NURS 6512 Building a Health History
Sample Answer for NURS 6512 Building a Health History Included After Question
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.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To prepare:
With the information presented in Chapter 2 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 2 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.
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 Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
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
A Sample Answer For the Assignment: NURS 6512 Building a Health History
Title: NURS 6512 Building a Health History
Health risk assessment is an important component in nursing practice. Health risk assessment enables nurses to identify the factors contributing to a patient’s health problem alongside the associated risks. The information for health risk assessment is obtained when performing a comprehensive health history taking from the patients. Health history taking entails the use of both subjective and objective assessments to understand the experiences of a patient with a disease. Subjective assessment entails the information that the patient gives concerning the condition while the nurse obtains objective data through further clinical investigations (Ball et al., 2019).
Effective interviewing techniques are important in obtaining the information that is needed from the 76-year-old black male with disabilities living in an urban setting. One of the interviewing techniques that I will use in obtaining information from the client is the use of open-ended questions. I will use open-ended structured questions to enable the patient to provide detailed information concerning his health problem. Open-ended questions will also enable the identification of additional factors that influence the experiences of the patient with the disease. The other approach to interviewing the patient that I will embrace will be asking questions that are specific to the condition of the patient. The questions that are asked should relate to the presenting complaint of the patient to ensure that adequate and objective information related to the health problem is achieved as possible. The other interviewing technique that I will embrace in the assessment of the patient in the case study is promoting privacy during the assessment. I will ensure that the environment where the assessment takes place is free from interruptions (Slade & Sergent, 2021). Privacy is important in the assessment process, as it builds the confidence in the patient.
The use of effective communication techniques will also be important in obtaining relevant information related to the disease from the patient. I will utilize a number of communication techniques in the process. One of the communication techniques will be active listening. Active listening enables the acquisition of information related to the critical issues that affect the disease process. I will also establish rapport to build confidence in the patient. Building rapport also sets the tone of the interview alongside promoting honesty in communication with the patient. The other communication technique that I will use in patient assessment is empathy. Empathy is a communication technique where the nurse places himself in the situation of the patient. Empathy is important in history taking and patient assessment because it allows the patient to feel that the nurse understands his experiences, thereby openness and honesty in his self-expression (Ball et al., 2019). Therefore, the effective use of the above communication techniques will enable the acquisition of accurate data that relates to the patient’s health status.
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An effective tool that can be used in assessing the patient in the case study is pain-rating scale. The pain rating scale can be used to assess the subjective pain rating of the patient to determine the interventions that should be embraced. The following is a category of questions that I will ask the patient with the aim of understanding his health problem.
- Please tell me what brings you to the hospital today?
- How long have you had the problem?
- Can you describe the characteristics of the problem such as location, relieving factors and precipitating factors?
- What are some of your values and beliefs that I should be aware of when planning the plan of care for your health problem?
- Do you think you have adequate support in your family and society that will enable you to manage the disease effectively?
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Physical Examination Handbook: An Interprofessional Approach. Elsevier.
Slade, S., & Sergent, S. R. (2021). Interview Techniques. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK526083/
A Sample Answer 2 For the Assignment: NURS 6512 Building a Health History
Title: NURS 6512 Building a Health History
For this discussion, I was assigned case E, the adolescent Hispanic/Latino boy living in a middle-class suburb. Initially, the Provider
should confirm that the patient speaks English; if not, appropriate accommodations should be made for an interpreter. Communication and interviews for building a health history with the adolescent population should be performed with respect, confidentiality, and flexibility (Ball et al., 2019). If a parent or guardian accompanies them, they should be informed at the beginning of the appointment that they may be asked to step out. This allows the patient to discuss concerns privately (Ball et al., 2019). It will also enable them to build trust with their Provider and discuss sensitive issues they may not feel comfortable telling their parents about (Ball et al., 2019). It should be made clear that there are limitations to confidentiality, which may be broken if there are safety concerns (Ball et al., 2019).
