NURS 6512 Diversity and Health Assessments -

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

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.

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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

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.

A Sample Answer 2 For the Assignment: NURS 6512 Diversity and Health Assessments

Title: NURS 6512 Diversity and Health Assessments

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

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.

A Sample Answer 3 For the Assignment: NURS 6512 Diversity and Health Assessments

Title: NURS 6512 Diversity and Health Assessments

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

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

A Sample Answer 4 For the Assignment: NURS 6512 Diversity and Health Assessments

Title: NURS 6512 Diversity and Health Assessments

The Scenario

Shawn Billings, a 28-year-old African American patient comes into the clinic today. He has been deemed a “frequent flyer” by the staff at the clinic and was at the clinic last week and 4 days ago with a migraine, given a shot of Toradol and Ativan and sent home. He is here today again for an extreme headache. He is very agitated today. He is here with his father and worried that he will not get any medication.

Data on Socioeconomic and Education Status for Black Males

Black men are the least likely, when compared to black women, white men, and white women, to have an advanced degree (Eggly et al., 2017). 4% of black men in America have a master’s degree, 9% of black women have a master’s degree, 8% of white men have a master’s degree, and 13% of white women have a master’s degree (Nzau et al., 2020). Black men are much more likely to be born into poverty and much less likely to get out of it compared to these same groups (Eggly et al., 2017). Black men make up about 6% of the population but account for over 30% of the prison population (Nzau et al., 2020). Black men have a shorter life expectancy than white men by about 4 years (Nzau et al., 2020). Black men are perceived as the most violent group of individuals, based on studies conducted to measure implicit bias (Nzau et al., 2020). More than 40% of white respondents ranked almost all or all black men as violent (Nzau et al., 2020). White males and black females were perceived as similarly violent, and white women were perceived as the least violent (Nzau et al., 2020). Black men earn more than black women, but less than white women and white men (Nzau et al., 2020). Black men are twice as likely to be unemployed than white men (Nzau et al., 2020).

Other Statistics to Consider

Statistics can sometimes be a blunt object to use when thinking of groups of people. For example, it is important to observe that the black population is diverse with people of various ethnic backgrounds and immigrants. Why does this matter? It is estimated that about 59% to over 70% of Nigerians hold a bachelor’s degree or higher (Ajobaju, 2021). The number varies in percentage levels for Nigerians because the number of Nigerians who took the survey, are estimated from the U.S. Census Bureau and is thought to have been grossly underestimated (Muri, 2012). About 31% of black immigrants have at least a bachelor’s degree while 33% of U.S. population has a bachelor’s degree or higher (Pew Research Center, 2022). About 1 in 10 blacks are immigrants (Pew Research Center, 2022). About 25 % of black immigrants make $100,000 yearly or higher compared to 17% of black born Americans (Pew Research Center, 2022). The average median income for immigrants is $63,000 and for black immigrants is $56,000 (Pew Research Center, 2022). Less than 1 out of 5 black immigrants lived below the poverty line in 2019 when about 1 in 5 black Americans lived below the poverty line in 2019 (Pew Research Center, 2022). On certain levels, black immigrants have a different experience in America than black Americans.

Blacks and Religion

U.S. born blacks are much more likely to be protestant than any other religion when compared to immigrant blacks (Pew Research Center, 2022). Immigrant blacks are more likely to claim to be Catholic and non-Christian (Pew Research Center, 2022). African blacks are the least likely to say they are unaffiliated to any religious groups (Pew Research Center, 2022). Overall, most black people in America seem to derive their sense of spirituality from religion (Pew Research Center, 2022).

Males

Generally speaking, men seem to be suffering within today’s culture (Reeves, 2022). The factors that are contributing to this are multifactorial. In some corners of pop culture, feminism is often deemed the primary culprit. However, there are many other factors that seem to play a significant role in why men are falling behind (Reeves, 2022). Traditionally male dominated jobs, which include construction workers, automotive jobs, truck drivers, farmers, pilots, and other male dominated sectors, have been areas where technology has dominated (Casey & Nzau, 2019). It should also be noted that male dominated sectors are also at the highest risk for death and fatal injuries (Industrial Safety & Hygiene News, 2020). The jobs with the highest risk for on-the-job deaths, include roofers, oil miners, firefighter supervisors, lineman, garbage collectors, iron workers, and power liners which all made the top 10 for the most dangerous jobs in America list (Industrial Safety & Hygiene News, 2020). Jobs that are traditionally dominated by women, like nurses and teachers, have been impacted by automation to a much lesser extent (Casey & Nzau, 2017).

Studies are showing that men, on average, tend to be better risk takers than women and have poorer impulse control when compared to women (Reeves, 2022). To some degree, this explains some of why more men than women, on average, tend to gravitate to jobs that are physically more dangerous, in free societies where women can choose to work these same jobs (Peterson, 2018). Today’s economy requires impulse control and long-term planning as humans continue to increase lifespan (Reeves, 2022). With the economy also demanding less labor-intensive jobs, like farming or factorial work, and instead prefer people with a psychological make-up that is less impulsive, and more prone to long term planning, the gap in education makes more sense and the problem for those who are less risk averse and wise in short sightedness, compounds (Reeves, 2022).

5 questions

With all of this in mind, it is important to understand my clients social and economic situation and temperamental make up. My questions would be holistic in approach. I would keep in mind, that as an ethnic woman, there will be men who are uncomfortable with being completely honest with me. I grew up in several places as a kid. I’ve grown up in small southern towns, I’ve grown up in northern cities, and I’ve grown up around a plethora of different ethnic cultures. Amongst every group, there’s always several things that most of the people in a culture love. For people in Texas for example, especially men, if I mention anything about the Dallas Cowboys, whether the person is a Texas native or not, it will almost always be a break the ice moment. Boston fans, even people who are not Boston fans, all love to talk about Boston fans. Many Jewish patients I’ve had enjoy speaking about some of the foods they prepare on Sabbath. If a foreigner shows interest in Jollof rice to an African patient, they will almost always share their favorite recipe of their special rice. It is a great ice breaker but don’t do it to patients on telemetry because they really get passionate about this. I mean obviously, being mindful that I am not offensive is important and so I usually try to do benign and non-offensive topics. My tone is always curious and fun in nature.

I’ll mention a topic but if the patient does not bite than I move on. In this situation, after calming the patient down, a good icebreaker will be relative to a show Shawn is watching, a nice shirt he may have on, or even something the father has on or a show he is watching. The point is, an ice breaker can get my patient to be more comfortable with me and it can also reveal how comfortable the patient is with me already. Humans tend to empathize the most with people who remind them of themselves (Bloom, 2018). A moment where there seems to be something a patient is interested in, that the provider may share an interest in too, can make patients feel like the provider is more like them then they thought. I would need to be sensitive to the fact the patient is generally seen as violent and poor and would also keep in mind that he does not trust that the staff will take care of him. This is implied by the fact that he does not think he will be medicated. Here are my 5 questions

Have you had a CT or MRI done on your brain before?
Do you, or anyone in your family, have a history of high blood pressure, seizures, or any types of cancers? Tell me what your medical and family history is?
What’s your job, friends, and home situation like?
What medication has worked the best for you and describe the pain? Tell me what activities make your head hurt worse?
Besides this hospital Shawn, give some things in your life stressing you out so I can work with you better