NURS-6512N Diversity and Health Assessments Discussion

NURS-6512N Diversity and Health Assessments Discussion

By Day 3 of Week 2

In this discussion, I will provide an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient assigned. I will also explain the issues that I would need to be sensitive to when interacting with the patient and provide at least five targeted questions I would ask the patient to build his or her health history and to assess his or her health risks.

Case Study 1: John Green, 33 year-old Caucasian male

Socioeconomic, Spiritual, Lifestyle & Cultural Factors

John Green is a 33-year-old Caucasian male who identifies as male, although he was assigned female at birth. He underwent gender transition two years ago and has fully transitioned socially and within his family. Currently, he is unemployed and has been purchasing testosterone online for self-administration. He has a history of smoking heavily for the last 10 years, uses marijuana regularly, and experiences episodes of depression. John is HIV positive but has maintained viral suppression. He is also concerned about his recent weakness and has moved back home with his parents.

Sensitive Issues

When interacting with John, it is crucial to be sensitive to several factors. Firstly, his gender transition and identification as a transgender man should be respected, and he should be addressed using his preferred pronouns. Avoiding any judgment or discrimination related to his gender identity is essential to create a safe and trusting environment.

Secondly, John’s use of online-purchased testosterone is a matter of concern. Sensitivity should be exercised to educate him about the potential risks of self-administration, including dosage, sterility, and health monitoring. It is important not to judge his choice but rather provide him with accurate information to ensure his safety.

Thirdly, his history of smoking, marijuana use, and depression episodes indicate potential health risks. While discussing these, it is crucial to approach with empathy and non-judgment, as these behaviors may be linked to coping mechanisms or other underlying issues. Offering support and guidance for smoking cessation and mental health should be done in a non-confrontational manner.

Fourthly, John’s HIV status requires sensitive handling. It is important to ensure he is adhering to his treatment regimen and is aware of the importance of regular medical follow-ups. Privacy and confidentiality regarding his HIV status should always be maintained.

NRNP-6665 Comprehensive Integrated Psychiatric Assessment Discussion Example

Lastly, his recent move back home and concerns about being a burden on his family and declining health suggest emotional distress. Sensitivity to his emotional well-being is crucial, and open discussions about his feelings, fears, and support systems should be encouraged.

Target Questions: Health History & Health Risks

1. How has your transition been for you socially and emotionally? Are there any challenges or successes you’d like to discuss?
2. Can you describe your experiences with self-administering testosterone? Have you encountered any issues or concerns related to this?
3. Smoking and marijuana use can have health impacts. Can you share more about your smoking habits and how marijuana fits into your lifestyle?
4. You mentioned episodes of depression. Can you tell me more about when these occur and how they affect you?
5. Regarding your HIV management, can you describe your medication routine and any recent changes or concerns?

Conclusion

Interacting with patients like John Green requires cultural competence, sensitivity, and a patient-centered approach. By respecting his gender identity, addressing his health risks without judgment, and providing support for emotional well-being, healthcare providers can build trust and facilitate comprehensive care.

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.

Centers for Disease Control and Prevention. (2020). Cultural competence in health and human services. https://npin.cdc.gov/pages/cultural-competence.

Kirubarajan, A., Patel, P., Leung, S., Park, B., & Sierra, S. (2021). Cultural competence in fertility care for lesbian, gay, bisexual, transgender, and queer people: a systematic review of patient and provider perspectives. Fertility and Sterility, 115(5), 1294–1301. https://doi.org/10.1016/j.fertnstert.2020.12.002.

NURS-6512N DIVERSITY AND HEALTH ASSESSMENTS DISCUSSION  response

Thank you for your feedback and kind words! I appreciate your insights into the importance of open and respectful communication when caring for transgender patients. It’s essential to create an environment where patients feel comfortable discussing their experiences, challenges, and emotions related to their transition. Your reference to Vermeir et al. (2018) highlights the significance of sensitive questioning and fostering a therapeutic relationship.

I completely agree that framing questions in a way that encourages patients to express themselves fully and without judgment is crucial, especially when addressing mental health concerns. Transgender individuals can face unique stressors and mental health challenges, as you mentioned. By asking open-ended questions about their mood and feelings, healthcare providers can gain a more comprehensive understanding of their emotional well-being.

I’m glad you found the selection of questions valuable for obtaining a strong health history for transgender patients. Your feedback reinforces the importance of patient-centered and culturally sensitive care in addressing the diverse needs of individuals within the transgender community.

Thank you again for your thoughtful response!

References

Shires, D. A., Stroumsa, D., Jaffee, K. D., & Woodford, M. (2018). Primary care providers’ willingness to continue gender-affirming hormone therapy for transgender patients. Family Practice, 35(5), 576–581. https://doi.org/10.1093/fampra/cmx119Links to an external site.

Vermeir, E., Jackson, L. A., & Marshall, E. G. (2018). Improving Healthcare Providers’ Interactions with Trans Patients: Recommendations to Promote Cultural Competence. Healthcare Policy, 14(1), 11–18. https://doi.org/10.12927/hcpol.2018.25552Links to an external site.