NURS 6512 Discussion Diversity and Health Assessments PEER POSTS

Calling a transgender person by their pronouns can decrease suicidal ideations, suicidal behaviors, and depressive symptoms (Grossman, 2018). Your questions are great which can bring forth honest answers. I think I would question if he a psychologist or psychiatrist that he thinks is helpful and how long has he been seeing them. If his mental health is deteriorating and his been going for a while, I think that is a clear sign that there might be a better mental health practitioner for him.

Dealing with depression can be challenging. Many elite psychologists and psychiatrists recommend however, that at some point, in order to get better, a person has to begin to have healthy exposure to the stimulation that is causing or contributing to their distress (Lembke, 2022). For example, a person who wants to overcome their fear of spiders would need counseling and at some point, a healthy amount of exposure to spiders possibly(Lembke, 2022). Even if it starts with pictures of the spider at first. At some point, John needs to integrate better into society if he wants to get to a healthier headspace (Peterson, 2018). John has taken some steps to do this by looking more like the gender he prefers to be called. People will call John by his preferred pronouns because it’s easier to do and this makes it easier for John to integrate into society. Thie fact that John is trying to look like the gender pronouns he wants to be called, I think should be acknowledged, it will help with his confidence and helps with his integration process. Overall, isolation and avoidance will not make John mentally healthier but instead more neurotic (Peterson, 2018).

References

Grossman, A. H., Pollitt, A. M., & Russell, S. T. (2018). Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. The Journal of adolescent health: official publication of the Society for Adolescent Medicine, 63(4), 503–505. https://doi.org/10.1016/j.jadohealth.2018.02.003

Lembke, A. (2022). Dopamine nation: Finding balance in the age of indulgence. Dutton.

Peterson, J. B. (2018). 12 Rules for Life: An antidote to chaos. Vintage Canada.

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).

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:

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 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!

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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.

Initial discussion

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The population in the united states is composed of people from diverse cultural backgrounds and this aspect is also duplicated in the healthcare system. To ensure the provision of quality and effective healthcare services to the diverse population, the healthcare providers must be competent, sensitive, and also be aware of the diversity of the patient cultures and other essential beliefs as well as avoid stigmatizing patients based on their cultural differences. When a healthcare provider is culturally competent, he or she accepts the diverse needs of their patients even though the diverse needs may be different from those of theirs. To ensure culturally competent healthcare services, the healthcare providers must be sensitive to the patient’s socioeconomic status, heritage and ethnicity. Distinct from cultural awareness and cultural sensitivity, cultural competence is the ability of healthcare providers to modify their practices such that they effectively meet the needs of the different cultural groups (Sharifi, Adib-Hajbaghery, & Najafi, 2019). On the contrary, cultural awareness and sensitivity highlight the ability to recognize the differences without necessarily modifying practices to meet the various needs of different patients.

Case scenario

The case study presents Mono Nu, who is a 44- year old Filipino patient who started blood thinner medications a period of two weeks ago. The patient is from a low-income household and hence does not afford the prescribed medication. Besides, he has no adequate understanding on the working mechanism of the medications or why they are necessary. In addition, the patient lacks a social support network so that he can maintain his medications. His main diet is fish and tofu, which may lack in some essential nutritional components hence affecting the mode of action of the blood thinner medications.

Cultural Factors

Mono Nu is from the Philippines which makes him have a different understanding of health and wellness contrary to people from the western culture. The culture in the Philippines is such that they rely on family, friends, and faith in God for healing (Cacho & del Castillo, 2022). This culture of health and wellness prevents the Philippines from access to healthcare. The culture of the patient, therefore, has an impact on his health because it can dictate his willingness to adhere to the prescribed medications (Collado, 2019). In addition, the patient does not understand why his medications are producing the anticipated results meaning that the patient might be frustrated or, might be in a state where he feels helpless. His choice of diet however indicates that he appreciates specific diet which is essential to healthy eating. As a health practitioner, some of the most sensitive issues to take into account while interacting with this particular patient include their age, cultural differences in terms of health beliefs, the likelihood of frustrations with the medications, and some potential side effects of medications.

Targeted Questions

What is your level of income? Do you have financial challenges in obtaining your prescribed medications?
Do you understand the mode of action of your blood thinner medications and why they are necessary for your current state?
Are there some cultural beliefs that may negatively influence your willingness to take the prescribed medications?
Do you have any social program that can assist you in obtaining your medications as prescribed?
Are there any other health concerns that you feel that I should be aware of?

References: NURS 6512 Discussion Diversity and Health Assessments PEER POSTS

Cacho, R., & del Castillo, F. (2022). God’s Benevolent Love in the Time of COVID-19 Pandemic: Articulations and Experiences of Select Filipino Youth. Religions, 13(2), 162.

