Communicating Effectively to Gather Appropriate Health-Related Information
Specific Socioeconomic, Spiritual, Lifestyle, and other Cultural Factors
Among the socioeconomic factors that should be specifically aware of, such as the patient’s homelessness or the lack of income stability, are the main social factors that intervene with the patient’s lifestyle. In the first place, homelessness precludes access to things like shelter and food, and it also eliminates the purchasing power of medical services since prioritization of survival needs is at center stage (Sleet & Francescutti, 2021). Financial instability can limit his access to treatments and regular medical schedules, worsening his health risks.
Furthermore, the patient’s lay spirituality will be crucial to his ability to cope and persevere. Being familiar with his spirituality helps to put the provider in a position where the provided interventions would resonate with the patient (Manning et al., 2019). Lifestyle factors, for example, smoking, frequently used as a coping mechanism, contribute to his general health risks, mostly considering his past alcohol abuse. In addition to the social aspects, he may face significant challenges as a male African American due to institutional healthcare restrictions and varying views within his community regarding health issues and illnesses.
Sensitive Issues
The careful sensitivity needed to care for the patient assigned properly has supposedly interrelated parties. When discussing his homelessness, tolerance is crucial because it can make him feel unworthy. Therefore, it is important to speak to him gently in order to boost his self-esteem. Additionally, by understanding and avoiding stereotyped condemnation, an attempt is made to comprehend and accept his coping style, which includes smoking (Pratt et al., 2022). A healthy treatment relationship model is established and built on respect and understanding, which leads to excellent communication and the provision of patient-oriented care that is specific to his status and experience. Beyond that, it is important to recognize and value his spiritual beliefs and culture.
The Communication Techniques I Would Use with this Patient
Building a relationship and ensuring effective delivery communication with the patient requires the use of compassionate and empathic approaches. Not only can listening be defined as hearing and nonjudgmental listening, but it can also facilitate the patient’s self-expression and emotional disclosure (Kwame & Petrucka, 2021). Questioning in an open-ended manner can encourage the patient to express his thoughts, feelings, and concerns about his care plan independently. This is a way to create a sense of control over his health journey. Further, reflective listening is much more than just an expression of sympathy; it reveals that you care by proving your comprehension using empathy and understanding.
Communication with this patient, who is of African American origin, would be highly dependent on the competence that every healthcare provider should be able to meet. Furthermore, the therapist’s approval of his customs, values, and beliefs will increase trust and lead to a deeper therapeutic relationship (Kwame & Petrucka, 2021). Besides, figuring out how his uplifting beliefs influence his health and wellness gives him a comprehension of the situation.
A Summary of the Health History Interview I Would Conduct with this Patient
While carrying out the health background questionnaire with the patient, I will pay attention to important factors that influence his lifestyle and maintain sensitivity to his current situation. Initially, I would find out his present living circumstances and check for any problems he has by, for example, asking a question like “Can you tell me more about your present living condition, as well as where you stay and if you are safe there?”. In light of his homelessness, it is critical to acknowledge his housing stability since this may have an impact on his ability to receive healthcare. In addition, I would examine his history of drug use by asking, “Can you tell me about your drinking habits, including how often you drink and when you started. Also, have you recently experienced withdrawal symptoms?” (Karosas, 2021). The purpose of the questions is to determine if he has a high risk of developing substance use disorders and other complications related to health, especially since he has had an encounter with alcoholic-related seizures.
Moreover, I would inquire about his habitats smoking to be able to evaluate his dependency to know the associated health risks that his use of cigarettes would worsen as a way of coping by asking, “Can you tell me about your smoking practices, including how frequently you smoke and when you began?” In this context, assessing respiratory and cardiovascular health risks is based on knowledge about his smoking behaviors. Even though research on his past medical forms ought to take place, including chronic conditions such as hypertension and diabetes, they need to be examined to determine enduring health risks that urgently demand management and treatment (Karosas, 2021). Next, I shall ask questions, such as “Have you had any encounters with healthcare givers in the past, and if so, can you tell me how you viewed those experiences?” This question lets the patient speak about any grievances he may have experienced, hence addressing potential obstacles to seeking healthcare and developing trust in the healthcare organization. Finally, I would measure his knowledge of hypertension and adherence to medication by asking, “Can you tell me anything you know about hypertension and how you cope with it? Are there any medications you normally take?” This question assesses his health knowledge and adherence to management, guiding interventions to advance hypertension management and lessen associated health dangers (Karosas, 2021). Via this questions screening, I plan to draw a wide range of information to appropriately judge a patient’s health risks and design a customized action plan that best suits his peculiar conditions and circumstances.
