NURS 6512 Diversity and Health Assessments
Sample Answer for NURS 6512 Diversity and Health Assessments Included After Question
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).
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.
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:
- 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 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 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.
A Sample Answer For the Assignment: NURS 6512 Diversity and Health Assessments
Title: NURS 6512 Diversity and Health Assessments
Patient Associated Factors
Cultural competence is described by the Centers for Disease Control and Prevention (n.d.) as a collection of compatible attitudes, practices, and rules that exist inside a system, organization, or group of experts and allow for productive cross-cultural work. As nurses and future providers, having cultural competence is essential to the health outcomes of the patients as it increases the quality of services. Our services are provided to many diverse cultures. Therefore, it is important to be knowledgeable of the patient’s culture and avoid stereotypes. This week’s case study follows the case of Shawn Billings. He is a 28-year-old African American patient who comes into the clinic today with a migraine. The staff has deemed him a “frequent flyer” due to his numerous office visits. He is worried that he will not receive his medication. The purpose of this discussion is to explain the factors associated with this patient and sensitive issues when interacting with the patient.
Given the patient’s case, it seems as though this patient has been affected by healthcare disparities in his community. Thus, his socioeconomic status, including income, community safety, education, social support, and employment, may be poor. The patient may have limited access to healthcare, or they may have received poor-quality care. This may be why he is worried that he will not receive his medication. African Americans tend to use spirituality and church as coping mechanisms. Churches were cited as dependable locations for finding health resources as well as spiritual and social support (Siler et al., 2021). With the patient being young, his lifestyle could include risky activities and lack of sleep, which could be two possible reasons for the patient’s migraines. In addition to these variables, the patient’s potential is limited due to the lack of culturally appropriate health information and services available to the patient.
Sensitive Issues
Because the patient is African American, he is at an increased risk of being stereotyped and discriminated against in the healthcare system. While seeking treatment for themselves or a member of their family, black people are more likely to encounter barriers to care and discrimination (KFF, 2022). Therefore, it is important to create a non-judgmental environment. Deeming the patient as a “frequent flyer” could be a sensitive issue as the patient’s concerns could be disregarded and a potential health problem could be missed. Family history and level of education are also sensitive issues for African American patients. Patients tend to exclude extended family from health history, and some may not know their family history due to lack of conversation regarding the topic or the patient may not know their biological family. Knowing your patient’s level of education assesses how well the patient will understand their diagnoses, treatment plan, and medications. It can also indicate how the provider will conduct education regarding their health. This includes if the provider needs to use pictures, audio, diagrams, etc. when providing education. Being sensitive to the patient’s socioeconomic and cultural factors ensures a non-biased approach and creates an environment that provides optimal quality care and greater efficiency regarding health outcomes for patients.
Targeted Questions
The five targeted questions I would ask the 28-year-old African American with complaints of a migraine include:
- What is your occupation? (This question assesses if the patient has a job that is strenuous, thus, leading to the exacerbation of a migraine).
- How are you sleeping? (This question assesses how much and well the patient is sleeping as a lack of sleep can exacerbate a migraine).
- Do you use any illicit or recreational drugs? (Because the patient is young, he may engage in risky behaviors including illicit or recreational drug use, which can have side effects that include headaches).
- What is your diet like? (The patient could be consuming foods that could trigger a migraine).
- Is there a family history of migraines? (Genetics could play a factor in the patient’s development of migraines).
References
Centers for Disease Control and Prevention. (n.d.). Cultural competence in health and human services | NPIN. https://npin.cdc.gov/pages/cultural-competence
KFF. (2022, March 22). Disparities in health and health care among black people. https://www.kff.org/infographic/disparities-in-health-and-health-care-among-black-people/
Siler, S., Arora, K., Doyon, K., & Fischer, S. (2021). Spirituality and the illness experience: perspectives of african american older adults. American Journal of Hospice and Palliative Medicine, 38(6), 618–625. https://doi.org/10.1177/1049909120988280
A Sample Answer 2 For the Assignment: NURS 6512 Diversity and Health Assessments
Title: NURS 6512 Diversity and Health Assessments
African American are discriminated and experience greater health disparities at a disproportionate rate than their other American counter parts. African Americans are dying of diseases that show up in their 20s to 40s that are usually found in whites at older ages (African American Health, 2017). A large population of African Americans have a low socioeconomic status, low educations and decreased access to care and other resources, such as the case study patient. in addition to assessing the patient’s occupation, sleep patterns, diet, family history and social behaviors, I would assess the patient’s environmental factors. Environmental factors such as smoke, strong smells, and loud noises that may trigger migraines (Website, 2021). However, these topics of conversation are sensitive and should be conducted in a way that coordinates with the RESPECT model. According to Ball et al. (2019) the RESPECT model is used to initiate patient centered care communication to meet the goal of improving their lives.
