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). NURS 6512 Diversity and Health Assessments Discussion Post
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.
- 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. NURS 6512 Diversity and Health Assessments Discussion Post
- 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. NURS 6512 Diversity and Health Assessments Discussion Post
Excellent post. Working detox for the past several years, I agree with you regarding the stigma of addiction and the lack of discrimination addiction carries. I have seen people struggle with addictions in various socioeconomic, race, and age groups; which makes it important to determine the individual’s needs to provide effective holistic patient-centered care.
Your assessment questions were great for this patient, I feel they will help in developing an accurate profile history.
1.)”Is there any family history of addiction including drugs or alcohol, and if so who and what type of addiction?”
I feel this is an excellent leading question regarding the patient’s history of family addiction, the patient may interpret this question as being an inquiry on genetics and/or learned behaviors.
2.) “What resources are you currently connected with to support your desire to abstain from drugs and alcohol, and do you feel they are beneficial and enough support for you?”
This is a great question to determine the patient’s needs. Recent evidence suggests using a tool called Brief Interventions (BI) for assessing a patient regarding substance use, motivation, and options tailored to the patient (Alexander, 2016).This intervention used to engage the individual and increase their understanding of risks and problems related to substance use, and motivate change (Alexander, 2016).
Brief Intervention Steps:
Step 1. Build rapport; getting to know the patient (Alexander, 2016).
Step 2. Inquire; What substances do you use? Consumption use? Is there anything you want to change about this habit? (Alexander, 2016)
Step 3. Determine where the individual is in the “stages of change” (Alexander, 2016).
Stage 1: Pre-contemplation- The patient has not considered or is unwilling to change and the provider is to educate and raise awareness (Alexander, 2016).
Stage 2: Contemplation- The patient considered change with uncertainty/ambivalence and the provider is to aid in resolving the patient’s hesitations (Alexander, 2016). NURS 6512 Diversity and Health Assessments Discussion Post
Stage 3: Determination- The patient is considering how to implement change and the provider aids in strategizing (Alexander, 2016).
Stage 4: Action: The patient begins to make changes, but needs help in process stabilization; the provider aids in implementation strategies and relapse reduction (Alexander, 2016).
Stage 5: Maintenance- The patient has reached their substance abstinence goal and continues to work on maintaining goals; the provider continues to support in positive feedback (Alexander, 2016).
Stage 6: Recurrence- The patient and provider work through the consequences (Alexander, 2016) NURS 6512 Diversity and Health Assessments Discussion Post.
Step 4: Keep track of the patient’s current stage and advice given and follow up, providing support and positive reinforcement (Alexander, 2016).
3.) “Do you feel your current group of friends and/or family help to support your desire to abstain or do you feel that the current situation you are in will only hinder from abstinence?”
This question is excellent in regard to determining the risk of relapse.
4.) “Are you experiencing any feelings of being down or depressed or any thoughts of hurting yourself or others?”
This is an important factor, especially since many of those with substance abuse disorders tend to have multiple mental health diagnoses.
5.) How long have you been out of your medication, and what barriers do you have to being able to refill and follow up with a primary provider?
Patient AG has a history of hypertension and is currently homeless, this is a vital question due to this comorbidity and can aid in future care.
NURS 6512 Diversity and Health Assessments Discussion Post Another topic I would also like to bring up is smoking cessation. Although he is in a stressful situation, this can be considered a teachable moment. Smoking cessation counseling tends to be placed on the backburning in various medical settings, however, education and various intervention strategies should be offered (Buchbinder et al., 2014).
Alexander, K. (2016). Brief interventions for clients with drug and alcohol issues. Journal of the Australian Traditional-Medicine Society, 22(1), 27–29. https://doi.org/https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=5&sid=60d70174-c64a-4cf2-b335-b95ed66582bb%40sdc-v-sessmgr02
Buchbinder, M., Wilbur, R., Zuskov, D., McLean, S., & Sleath, B. (2014). Teachable moments and missed opportunities for smoking cessation counseling in a hospital emergency department: A mixed-methods study of patient-provider communication. BMC Health Services Research, 14(1). https://doi.org/10.1186/s12913-014-0651-9 NURS 6512 Diversity and Health Assessments Discussion Post