Last Updated on February 1, 2023 by Admin
JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs
Diversity and Health Assessments
Case Study 1
JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father\’s health needs. He has ahx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.\”
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
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.
. Retrieved from https://npin.cdc.gov/pages/cultural-competence
- United States Department of Human & Health Services. Office of Minority Health. (n.d.). A physician’s practical guide to culturally competent care
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.
. Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/
- Coleman, D. E. (2019). Evidence based nursing practice: The challenges of health care and cultural diversity
- . 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
. The Health Care Manager, 35(2), 94–102. https://doi.org/10.1097/hcm.0000000000000100
Expert Answer and Explanation
Explanation of the Spiritual, Socioeconomic, Lifestyle, and Cultural Factors are associated with the Patient
Patient care involves a combination of different aspects such as spiritual, lifestyle, socioeconomic, and cultural well-being (Di Lorito, Dening, & Vollm, 2018). In the case of JC, an 86 y.o. male pt. with a history of hypertension, GERD, b12 deficiency chronic prostatitis and overdependence on his daughter, there are a range of socioeconomic and lifestyle factors that could account for the present manifestation of the condition. The first socioeconomic factor I would be sure to consider is his source of income.
While it may be evident that an 86 y.o. individual is unlikely to be actively working, there are financing options that could make his condition appear better, such as retirement funding. Presently, the patient relies on his daughter fully for the financial and physical upkeep, and possibly for his current drugs, lisinopril, Prilosec, cipro, and B12 injections.
The other significant socioeconomic factor that may affect his delivery is the presence of a suitable insurance scheme such as health insurance which could cover for all the associated costs of medication (Clarrett & Hachem, 2018). One of the lifestyle/cultural factors is the family set up, or the role of the children in supporting their ageing parents. That is, if there is a cultural allowance of JC’s daughter of taking the parents to a care institution, the entire situation would possibly be completely different.
Issues that I would need to be Sensitive to when interacting with the Patients
The first issue I would have to be sensitive when interacting with JC is his spiritual beliefs regarding the healthcare conditions he faces. Specifically, I would be sure to assess what he believes is the relationship between his condition and the spiritual wellness. This could be done using a spiritual needs assessment, and would help to increase the overall awareness of the condition of the patient (Sithey et al., 2018).
Another issue I would be sensitive in when interacting with patient JC is the cultural values and how they affect their relationship with the daughter. Specifically, I would be sure to evaluate how the cultural values determine the wellbeing of the patient and whether it would be appropriate to refer him to a home care institution such as a hospice (Perez-Jover et al., 2018). Lastly, I would be sensitive when discussing the financial information of JC with regard to his healthcare, as it is evident that he already faces some disappointments because of his inability to raise his medical care costs.
Targeted Questions I would ask the Patient to build their Health History and his Health Risks
Target questions for the patients would be useful in determining the dos and the don’ts during the process of delivering care to the patient. One of these questions would be whether or not he is open to going to a healthcare home, where they would receive less family contact and more interaction with strangers who possibly share his problems (Jacob et al., 2019).
Another question I would ask the patient is his frequency of falls or the number of times when he almost encountered a fall (Jacob et al., 2019). Also, to evaluate the health risks, I would be sure to examine the daughter to give information about the behavior of the patient when at home. Most importantly, I would assess the financial history of the patient, including consideration for things such as health insurance.
Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal reflux disease (GERD). Missouri medicine, 115(3), 214. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/
Di Lorito, C., Dening, T., & Vollm, B. (2018). Ageing in forensic psychiatric secure settings: The voice of older patients. The Journal of Forensic Psychiatry & Psychology, 29(6), 934-960. https://doi.org/10.1080/14789949.2018.1513545
Jacob, J., Palat, G., Verghese, N., Chandran, P., Rapelli, V., Kumari, S., & Ozdemir, S. (2019). Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: Evidence from the APPROACH cross-sectional survey in Hyderabad-India. BMC palliative care, 18(1), 1-12. https://doi.org/10.1186/s12904-019-0465-y
Perez-Jover, V., Mira, J. J., Carratala-Munuera, C., Gil-Guillen, V. F., Basora, J., López-Pineda, A., & Orozco-Beltrán, D. (2018). Inappropriate use of medication by elderly, polymedicated, or multipathological patients with chronic diseases. International journal of environmental research and public health, 15(2), 310. https://doi.org/10.3390/ijerph15020310
Sithey, G., Li, M., Wen, L. M., Kelly, P. J., & Clarke, K. (2018). Socioeconomic, religious, spiritual and health factors associated with symptoms of common mental disorders: a cross-sectional secondary analysis of data from Bhutan’s Gross National Happiness Study, 2015. BMJ open, 8(2), e018202. http://dx.doi.org/10.1136/bmjopen-2017-018202
Other Solved Questions:
“which of the following is not an example of a risk factor”
“cultural considerations for caucasian female”