when completing your Assignment.

To prepare:

• Reflect on your experience as an advanced practice nurse and on the information provided in the Week 1 Learning Resources on building a health history and the Week 2 Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, your Instructor will assign a case study for this Assignment. Note: Please see the Course Announcements section of the classroom for your Case Study Assignment.
• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of your assigned patient.
• Consider how you would build a health history for the patient. What questions would you ask? How might you target your questions based on the patient’s social determinants of health? How would you frame the questions to be sensitive to the patient’s background, lifestyle, and culture?
• Identify any potential health-related risks, based on the patient’s age, gender, ethnicity, or environmental setting, which should be taken into consideration.
• What risk assessment instruments would be appropriate to use with this patient?
• What questions would you ask to assess the patient’s health risks?
• Select one (1)risk assessment instrument discussed in the Learning Resources or another tool with which you are familiar, related to your selected patient.
• Develop five (5)targeted questions you would ask the patient to build their health history and to assess their health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What communication techniques would be most appropriate to use with this patient? What strategies can you as an APRN employ to be sensitive to different cultural factors while gathering the pertinent information?