Collado, Z. C. (2019). Challenges in public health facilities and services: evidence from a geographically isolated and disadvantaged area in the Philippines. Journal of Global Health Reports, 3.

Sharifi, N., Adib-Hajbaghery, M., & Najafi, M. (2019). Cultural competence in nursing: A concept analysis. International journal of nursing studies, 99, 103386.

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I enjoyed reading your post. It is important that providers know and understand different modes of communication, when, and how to use them with their various patients. In addition to communication, they should also know how health beliefs may vary from one culture to another, also how diet and nutritional practices may be different (Ball, et., 2019). Anticoagulants or blood thinners are a serious and important class of medication that prevent or reduce the risk of a blood clot. Patients should be educated on why they are on this medication, its use, and when and how to take the medication. They should be aware of labs and how often the lab should be monitoring and foods they needed to avoid while on this medication. As you mentioned in your discussion that the culture of the patient, therefore has an impact on his health because it dictates his willingness to adhere to the treatment (Collado, 2019). Some cultures or countries believe that they do not need medications for some illnesses because of not being aware of illness, resources, or how to treat them. Providers should educate, provide resources and allow patients to demonstrate what they learned or skills in order to make sure that they understand what was discussed.

References: NURS 6512 Discussion Diversity and Health Assessments PEER POSTS

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.

Collado, Z. C. (2019). Challenges in public health facilities and services: evidence from a geographically isolated and disadvantaged area in the Philippines. Journal of Global Health Reports, 3.

I agree with you, the emphasis should be more on the patient cultural background. Generally, when interacting with this patient, the patient’s condition, race, culture, life experiences, and beliefs; should be put into consideration (Ball, Dains, Flynn, Solomon, & Stewart, 2019). Cultural beliefs played a key role in patient health. In this case study, Mono Nu is from the Philippines and has a culture that has been known for the traditional use of plant medicines. There are several factors that the healthcare professional should consider when assessing patients with different cultural backgrounds. First, this professional should consider the patient’s socioeconomic status since they are likely to affect the patient’s health literacy, perception of healthcare, health-seeking behavior, ability to afford medical services, and the risk factors that patients face (Arpey et al., 2017; McMaughan et al., 2020).

with this, in mind, the health care professional will assess the patient’s drug history and make sure to ask about herbal supplements. Many herbal plant decreased the effectiveness of the medicine and block the action of blood thinners. Warfarin for instance role is to prevent clot formation, a diet rich in VitK decreased the effectiveness of the medication and may lead to severe health consequences (Rosenthal and Burchum, 2018). Also, it’s important that the healthcare professional educate patient Mono Nu about the importance of blood thinners and emphasize more the diet low with vitk.

References :NURS 6512 Discussion Diversity and Health Assessments PEER POSTS

Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status affects patient perceptions of health care: A qualitative study. Journal of Primary Care & Community Health, 8(3), 169–175. https://doi.org/10.1177/2150131917697439

Ball, J.W., Dains, J.E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination. (9th ed.). St. Louis, MO: Elsevie Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice nurse and physicians assistant. St. Louis, MO: Elsevier.

Thanks for sharing your discussion and explaining the difference between cultural awareness, sensitivity and competence.

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Week 2 Initial post NURS-6512N

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Cultural Competence Case Study group B

Culture generally is about entire human behaviors, attitudes and ideas, speech patterns, imaginations, language, beliefs, and etiquette; basically, it is features that distinguish one group entity from other groups of human entities (Ball, Dains, Flynn, Solomon, & Stewart, 2019).

Healthcare professionals should demonstrate competence when dealing with diverse patients. According to Nair and Adetayo (2019), cultural competence is beneficial for both patients and healthcare providers since it encourages patient engagement/participation, promotes respect, enhances understanding between persons, and promotes better health outcomes. This competence is particularly vital when dealing with patients in multicultural societies like the US that are characterized by cultural diversity. In the assigned case study, for instance, the language barrier inhibits communication between a healthcare professional and Paloma Hernandez and may have led to poor health outcomes for the patient.

