Posted: January 23rd, 2023

NURS 6512 Building a Health History week 1 discussion

NURS 6512 Building a Health History week 1 discussion

Good communication techniques can encourage patient disclosure and break the barriers that block and encourage patient apprehension. It can cause the patient to recuse themselves from seeking and receiving medical care. Practitioners should be versatile in their approach and interviewing techniques to allow the foundations needed to develop the patients’ health history, especially those from diverse cultural backgrounds. Some techniques that can be used are self-disclosure, expressing empathy, and involving the patient in the decision-making process. Finding a commonality allows for open dialogue between the patient and the provider. It enables the patient to talk about their fears without judgment and for both to be able to ask open-ended questions; offers the provider to practice patient-centered care and to actively listening to both parties’ wants and needs (Padela & Zaidi, 2018).

In this case, the patient is a 26-year-old Lebanese female living in graduate student housing who visits the medical clinic. Understanding the Lebanese culture and their practices will help the practitioner provide care and treatment (Attum, 2020). Cultural competency plays a major role in defining the medical relationship between provider and patient. It is defined as having the ability to provide care to those with differing values, beliefs, and behaviors by incorporating the practice of providing care that meets the patient’s needs (Hembley, 2015). Recognizing your patients’ cultural demographics is an empathetic approach to treatment and shows that the practitioner acknowledges and values that individual patient. It allows a trusting connection to be formed, enabling pertinent information to be exchanged and received between the provider and patient on a scale that meets the patient’s overall needs (Hembley, 2015). NURS 6512 Building a Health History week 1 discussion

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Once the patient connects, they experience reduced stress during and post-visits. They have better adherence to treatment, which allows for better outcomes; the practitioner also has a renewed sense of meaning and fulfillment and fewer burnout experiences (Hembley, 2015). When a provider’s approach is expressed through sensitivity to their patients’ cultural differences, it sets up a patient-centered relationship. For adequate diagnosis and treatment, the patient has to open up and discuss health-related issues that may disrupt their cultural beliefs and values. For example, many women from this region of the world view gynecological examination as an invasion against their modesty and virginity for unmarried women (Padela & Zaidi, 2018). Patient education will only be accepted if the patient is willing and motivated to participate in the learning process. For providers, the first step is to find a way to connect and be accepted by the patient; this can be accomplished by showing empathy towards their belief system.

There is an unmet need for guidelines for young women’s health and wellness practices in general from this population, making it imperative to evaluate the patient’s health risks and hazards. A health risk assessment helps both patient and doctor identify areas of concern (Hembley, 2015). For successful care and treatment, a trusting relationship between the patient and provider is essential to their needs. It allows the patient to be accountable for their actions and be an active participant in their health and well-being. Enabling them to identify health-related issues as they arise and immediately address them with their provider for swift treatment and better outcomes.

According to the Centers for Disease Control (CDC), Lebanese women’s reproductive health needs to be improved. The CDC states that more than 50% of Lebanese women between the ages of 18 and 45 do not use any form of birth control. Women from this region are more prone to developing abnormalities such as dysmenorrhea, severe pelvic pain, and injury, along with other preventable and treatable medical comorbidities like anemia, hypertension, and diabetes (CDC, 2017).

  There are premeditated barriers to receiving reproductive or gynecological care due to different cultural values and beliefs. Some of the clinical challenges for many of these women are based on having same-sex providers, their need for modesty in the clinical setting, and respect for their religious obligations (Padela & Zaidi, 2018). These barriers can be detrimental to this population if patient-doctor relationships and communication are not improved. Finding common ground is imperative for preventing pathologies as cervical cancer, infertility, and sexually transmitted diseases (Padela & Zaidi, 2018). Because of the barriers preventing women from this region to seek medical care, providers need to be competently aware of the risks associated with a lack of knowledge of cultural diversity and values.

 

Five target question to assess her health risks and begin building a health history

 

  1. How are you today?

  2.  How can I help you make this experience more comfortable for you?

  3. What are your spiritual or religious beliefs; is it important to you, and how do you feel it will impact your care?

  4. How do you feel about us discussing your reproductive health?

  5. Are you sexually active?

 

Reference:

Attum, B. (2020, July 8). Cultural Competence in the Care of Muslim Patients and Their Families. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK499933/.

