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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.
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 AG is a 54-year-old Caucasian male – NURS 6512 discussion post.
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Ball et al. (2019), explain that patients age differently and their knowledge, cognitive abilities, personality, and experience will influence how the interview is conducted by a provider. There could be a multitude of reasons as to why an older adult can become homeless. This includes unemployment due to corporate age discrimination as told by Murphy and Eghaneyan (2018). AG’s drug and alcohol use could be a reason as to why he lost his employment and due to financial constrains, was unable to pay rent or mortgage. It is the responsibility of the nurse practitioner to gather information from the patient and not make assumptions about situations. The socioeconomic factors we are looking at are employment, education, and income per Coogle and Owens (2015).
An individual’s income plays an important role in the determinant of health according to Mullen (2015). Having a higher income enables better nutrition, housing, health care, and recreation per Tsai (2018). On the other hand, poverty has a strong detrimental effect on health and is normally associated with unhealthy or risky behaviors as reported by Tsai (2018). People with low income have been observed to have more association with the consumption of unhealthy goods, like tobacco, alcohol and illicit drug use according to Tsai (2018). AG has no income and therefore has fewer chances of seeking healthcare resources or preventative services. These services could mean the difference between having a manageable health condition versus late stage multiple diagnosis and treatment. AG smokes, uses drugs and alcohol which shows his lack of health promoting behaviors AG is a 54-year-old Caucasian male – NURS 6512 discussion post.
Education is one of the focal determinants of health and is an indicator of a person’s socio-economic status per Mullen (2015). People who are better educated have fewer morbidities than their counterparts according to Hook and Markus (2020). We do not know AG’s level of education and therefore we cannot draw any conclusions. AG’s lifestyle is contributing to his present status which is having a negative effect on his health. From his chosen lifestyle, AG can end up having a heart attack or death from uncontrolled hypertension and the use of illicit drugs. Cigarette smoking can also increase cardiovascular problems as well as cause cancer.
AG needs support and education in the management of his illness. Due to the socioeconomic factors unfolding in his life, he may become depressed and without help, may contemplate suicide. Inquiring about AG’s mood like depression or anxiety can allow the NP to analyze what resources are appropriate. There is no mention of any religious preferences and this could be a question that the NP can ask during patient interviews.
Drug users and homeless individuals experience severe health inequalities and barriers to accessing healthcare. It is the duty of the healthcare workers to change their perception of others and be receptive to other people’s cultures as O’Donnell et al. (2019) explain.
AG may have reservations about speaking about his adversities with a new provider for fear of being judged or prejudice. As a nurse practitioner, one should be cautious about how questions are posed to the patient as Coogle and Owens (2015) explain. A tone that is accusatory will not yield pertinent information. The NP should make sure that they are not passing judgement or being prejudice against any patient that they encounter per Ball et al. (2019). The nurse practitioner should listen carefully to AG during the information gathering process AG is a 54-year-old Caucasian male – NURS 6512 discussion post. The nurse practitioner should also be careful of the non-verbal cues they present. How a clinician controls their emotions is also a strong communication skill that is very important during the interview process.
AG did not choose a healthy lifestyle and therefore the nurse practitioner can offer AG resources that can aid him in his health quest. Smoking cessation resources should also be offered when AG is ready to give up the unhealthy habit. At this time, it is imperative that the clinician offers full support and not force AG to give up any behaviors unwillingly. The nurse practitioner does not know anything about AG and therefore must use the RESPECT model as advised by Ball et al. (2019).
Questions pertaining to why he chose to use drugs and alcohol should be asked respectfully without any preformed notions from the NP per Ball et al. (2019). A trusting relationship must be formed with AG who may probably be embarrassed about the life choices he has made. AG is in his early fifties and mid-life crisis is also a concern at
this time and therefore the NP must not make him feel like he is a failure. Instead AG needs reassurance, support, guidance and with the help of the NP, he can set a goal that is attainable per Coogle and Owens (2015).
Part of the information gathering involves asking the patient his allergies and the reactions experienced, the patient’s family history of illnesses, any previous surgeries to name a few.
Have you had any other previous hospitalizations including any mental health stay
Can you please tell me how you ended up staying at the shelter or being homeless
When did you start using cocaine, alcohol and tobacco substances
What were your last employment and the duration
What is your highest level of education
Do you have any religious or cultural preferences, that we need to put in place AG is a 54-year-old Caucasian male – NURS 6512 discussion post
Do you ever experience feelings of hopelessness, depression, sadness
Are there are resources that you would like to have access to
Is there anything else you think we might be able to assist you with
AG should have an opportunity to ask any questions or clarify information. Resources should be offered by the nurse practitioner who can also put AG in contact with a social worker for further commendations.
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.
Coogle, C., & Owens, M. (2015). Screening and Brief Intervention for Alcohol Misuse in Older Adults: Training Outcomes Among Physicians and Other Healthcare Practitioners in Community-Based Settings. Community Mental Health Journal, 51(5), 546–553. https://doi-org.ezp.waldenulibrary.org/10.1007/s10597-014-9804-x
Hook, C. J., & Rose Markus, H. (2020). Health in the United States: Are Appeals to Choice and Personal Responsibility Making Americans Sick? Perspectives on Psychological Science, 15(3), 643–664. https://doi-org.ezp.waldenulibrary.org/10.1177/1745691619896252
Mullen, J. (2015). Living Longer Better: A Call to Action to Promote the Health of Older Adults and Their Communities. Journal of Public Health Management & Practice, 21(4), 410–412. https://doi-org.ezp.waldenulibrary.org/10.1097/PHH.0000000000000280
Murphy, E. R., & Eghaneyan, B. H. (2018). Understanding the Phenomenon of Older Adult Homelessness in North America: A Qualitative Interpretive Meta-Synthesis. British Journal of Social Work, 48(8), 2361–2380. https://doi-org.ezp.waldenulibrary.org/10.1093/bjsw/bcx163
O’Donnell, P., Tierney, E., O’Carroll, A., Nurse, D., & MacFarlane, A. (2016). Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study. International Journal for Equity in Health, 15(1), 197.
