The patient I will interview is a 38-year-old Native American pregnant female living on a reservation. One very important part of building a good relationship with the patient is to build trust and help the patient feel comfortable to discuss anything she may need. It is important for me as the provider to have courtesy and build a connection with the patient (Ball, et al., 2019). Having kindness and building rapport with a patient is a great way for the patient to open up and for me to truly let the patient know they are valued and cared for 38-year-old native American pregnant female living on a reservation.
The approach I like best is the patient-centered approach. When this approach is used, patients are fully involved in their health care decisions. This is part of rapport building but also helps give the patient a feeling of autonomy, engagement, and control of their health (Bridges, et al., 2018). Health care is better when a patient feels respected and part of the decision process. Especially in this case of the pregnant Native American patient because when it comes to different cultures and when a patient is put first, their culture is not only acknowledged but included with sensitivity in their health care. The patient may have holistic care she would like to use or other cultural factors that I may not be fully aware of.
As this patient’s provider, I would first meet the patient and ask her to tell me about herself. I would ask questions about her family and her support group. I would see what support and resources she has. I would see if she had health insurance through the government and see if she was aware of the resources available to her. According to Kramer et al. (2009) many Native American women have health disparities and do not access all the benefits they could receive through Indian Health care Services. I would make sure she had information given to her in order to speak to someone to utilize the services she could receive 38-year-old native American pregnant female living on a reservation.
I would ask her about her familial history. Finding out about the patient’s risk is very important when assessing a pregnant female. When a provider can truly know the risks the patient may have and can talk about the perceived risks the patient may think they may have, then come to an agreeable level of risk, the baby’s health is positively associated with the congruence of knowledge (Cannella et al., 2013). It is important to truly know all the risk factors and perceived risk factors the patient may have. When the patient is given the time to talk and is not rushed, she may open up a bit more to me as her provider as well. It is important to be patient and to give the patient time to open up.
I would also feel it is part of my duty as a provider to ensure the patient has a safe place to live to ensure the baby gets good prenatal and postnatal care. The patient may not know the importance of eating healthy, taking prenatal vitamins, or about certain foods or drinks in a diet that are good or bad for her. It is important for the provider to make sure the patient knows their social determinants of health. Depending on the patient’s knowledge, she may not know about all the certain risks her culture, age, or health history may have in her pregnancy. According to Tesfalul et al. (2021) some providers do not tell the patients all their potential risks or determinants for health due to anxiety or knowing how to properly tell them 38-year-old native American pregnant female living on a reservation. I would find it my duty to learn about and help my patients know about their social determinants of health. Some things would be about diabetes, living conditions, or even age, as over 35 years is considered a geriatric pregnancy. It is my job to recognize the potential risks and let the patient know of them and assess and manage her healthcare according to her social determinants of health.
I would ask my patient is she felt at risk for her or her child’s wellbeing or safety. I would want to make sure she felt safe and free from violence, poverty, or even mental health. I also definitely would make sure my patient felt she had good support during her pregnancy. I would ask the following questions:
- Whom do you live with?
- Do you feel safe in your home?
- Was your pregnancy planned?
- Do you have a partner that supports you?
- Do you feel depressed or sad in any way?
- What more could I do for you regarding your pregnancy so you feel supported so you can have a safe and successful pregnancy?
In conclusion, I would want to make sure that my patient leaves the first appointment feeling safe, knowledgeable, and supported. I want her to know I care about her and want the best care for her. I also want her to know I will respect any cultural decisions she makes in her health care. It is also important she knows of potential risks if she does not have good health care while pregnant. I would want to make sure she takes her vitamins, has a healthy diet, feels safe in her environment, and takes the necessary tests since she is considered a geriatric pregnancy. I would make sure she leaves my office feeling aware and empowered in her health care supported during her pregnancy. It is important to know the patient’s history and also future plan and ensure she is making the best decisions possible for her to have a successful and healthy pregnancy 38-year-old native American pregnant female living on a reservation.
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.). Elsevier Mosby.
Bridges, J. F., Crossnohere, N. L., Schuster, A. L., Miller, J. A., Pastorini, C., & Aslakson, R. A. (2018). A patient and community-centered approach selecting endpoints for a randomized trial of a novel advance care planning tool. Patient Preference & Adherence, 12, 241–249. https://doi-org.ezp.waldenulibrary.org/10.2147/PPA.S150663
Cannella, D., Auerbach, M., & Lobel, M. (2013). Predicting birth outcomes: Together, mother and health care provider know best. Journal of Psychosomatic Research, 75(4), 299–304. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jpsychores.2013.08.004
Kramer, B. J., Jouldjian, S., Washington, D. L., Harker, J. O., Saliba, D., & Yano, E. M. (2009). Health care for American Indian and Alaska Native women. Women’s Health Issues, 19(2), 135–143. https://doi-org.ezp.waldenulibrary.org/10.1016/j.whi.2008.11.002
Tesfalul, M. A., Feuer, S. K., Castillo, E., Coleman-Phox, K., O’Leary, A., & Kuppermann, M. (2021). Patient and provider perspectives on preterm birth risk assessment and communication. Patient Education and Counseling. https://doi-org.ezp.waldenulibrary.org/10.1016/j.pec.2021.03.038 38-year-old native American pregnant female living on a reservation
Discussion: Building a Health History