Socioeconomic and Cultural Factors

• By Day 1 of this week, you will create a new patient profile (You can Make up your information as needed for History and Physical, findings, vitals and such. New profile is to be madeup*Not Provided to each individual.
• 80 year old white male with angina lives on a farm 80 miles away from a healthcare center (Last Name A through L)
• 21 year old Filipino college student living in a dorm wanting to know what birth control is and what are good options for her (Last Names M through Z).

To prepare:

• Reflect on your experience as an advanced practice nurse and on the information provided in the Week 1 Learning Resources on building a health history and the Week 2 Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, your Instructor will assign a case study for this Assignment. 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 your assigned patient.
• Consider how you would build a health history for the patient. What questions would you ask? How might you target your questions based on the patient’s social determinants of health? How would you frame the questions to be sensitive to the patient’s background, lifestyle, and culture?
• Identify any potential health-related risks, based on the patient’s age, gender, ethnicity, or environmental setting, which should be taken into consideration.
• What risk assessment instruments would be appropriate to use with this patient?
• What questions would you ask to assess the patient’s health risks?
• Select one (1)risk assessment instrument discussed in the Learning Resources, or another tool with which you are familiar, related to your selected patient.
• Develop five (5)targeted questions you would ask the patient to build their health history and to assess their health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What communication techniques would be most appropriate to use with this patient? What strategies can you as an APRN employ to be sensitive to different cultural factors while gathering the pertinent information?

Assignment: Building a Health History With Cultural and Diversity Awareness  

Include the following:

• Explain the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Be specific.
• Explain the issues that you would need to be sensitive to when interacting with the patient, and why.
• Describe the communication techniques you would use with this patient. Include strategies to demonstrate sensitivity with this patient. Be specific and explain why you would use these techniques.
• Summarize the health history interview you would conduct with this patient. Provide at least five (5)targeted questions you would ask the patient to build their health history and to assess their health risks. Explain your reasoning for each question and how you frame each for this specific patient.
• Identify the risk assessment instrument you selected, and then justify why it would be applicable to your assigned patient. Be specific.

Assignment: Building a Health History With Cultural and Diversity Awareness

1. Socioeconomic, Spiritual, Lifestyle, and Cultural Factors

Socioeconomic Factors:

• Living Location: The patient lives on a farm 80 miles away from a healthcare center, indicating potential issues with access to healthcare services.
• Income: As a farmer, his income may be variable and influenced by seasonal and market conditions, potentially impacting his ability to afford healthcare.
• Education: His level of education may influence his understanding of his health condition and adherence to medical advice.

Spiritual Factors:

• Religious Beliefs: Understanding any religious beliefs he may have that could influence his healthcare decisions, such as views on certain medical treatments or procedures.

Lifestyle Factors:

• Occupation: Farming is a physically demanding job, which might impact his health, particularly with a condition like angina.
• Diet and Exercise: His lifestyle may include a diet high in fresh produce or alternatively, it could be high in fatty, fried foods typical of some rural diets. His physical activity levels may be high due to his work.

Cultural Factors:

• Rural Living: Rural cultural norms, such as self-reliance and stoicism, may affect how he perceives and reports symptoms.
• Ethnicity: As a white male, understanding any cultural norms or biases that may affect his healthcare experiences and expectations.

2. Sensitivity Issues

• Access to Healthcare: Given his distance from healthcare facilities, transportation and timely access to medical care are critical issues.
• Healthcare Literacy: Assessing his understanding of his health condition and ensuring communication is clear and jargon-free.
• Cultural Norms: Being sensitive to any rural cultural norms that might influence his healthcare behavior, such as reluctance to seek help or share health concerns.

3. Communication Techniques

• Clear and Simple Language: Using layman’s terms to ensure he understands his condition and treatment options.
• Active Listening: Demonstrating empathy and understanding by listening carefully to his concerns and health complaints.
• Open-Ended Questions: Encouraging him to share more about his health and lifestyle without feeling rushed.
• Respectful Tone: Ensuring that communication is respectful and acknowledges his life experiences and values.

4. Health History Interview

Targeted Questions:

1. “Can you tell me about your typical day on the farm?”
   • Reasoning: To understand his daily physical activity, stress levels, and overall lifestyle.
2. “Have you experienced any new or worsening symptoms of chest pain or discomfort recently?”
   • Reasoning: To assess the current status of his angina and identify any potential exacerbations.
3. “How do you manage your angina symptoms currently, and what medications are you taking?”
   • Reasoning: To evaluate his current treatment regimen and adherence to it.
4. “Do you have any difficulties accessing medical care or obtaining your medications?”
   • Reasoning: To identify barriers to care due to his remote location.
5. “Are there any religious or personal beliefs that might affect your healthcare decisions?”
   • Reasoning: To ensure that his care plan aligns with his values and beliefs.

5. Risk Assessment Instrument

Selected Instrument: The Framingham Risk Score

• Justification: The Framingham Risk Score is applicable as it assesses the risk of cardiovascular events based on factors like age, cholesterol levels, blood pressure, and smoking status. This tool will help in understanding his risk of further cardiovascular issues and guide preventive measures.

Summary

Building a health history for an 80-year-old male with angina who lives in a rural area involves understanding the socioeconomic, spiritual, lifestyle, and cultural factors that affect his health. Sensitive communication techniques, such as using clear language and active listening, are essential. The interview should include targeted questions to uncover key aspects of his health and lifestyle. The Framingham Risk Score is an appropriate tool to assess his cardiovascular risk, considering his age and health condition.