The Risk Assessment Instrument Selected
I would choose to use the CAGE questionnaire for this patient. This analgesic is suitable for this patient because of the history of alcohol use and, not so recently, the experience of seizures that patients affected by alcohol can have. CAGE is made of a few simple questions to be used to find out whether you have an alcohol use disorder (Wolf et al., 2020). Answering the CAGE instrument can help determine whether the patient has an alcohol dependency, abuse, or other alcohol-related problem, which could be one of the risk factors for his health, given his estimate of his alcohol usage. Moreover, the ultimate reason for the CAGE questionnaire’s popularity among healthcare professionals lies in its brevity and simplicity, which makes it practical for use in several different clinical settings, including primary care and emergency departments, which plugs into the healthcare setting that the client is currently seeking assistance (Wolf et al., 2020). Embedding the ‘CAGE’ query in the guidelines of the examination allows healthcare providers to rapidly detect alcohol-related risks, creating a basis for assigning treatments that the person needs to get into sober living.
References
Karosas, L. M. (2021). Health history, the patient interview, and motivational interviewing. In connect.springerpub.com. Springer Publishing Company.
Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(158), 1–10. https://doi.org/10.1186/s12912-021-00684-2
Manning, L., Ferris, M., Narvaez Rosario, C., Prues, M., & Bouchard, L. (2019). Spiritual resilience: Understanding the protection and promotion of well-being later in life. Journal of Religion, Spirituality & Aging, 31(2), 168–186. https://doi.org/10.1080/15528030.2018.1532859
Pratt, R., Xiong, S., Kmiecik, A., Strobel-Ayres, C., Joseph, A., Rose, S. A. E., Luo, X., Cooney, N., Thomas, J., Specker, S., & Okuyemi, K. (2022). The implementation of a smoking cessation and alcohol abstinence intervention for people experiencing homelessness. BMC Public Health, 22(1). https://doi.org/10.1186/s12889-022-13563-5
Sleet, D. A., & Francescutti, L. H. (2021). Homelessness and public health: A focus on strategies and solutions. International Journal of Environmental Research and Public Health, 18(21), 11660. https://doi.org/10.3390/ijerph182111660
Wolf, C., Curry, A., Nacht, J., & Simpson, S. A. (2020). Management of alcohol withdrawal in the emergency department: Current perspectives. Open Access Emergency Medicine, Volume 12(1), 53–65. https://doi.org/10.2147/
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Question 
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting.
There may also be significant cultural factors. In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged Black women to maintain a weight above what is considered healthy. Randall explained from her observations and her personal experience, as a Black woman, that many African American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Communicating Effectively to Gather Appropriate Health-Related Information
Randall’s statements sparked a great deal of controversy and debate at the time; however, they emphasize an underlying reality in the healthcare field: Different populations, cultures, and groups have diverse beliefs and practices that impact their health. APRNs and other healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
As an advanced practice nurse, you must build a patient health history that takes into account all of the factors that make a patient unique and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with each patient, but it will also enable you to more effectively gather the information needed to assess a patient’s health risks.
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.
Note: You are expected to draw on the resources for both Week 1 and Week 2 when completing your Assignment.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resource links to access the resources.
WEEK 1 WEEKLY RESOURCES
WEEK 2 WEEKLY RESOURCES
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?
Assignment: Building a Health History With Cultural and Diversity Awareness
Include the following:
Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific.
Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.
Summarize the health history interview you would conduct with this patient. Provide at least five (5) targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.
Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific. :