NURS 6512 Discussion: Building a Health History
Asian American Woman with Breast Cancer
Effective communication plays a crucial role in creating a precise and comprehensive patient history. Various factors, such as age, gender, ethnicity, and environmental context, significantly influence a patient’s health or illness. As an advanced practice nurse, it is essential to acknowledge and consider these factors, adapting communication techniques accordingly. This approach not only facilitates the establishment of a strong rapport with patients but also enhances the ability to gather information effectively, contributing to a thorough assessment of the patients’ health risks.
In the context of this discussion, you will assume the role of a clinician responsible for constructing a health history for a specific new patient assigned by your instructor.
Struggling to meet your deadline?
Get your assignment on NURS 6512 Discussion: Building a Health History done by certified MDs and PhDs in the USA. ORDER NOW!
Photo Credit: Sam Edwards / Caiaimage / Getty Images
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
- By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
- How would your communication and interview techniques for building a health history differ with each patient?
- How might you target your questions for building a health history based on the patient’s social determinants of health?
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
- Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
- Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
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.
Communication Techniques
Constructing a comprehensive patient history through effective interviewing is a pivotal aspect of providing high-quality healthcare. The initial interaction establishes the foundation for a successful patient-provider partnership, emphasizing the importance of a patient-centered approach. Patient-centered care, as defined by the Institute of Medicine (IOM), involves respecting and responding to patients’ wants, needs, and preferences to enable them to make choices aligning with their circumstances (Jawad Hashim, 2017). Creating a serene, patient-focused environment is crucial for fostering trust and addressing questions, concerns, and explanations during the interview process (Ball et al., 2019).
In the context of interacting with individuals from diverse cultures, such as an older Asian American woman, cultural competence becomes paramount. Ensuring that the patient comprehends the interview, addressing questions, and avoiding medical jargon are vital aspects of effective communication (Ball et al., 2019).
The Interview:
Breast cancer affects Asian women 50-60% more than other cultures (Zhao & Conard, 2016), and factors like health disparities, modesty, religious beliefs, and cultural norms can impact mammography screenings among Asian American women (Weng & Wolf, 2016). Recognizing the challenges faced by Asian American women in healthcare access and screenings, I must approach the interview with cultural sensitivity. Inquiring about any familial or personal history of breast cancer is essential in understanding the patient’s unique circumstances and addressing potential disparities.
Risk Assessment:
Given the patient’s age and cultural background, she is at an increased risk for breast cancer and osteoporosis. Ordering diagnostic tests and screening exams is imperative for comprehensive risk assessment. These may include a chem panel to evaluate hormone levels, electrolytes (phosphorus, calcium, and calcitonin), a bone density exam, and a mammogram. Checking for past mammogram results for comparison is crucial. Following the completion of these tests, scheduling a follow-up appointment is essential to discuss the results and collaboratively develop a treatment plan if needed. This proactive approach aligns with the principles of patient-centered care and ensures thorough and tailored healthcare for the patient.
5 Targeted Questions
1. What has brought you into the clinic today?
2. Do you have any chronic medical conditions?
3. Do you have medications that you are taking at this time?
4. Have you ever had a bone scan in the past?
5. When was your last mammogram?
6. What are your main concerns today?
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.
Jawad Hashim, M. (2017). Patient-Centered Communication: Basic Skills. American Family Physician, 95(1), 29–34. https://www.aafp.org/afp/2017/0101/p29.html
Weng, S. S., & Wolfe III, W. T. (2016). Asian american health inequities: An exploration of cultural and language incongruity and discrimination in accessing and utilizing the healthcare system. International Public Health Journal, 8(2), 155–167. com.ezp.waldenulibrary.org/login.aspx?direct=true&db=rzh&AN=118800385&site=edslive&scope=site
Zhao, M., & Conard, P. L. (2016). Content validity of a screening instrument for breast cancer early detection among asian american women: the cultural health and screening mammography belief scale. Journal of Nursing Measurement, 24(3), 356–364. https://doi-org.ezp.waldenulibrary.org/10.1891/1061-3749.24.3.356
Maureen Hopkins Sick Visit Shadow health: Management of Endocrine Conditions
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:
- Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
- Suggest additional health-related risks that might be considered.
