A patient's socioeconomic, spiritual, lifestyle, and other cultural factors
John Green, 33 year-old Caucasian male, presents to the office to establish as a new patient. John’s natal sex is female but he identifies as a male. He transitioned from female to male 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has been obtaining testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smokes 3-6 marijuana joints every weekend (has an active green card), and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks which prompted him to move back home with his parents. He takes Biktarvy once daily that comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and unemployed he will be a burden on his family, and he thinks his health may be declining.
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.
Sample Solution
Socioeconomic Factors: John is unemployed and has recently moved back home with his parents. This can be an indication of financial stress which can then lead to health-related issues such as depression and anxiety, as well as physical health problems due to decreased access to resources. He also uses Telehealth for his suppression medications, indicating a lower level of access or financial difficulty in covering the cost of healthcare.
Lifestyle Factors:
John smokes cigarettes and marijuana on a regular basis, both of which are damaging to one’s general health. He is also HIV positive and has not received any healthcare since transitioning other than obtaining suppression medications through Telehealth. His overall lifestyle habits could potentially increase his risk for additional illnesses or complications from existing conditions if left unchecked or unaddressed by healthcare professionals.
Spiritual/Cultural Factors:
John identifies as male but was natal female, so he may have experienced some discrimination regarding this transition within his family or community setting that could affect how he interacts with the medical staff when seeking care. It is important to consider cultural sensitivity when interacting with John so that he feels comfortable discussing all aspects of his life openly without fear of judgement or discrimination due to gender identity concerns. Additionally, it is likely that John may not have had much support during his transition process due to cultural norms related to gender roles within society at large; understanding these nuances can help ensure that John receives proper care and support while being treated in the medical office environment.
Targeted Questions:
1) What specific symptoms have you been experiencing over the last few weeks?
2) How long have you been smoking cigarettes per day?
3) What kind of marijuana do you smoke (indica/sativa)? How often per week?
4) Are there any other recreational drugs that you use regularly? 5) Have you ever been tested for Hepatitis C before?