How many times in the past 3 months have you used recreational/illegal drugs or used a prescription drug for nonmedical reasons?
Discussion: Building a Health History Interview Summary and Communication Techniques My assigned patient was a 26-year-old Lebanese female living in graduate-student housing. When conducting an interview to gather health history, it is important to treat each patient as a unique individual. Providers should recognize that cultural diversity exists, and display sensitivity to the patient’s heritage, sexual orientation, socioeconomic situation, ethnicity, and cultural background (Ball, Dains, Flynn, Solomon & Stewart, 2019). This particular patient is a young female adult of Lebanese descent, who is attending college. One of the main goals of documenting the history of a patient is to identify factors outside of past or current medical conditions that may influence the patient’s overall health or behavior that create risk factors for specific conditions (Sullivan,, 2019). Targeting appropriate questions toward what we initially know about a patient’s background can help to build trust and facilitate effective communication between the patient and the provider. When conducting an assessment of a patient’s health history, a primary objective is to discover the details about a patient’s concern, explore expectations for the encounter, and display genuine interest, curiosity, and partnership (Ball et al., 2019). Health related risks that this patient might experience can include poor eating habits, alcohol or other substance abuse, stress, anxiety, lack of sleep and reproductive issues. This particular patient is Lebanese and therefore cultural values may be of great importance to her. According to Shaya, Al Homsi, Eid, Haidar, Khalil, Merheb and Honein-Abou Haidar (2019) people of Lebanese heritage value providers who are ‘non-materialistic’, have a good rapport, and have sufficient encounter time with patients. Social factors that enhance trust in the provider include: being a family member, recommended by a family member, featured in mainstream media, and/or having a good reputation. Providers should recognize and be perceptive to differences in attitudes, behaviors, values, world-views and communication styles during medical encounters with culturally diverse patients (Ahmed & Bates, 2007). Furthermore, this patient is a graduate college student. This population carries another set of values, especially in light of advancing technology. A study by Kwan, Shaw and Murnane, (2019) revealed that the proportion of online health information seekers is 19% higher among college graduates than high school graduates. Since this population is generally comfortable accessing health information via the internet, providers should consider talking with these patients about the merits of certain web-sites in order to help direct them to the most reputable and reliable sources. Risk Assessment Graduate college students, and especially female students, like the one in this provided example may be prone to high levels of stress or anxiety. One risk assessment tool that could be useful in this scenario is the Generalized Anxiety Disorder 7-item (GAD-7) Scale. The anxiety and their related disorders are the most prevalent of all mental health conditions, disproportionately affecting women. (Fairbrother, Corbyn, Thordarson, Ma & Surm, 2019). The GAD-7 risk assessment tool was created mainly for the primary care environment. It has been shown to have a sensitivity of 0.83 and specificity of 0.90 in the detection of Generalized Anxiety Disorder (Fairbrother et al., 2019). Targeted Questions 1. How many times in the past 3 months have you used recreational/illegal drugs or used a prescription drug for nonmedical reasons? 2. Over the past 3 months, how often have you felt depressed or hopeless? 3. Over the past 3 months, how often have you felt nervous, irritable or anxious? 4. How many times in the past week have you eaten fast food or processed snacks? 5. In the past week, how many times did you consume fresh fruits or vegetables? 6. In the past week, how many times have you engaged in >30 minutes of exercise? 7. Do you feel that you have adequate emotional and social support? References: Ahmed, R., & Bates, B. R. (2007). Gender differences in patients’ perceptions of physicians’ cultural competence in health care interactions. Women’s Health & Urban Life, 6(2), 58–80. 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. Fairbrother, N., Corbyn, B., Thordarson, D. S., Ma, A., & Surm, D. (2019). Screening for perinatal anxiety disorders: Room to grow. Journal of Affective Disorders, 250, 363–370. