Feb 23, 2024 Discussion: Diversity & Health Assessments
Discussion: Diversity and Health Assessments Discussion: Diversity and Health Assessments ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Discussion: Diversity & Health Assessments NURS 6512 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). Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT Struggling to Meet Your Deadline? Get your assignment on Discussion: Diversity & Health Assessments done on time by medical experts. Don’t wait – ORDER NOW! Meet my deadline 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! 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. Submission and Grading Information Grading Criteria To access your rubric: Week 2 Discussion Rubric Post by Day 3 of Week 2 and Respond by Day 6 of Week 2 To Participate in this Discussion: Week 2 Discussion What’s Coming Up in Week 3? Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images Next week, you examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition. You will also begin your first DCE: Health History Assessment which will be due in Week 4. Plan your time accordingly. Overview of Digital Clinical Experiences (DCE) and Lab Components Throughout this course, you are required to not only complete your standard course assignments and discussions, but you will also complete DCE and Lab Components that are either structured as optional or required assignment submissions. Please take the time to review your DCEand Lab Components for this course that are required submissions. See the table below and the attached table for specific DCE and Lab Components for the course. Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total score of 80% or better, but you must take all attempts by the Day 7 deadline. You must pass BOTH the Health History and Comprehensive (head-to-toe) Physical Exam of at least a total score of 80% in order to pass the course. Week Digital Clinical Experiences Lab Components Module 1: Comprehensive Health History Week 1: Building a Comprehensive Health History Module 2: Functional Assessments and Assessment Tools Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children DCE: Health History Assessment (assigned in Week 3, due in Week 4) Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children Module 3: Approach to System Focused Advanced Health Assessments Week 4: Assessment of the Skin, Hair, and Nails DCE: Health History Assessment Lab Assignment: Differential Diagnosis for Skin Conditions (SOAP Note for differential diagnosis) Week 5: Assessment of Head, Neck, Eyes, Ears, Nose, and Throat DCE: Focused Exam: Cough Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat (Episodic SOAP Note) Week 6: Assessment of the Abdomen and Gastrointestinal System Lab Assignment: Assessing the Abdomen (Analyze SOAP Note) Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System DCE: Focused Exam: Chest Pain Week 8: Assessment of the Musculoskeletal System Discussion: Assessing Musculoskeletal Pain (Episodic SOAP Note) Week 9: Assessment of Cognition and the Neurologic System DCE: Comprehensive (head-to-toe) Physical Assessment Case Study Assignment: Assessing Neurological Symptoms (Episodic SOAP Note) Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal Lab Assignment: Assessing the Genitalia and Rectum (analyze SOAP Note) Module 4: Ethics in Assessment Week 11: The Ethics Behind Assessment Lab Assignment: Ethical Concerns Next Week To go to the next week: Week 3 Learning Resources Required Readings (click to expand/reduce) 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. Chapter 1, “The History and Interviewing Process” (Previously read in Week 1) This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients. Chapter 2, “Cultural Competency” This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. Chapter 2, “Evidenced-Based Clinical Practice Guidelines” Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi:10.3109/02770903.2014.906605 Credit Line: Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis by Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J., in Journal of Asthma, Vol. 51/Issue 7. Copyright 2014 by Taylor & Francis, Inc. Reprinted by permission of Taylor & Francis, Inc. via the Copyright Clearance Center. The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma. Centers for Disease Control and Prevention. (2015). Cultural competence. Retrieved from https://npin.cdc.gov/pages/cultural-competence This website discusses cultural competence as defined by the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website. United States Department of Human & Health Services. Office of Minority Health. (n.d.). A physician's practical guide to culturally competent care. Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/ From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve. Espey , D. K., Jim, M. A., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(Suppl 3), S303–S311. The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives. Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., & Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers. Southeast Asian Journal of Tropical Medicine and Public Health, 47(1), 109–120. The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving healthcare services at primary healthcare centers. Required Media (click to expand/reduce) As we begin Week 2, I want to start by saying how impressed I am! The discussions have been excellent! All of you should be commended for being so complimentary to your peers, while also initiating stimulating dialogue! We are going to have a great 11 weeks with the enthusiasm and the effort being demonstrated to date. Here are some items of interest as we begin another busy week! Be sure to listen to Dr. Harris’s week module reviews and lectures….they are full of valuable information for assignments/expectations throughout this course. APA– everyone’s APA looks very good, and I am glad to see so many of you reaching out for additional scholarly citations. Just some common errors that I have found in the past when I have taught this course, so I will share with you here: When using quotation marks, you need to list the page number in the intext citation. When you are citing statistics, you need to reference the statistic at the end of the sentence. Website citations…… Author/Name of Site. (Year, Month Day). Title of webpage. Title of Site. (URL address). Weekly Discussions It would be helpful to me, as well as your classmates that you start a new thread for your main post, and title it (Last Name, Week 2, Main Post). This will help us identify what is a main post vs. response. Also, give as much detail as possible, and support with scholarly references. In your peer responses you should add to the conversation, and pose questions to further the conversation. For this week, you will discuss diversity: · 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? Case Study Assignments: The following will be the assignments for this week’s Case Study: My patient is TJ, a 32-year-old pregnant lesbian, who is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over the counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortions 0. It is important for the provider to be aware of the sexual orientation of a patient. When working with a patient who is of a sexual minority it becomes equally important for the provider to know of any potential feelings regarding heterosexism and homophobia within themselves. Feelings of apprehension or reluctance to discuss preferences can be assuaged by using nonjudgmental words, tone, posture, and approach to examining the patient (Ball, et al 2019). In order to build a health history for my patient, trust and honesty can be initially instilled by offering informational pamphlets and resources in the office and waiting areas. Then a supportive relationship can be best developed by asking gender neutral questions and then building upon the initial interaction with more direct and open questions. Questions that are open-ended versus simple yes or no responses would be more likely to create a discussion rather than close down the discussion. For example, asking about the patient’s living situation rather than whether they are married or if the patient has a boyfriend/girlfriend would be a nonjudgmental approach to any circumstances. To start the patient assessment, general questions such as establishing why the patient has made the appointment with the provider; when the health problem started; and the length of time for symptoms. The patient’s age, marital status, gender, occupation, previous hospital/medical concerns/medications prescribed; over the counter/natural supplements used; pregnancy insemination date; and last lab draw date can be noted in the patient’s record. A completed patient history would include a timeline of the symptoms and what the patient status was prior to the symptoms starting; female productive history, sexual history, aggravating factors; and alleviating techniques. This is also a good time to be alert for a secondary health concern that the patient may want to discuss and determining the patient’s support system that is available over the next few months. Vaginal discharge in pregnant women is common and may be normal or abnormal. Physiological vaginal discharge in pregnancy is colorless or white, non-irritating, and odorless with no sequelae. It is important to ask the patient: When did the discharge begin? Color of discharge? Is there any odor? Do you have any vaginal pain? Any symptoms of urinary tract infection? Once these questions are answered, it would also be important to complete a vaginal exam with swabs taken to determine if there is any infection in the discharge and obtain a urine sample to test for a urinary tract infection. This is also an opportune time to complete patient education on some of the reasons why a female can have a discharge during pregnancy (Ball, et al 2019). Resources Ball. J. W., Dains. J. E., Flynn. J. A., Solomon. B. S. & Steward. R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883588/ Prasad. D., Parween. S., Kumari. K. & Singh. N (2021). Prevalence, etiology, and associated symptoms of vaginal discharge during pregnancy in women seen in a tertiary care hospital in bihar. Cureus. Jan 14;13(1): e12700. doi: 10.7759/cureus.12700. PMID: 33614308; PMCID: PMC7883588. Retrieved from: https://www.ncbi.nlm.nih. gov/pmc/articles/PMC7883588/ Last Name A-M: JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has ahx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter” Last Name N-Z: TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over the counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortion 0 Shadow Health: Please be sure to follow the course announcements to assist with your troubleshooting of this tool. As I receive information, I will be posting it there. I hope everyone has a great week!!! The assigned case study features a White young adult male patient who underwent a gender transition two years ago. Numerous socioeconomic, spiritual, lifestyle and other cultural factors have an impact on the patient’s health and well-being. The patient’s socioeconomic situation prevents him from affording to seek proper medical care services because he is currently unemployed and has no health insurance (Bringedal & Isaksson R, 2021). His lifestyle, which includes marijuana and tobacco use, is detrimental to his physical and emotional well-being. In terms of his spirituality, the patient