There are several factors that the healthcare professional should consider when working with the patient. First, this professional should consider the patient’s socioeconomic status since they are likely to affect the patient’s health literacy, perception of healthcare, health-seeking behavior, ability to afford medical services, and the risk factors that patients face (Arpey et al., 2017; McMaughan et al., 2020). Socioeconomic factors are of great significance when serving patients like Paloma whose communities have higher rates of poverty. Other factors like spirituality may also affect health-seeking behavior, perception towards treatment, medication adherence, and medication refusal. For instance, some patients could refuse medication on a religious basis or their belief that healing comes from God. Precisely, Latinos have tight religious ties and view the church as a major spiritual, social, and educational resource for the people and a significant determinant of medication compliance (Caplan, 2020; Gast et al., 2020). Although healthcare professionals should help patients to overcome their health problems, they must always respect the patients’ views and interests. Lifestyle factors should also be considered when dealing with patients like Paloma due to their impact on risk factors, treatment, and health outcomes. For instance, lifestyles like smoking, alcohol consumption, and the diet (foods that the patient consumes) could affect their likelihood of developing gastrointestinal complications (Capurso & Lahner, 2017; Livovsky et al., 2020). Other important cultural factors include language, beliefs, and values. For instance, close family and social ties among Latinos could be a good facilitator for accessing health support, although the language barrier could interfere with communication and involvement in clinical decisions. For instance, miscommunication due to a language barrier between the healthcare professional and the patient created confusion, poor medication adherence, or the consumption of dosage, which could in turn have led to the re-hospitalization of the patient.

There are many reasons why healthcare professionals should be sensitive when dealing with patients like Paloma. Cultural competence, awareness, and sensitivity reduce the risk of misunderstanding/misjudging patients from other cultures, reduces the risk of bias, guide healthcare professionals to select the right words, promote respect between patients and healthcare professionals, and help healthcare professionals to involve patients in clinical decision-making. In other words, cultural competence is critical to care coordination and patient-centered care as it encourages patient engagement and ensures that their health needs are met. Cultural insensitivity could lead to communication barriers, conflicts, lack of respect, and lack of collaboration.

Creating a health history for Paloma can significantly help in assessing the patient, tracking her progress, and making informed clinical decisions. Below are some important questions that are relevant to Paloma.

When did your pain start?
Where is the location of your pain?
How would you rate your pain on a scale of 1-10?
Do you smoke or drink?
Do you always take Omeprazole as instructed, and how does this medication affect your pain?
Are there any foods on your diet that you believe could be worsening your abdominal pain?
Do you eat a lot of spicy food?

References: NURS 6512 Discussion Diversity and Health Assessments PEER POSTS

Ball, J.W., Dains, J.E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination. (8th ed.). St. Louis, MO: Elsevier

Caplan, S. (2019). Intersection of cultural and religious beliefs about mental health: Latinos in the faith-based setting. Hispanic Health Care International, 17(1), 4–10. https://doi.org/10.1177/1540415319828265

Capurso, G., & Lahner, E. (2017). The interaction between smoking, alcohol and the gut microbiome. Best Practice & Research Clinical Gastroenterology, 31(5), 579–588. https://doi.org/10.1016/j.bpg.2017.10.006

Gast, J., Peak, T., & Hunt, A. (2017). Latino health behavior: An exploratory analysis of health risk and health-protective factors in a community sample. American Journal of Lifestyle Medicine, 14(1), 97–106. https://doi.org/10.1177/1559827617716613

Livovsky, D. M., Pribic, T., & Azpiroz, F. (2020). Food, eating, and the gastrointestinal tract. Nutrients, 12(4), 986. https://doi.org/10.3390/nu12040986

McMaughan, D. J., Oloruntoba, O., & Smith, M. L. (2020). Socioeconomic status and access to healthcare: Interrelated drivers for healthy aging. Frontiers in Public Health, 8(231), 231. https://doi.org/10.3389/fpubh.2020.00231

Nair, L., & Adetayo, O. A. (2019). Cultural competence and ethnic diversity in healthcare. Plastic and Reconstructive Surgery – Global Open, 7(5), e2219. https://doi.org/10.1097/gox.0000000000002219

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Discussion: Diversity and Health Assessments

Culture and socioeconomic factors influence the health outcomes for patients. Therefore, understanding the specific needs of the patients helps in developing appropriate intervention measures that guarantee better outcomes (Hu et al., 2019). In this case, JC is an at-risk 86-year-old Asian male who is financially and physically dependent on the daughter. The patient presents with hypertension, gastroesophageal reflux disease, chronic prostatitis, and b12 deficiency.

Socioeconomic, Spiritual, Lifestyle, and Other Cultural Factors Associated with the Patient

The patient is lonely considering that she depends on her daughter who is a single mother and has no time or money for the father’s health needs. In addition, the patient does not get spiritual support. Considering his age and physical instability, he cannot attend religious activities (Lee, 2017). The patient feels that he is already a burden to his daughter and feels sorry about it as evident in his conversation during his visit to the clinic. The reduced mobility and lack of social and spiritual support expose the patient to a sedentary lifestyle. Also, poor dietary intake could impact his health outcomes. Furthermore, understanding the Asian culture is necessary to interact appropriately with the patient.