Tsai, J. (2018). Lifetime and 1-year prevalence of homelessness in the US population: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Journal of Public Health, 40(1), 65–74. https://doi-org.ezp.waldenulibrary.org/10.1093/pubmed/fdx034
In May 2012, Alice Randall authored an article for The New York Times discussing cultural factors that influence the body weight preferences of black women. Randall, drawing from her personal experience as a black woman, pointed out that many African-American communities view overweight women as more beautiful and desirable than those at a healthier weight, stating, “Many black women are fat because we want to be” (Randall, 2012).
Randall’s statements generated significant controversy and debate. Nevertheless, they underscore a fundamental reality in healthcare: diverse populations, cultures, and groups hold distinct beliefs and practices that affect their health. Nurses and healthcare professionals must acknowledge this reality and adjust their health assessment techniques and recommendations to accommodate this diversity.
In this Discussion, we will explore various socioeconomic, spiritual, lifestyle, and other cultural factors that should be considered when constructing a health history for patients with diverse backgrounds. Your Instructor has assigned a case study for this Discussion.
– Reflect on your nursing experiences and the information presented in this week’s Learning Resources concerning diversity issues in health assessments.
– By Day 1 of this week, your Instructor will assign you a specific case study. Please check the “Course Announcements” section for your case study assignment.
– Reflect on the particular socioeconomic, spiritual, lifestyle, and cultural factors related to the health of the assigned patient.
– Consider how you would build a health history for this patient. Develop five targeted questions that you would ask to construct the patient’s health history and assess their health risks, phrasing them in a manner sensitive to the patient’s background, lifestyle, and culture.
– Contemplate the challenges associated with communicating with patients from various populations. As a nurse, what strategies could you employ to be sensitive to different cultural factors while gathering pertinent information?
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Clarify the issues that require sensitivity when interacting with this patient and provide reasons for your choices. Finally, present at least five targeted questions you would ask the patient to build their health history and assess their health risks.
Note: For this Discussion, you must complete your initial post before you can view and respond to your colleagues’ posts. Start by clicking on the “Post to Discussion Question” link, then select “Create Thread” to compose your initial post. After submitting, you cannot edit or delete your own posts, and you cannot post anonymously.
Read a selection of your colleagues’ responses.
Respond on or before Day 6, on at least two separate days, to at least two colleagues who were assigned different patients. Critique your colleagues’ targeted questions and elucidate how the patient might interpret these inquiries. Discuss whether any of the questions would be applicable to your patient and provide reasoning for your response.
Case Study 2:
AG is a 54-year-old Caucasian male who was referred to the 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.
Socioeconomic factors affecting AG include homelessness, financial instability, and limited access to adequate healthcare. During the initial interview, I would assess his financial situation, his ability to secure stable long-term housing, and whether he has any family or social support. Additionally, I would inquire about any previous rehab experiences and his willingness to engage in inpatient rehab for stabilization and counseling to address his substance abuse issues (Cuevas & Whitney, 2019). It’s crucial to discuss his plans and the duration of his stay at the homeless shelter, as it is temporary, and long-term housing should be a part of his care plan (Manning & Greenwood, 2019).
AG’s perceived quality of life is influenced by his current lifestyle, including substance abuse and unstable housing. Being a 54-year-old Caucasian male, it’s essential to approach him with sensitivity to cultural differences to ensure effective communication. Considering his history of substance abuse and seizures, assessing his cognitive function is crucial. Sensitivity should be maintained when discussing his finances, income sources, access to healthcare, family relationships, and community ties. Additionally, inquiries about his religious or faith-based beliefs should be handled with respect and openness to accommodate his cultural preferences (Ball, Dains, Flynn, Solomon, & Stewart, 2019).
1. Can you provide me with a detailed medical history, including when you were first diagnosed with hypertension, and do you have any family history of cardiovascular disease?
2. Could you describe your substance use history, including the types of substances used, the duration of use, and any previous attempts to quit?
3. Have you experienced any previous hospitalizations, including any related to mental health concerns?
4. Can you tell me about your last employment and how long you were employed there?
5. Do you have any religious or spiritual beliefs that are important to you, and would you like them to be considered in your care plan?
AG should also be given an opportunity to ask questions or clarify any information. Offering resources and connecting him with a social worker for additional support and recommendations should be part of the care plan.
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.
Cuevas, R., & Whitney, G. (2019). Better Together: An Early Head Start Partnership Supporting Families in Recovery Experiencing Homelessness. ZERO TO THREE, 39(4), 29–34.
Manning, R. M., & Greenwood, R. M. (2019). Recovery in Homelessness: The Influence of Choice and Mastery on Physical Health, Psychiatric Symptoms, Alcohol and Drug Use, and Community Integration. Psychiatric Rehabilitation Journal, 42(2), 147–157. https://doi-org.ezp.waldenulibrary.org/10.1037/prj0000350
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