BK is a 16-year-old Caucasian female who comes in with her grandmother for an annual exam. The grandmother reports BK has been “acting strange, staying in her room all the time
Diversity and Health Assessments
Group 2: CASE STUDY 2
BK is a 16-year-old Caucasian female who comes in with her grandmother for an annual exam. The grandmother reports BK has been “acting strange, staying in her room all the time and refusing to do all the things she used to enjoy like singing in the youth choir”. Grandmother shares that BK’s mother is a drug addict is currently incarcerated so she is worried BK is using drugs and wants her tested for drugs. BK is not on any medications. She is obese and does not make eye contact when you enter the room.
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
Patient’s Socioeconomic, Spiritual, Lifestyle, And Other Cultural Factors
In the case of BK, a 16 y.o. female Caucasian patient who reportedly acts strange since the incarceration of her mother, there are many lifestyle, spiritual, cultural, and socioeconomic that I would put to consideration when addressing her condition. First, being in her middle adolescent age, it is likely that her actions may be influenced by the stage of life, such as being rebellious through things such as not making eye contact with the physician when she steps into the examination room (Allison, 2017).
Also, this age is critical for the patient as she is more inclined to achieve tasks on her own, and hence the parents need to be more observant of any changes that may be beyond the ordinary (Leavitt et al., 2018). The age is also risky for the patient as she may be more susceptible of substance abuse due to the influence from her peers at school. Regarding the economic status, the patient may be working during holidays to help her with the basic necessities such as phone bills (Leadbeater, Ames, & Linden, 2019).
Her lifestyle may also be determined largely by the quality of the school, family, and neighborhood with which she spends most of her time. Culture wise, Caucasians are known to be loyal to the parents at the age of 16, and hence she may be encountering a significant gap due to the absence of her mother in her upbringing, and may have less attention to her foster mother, the grandmother, who now takes care of her.
Issues I should be Sensitive with when interacting with the Patient
I would be sensitive when interacting with the patient about the idea of being incarcerated or going to juvenile as a result of bad habits as this may arouse the trauma of losing her mother to prison at such an early age. Also, I would be careful when discussing drug abuse with her since it is evident that the family has a history of drug abuse and hence I should approach the topic in a way that allows the patient to open up about the personal experiences of drug abuse.
Most importantly, I would be sure to discuss the idea of becoming a victim of illicit drug abuse disorder, which has affected at least 3% of adolescents in the US (Willing et al., 2018). Lastly, I would be sure to be sensitive when talking about suicide and depression, as the patient shows some of the early signs of these conditions such as refusing to open up about her fears.
Targeted Questions for Building History and Examining Health Risks
The following are some of the targeted questions that I would use to determine the patient’s specific health risks and build her health history:
- Have you ever had suicidal thoughts? If yes, what made you have them and how did you handle them? Did you share with your family and friends?
- Are you currently using any illicit drugs?
- Do you think you are pregnant? What would make you think so or not?
- Do you feel lonely about your mother being incarcerated?
- Are you comfortable with your current guardian or state of living?
Allison, R. L. (2017). Back to basics: The effect of healthy diet and exercise on chronic disease management. South Dakota Medicine, Spec No, 10–18. Retrieved from www.sdsma.org
Leadbeater, B. J., Ames, M. E., & Linden, C. A. N. (2019). Age? Varying effects of cannabis use frequency and disorder on symptoms of psychosis, depression and anxiety in adolescents and adults. Addiction, 114, 278–293. doi:10.1111/add.14459
Leavitt, R. A., Ertl, A., Sheats, K., Petrosky, E., Ivey-Stephenson, A., & Fowler, K. A. (2018). Suicides among American Indian/Alaska Natives – National Violent Death Reporting System, 18 sates, 2003-2014. Morbidity & Mortality Weekly Report, 67, 237–242. doi:10.15585/mmwr.mm6708a1
Willging, C. E., Sommerfeld, D. H., Jaramillo, E. T., Lujan, E., Bly, R. S., Debenport, E. K., Verney, S. P., & Lujan, R. (2018). Improving Native American elder access to and use of health care through effective health system navigation. BMC Health Services Research, 18, 464-480. Doi: 10.1186/s12913-018-3182-y
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