would find it challenging to join a faith that endorses gender transition without risking his mental health. As a Caucasian, the client may face discrimination for being transsexual. It will be necessary for the Nurse Practitioner to utilize tact when speaking with the patient about several topics about his health and way of life (Safer & Tangpricha, 2019). For instance, it’s vital to use inclusive language and ask open-ended inquiries that let patients describe their gender identity and sexuality in their own words. It’s crucial to inquire about the patient with care and consideration about his HIV diagnosis and depressive episodes. When it will be required to disclose information about a patient’s body to other healthcare practitioners for medical purposes, the nurse practitioner should presume that this information is very confidential and should notify patients in advance (López et al., 2020). Frequently, more pertinent, direct queries are preferable. The following five inquiries will be made to further evaluate the patient’s health (Ball et al., 2019): What surgical procedures have you had? What additional symptoms are you having besides feeling weak? How long have you been receiving hormone treatment? How are you dealing with your recent depressive episode? What kind of health promotion do you perform? References 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. Bringedal, B., & Isaksson RØ, K. (2021). Should a patient’s socioeconomic status count in decisions about treatment in medical care? A longitudinal study of Norwegian doctors. Scandinavian Journal of Public Health, 140349482110336. https://doi.org/10.1177/14034948211033685 López, S. R., Ribas, A. C., Sheinbaum, T., Santos, M. M., Benalcázar, A., Garro, L., & Kopelowicz, A. (2020). Defining and assessing key behavioral indicators of the Shifting Cultural Lenses model of cultural competence. Transcultural Psychiatry, 57(4), 594–609. https://doi.org/10.1177/1363461520909599 Safer, J. D., & Tangpricha, V. (2019). Care of Transgender Persons. New England Journal of Medicine, 381(25), 2451–2460. https://doi.org/10.1056/nejmcp19036 Rubric Detail Select Grid View or List View to change the rubric’s layout. Content Name: NURS_6512_Week_2_Discussion_Rubric Outstanding Performance Excellent Performance Competent Performance Proficient Performance Room for Improvement Main Posting: Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. Points Range: 44 (44%) – 44 (44%) Thoroughly responds to the discussion question(s) is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. supported by at least 3 current, credible sources Points Range: 40 (40%) – 43 (43%) Responds to the discussion question(s) is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 75% of post has exceptional depth and breadth supported by at least 3 credible references Points Range: 35 (35%) – 39 (39%) Responds to most of the discussion question(s) is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of post has exceptional depth and breadth supported by at least 3 credible references Points Range: 31 (31%) – 34 (34%) Responds to some of the discussion question(s) one to two criteria are not addressed or are superficially addressed is somewhat lacking reflection and critical analysis and synthesis somewhat represents knowledge gained from the course readings for the module. post is cited with fewer than 2 credible references Points Range: 0 (0%) – 30 (30%) Does not respond to the discussion question(s) lacks depth or superficially addresses criteria lacks reflection and critical analysis and synthesis does not represent knowledge gained from the course readings for the module. contains only 1 or no credible references Main Posting: Writing Points Range: 6 (6%) – 6 (6%) Written clearly and concisely Contains no grammatical or spelling errors Fully adheres to current APA manual writing rules and style Points Range: 5.5 (5.5%) – 5.5 (5.5%) Written clearly and concisely May contain one or no grammatical or spelling error Adheres to current APA manual writing rules and style Points Range: 5 (5%) – 5 (5%) Written concisely May contain one to two grammatical or spelling error Adheres to current APA manual writing rules and style Points Range: 4.5 (4.5%) – 4.5 (4.5%) Written somewhat concisely May contain more than two spelling or grammatical errors Contains some APA formatting errors Points Range: 0 (0%) – 4 (4%) Not written clearly or concisely Contains more than two spelling or grammatical errors Does not adhere to current APA manual writing rules and style Main Posting: Timely and full participation Points Range: 10 (10%) – 10 (10%) Meets requirements for timely and full participation posts main discussion by due date Points Range: 0 (0%) – 0 (0%) NA Points Range: 0 (0%) – 0 (0%) NA Points Range: 0 (0%) – 0 (0%) NA Points Range: 0 (0%) – 0 (0%) Does not meet requirement for full participation First Response: Post to colleague’s main post that is reflective and justified with credible sources. Points Range: 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings responds to questions posed by faculty the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives Points Range: 8.5 (8.5%) – 8.5 (8.5%) Response exhibits critical thinking and application to practice settings Points Range: 7.5 (7.5%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting Points Range: 6.5 (6.5%) – 7 (7%) Response is on topic, may have some depth Points Range: 0 (0%) – 6 (6%) Response may not be on topic, lacks depth First Response: Writing Points Range: 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues Response to faculty questions are fully answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English Points
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