6512-2 Diversity and Health Assessments RESPONSES.

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.6512-2 Diversity and Health Assessments RESPONSES.

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Maari B. Wk 2 Discussion post

COLLAPSE

Top of Form

Achieving competence related to a patient’s socioeconomic, spiritual, lifestyle, and cultural factors is part of patient-centered care. It is a healthcare professional’s job to maintain sensitivity to a patient’s cultural background. An important part of a medical provider’s role is to understand a patient’s cultural identity and how it may interact with their health, health belief and practices, and family relationships. In this discussion, a 16-year-old Caucasian female, BK, presents to the clinic for an annual exam with her grandmother. The grandmother is concerned about her behavior in relation to her recent withdrawn and disinterested behavior. Grandmother is taking care of BK because her mother is incarcerated and is concerned her granddaughter is partaking in illicit drugs.6512-2 Diversity and Health Assessments RESPONSES.

Several factors are taking place with this patient. Determining these factors may require additional interview questions about their interaction and effects on patient BK. External factors, such as familial and social or environmental issues, interact with internal factors, such as biological and cognitive development (McLeod et al., 2013). In this adolescent patient, lifestyle and socioeconomic factors may be contributing to the presentation of her withdrawn behavior. It will be imperative to discuss with both the grandmother and the adolescent individually to determine areas that may be too sensitive to discuss in the presence of the other person.6512-2 Diversity and Health Assessments RESPONSES. The teen’s home life, developmental history, academic history, and family history of psychopathology may be at play. If the grandmother is the only adult figure in the household, the home environment may be affected by alterations in finances and parental roles. If the mother was recently incarcerated, this may be affecting the patient is several ways including depression, separation anxiety, anger towards her parent, etc. It will be imperative to further interview the patient to identify the behavior of interest, the antecedent events, and the consequent events (McLeod et al., 2013). These behaviors are of interest relating to the preceding stimuli to a behavior and the punishers and reinforces of the behavior.6512-2 Diversity and Health Assessments RESPONSES.

Some targeted questions to further identify health risks and build history on this patient include:

• “Who are the parental figures in your life? And how do they play a role in your everyday life?”
• “How many times in the last week did you feel sad?”
• “Do you have thoughts on harming yourself?”
• “What things do you do for fun? What things do you and your family do for fun?”
• “What things do you do when you’re feeling sad?”
• “Who do you talk to when you’re upset?”

These questions can often be difficult for a patient to be asked and building rapport can prove to be beneficial prior to asking these sensitive questions. It appears the patient is exhibiting some withdrawn behavior and may have some underlying depression or other mental health concerns. Building a trusting patient-provider relationship can help to induce disclosure of sensitive topics.6512-2 Diversity and Health Assessments RESPONSES. Adolescents with depression have had higher levels of negative affect when compared to their peers, especially in females (Nelson et al., 2017). This exemplifies the importance of identifying suicidal ideations and self-harm risk to identify areas of acute intervention. One study showed that emotional neglect had an increased effect on suicidal ideation with depression symptoms (Sekowski et al., 2020). Several conflicts may exist in the household with distrust from the grandmother, the home life when the mother was doing drugs, the impact of a father figure, etc. Determining these may give a better picture of the underlying behaviors. It may be beneficial to have the patient fill out the Patient-Health Questionaire-9 (PHQ-9) when speaking alone with the grandmother to identify further areas for follow-up questions with the patient. When speaking with the grandmother, asking about what her impressions of the patient’s home life may add information as well.6512-2 Diversity and Health Assessments RESPONSES.

In summation, the multifactorial effects of this patient’s homelife, culture, and background all affect the behavioral presentation. Family dynamics can create an especially sensitive dialogue between the family, patient, and provider. Having private interviews and building rapport can be beneficial in creating adequate and truthful disclosures that need to be addressed. In this case of a withdrawn 16-year-old female, determining mental health risk, safety, and multifactorial effects can assist the medical provider in identifying areas of intervention. 6512-2 Diversity and Health Assessments RESPONSES.

