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.
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 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.
Colleague1
Case study: 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.
When treating a patient, we need to treat them with a holistic approach. Holistic health is treating the patient’s mind, body, spirit, and social needs rather than just focusing on physical health (Holland, 2018). The socioeconomic status of this patient could negatively impact his health. He is an elderly patient that is dependent on his daughter for financial stability, and his daughter is a single mother who is financially unstable herself. The patient’s financial hardships can make it hard to seek medical attention when needed, maintain a well-balanced diet, and participate in other activities that could improve his quality of life. The patient has not discussed any spiritual background but may be lacking the spiritual guidance that could improve his health and quality of life. Studies show that patients that are spiritual are better at coping and making important medical decisions (Spiritual Care, 2020).
Culture
It is a belief among Asian-Americans that if you seek mental health or discuss any mental health issues you are facing, you are considered to be crazy (Tanap, 2019). Their culture also believes that the men should be providers, J.C. is dependent on his daughter which is a strain on his mental health because he may believe he is failing by not being the provider. He also expresses stress about not wanting to burden his daughter. It is crucial to express the importance of good mental health to the patient and remind him that there is no shame in seeking help.
Communication
The physician needs to be culturally competent and sensitive to the patient’s socioeconomic situation, ethnicity, and cultural background when communicating with the patient. A provider should ask a patient what exactly they mean when they need clarification as a provider, and they also need to continue to ask the patient if they understand or need clarification. If a provider is not sensitive to these items, communication and trust can be lost (Ball et al., 2019). The Asian culture relies more on body language than actual words for effective communication, good posture, tone of voice, and gestures are important when communicating with this specific patient. In the Asian culture, they may smile a lot when they are uncomfortable or do not understand, this is a que that we as providers need to clarify the information we just provided (Pier, n.d.).
5 Targeted Questions
1. How are you feeling in general about your health? What is concerning you about your health recently?
2. Have you ever considered looking into resources in the community that could help with managing your health?
3.Do you have trouble affording your medications or are you ever worried you will not be able to afford groceries?
4. What do you typically eat in a day?
5. Do you feel safe at home? 6. Do you have any trouble performing daily activities such as bathing, feeding yourself, or getting dressed?
7. Do you feel sad or depressed? If so, How many days a week would you say that you feel sad?