Table of Contents
NURS 6512 Building a Comprehensive Health History Discussion Paper Example
NURS 6512 Building a Comprehensive Health History Discussion Assignment
NURS 6512 Building a Comprehensive Health History Discussion Assignment Brief
Course: NURS 6512 – Advanced Health Assessment and Diagnostic Reasoning
Assignment Title: NURS 6512 Building a Comprehensive Health History Discussion Assignment
Assignment Instructions Overview
Effective communication is vital for constructing an accurate and detailed patient history. Various factors, including age, gender, ethnicity, and environmental setting, significantly influence a patient’s health or illness. Advanced practice nurses must tailor their communication techniques to these factors to establish rapport and effectively gather information. This discussion involves building a health history for a newly assigned patient, considering their unique characteristics and health risks.
Understanding Assignment Objectives
The primary objective of this assignment is to develop skills in collecting comprehensive health histories through effective communication. This involves understanding the importance of individualized communication strategies that address the specific needs of patients based on their demographic and environmental contexts. The assignment also aims to enhance the ability to utilize appropriate risk assessment tools and identify potential health-related risks.
Competencies Measured
This assignment measures competencies in several key areas:
- Communication Skills: Demonstrates the ability to tailor interview techniques to individual patient needs.
- Cultural Competency: Shows awareness and integration of the patient’s cultural, ethnic, and socioeconomic background into the health history.
- Risk Assessment: Proficient in identifying and utilizing appropriate risk assessment instruments.
- Critical Thinking: Develops targeted questions that effectively probe health risks and concerns.
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NURS 6512 Building a Comprehensive Health History Discussion Paper Example
Building a Comprehensive Health History for a 38-Year-Old Native American Pregnant Female
Effective communication skills are crucial for obtaining an accurate and comprehensive health history from patients. These skills not only foster a positive patient-provider relationship but also ensure higher patient satisfaction and compliance (Berman & Chutka, 2016). According to Berman and Chutka (2016), patients often express dissatisfaction with healthcare providers who do not listen attentively. Communication encompasses not only verbal exchanges but also active listening and nonverbal cues, such as facial expressions, nodding, and body posture, which convey empathy and support (Hashim, 2017). This discussion will focus on the specific techniques and considerations necessary for interviewing a 38-year-old Native American pregnant female living on a reservation.
Communication Techniques with Rationale
The interview with this patient must prioritize cultural competence and sensitivity. Native American communities often face significant health disparities, unemployment, and overcrowded living conditions, which impact overall health and access to care (Native American Aid, 2015). Understanding the patient’s cultural background is essential for building trust and ensuring effective communication. The healthcare provider must use language and literacy levels appropriate for the patient and ensure the availability of professional interpreter services if necessary. This approach will help in gathering comprehensive information regarding the patient’s medical history, family health history, and environmental and behavioral risk factors (Sullivan, 2019).
Selected Risk Assessment Instrument with Rationale
In this scenario, the HEEADSSS screening tool is particularly appropriate for assessing the patient’s health risks. The HEEADSSS interview framework evaluates the home environment, education and employment, eating habits, peer-related activities, drug use, sexuality, mental health (suicide/depression), and safety from injury and violence (Klein, Goldenring, & Adelman, 2015). Given the higher prevalence of substance use and mental health issues in Native American communities (Park-Lee, Lipari, Bose, & Hughes, 2018), this tool is effective in identifying potential health threats to both the mother and her unborn child.
The following targeted questions are designed to assess the health risks of the patient and begin building a comprehensive health history:
- Is this your first pregnancy?
- How are you feeling about being pregnant?
- When was your last menstrual cycle?
- When was the last time you consumed alcohol or used illicit drugs?
- Do you have any existing health problems or medical conditions?
Introducing oneself to the patient and any accompanying individuals is the first step in the interview. Addressing the patient by their preferred name and ensuring that the consultation is not rushed are essential for building rapport and trust (Berman & Chutka, 2016). The healthcare provider must maintain consistent eye contact and use nonverbal communication effectively to demonstrate interest and empathy (Hashim, 2017). Open-ended questions will facilitate understanding of the patient’s perspective and provide opportunities for the patient to express concerns (Hashim, 2017).
In addition to verbal communication, the provider must be aware of the patient’s unspoken issues and gently probe when necessary. The “ask-tell-ask” approach is recommended to avoid overwhelming the patient with information and to ensure they understand the information provided (Berman & Chutka, 2016). Proper closure of the interview, with an invitation for the patient to ask additional questions, is important to address any lingering concerns (Hashim, 2017).
In summary, building a comprehensive health history for a 38-year-old Native American pregnant female requires cultural competence, effective communication skills, and appropriate use of risk assessment tools. The HEEADSSS screening tool is particularly useful for identifying health risks in this context. Through a combination of verbal and nonverbal communication techniques, the healthcare provider can gather the necessary information to ensure the patient’s health and well-being.
References
Berman, A. C., & Chutka, D. S. (2016). Assessing effective physician-patient communication skills: “Are you listening to me, doc?” Mayo Clinic Proceedings, 91(2), 173-181.
Hashim, M. J. (2017). Patient-centered communication: Basic skills. American Family Physician, 95(1), 29-34.
Klein, D. A., Goldenring, J. M., & Adelman, W. P. (2015). HEEADSSS 3.0: The psychosocial interview for adolescents updated for a new century fueled by media. Contemporary Pediatrics, 32(1), 16-28.