The discussion post offers an analysis of the appropriate care approach for a client scenario. The author describes the client (BK) and the scenario as well as the interactions. It is commendable that the author focuses on the cultural aspects of care by identifying the need for cultural competence and sensitivity in care delivery.6512-2 Diversity and Health Assessments RESPONSES. In addition, the author raises concern about spirituality and the implications for care delivery. Besides that, the author presents some targeted questions that facilitate efforts to better understand the needs of the client. Still, there are some concerns that should be addressed to better improve the analysis. Firstly, there is a need to address concerns about client autonomy and informed consent. The teenage client was brought in for care by her grandmother, and it is important to get the client’s opinion on whether she feels the need for the care and if she would be receptive to care. A receptive client would better support the care delivery efforts thus improving the outcomes. Additionally, this understanding would help in directing the care efforts in terms of therapy approach applied. Secondly, the author makes an assumption about the client’s spirituality without verifying this with the client or presenting tangible evidence to support the claims. Such assumptions have implications for the care approaches and could result in an ineffective approach being applied (Sperry, 2016). Thirdly, the list of questions do not match the case scenario. The grandmother is concerned that the client could be using drugs as her mother is using drugs. As such, the questions should be related to the use of drugs or any other substance (Pitta, 2014). Overall, the discussion has been well presented and would be improved by including the suggested changes.6512-2 Diversity and Health Assessments RESPONSES.

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.6512-2 Diversity and Health Assessments RESPONSES.

Ijeoma A. 

Initial Discussion

COLLAPSE

Top of Form

The scenario that I was assigned to is BK is a 16-year-old Caucasian female who comes in with her grandmother for an annual exam. The grandmother reports BK has been “acting strange, staying in her room all the time and refusing to do all the things she used to enjoy like singing in the youth choir”. Grandmother shares that BK’s mother is a drug addict is currently incarcerated, so she is worried BK is using drugs and wants her tested for drugs. BK is not on any medications. She is obese and does not make eye contact when you enter the room.6512-2 Diversity and Health Assessments RESPONSES.

According to (Ball, 2015). Each patient should be treated according to their cultural, religious, socioeconomic, and personal beliefs.  In interacting with this patient, culture plays a huge role. Culturally competent healthcare providers can adapt to the unique needs of patients from various cultural backgrounds, developing a trusting relationship between the healthcare provider and the patient (Ball, Dains, Flynn, Solomon, & Stewart, 2015). As a provider, I will welcome both grandma and the patient, make them feel comfortable and ask the grandma to excuse us since BK is 16-year-old female and considered as an adolescent. Effective communication with adolescents requires seeing the patient alone, tailoring the discussion to the individual patient, and understanding the role of the parents and of confidentiality (Ham & Allen, 2012).

Based on the spiritual issue, my assumptions are that BK attends church because it is stated that she likes to sing in the youth choir. BK staying in her room all the time calls for concern because it is not part of her life style. From all indication. BK’s life style is not as it used to be and calls for attention.6512-2 Diversity and Health Assessments RESPONSES.

The thing I will be sensitive about is the report from grandma that BK acts strange, staying in her room all the time and refusing to do all the things she used to enjoy like singing in the youth choir is not her real self. According to Pre-teen and teenage depression, (2019) if your child stops doing things he usually enjoys, doesn’t seem to be enjoying the things he’s doing, isn’t doing so well at school or is taking more risks than usual, this could be a sign that he’s feeling very anxious, depressed or stressed.6512-2 Diversity and Health Assessments RESPONSES.

This calls for in debt assessment to know what is going on, when, why she is acting the way she is doing. because to grandma BK “acting strange” is new. When interacting with this patient I will be also be sensitive with the fact that her mother is a drug addict and is currently incarcerated and also that BK is obese. The reason why I will be sensitive to this is because BK is not happy, not behaving the way she used to, not having her mother around at a time when she most needed her is devastating and frustrating, and being overweight at her age puts her self-esteem down, young girls of her age would prefer to look skinny and radiant. To her she is out of shape and will be feeling bad about it.

5 targeted questions

1.Do you feel safe at your house?

2. Do you take your meals normally?
3. Are you in school? What extracurricular activities do you participate in?
4. Do you have friends; do you go out with your friends to have fun?
5. Do you feel depressed? Have you ever thought of harming yourself?

Overall, being calm nonjudgmental will help with the assessment so that BK will freely interact with the provider. Her lack of eye contact may look like she is in not engaging in the assessment but giving her the time to gain trust will be very helpful.6512-2 Diversity and Health Assessments RESPONSES.