Centers For Disease Control, CDC. (2017, January 10). Healthcare Access and Health Concerns among Syrian Refugees Living in Camps or Urban Settings Overseas. https://www.cdc.gov/immigrantrefugeehealth/profiles/syrian/healthcare-diet/index.html.

Hembley, C. (2015, February 25). Six Keys to Effective Physician-Patient Interactions. Physicians Practice.https://www.physicianspractice.com/view/six-keys-effective-physician-patient-interactions.

IES (2020). Lebanese Culture – Core Concepts. Retrieved from https://culturalatlas.sbs.com.au/lebanese-culture/lebanese-culture-core-concepts

Padela, A., & Zaidi, D. (2018). The Islamic tradition and health inequities: A preliminary conceptual model based on a systematic literature review of Muslim health-care disparities. Avicenna Journal of Medicine, 8(1), 1–13. https://doi.org/10.4103/ajm.ajm_134_17

 

 

Discussion: Building a Health History

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. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

  • By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
  • How would your communication and interview techniques for building a health history differ with each patient?
  • How might you target your questions for building a health history based on the patient’s social determinants of health?
  • What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks? NURS 6512 Building a Health History week 1 discussion
  • Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
  • Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
  • Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6512 Building a Health History week 1 discussion

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:

  • Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
  • Suggest additional health-related risks that might be considered.
  • Validate an idea with your own experience and additional research.
  • NURS 6512 Building a Health History week 1 discussion

 

Building a Health History

The patient is a 26-year-old Lebanese female student living in graduate student housing. Communication techniques would first be to establish preferred primary language to communicate in. According to Ball et al. (2019) states, “maintain eye contact and use a conversational tone” (p.1). Communication should be aimed at building a patient-centered rapport and obtaining a clear outlook of the patient’s condition and healthcare morale. My communication approach would be respectful and polite to build an ideal nurse-patient relationship successfully. I would then assess the patient for learning needs and learning requirements aimed at health promotion by using a language line interpreter. The patient’s learning needs, abilities, preferences, and readiness to learn are then assessed. Major assessment parameters would target social determinants such as cultural and religious practices, emotional barriers, desire and motivation to learn, physical and cognitive limitations, financial concerns, and identifying language barriers. I would update learning methods so the entire multidisciplinary team that teaches the patient can be aware of the education assessment entirety and refer to this before teaching the patient and family.

Risk Assessment

It is important to identify the appropriate health risk assessment strategies in patients with different cultures and religions related to their definition of health promotion and disease prevention. Based on the information is given, I would use a healthy female adult risk assessment to ask questions to identify healthy female habits and practices related to Lebanese women’s culture. The purpose of the risk assessment is to build a collection of data related to the patient condition and risk for developing related medical conditions. Questions are aimed at demographics, lifestyle, personal health history, family health history, and biometrics (such as blood pressure, weight, cholesterol, etc.); other data includes genetic/genomics and individual preferences, according to Wu and Orlando (2015) NURS 6512 Building a Health History week 1 discussion.

Potential Health-Related Risk

Language barriers and culture should always be considered as they can pose a potential health-related risk due to the misinterpretation or misunderstanding of information and strategies provided. Sah et al. (2019), “many migrants may be unfamiliar with the norms and practices of a new country where sociocultural and geographical circumstances can have a huge impact on their health (p. 65). Effective communication is the primary goal of preventing immigrants’ health-related issues and producing positive outcomes associated with potential health risks. It leads to better health outcomes and wiser allocation of resources, and greater patient and family satisfaction.

Five Targeted Questions

?When was your last OBgyn visit?

?Last normal menstrual cycle?

?Any pregnancies?

?The use of contraceptives?

?Sexual history?

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An 

interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Sah, L. K., Burgess, R. A., & Sah, R. A. (2019). Medicine doesn’t cure my worries’: Understanding the drivers of

mental distress in older Nepalese women living in the UK. Global Public Health, 14(1), 65–69.

https://doi.org/10.1080/17441692.2018.1473888

Wu, R. R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: Barriers

and benefits. Postgraduate Medical Journal, 91(1079), 508. https://doi.org/10.1136/postgradmedj-2014-

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