Native American Aid. (2015). Living conditions. Retrieved June 2, 2020, from http://www.nativepartnership.org/site/PageServer?pagename=naa_livingconditions
Park-Lee, E., Lipari, R. N., Bose, J., & Hughes, A. (2018). Substance use and mental health issues among U.S.-born American Indians or Alaska natives residing on and off tribal lands. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/DRAIANTribalAreas2018/DRAIANTribalAreas2018.pdf
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.
Response to Colleague 1: Interview Techniques and Health Risks for an Adolescent Hispanic Male
The approach to constructing a comprehensive health history for an adolescent Hispanic male demonstrates a thorough understanding of culturally sensitive communication. Enhancing this strategy with additional interview and communication techniques may further improve patient outcomes.
Additional Interview and Communication Techniques
Implementing motivational interviewing can significantly engage adolescents in identifying their motivations for behavior change, which is crucial for addressing issues like substance use or risky behaviors (Miller & Rollnick, 2013). Additionally, involving family members in the interview process, with the adolescent’s consent, aligns with the cultural significance of family in decision-making within Hispanic communities (Cabassa, 2010). Utilizing visual aids such as diagrams, charts, or videos to explain medical concepts can enhance understanding and retention, particularly for discussing complex issues like sexual health or substance abuse.
Additional Health-Related Risks
Identifying potential mental health issues is vital, given the higher risk for depression and anxiety among Hispanic adolescents, often linked to acculturation stress and discrimination (Lorenzo-Blanco et al., 2012). Moreover, the increased risk of obesity and type 2 diabetes within this demographic necessitates inquiries about dietary habits, physical activity, and family history of these conditions (Cruz, 2019).
References
Cabassa, L. J. (2010). Latino immigrant men’s perceptions of depression and attitudes toward help seeking. Hispanic Journal of Behavioral Sciences, 32(3), 345-363.
Cruz, M. L. (2019). The increasing prevalence of obesity and diabetes among Hispanics in the United States. Journal of Health Disparities Research and Practice, 12(2), 82-90.
Lorenzo-Blanco, E. I., Unger, J. B., Oshri, A., Baezconde-Garbanati, L., & Soto, D. (2012). Acculturation, enculturation, and symptoms of depression in Hispanic youth: The roles of gender, Hispanic cultural values, and family functioning. Journal of Youth and Adolescence, 41(10), 1350-1365.
Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.
Response to Colleague 2: Interview Techniques and Health Risks for an Elderly African American Male with Cardiovascular Disease
The outlined strategies for interviewing an elderly African American male with cardiovascular disease are effective. Expanding on these techniques and considering additional health risks will enhance patient care.
Additional Interview and Communication Techniques
Using the teach-back method ensures the patient comprehends the provided information by having them repeat it in their own words, which is particularly important for managing chronic conditions like cardiovascular disease (Schillinger et al., 2003). Addressing cultural health beliefs helps tailor care plans to be more acceptable and effective, considering some African American patients might use home remedies or have specific dietary practices impacting cardiovascular health (Mayo Clinic, 2020). Engaging the patient’s social support systems, such as family, friends, or community organizations, improves adherence to treatment plans, especially for elderly patients who might struggle with isolation or transportation to appointments (Berkman et al., 2000).
Additional Health-Related Risks
Given the higher prevalence of hypertension among African American males, hypertension management through regular monitoring and adherence to antihypertensive medications is crucial (Lackland, 2014). Additionally, due to the increased risk for chronic kidney disease associated with hypertension and diabetes, regular screening for kidney function should be prioritized (Norris & Agodoa, 2005). Addressing medication adherence challenges, often due to polypharmacy, side effects, or cognitive decline, can be managed through strategies like simplifying medication regimens or using pill organizers (Krousel-Wood et al., 2004).
References
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51(6), 843-857.
Krousel-Wood, M., Thomas, S., Muntner, P., & Morisky, D. (2004). Medication adherence: A key factor in achieving blood pressure control and good clinical outcomes in hypertensive patients. Current Opinion in Cardiology, 19(4), 357-362.
Lackland, D. T. (2014). Racial differences in hypertension: Implications for high blood pressure management. American Journal of the Medical Sciences, 348(2), 135-138.
Mayo Clinic. (2020). Cardiovascular disease in African Americans. Retrieved from https://www.mayoclinic.org
Norris, K., & Agodoa, L. (2005). Unraveling the racial disparities associated with kidney disease. Kidney International, 68(3), 914-924.
Schillinger, D., Piette, J., Grumbach, K., Wang, F., Wilson, C., Daher, C., … & Bindman, A. B. (2003). Closing the loop: Physician communication with diabetic patients who have low health literacy. Archives of Internal Medicine, 163(1), 83-90.
Detailed Assessment Instructions for the NURS 6512 Building a Comprehensive Health History Discussion Assignment
Discussion: Building a Health History
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
Photo Credit: Sam Edwards / Caiaimage / Getty Images
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
- By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
- How would your communication and interview techniques for building a health history differ with each patient?
- How might you target your questions for building a health history based on the patient’s social determinants of health?
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
- Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
- Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history Building a Health History NURS 6512 week 1 Discussion Post.
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
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 1
Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:
- Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
- Suggest additional health-related risks that might be considered.
- Validate an idea with your own experience and additional research.
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