Pre-visit questionnaires are a helpful tool that may be used to gather chief concerns by allowing the patient to write them down and then give them to the Provider (Ball et al., 2019). This may help with any concerns or questions the adolescent may find embarrassing or shameful.
The Provider should use open-ended questions to build the adolescent’s health history. Understanding the patient’s living situation, school activities, employment, and social environment are vital to evaluate areas that may identify risky behaviors. Concerning this patient’s Hispanic/latino ethnicity, it is essential for the Provider to understand his cultural beliefs, values, and characteristics (Murray et al., 2022). It is also important not to assume that this patient has the cultural views that are stereotyped as Hispanic/Latino. The Provider must demonstrate cultural humility and display and genuine interest in understanding their belief system (Ball et al., 2019). There is an increased risk of suicide among Hispanic/Latino adolescents due to cognitive and emotional vulnerabilities, difficulty coping, social disconnection, and acquired ability to perform (Murray et al., 2022).
The risk assessment instrument applicable to this patient population is HEEADSSS. This instrument addresses the significant areas for risks for adolescents, including home environment, education, employment, eating, activities, drugs, sexuality, suicide/depression, and safety (Ball et al., 2019). This technique is initiated with open-ended, nonjudgmental questions and advances to more sensitive topics such as sexuality, depression, and thoughts of suicide (Sacks & Westwood, 2003).
According to Sacks & Westwood (2003), some target questions that a Provider should ask:
How are things at home? Tell me about your living situation. Do you feel safe at home? How is school? Tell me about your friends. Do you do outside-of-school activities? Do you work? How is your diet? Are you happy with your appearance? Have you ever tried any drugs? Are you dating? Are you sexually active? Have you ever been a victim of violence? Do you feel more down than happy? Have you ever thought of hurting yourself?
Each answer may transition into another discussion giving a clearer picture of the patient’s life and health history (Sacks & Westwood, 2003).
Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination: An interprofessional approach. Elsevier.
Murray, T., Roges, E., & Henry, M. (2022, July 28). Using cuento to support the behavioral health needs of Hispanic/latinos. SAMHSA. https://www.samhsa.gov/blog/using-cuento-support-behavioral-health-needs-hispanic-latinos
Sacks, D., & Westwood, M. (2003). An approach to interviewing adolescents. Paediatrics & Child Health, 8(9), 554–556. https://doi.org/10.1093/pch/8.9.554
A Sample Answer 3 For the Assignment: NURS 6512 Building a Health History
Title: NURS 6512 Building a Health History
Your case was quite an interesting one to research. Omenka, Watson, and Hendrie (2020) conducted a scoping review of African immigrants’ health disparities. Scoping studies are a type of research to identify available evidence or gaps on a subject of interest (Munn et al., n.d.). With that said, Omenka, Watson, and Hendrie (2020) found little research has been specifically conducted on African immigrants; instead, the researchers found African immigrants were being grouped in research studies conducted on African Americans. On that note, I find it important to differentiate the health and spiritual beliefs of both cultures so that, as clinicians, we can provide culturally competent care.
I agree with your statement on creating a safe zone for the patient before conducting sexual history assessment; this will build trust and the patient will be willing to openly share personal health history. According to Omenka, Watson, and Hendrie (2020), African immigrants view HIV as a spiritual problem and are more likely to seek medical attention when a disease is in its advanced stages. Hence, the importance of early intervention is important.
Additional interview questions that may be of value in this situation may be to ask, “can you tell me how you view illness?” and Ball et al. (2019) suggests asking, “what do I need to know as your clinician to provide care for you?” Likewise, Ball et al. (2019) suggest not pressing an issue when communicating with patients. Great post.
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.). St. Louis, MO: Elsevier Mosby.
Munn, Z., Peters, M. D. J., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (n.d.). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology, 18. https://doi-org.ezp.waldenulibrary.org/10.1186/s12874-018-0611-x
Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review. BMC Public Health, 20(1), 27. https://doi-org.ezp.waldenulibrary.org/10.1186/s12889-019-8127-9