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As a nurse practitioner, it’s crucial to conduct health assessments with cultural competence and effective patient-centered communication. Adapting the health assessment to each individual’s personal beliefs and values is essential for building a trusting patient-provider relationship (Ball et al., 2019). Being aware of issues that can affect different patient populations is crucial for providing the best care.
Patient Scenario
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TJ, a 32-year-old pregnant lesbian, is experiencing vaginal discharge during her annual exam. She has had no complications in this pregnancy from a sperm donor bank. She is receiving obstetrician care, taking prenatal vitamins, and Tylenol when needed. Her family has a history of diabetes. Gravida 1; Para 0; Abortions 0.
Socioeconomic, Spiritual, Lifestyle, & Cultural Factors
TJ, as a member of the Lesbian, Gay, Bisexual, and Transgender (LGBT) community, faces discrimination in healthcare (Ball et al., 2019). Extra time and support are needed during her clinic visit. Using neutral pronouns and respecting her beliefs is important. LGBT individuals may face economic challenges. TJ may receive government assistance. Her belief system and lifestyle may differ from the NP’s own experiences, and they may face legal, financial, and social challenges.
Sensitive Issues
Sensitive issues for TJ include lifestyle and sexual partners. Since she has vaginal discharge, it’s important to inquire about sexual partners and protection practices, ruling out STDs, gestational diabetes, and bacterial vaginosis.
Targeted Questions
Five targeted questions to ask TJ include:
1. How would you like us to address you, your partner, and your baby?
2. Are you currently sexually active?
3. How long have you been experiencing this vaginal discharge, and how would you describe it?
4. When was your last prenatal visit?
5. Do you have any questions for me at this time?
In conclusion, providing healthcare to diverse patient populations requires cultural humility. The healthcare team must offer appropriate care by understanding the patient’s perspective. It’s essential to avoid stereotypes and recognize the uniqueness of each individual’s healthcare needs (Griggs, Waddill, Bice, & Ward, 2021).
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.
Griggs, K. M., Waddill, C. B., Bice, A., & Ward, N. (2021). CARE DURING PREGNANCY, CHILDBIRTH, POSTPARTUM, AND HUMAN MILK FEEDING for Individuals Who Identify as LGBTQ+. MCN: The American Journal of Maternal Child Nursing, 46(1), 43–53.
Discussion: Diversity and Health Assessments
The case study you provided highlights the importance of considering socioeconomic, spiritual, lifestyle, and cultural factors when conducting health assessments. In this context, addressing issues related to LGBT health is crucial. However, it’s important to recognize that not all LGBT individuals have the same experiences, and individualized care is key.
Your targeted questions are well thought out, but one aspect that could be considered is the potential presence of a co-mother if TJ has a partner. As shown in the article you referenced from “The Conversation,” there can be heightened feelings of anxiety and depression among lesbian co-mothers. Educating and supporting both partners is essential to reduce the risk of postpartum depression.
Overall, your approach to this discussion reflects the need for healthcare professionals to be sensitive to the unique needs and challenges of diverse patient populations, providing patient-centered care and tailored support.
Reference:
Greenfield, Mari. (2019, October 8). How pregnancy can be made more difficult by maternity care’s notions of ‘normal’ . https://theconversation.com/us. https://theconversation.com/how-pregnancy-can-be-made-more-difficult-by-maternity-cares.
Discussion: Diversity and Health Assessments
May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).
Photo Credit: Getty Images
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
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.
To prepare:
- 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?
By Day 3 of Week 2
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.
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!
Read a selection of your colleagues’ responses.
By Day 6 of Week 2
Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.
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