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Diversity and Health Assessments

Diversity and Health Assessments

Nursing care is an important aspect of every patient’s health outcomes. However, several health determinants have to be considered during nursing care provided to a patient (Singh et al., 2017). Some of these factors vary from social factors, cultural factors, lifestyle, economic factors, and spiritual factors. When the mentioned health determinants are put into consideration during patient treatment, a good diagnosis is made during the assessment, appropriate interventions are developed, and a better prognosis is seen as the patient continues with treatment.

Socioeconomic factors that influence the treatment of AG in the case study given include poverty (Walter & Saggers, 2020). Lack of enough funds to afford healthcare services has a negative health impact on a patient. Due to a lack of enough funds, they are unable to pay for their medical insurance that can cover their drugs. They are likely to receive preventive care services such as vaccination against communicable diseases. Even if AG can afford healthcare, access to quality healthcare is also a limitation. Therefore, poverty contributes largely to one’s health as a patient. Economic stability is also noted in this case study. The patient cannot afford to pay for a shelter. That means, upon discharge from the clinic, he has nowhere to go. To add on, he has no family to take care of him in case of a seizure reoccurrence. Therefore, even if he is discharged, he is likely to develop mental health problems such as mental depression and seek comfort in taking alcohol again. Drinking alcohol for his case worsens his situation. He is likely to hurt himself more when he develops seizures and could develop hepatic toxicity leading to liver failure.

The other social health determinants include lifestyle factors (Graham & White, 2016). AG is an alcohol addict who is battling addiction. He is a cigarette smoker, uses cocaine, and lives with high blood pressure. However, he is currently on amlodipine to manage his hypertensive state. Even though he is under medication, some complications can arise with the use of drugs, cigarette smoking, and alcoholism. The effectiveness of the amlodipine medication is likely to be reduced, and the body is developing resistance to this drug. The patient is also likely to experience withdrawal symptoms that can trigger seizure reoccurrence. Therefore, he needs close monitoring for quite some time. Alcohol consumption reduces drug metabolism. Therefore, the dosages of drugs can cause systemic toxicity, worsening the state of the patient. Since AG is a cigarette smoker, he is likely to develop respiratory complications. Staining of the lungs may lead to lung atelectasis since capillary perfusion has been interfered with. Therefore, during the assessment, it is important to note how long the patient has been smoking cigarettes and how many bags. During management, it is also important that a nurse monitors respiratory vital signs.

The psychological factor is another sociocultural health determinant (Martino et al., 2019). Mental stability plays a role in one’s health. For AG to calm down, he has to smoke a cigarette. This shows an aspect of mental instability. AG needs support from his family members, friends, and nurses. Therefore, the interpersonal relationship between nurses and their patients is important. The two issues that need sensitivity in this patient include family history and socioeconomic history. He could be a victim of a divorced marriage or an accident incident. This is seen in his reaction to the situation, such as cigarette smoking to calm down. Family history is considered sensitive and more confidential.

The five targeted questions to help assess his health risks include:

  1. How many packets of cigarettes do you smoke to calm you down?
  2. Does the drug you use (amlodipine) still reduce your high blood pressure?
  3. How often do you use cocaine?
  4. How do you manage seizures when alone?
  5. Do you experience any withdrawal symptoms?

References

Graham, H., & White, P. C. L. (2016). Social determinants and lifestyles: integrating environmental and public health perspectives. Public health141, 270-278. https://doi.org/10.1016/j.puhe.2016.09.019

Martino, G., Langher, V., Cazzato, V., & Vicario, C. M. (2019). Psychological factors as determinants of medical conditions. Frontiers in psychology10, 2502. https://doi.org/10.3389/fpsyg.2019.02502

Singh, G. K., Daus, G. P., Allender, M., Ramey, C. T., Martin, E. K., Perry, C., … & Vedamuthu, I. P. (2017). Social determinants of health in the United States: addressing major health inequality trends for the nation, 1935-2016. International Journal of MCH and AIDS6(2), 139. https://dx.doi.org/10.21106%2Fijma.236

Walter, M., & Saggers, S. (2020). Poverty and social class. In Social determinants of Indigenous health (pp. 87-107). Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9781003117247-5/poverty-social-class-maggie-walter-sherry-saggers

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Question 


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).

Photo Credit: Getty Images

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.

To prepare:

Diversity and Health Assessments

Diversity and Health Assessments

  • 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.
  • 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 (These three questions are the discussion questions)

  1. an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned.
  2. Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
  3. 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.
CASE STUDY: 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.

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