Issues That You Would Need to Be Sensitive to When Interacting with the Patient

In interacting with the patient, one must be sensitive to avoid the possibility of conflict arising (Ball et al., 2019). In this case, it will be necessary to ask the patient whether he will be comfortable using the prescribed medications over the traditional medications (Xin et al., 2020). Besides, it is important to understand the additional medications that the client could be taking to avoid adverse medication interactions. The patient is physically inactive and this means that he may not engage appropriately in the activities of daily living. Therefore, asking the patient about his ability to bathe and feed will be important.

The targeted questions to ask will include:

Do you have health insurance?

How often do you check your blood pressure?
How many meals do you take in a day?
Do you always take medications as prescribed?
Do you think your daughters offer you enough support?

The assessment aims at identifying the underlying factors that could affect the patient’s illnesses. The human healing processes depend on other factors such as spiritual and socioeconomic needs. In this case, the patient is lonely and requires enough social support.

References: NURS 6512 Discussion Diversity and Health Assessments PEER POSTS

Ball, J., Dains, J., Flynn, J., Solomon, B., Stewart, R. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Hu, Y., Jiao, M., & Li, F. (2019). Effectiveness of spiritual care training to enhance spiritual health and spiritual care competency among oncology nurses. https://doi.org/10.21203/rs.2.16979/v2

Lee, R., Eun-Kyoung, O. (2017). Faith, spirituality, and values among Asian-American older adults: An exploratory factor analysis of the multidimensional measures of religion and spirituality. Mental Health, Religion & Culture, 19 (8), 920–931.    doi:10.1080/13674676.2017.1290593

Xin, B., Mu, S., Tan, T., Yeung, A., Gu, D., Feng, Q. (2020).  Belief in and use of traditional Chinese medicine in Shanghai older adults: A cross-sectional study. BMC Complement Medicine and Therapies 20 (128). https://doi.org/10.1186/s12906-020-02910-x. https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-020-  02910-x

I enjoyed reading your entry. The targeted questions you suggested would help you gather more information about the patient. On a scale of 0-10, 0 being no pain and 10 being the worst pain, how can you rate your headache? The patients’ pain level can help you understand how critical the pain may be effecting the patient. Depending on the severity of the headache you have to monitor for other healthcare issues he could possibly be facing. The patient would most likely be open to explain how bad the headache is hurting him. Do you smoke cigarettes, drink alcohol, or use any recreational drugs? This question is a good question because some of these things aggravate a headache even more and some recreational drugs can enhance a headache. Recreational drugs cause a risk to a patients’ health and may enhance a patients want to self harm. Also there are negative impacts of cigarettes, alcohol, and drugs on the patients’ health. Smoking cigarettes increases the risk for heart disease, stroke, and cancer (Health effects of cigarette smoking, 2021). Do you feel safe at home? How much sleep do you get? Do you feel depressed? Do you feel like hurting yourself? These four questions help the provider understand the patient’s mental health level. The patient safety and mental health is important to address when addressing medical issues. The patients’ frequent flyer status at the hospital may be a indicator of situations sometimes characterized by physical, mental, spiritual, and social deprivation of their home situations (Huang, van der Borght, Leithaus, Flamaing, and Goderis, 2020). The patient may no be that open to answering these questions because they may seem invasive to him. I would try to make the patient feel comfortable and safe before assessing him. What coping skills/mechanism works for you when you are stressed? The patients coping skills is important to address because the patient is a frequent flyer to the hopital. The patient may be lacking coping skills and may be reluctant to open up about his coping mechanisms. Patients with maladaptive coping mechanisms are more likely to engage in health risk behaviors (Algorani & Gupta, 2022). What do you do for a living? Although this is a good question, I don’t believe this would help you gather information about the patients chief complaint.

The questions that would apply to my patients is the questions about coping mechanisms, safety, depression, and self harm. My patient is a transgender male that recently came out so his mental health status may be a risk for depression and possible self harm. My patient has also had losses in employment and had to move back home with his parents so his coping skills may be questioned on how he is dealing with the recent transitions in his life. My patient also may face a lot of bias, discrimination, and stigmas with his recent transition to male which could place him in harms way. The question about smoking, alcohol, and drugs would also apply to my patient because he smokes cigarettes and marijuana.

Algorani EB, Gupta V. Coping Mechanisms. [Updated 2022 Apr 28]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559031/

Centers for Disease Control and Prevention. (2021, October 29). Health effects of cigarette smoking. Centers for Disease Control and Prevention. Retrieved March 10, 2023, from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/#health-risks

Huang, M., van der Borght, C., Leithaus, M., Flamaing, J., & Goderis, G. (2020). Patients’ perceptions of frequent hospital admissions: a qualitative interview study with older people above 65 years of age. BMC geriatrics, 20(1), 332. https://doi.org/10.1186/s12877-020-01748-9Links to an external site.