- Validate an idea with your own experience and additional research.
sample response 1
You brought up insightful considerations in the realm of risk assessments, introducing ideas such as testing for hormone levels and assessing osteoporosis risk. Furthermore, I was not aware that Asian American women face a 50% higher likelihood of developing breast cancer compared to other cultural groups. This statistic prompted me to delve into my own research to comprehend the staggering prevalence within this population. Gomez et al. (2010) propose a potential explanation, suggesting that US Asian women, perceived as generally healthier, might engage less in routine doctor visits for prescreenings and preventative measures. As healthcare providers, it is imperative to devise strategies that motivate individuals from all backgrounds, irrespective of perceived health status, to undergo breast cancer screenings, especially considering it is the most prevalent cancer type among women (Gomez et al., 2010).
Your discussion on cultural sensitivity resonates deeply with me, prompting a humble acknowledgment of my own gaps in understanding various cultures to be the most effective physician in terms of cultural sensitivity. Recognizing the value of patients feeling their cultures are respected, as highlighted by Tucker et al. (2011), underscores the importance of being culturally aware in providing comprehensive care. I realize that acquiring cultural competence is an ongoing process that requires dedication and experience to continually enhance my effectiveness in this aspect.
Your advice on conducting a thorough workup and panel for a comprehensive examination is well-taken. I would extend this approach by engaging in a meaningful conversation with the patient about her specific risks as an Asian American, encouraging her to disseminate information about risks to her family and friends. Proactive healthcare, combined with patient education and advocacy, is crucial. Empowering patients to be active participants in their healthcare journey, fostering a sense of partnership with providers, can significantly contribute to successful health outcomes.
References
Gomez, S. L., Quach, T., Horn-Ross, P. L., Pham, J. T., Cockburn, M., Chang, E. T., Keegan, T. H., Glaser, S. L., & Clarke, C. A. (2010). Hidden breast cancer disparities in Asian women: disaggregating incidence rates by ethnicity and migrant status. American Journal of Public Health, 100(Suppl 1), S125–S131. https://doi.org/10.2105/AJPH.2009.163931
Tucker, C. M., Marsiske, M., Rice, K. G., Nielson, J. J., & Herman, K. (2011). Patient-centered culturally sensitive health care: model testing and refinement. Health psychology: official journal of the Division of Health Psychology, American Psychological Association, 30(3), 342–350. https://doi.org/10.1037/a0022967
sample response 2
Thanks for the great points. You’ve highlighted valuable aspects of effective healthcare communication, emphasizing the importance of understanding patient beliefs and culture. Being self-aware as a provider, along with being a skilled listener and observer, is crucial for successful communication. Nonverbal cues, such as facial expressions and body language, play a role in complementing active listening.
Your recommendation for patient-centered culturally sensitive healthcare is noteworthy. It involves emphasizing patient-desired behaviors, fostering a partnership in the patient-provider relationship, and empowering patients to share their views on culturally sensitive care. This approach is unique in that it prioritizes the perspectives of culturally diverse patients, promoting respect and trust in healthcare interactions.
References
Jones, D. S. (2006). The persistence of american indian health disparities. American Journal of Public Health, 96(12), 2122–2134. Retrieved September 2, 2021, from https://doi.org/10.2105/ajph.2004.054262
Tucker, C. M., Marsiske, M., Rice, K. G., Nielson, J., & Herman, K. (2011). Patient-centered culturally sensitive health care: Model testing and refinement. Health Psychology, 30(3), 342–350. https://doi.org/10.1037/a0022967
Tucker CM, Marsiske M, Rice KG, Nielson JJ, Herman K. Patient-centered culturally sensitive health care: model testing and refinement. Health Psychol. 2011;30(3):342-350. doi:10.1037/a0022967
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.). Mosby.
Dont wait until the last minute.
Provide your requirements and let our native nursing writers deliver your assignments ASAP.