Diversity and Health Assessment
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.
Scenario:
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 a hx 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 daughterâ€
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Diversity and Health Assessment
Patients from diverse cultural backgrounds need more proficiency in the dominant language of the healthcare facility (Shepherd et al., 2019). This hinders effective communication, leading to misunderstandings, misdiagnoses, and medication errors. Nurses should be aware of language barriers and use language assistance services to ensure clear and accurate communication. Also, some religions have dietary restrictions, specific rituals during illness, or preferences for same-gender healthcare providers, which the nurse should be aware of.
According to Markey et al. (2018), understanding cultural traditions and customs related to health and healthcare can help nurses provide culturally competent care. Nurses should adapt their communication to ensure that patients comprehend their condition, treatment plans, and instructions for self-care. Nurses should inquire about traditional healing practices and collaborate with patients to ensure safe, coordinated care that respects their beliefs. Lastly, nurses should educate themselves about different cultures and strive to develop cultural competence, which helps them understand cultural norms, values, and healthcare practices relevant to their patient population.
Socioeconomic Factors
The patient’s income and insurance coverage can impact their access to healthcare services, including medication affordability and follow-up appointments. A patient’s level of education can affect their understanding of hypertension, its management, and adherence to treatment plans. Barriers such as transportation issues affect patients’ ability to seek regular medical care and attend appointments.
Spiritual Factors
A patient’s spiritual beliefs influence their coping mechanisms, ability to handle stress, and willingness to engage in self-care practices. Some patients may turn to religion as a coping mechanism for stress.
Lifestyle Factors
Lifestyle factors such as dietary choices, stress, and lack of physical activity influence a patient’s adherence to medication. Nurses should assess the patient’s understanding of their medication regimen and any barriers to compliance.
Cultural Factors
Shahin et al. (2019) highlighted that different cultures may have unique beliefs about the causes and treatment of hypertension, and a nurse should ask open-ended questions to understand patient’s perspectives. Nurses should inquire about cultural dietary practices and offer dietary guidance. Some patients may use traditional or herbal remedies to manage their health, and nurses should be aware of their safety in conjunction with prescribed medications.
Target Questions
- Are there any instances of early heart disease, strokes, or high blood pressure in your family?
- How many servings of fruits and vegetables do you typically eat daily?
- What types of physical activities do you enjoy or engage in regularly?
- Are you taking your prescribed medications regularly and as instructed by your healthcare provider?
- How often do you visit your healthcare provider for routine check-ups and blood pressure monitoring?
References
Markey, K., Tilki, M., & Taylor, G. (2018). Understanding nurses’ concerns when caring for patients from diverse cultural and ethnic backgrounds. Journal of Clinical Nursing, 27(1-2), e259-e268.
Shepherd, S. M., Willis-Esqueda, C., Newton, D., Sivasubramaniam, D., & Paradies, Y. (2019). The challenge of cultural competence in the workplace: perspectives of healthcare providers. BMC Health Services Research, 19(1), 1-11.
Shahin, W., Kennedy, G. A., & Stupans, I. (2019). The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: A systematic review. Patient Preference and Adherence, 1019-1035.