AG is a 54-year-old Caucasian male who was referred to your clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal.
Case study #2
AG is a 54-year-old Caucasian male who was referred to your clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal. He has hypertension and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke cigarettes to calm down since he is not drinking anymore
In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.
- Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
- By Day 1 of this week, you will be assigned a case study by your Instructor. 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 the patient assigned to you.
- Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
- Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
- 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.
- Chapter 2, “Cultural Competency”
This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.
- Chapter 2, “Cultural Competency”
- Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
- Chapter 2, “Evidenced-Based Clinical Practice Guidelines”
- Centers for Disease Control and Prevention. (2020, October 21). Cultural competence in health and human services
- Links to an external site.. Retrieved from https://npin.cdc.gov/pages/cultural-competence
This website discusses cultural competence as defined by the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website.
- United States Department of Human & Health Services. Office of Minority Health. (n.d.). A physician’s practical guide to culturally competent care
- Links to an external site.. Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/
From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.
- Coleman, D. E. (2019). Evidence based nursing practice: The challenges of health care and cultural diversity
- Links to an external site.. Journal of Hospital Librarianship, 19(4), 330–338. https://doi.org/10.1080/15323269.2019.1661734
- Young, S., & Guo, K. L. (2016). Cultural diversity training
Links to an external site.. The Health Care Manager, 35(2), 94–102. https://doi.org/10.1097/hcm.0000000000000100
Expert Answer and Explanation
Diversity and Health Assessment
During their practice, healthcare practitioners meet and interact with patients with cultural identities that are diverse, and this warrants the need for these practitioners to adapt care in a way that meet the nursing needs of the diverse patients. The patient’s cultural and spiritual beliefs influence the way they respond to the clinical interventions, and a provider who takes these beliefs into consideration is likely to provide care that is holistic (Speck, 2016). This applies during the assessment of the patient, and it is imperative to examine the socioeconomic, spiritual, and cultural and lifestyle factors related to an assigned patient. It is also important to explore the key sensitive features about the patient which a provider has to look at.
Factors Linked to the Patient
Reflecting on the patient’s scenario, one can link a number of factors to this patient. For instance, the patient is economically and socially disadvantaged considering that he is homeless. He seems to lack family and social support, and this makes him vulnerable to suffering serious disease events.
The patient has a history of using substance, and this puts him at risk of developing mental health problem. The patient is a smoker, and because of his lifestyle choices, he has hypertension. The patient does not have medication for his blood pressure disease, and this is probably because of his financial status (Isaac, Hay, & Lubetkin, 2016). This indicates that his substance use behavior is making it possible for him to get the medications.
Issues to be Sensitive To
As a caregiver and during my interaction with this patient, I will need to be sensitive to certain key issues. One of these issues is the patient’s cultural background considering that the patient’s beliefs can influence how they answer questions. It is also imperative to take into consideration the patient’s spiritual beliefs. This is because the patient may refuse the clinical assessment because of their beliefs.
However, the social environment of this patient matters, and it is important to consider it when interacting with this patient (Lawati et al., (2018). The lack of shelter can hamper the advancement of the treatment objectives by affecting the patient’s adherence to the medications. This is a risk factor that can impede the patient’s recovery efforts from the use of substances.
Questions for Assessing the Patient’s Health Background
- Do you have history of substance use in your family?
- For how long have you been using psychotic substances?
- Do you receive any form of support from family members?
- What are some of the clinical symptoms you exhibit which you feel I should know about?
In overview, it is important to perform comprehensive assessment of the patient to understand their spiritual and cultural needs. When assessing patients, providers have to be sensitive to these needs because these needs affect how these patients respond to questions, and the perceptions they have on clinical interventions. Caregiver-patient relationship is critical when it comes to the diagnosis of the disease, and the failure by the provider to build this relationship can hamper efforts focused on performing successful diagnosis.
However, the caregiver has to also consider the environment of the patient considering that patients without homes are less likely to adhere to the prescription details. Based on the results of the cultural, physiological and spiritual assessment, the caregiver can tailor treatment in a way that meets every need of the patient.
Isaac, K. S., Hay, J. L., & Lubetkin, E. I. (2016). Incorporating Spirituality in Primary Care. Journal of religion and health, 55(3), 1065–1077.Doi: https://doi.org/10.1007/s10943-016-0190-2.
Lawati, M., Dennis, S., Short, S. D., & Abdulhadi, N. N. (2018). Patient safety and safety culture in primary health care: a systematic review. BMC family practice, 19(1), 104. Doi: https://doi.org/10.1186/s12875-018-0793-7.
Speck P. (2016). Culture and spirituality: essential components of palliative care. Postgraduate medical journal, 92(1088), 341–345. Doi: https://doi.org/10.1136/postgradmedj-2015-133369.
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