References
African American Health. (2017, July 3). Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/aahealth/index.html
Ball, J. W., Dains, J. E., & Flynn, J. A. (2019). Seidel’s Guide to Physical Examination (9th ed.). Elsevier Health Sciences (US). https://mbsdirec
Links to an external site.t.vitalsource.com/books/9780323481953
Website, N. (2021b, November 18). Causes. nhs.uk. https://www.nhs.uk/conditions/migraine/causes/#:~:text=The%20exact%20cause%20of%20migraines,blood%20vessels%20in%20the%20brain
A Sample Answer 3 For the Assignment: NURS 6512 Diversity and Health Assessments
Title: NURS 6512 Diversity and Health Assessments
This is a detailed post about the case study. Indeed, I agree with you that nurses should demonstrate cultural competence is essential to the health outcomes of the patients as it increases the quality of services. Cultural competence assists healthcare providers in communicating, understanding, and associating with patients effectively (Young & Guo, 2020). It also centers on appreciating the relationship between nurses and patients. Cultural competence is crucial in promoting communication, which sustains the safety of patients. Effective communication enables healthcare professionals to gather precise medical data. It also fosters active dialogue where patients and providers can freely ask questions, develop trust, and correct misunderstandings. Failure by healthcare professionals to identify the distinctions between them and their patients may unintentionally give poor-quality care (Botelho & Lima, 2020). As such, cultivating skills that enhance cross-cultural communication is instrumental in providing equitable care.
In this case, I concur that the patient is most likely at an increased risk of being stereotyped and discriminated against in the healthcare system due to his African American origin. Indeed, the best way to assess this patient is to create a non-judgmental environment during the interview (Van Humbeeck et al., 2020). This can be achieved by adopting an attitude of empathy, acceptance, and genuineness. The nurse practitioner must also be ready to identify cultural differences, demonstrate active listening skills, and reflect on the state of mind. Respecting the patient’s beliefs and listening to his concerns are essential. Nurse practitioners should be able to understand the patient without being distracted by their experiences and thoughts. If the patient feels safe during the interview, he will likely feel comfortable and speak openly. The patient’s needs are met, providing the best possible nursing care.
References
Botelho, M. J., & Lima, C. A. (2020). From cultural competence to cultural respect: A critical review of six
models. Journal of Nursing Education, 59(6), 311-318. https://doi.org/10.3928/01484834-20200520-03
Van Humbeeck, L., Malfait, S., Holvoet, E., Vogelaers, D., De Pauw, M., Van Den Noortgate, N., & Van Biesen,
W. (2020). Value discrepancies between nurses and patients: A survey study. Nursing ethics, 27(4), 1044-
1055. https://doi.org/10.1177/0969733020906595
Young, S., & Guo, K. L. (2020). Cultural diversity training: the necessity of cultural competence for health care
providers and in nursing practice. The health care manager, 39(2), 100-108. DOI:
10.1097/HCM.0000000000000294
A Sample Answer 4 For the Assignment: NURS 6512 Diversity and Health Assessments
Title: NURS 6512 Diversity and Health Assessments
I enjoyed your post, as it was very informative. You shared some great information on African American experiences in healthcare. Unfortunately, there are biases that they face that affect how they view healthcare and providers.
Your targeted questions are excellent and will be instrumental in getting background information on treating this patient’s condition. Stress at work, missing sleep, and certain foods can contribute to the development of migraines, so the questions addressing those are on point (Mayo Clinic, 2021). The question about illicit or recreational drug use is essential because this factor can contribute to migraines, but depending on who’s asking the question, the patient may become offended. For instance, if a White provider asks this question, the patient may think it’s being asked because he’s Black. Studies show that minorities tend to establish a more trusting relationship with minority providers (Minority Patients Benefit from Having Minority Doctors, but That’s a Hard Match to Make, n.d.). If the patient is using these types of drugs, he may not admit it if he feels judged or uncomfortable with the provider who’s asking.
My patient is 33-year-old John Green. Some of the targeted questions you’re asking your patient can also help assess my patient. My patient has depressive episodes, so asking about his sleep pattern could be instrumental, as depression affects one’s sleep pattern (Grant, 2020). This patient is also HIV positive, so asking about illicit drug use helps assess his lifestyle and how he possibly contracted HIV (Centers for Disease Control and Prevention, 2020).