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jad.2019.03.052 Kwan, G., Shaw, J. A., & Murnane, L. (2019). Internet usage within healthcare: How college students use the internet to obtain health information. Journal of Consumer Health on the Internet, 23(4), 366–377. https://doi-org.ezp.waldenulibrary.org/10.1080/15398285.2019.1681247 Shaya, B., Al Homsi, N., Eid, K., Haidar, Z., Khalil, A., Merheb, K., Honein-Abou Haidar, G., & Akl, E. A. (2019). Factors associated with the public’s trust in physicians in the context of the Lebanese healthcare system: a qualitative study. BMC Health Services Research, 19(1), N.PAG. Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis. Building a Comprehensive Health Assessment According to Ball, Dains, Flynn, Solomon, and Stewart (2019), it is essential to establish a meaningful relationship with the patient in building a comprehensive health history due to it is a critical component in providing a high-quality of care. As health care providers, it is necessary to allow the patient to make decisions in their care and respect their choices. It is also essential to consider the patient’s cultural beliefs, values, and faith when building a health assessment (Ball et al., 2019). Communication Techniques Balls et al. (2019) mentioned that an excellent relationship between a health care provider and the patient depends on the communication skills of a health care provider. In communicating with the patient, it is necessary to have connection, respect, and comfort. The relationship is built by maintaining eye contact while talking to the patient. However, it depends on the cultural background of the patient. According to Uono and Hietanen (2015), maintaining eye contact during social interaction is more important to Western Europeans compare to East Asians. Japanese people are taught not to gaze into someone else eyes due to maintaining eye contact is considered disrespectful. It is also necessary for a health care provider to maintain a trusting relationship with the patient to allow the patient to share confidential information. Effective communication is a powerful key in preventing malpractice and an effective way to provide high-quality care for the patient (Nguyen, Hong, & Prose, 2013). Risk Assessment Tool Studies by Wu and Orlando (2015) shows that risk assessment allows an individual to point out the importance of health promotion and disease prevention. Gathering health information from the patient is a crucial component in determining chronic illnesses and more. In building a comprehensive health history of a 26 years old Lebanese living in a graduate school housing, a health practitioner must assess the living situation of the patient to evaluate the safety of the patient. Also, it is essential to know the religion of the patient due to culture, and faith can affect how a person views their health and diseases (Ball et al., 2019). Moreover, breast cancer risk assessment is essential to this patient due to breast cancer is one the leading cause of mortality among women (Arevian, Noureddine, & Abboud, 2011). Lebanon has the highest number of breast cancer cases over the past 50 years (Elias, Bou-Orm, & Adib., 2017) Some of the contributing factors to the increase of breast cancer include menstrual history, ethnicity characteristic, and alcohol consumption (Arevian et al., 2011). Five Targeted Questions Tell me about your living situation? What religion do you practice? How often do you visit your primary doctor? Do you drink alcohol? Are you sexually active? Do you get your period regularly? References Arevian, M., Noureddine, S., & Abboud, S. (2011). Beliefs Related to Breast Cancer and Breast Cancer Screening Among Lebanese Armenian Women. Health Care for Women International, 32(11), 972–989. https://doi- org.ezp.waldenulibrary.org/10.1080/07399332.2011.580405 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. Elias, N., Bou-Orm, I. R., & Adib, S. M. (2017). Patterns and determinants of mammography screening in Lebanese women. Preventive Medicine Reports, 5, 187–193. https://doi- org.ezp.waldenulibrary.org/10.1016/j.pmedr.2016.12.015 Nguyen, T. V., Hong, J., & Prose, N. S. (2013). Compassionate care: Enhancing physician– patient communication and education in dermatology: Part I: Patient-centered communication. Journal of the American Academy of Dermatology, 68(3), 353. https://doi-org.ezp.waldenulibrary.org/10.1016/j.jaad.2012.10.059 Uono, S., & Hietanen, J. K. (2015). Eye contact perception in the West and East: a cross-cultural study. Plos One, 10(2), e0118094. https://doi- org.ezp.waldenulibrary.org/10.1371/journal.pone.0118094 Wu, R. R., & Orlando, L. A. (2015). Implementation of health ris assessments with family health history: Barriers and benefits. Postgraduate Medical Journal, (1079), 508-513. 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. please response to each separately
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