Assignment Cultural Competence Skills: Adherence Essay
Assignment Cultural Competence Skills: Adherence Essay
Communication Steps and Cultural Aspects to Consider
Patient care outcomes greatly depend on successful communication between the healthcare provider and the patient. In the provided case scenario, it is important to inform the patient on the importance of abiding strictly to the prescribed drug regiment for a desirable outcome. However, given that the patient is a non-English speaker, effective communication can only be achieved through a translator or a family member, of which the latter is applicable in this case (Constantinou, Papageorgiou, Samoutis, & McCrorie, 2018). I will take the following steps in communicating with the patient regarding the importance of taking antihypertensive medications (Gasiorek & van, 2018):
- Set the stage and mood for the interview: This will take about 30 to 60 seconds. I will start by welcoming the patient together with the family member, by using the name written on the patient’s report sheet. I will then introduce myself and the role that I play. To make the patient ready, I will try to make them comfortable by allowing them to sit down and ease up.
- Elicit the main concern for the visit: I will then approximate the amount of time that I have with the patient, forecast on what will happen through the interview, obtain a list of all the issues that I would like to communicate with the patient and make a summary.
- Start the interview with non-focusing skills to allow the patient to express herself through the family member for about 1 to 2 minutes: I will begin by asking an open-ended question together with non-focusing open-ended skills such as attentive listening.
- Employ focusing skills to learn three main things, the symptom story, personal and emotional context for about 3 to 10 minutes: I will provoke stories about the symptoms of the side effects, the patients personal context and emotional context, and respond appropriately to her emotions to show empathy, and expand the story for further understanding.
- Transition to the middle of the communication for about 2 to 3 minutes: I will give the patient a brief summary of the reasons why she was prescribed the specific drugs, the common side effects, how to control those side effects, alternative medications, and their side effects, and what will happen if she stops taking the drugs.
- Show appreciation for her cooperation.
When dealing with patients from diverse cultural backgrounds, it is usually important to understand certain aspects such as informed consent and full disclosure. For instance, the patient might have presented to the clinic with a family member but does not want the family member to have a full understanding of their healthcare complication and prognosis (Tucker et al., 2015). In some other cases, the patient might not want to be aware of the seriousness of their health condition expecting to leave the burden and related decisions
to their family members. Other cultures, such as the Indians might fail to take medication due to symptoms such as pain, because of their cultural believes in divine interventions and spiritual healing (Alizadeh, & Chavan, 2016). Consequently, communicating to patients from different cultures such as the Indians also needs the physician to understand their communication skills, based on their cultural aspects such as the characteristic of promoting social distance and closeness of the relationship. For instance, Indians have hierarchical respect for people with higher social status and elders and hence may tend to be silent during the conversation, preventing them from fulling explaining or giving their actual feeling about a situation (Kang et al., 2016). Consequently, when looking at the closeness of relationships, most Indian who strongly believe in their culture are used to traditional medicine which might make it hard to convince them about the importance of conventional drugs.
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Nurse: Hi, is it (patient’s name)?
Nurse: Welcome, have a seat. My name is ______. I am a registered nurse practitioner. I will be helping you today. What seems to be the problem?
Patient: I have been taking the drugs that I was given for my hypertension, but they are making me feel sick. I stopped taking them.
Nurse: How do they make you feel?
Patient: Sometimes I feel nauseated and even vomit, sometimes I feel weak and tired, sometimes I am constipated while other times I experience diarrhea. Sometimes when I am at work, I feel dizzy and lightheaded. I just don’t want to take them anymore.
Nurse: How often do you experience those symptoms?
Patient: Mostly midday, that is for the drugs that I take in the morning. But not every day.
Nurse: What about your condition, do you feel like the drugs are properly managing your hypertension?
Patient: I feel better, and my blood pressure is fine, except for the side effects.
Nurse: It seems like you are tolerant of the prescribed medication for your hypertension. However, a reduction in blood pressure is associated with other adverse effects on glucose homeostasis and among other body normal processes. In line with that, most patients will normally complain of common side effects, just like the ones you have mentioned in addition to headache among others. Some of these symptoms can be managed using OTD, or home-based remedies recommended by a medical practitioner. However, it is very important that you continue taking your drugs so as to benefit from them maximumly. Since hypertension is lifelong, most of those side effects will disappear with time as the body adapts to the medication. Are there any questions regarding the medication that you would like to know?
Patient: What about when the symptoms worsen?
Nurse: There are minimal possibilities of that happening. However, in the case of worsened side effects, or adverse symptoms, seek medical attention immediately.
Patient: I will keep that in mind.
Nurse: In case of other queries before your next visit, don’t hesitate to call. Otherwise, I appreciate your visit and thank you for your cooperation. Have a good day.
Patient: Thank you.
Identification of Needed Resources
Due to the communication and cultural barriers, the patient requires additional education and support resources to help her realize the importance of taking medication to control her hypertensive health condition (Constantinou, Papageorgiou, Samoutis, & McCrorie, 2018). Some of the necessary resources in central Florida that might help the patient are listed in the table below:
|American Heart Association||237 E Marks St, Orlando, FL 32803, USA||+1 407-481-6300||https://www.heart.org/en/affiliates/florida/orlando||To help the patient with healthy living skills for patients with cardiovascular diseases such as hypertension.|
|Central Florida Stroke Club||601 E Rollins St
Orlando, Florida 32804
|(407) 303-5600 x1104589
|To listen to stories from stroke survivors to be able to comprehend the importance of taking medication.|
|Pulmonary Hypertension Association||801 Roeder Road, Ste. 1000
Silver Spring, MD 20910
|https://phassociation.org/pulmonary-hypertension-community-raises-crucial-funds-in-2018-to-support-phas-mission/south-florida/||To support people living with hypertension, and inform them on how they can improve their quality of life.|
You are assigned to a clinic in which a non-English speaking client communicates through a family member. She is complaining about her current hypertension medication. During the last visit to your clinic, this client was prescribed the medication by the doctor, but the client does not like the side effects the medication caused and stopped taking it.
In a 3 page Word document, explain what steps you would take to communicate the importance of taking the medication to this client through her family.
In your explanation, include a script of your dialogue about her lack of adherence to the medication. Also include what other resources you might need to ensure you are effectively communicating.
1. Steps to communicate the importance of the medication (How would you communicate this information?) Use Vietnamese, Indian or Haitian cultures. What are cultural aspects to consider? (in text citation required)
2. Script of dialogue (Include a script of dialogue in which you interact with the patient about her noncompliance with the doctor\\\’s original orders) (in text citation required)
3. Identification of needed resources (Minimum of three, include name, address, phone, web address, purpose) What resources in your community- Central Florida- would assist the client in the scenario provided? If this were your client in Central Florida what resources would you provide? (in text citation required)
*Use APA level 1 headings
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