Zakiya Unique Johnson
Intro
 Advanced practice registered nurses (APRNs) must take into account the effects of variables like cultures and developmental conditions in order for health assessments to be effective and support the patient’s health. The fact that various populations, cultures, and groups have various beliefs and behaviors that have a range of effects on their health in a number of contexts is also crucial to notice. To complement the diversity, they will meet, APRNs must develop the ability to adjust their health assessment methodologies and approaches. The goal of this discussion is to clarify the socioeconomic, spiritual, lifestyle, and other cultural aspects of the assigned patient case study, as well as the issues that the APRN should be aware of when interacting with the patient. It also offers specific questions that should be asked in order to develop a health history and evaluate the patient’s health risks.
 
Socioeconomic, Spiritual, Lifestyle & Cultural Factors
The patient is a 33-year-old single Caucasian who, while being born a woman, identifies as male. The patient transitioned about two years ago and told his loved ones and friends about it. He is currently jobless and intends to return to live with his parents. He has been a well-known heavy smoker for a number of years, suffers from depression, and has has HIV . The patient was given an HIV diagnosis three years ago, but according to his most recent blood work, he has been virally suppressed for six months. He currently takes Biktarvy once daily, which was provided at no cost to the patient, and testosterone every seven days, which he obtains on the internet. Other than his telehealth appointment three months ago to collect his suppression meds, the patient has not previously received any medical attention. The patient comes in to establish himself as a new patient and to address his recent symptom of feeling extremely weak, which effectively led him to return home with his parents. There is no relevant historical medical history or family history for the patient. The patient is still concerned about his deteriorating health, his unemployment, and his reliance on his family.
 
Target Questions: Health History & Health Risks
The APRN should make sure that patient-centered care, cultural competency, and cultural humility are kept at the forefront and overlap at the very least when getting ready to ask the patient questions to develop a health history and address health concerns. Patient-centered care enables professionals to address health promotion and illness prevention while also reducing constrictive behavior, comprehending the phases of the medical interview (Ball et al., 2019). Healthcare professionals must maintain cultural competence by remaining mindful of patients’ ethnicity, sexual orientation, socioeconomic background, and religious beliefs (Ball et al., 2019). Cultural humility is the capacity for practitioners to acknowledge their knowledge and cultural perspective gaps while remaining receptive to fresh viewpoints (Ball et al., 2019). The patient-practitioner connection can be strengthened and made more fruitful when the practitioner views the patient as an individual as opposed to a member of a group. Together, these three ideas guarantee that the APRN respects the patient’s values, beliefs, and preferences, communicates their unwavering positive regard, and offers instruction that is specific to their requirements and level of knowledge (Ball et al., 2019). The RESPECT model, which stands for rapport, empathy, support, partnership, explanations, cultural competence, and trust (Ball et al., 2019), could also be used by the APRN to help construct the patient’s medical history. This concept is a fantastic tool for patient-centered care and cross-cultural communication, fostering respect for patients across cultural divides. The following targeted questions could be used by the APRN as a starting point for establishing the patient’s medical history and determining his health risks:
* What are your healthcare goals? What are you hoping to achieve today?
* How is your transition is going so far? Are there any challenges you’ve struggled with? What is going well?
* How are you feeling today? Can you describe your lows, highs, and moments of comfort?
* How long have you experienced your current symptoms?
* How often are you taking your medications? Do you have a routine or schedule with your medications?
* Can you demonstrate how you administer your testosterone intramuscular (IM) injections? I want to be sure you can receive safe-needle handling education if you are interested or there is a need for it.
* How many sexual partners have you had in the last six months?
Conclusion
“A culturally competent healthcare provider adapts to the unique needs of patients from backgrounds and cultures that differ from his or her own” (Ball et al., 2019, p. 22). Crossing the cultural barrier enables APRNs to broaden their perspectives and be more considerate of how they can provide their patients with the best care and support while honoring their cultural distinctions. Being flexible in the face of cultural diversity and striving to develop cultural competence change throughout time as “individuals and organizations are at various levels of awareness, knowledge, and skills along the culture competence continuum” (Centers for Disease Control and Prevention, 2020, para. APRNs must have a solid understanding of themselves to the point that they can utilize probing questions to avoid perceiving the patient as a stereotype in order to develop a strong health history. In general, it is crucial for practitioners to understand themselves in order to better understand their patients because preconceptions and attitudes are frequently produced from cultural viewpoints. The APRN can have sincere intentions to advance cultural competency by being flexible enough to meet each patient’s specific needs.
 