References
Centers for Disease Control and Prevention. (2020, October 28). HIV Transmission | HIV Basics | HIV/AIDS | CDC. Www.cdc.gov. https://www.cdc.gov/hiv/basics/transmission.html#:~:text=Most%20people%20who%20get%20HIV
Grant, A. (2020, March 18). Depression and Its Effect on Your Life. Rtor.org. https://www.rtor.org/2020/03/18/depression-and-its-effect-on-your-life/
Mayo Clinic. (2021, July 2). Migraine – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201
Minority Patients Benefit From Having Minority Doctors, But That’s a Hard Match to Make. (n.d.). Www.michiganmedicine.org. https://www.michiganmedicine.org/health-lab/minority-patients-benefit-having-minority-doctors-thats-hard-match-make
A Sample Answer 5 For the Assignment: NURS 6512 Diversity and Health Assessments
Title: NURS 6512 Diversity and Health Assessments
Your post is very informative. I agree with you. The provider must understand what it means for a patient to be transgender or gender-diverse. According to Dolan et al. (2020), it is crucial to understand the difference between sex, gender, and gender non-conformity. Sex is assigned at birth by chromosomal, gonadal, and anatomical characteristics. Gender forms part of an individual’s personal and social identity and may be fixed or fluid. Gender non-conformity describes individuals whose gender identity, role, or expression differs from what is normative for their assigned sex. In your case study, the patient is a transgender male. Dolan et al. (2020) state that a transgender male is a person who identifies as a male but was assigned female at birth (Dolan et al., 2020). It is crucial to understand this population and their healthcare needs to ensure a trusting provider-patient relationship and produce an attainable positive patient treatment outcome.
You mention that Mr. Green is accessing testosterone online, which can be dangerous. These patients who choose hormone therapy must be under the care of a physician. Mwamba et al. (2022) report that transgender patients must have their hormone levels checked regularly to ensure that their free testosterone levels remain within a normal male physiological range and that estradiol levels are sufficiently suppressed. Also, those trans male patients are at risk for the depletion of endogenous hormones or influx of androgens that must be addressed and managed with the physician before beginning testosterone treatment. The patient’s hematocrit and hemoglobin levels are monitored every three months for the first year and then twice a year to watch for the risk of polycythemia (Mwamba et al., 2022). Therefore, asking about herbal medications, drugs, or supplements should include inquiring about testosterone use. Questions about dosage, type, frequency, and amounts are appropriate. Determining the patient’s knowledge about administering is also important. Educating the patient on preventative care and the importance of regular clinic visits is vital to safe and effective treatment. Another critical aspect of the assessment includes the suicidal risk and depression scale. Price-Feeney et al. (2020) state that transgender individuals are more than double the risk for depressed mood and suicidality compared with their cisgender counterparts. Transgender men are at highest risk (Price-Feeney et al., 2020).
The suicide risk assessment and depression assessment also apply to the patient in my case study. My patient has been seen for headaches multiple times. These numerous visits have deemed him a frequent flyer. Thus, the uncontrolled chronic pain is causing agitation, and his father worries he is not getting proper care. Jahangir et al. (2020) report that patients who receive no treatment for headaches manifest a history of anxiety and later display severe somatic symptoms. Depression affects almost 80% of migraine sufferers, who are more likely to experience intense anxiety and suicidal tendencies (Jahangir et al., 2020). Both of these patients in this week’s case study warrant the evaluation of mental health, including suicidal risk.
References
Dolan, I. J., Strauss, P., Winter, S., & Lin, A. (2020). Misgendering and experiences of stigma in health care settings for transgender people. Medical Journal of Australia, 212(4), 150. https://doi.org/10.5694/mja2.50497
Jahangir, S., Adjepong, D., Al-Shami, H. A., & Malik, B. H. (2020). Is there an association between migraine and major depressive disorder? A narrative review. Cureus, 12(6), e8551. https://doi.org/10.7759/cureus.8551
Mwamba, R. N., Adaora Ekwonu, Guimaraes, P. V. B., & Raheem, O. (2022). The efficacy, safety, and outcomes of testosterone use among transgender men patients: A review of the literature. Neurourology and Urodynamics, 42(5), 921–930. https://doi.org/10.1002/nau.25094
Price-Feeney, M., Green, A. E., & Dorison, S. (2020). Understanding the mental health of transgender and nonbinary youth. Journal of Adolescent Health, 66(6). https://doi.org/10.1016/j.jadohealth.2019.11.314