 
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.
 
Centers for Disease Control and Prevention. (2020). Cultural competence in health and human
services. https://npin.cdc.gov/pages/cultural-competence.
 
Kirubarajan, A., Patel, P., Leung, S., Park, B., & Sierra, S. (2021). Cultural competence in fertility care for
lesbian, gay, bisexual, transgender, and queer people: a systematic review of patient and provider
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Sketa Simone Bennett
John Green, a 33-year-old Caucasian male, has presented to the office as a new patient. It’s important to note that John’s natal sex is female, but he identifies as a male, having completed his transition two years ago, including social and familial aspects. When interacting with John, it is crucial to be respectful and affirming of his gender identity by using his chosen name and pronouns (he/him). Understanding the unique healthcare needs and challenges faced by transgender individuals is essential in providing appropriate care (Cicero et al., 2019).
John’s current socioeconomic status is marked by unemployment, and he has recently moved back home with his parents. This change in circumstances may cause financial stress and dependence on his family, potentially impacting his mental health. It’s important to address his concerns about being a burden on his family and to explore any vocational or job-seeking support he may require during this period of transition (Liu et al., 2020).
John’s lifestyle presents several notable factors that need consideration. He is a heavy smoker, consuming two packages of cigarettes daily for the past decade, and also uses marijuana regularly. Both substance use habits have the potential to adversely affect his overall health and interact with any medications he is currently taking (Moller et al., 2021). Discussing these habits with a non-judgmental approach and exploring strategies to reduce or quit smoking and marijuana use is crucial.
John has a history of depression episodes, which could be influenced by various factors such as unemployment, his gender transition, or living with HIV. Assessing the severity of his depression, any suicidal ideation, and exploring appropriate mental health support and referrals are essential aspects of his care.
In addition to his depression, John is living with HIV, having been diagnosed for the past three years. However, it’s noteworthy that he is virally suppressed, as confirmed by his last blood draw six months ago. Maintaining medication adherence, monitoring his viral load regularly, and addressing any concerns or misconceptions he may have about HIV and its treatment are vital for his overall health (Moller et al., 2021).
To build John’s health history and assess potential health risks, sensitive questions should be asked. These questions may include inquiring about his experiences during his gender transition, exploring the impact of unemployment and the recent move on his mental health, discussing his smoking and marijuana use, inquiring about the details of his depression episodes, and understanding his experiences living with HIV and any medication-related concerns.
Questions to build John’s health history and assess health risks include:
1. Can you share more about your experience with your gender transition? Are there any specific healthcare needs or concerns related to your transition that you’d like to discuss?
2. How has unemployment and the recent move back home affected your mental health? Are you open to exploring strategies for coping with stress during this period?
3. Can you describe your current smoking habits and marijuana use? Have you ever tried to quit or reduce these habits?
4. You mentioned a history of depression episodes. Can you provide more details about when these episodes occur, their severity, and any triggers you’ve noticed?
5. How has living with HIV impacted your daily life and overall health? Are you experiencing any side effects from your medication, Biktarvy?
References
Cicero, E. C., Reisner, S. L., Silva, S. G., Merwin, E. I., & Humphreys, J. C. (2019). Healthcare experiences of transgender adults: An integrated mixed research literature review. ANS. Advances in Nursing Science, 42(2), 123. https://doi.org/10.1097%2FANS.0000000000000256
Liu, Z., Heffernan, C., & Tan, J. (2020). Caregiver burden: A concept analysis. International Journal of Nursing Sciences, 7(4), 438-445. https://doi.org/10.1016%2Fj.ijnss.2020.07.012
Moller, C. I., Cotton, S. M., Badcock, P. B., Hetrick, S. E., Berk, M., Dean, O. M., … & Davey, C. G. (2021). Relationships between different dimensions of social support and suicidal ideation in young people with major depressive disorder. Journal of Affective Disorders, 281, 714-720. https://doi.org/10.1016/j.jad.2020.11.085