Diversity and Health Assessments Discussion

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

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Discussion: Diversity and Health Assessments

Self-awareness of cultural differences is the first step to the delivery of linguistically and culturally-competent care. Cultural competence is a critical element in health care considering the growing cultural diversity in the United States. However, cultural diversity is not just about race or ethnicity. In contrast, cultural diversity also includes socioeconomic, linguistic, and spiritual factors that influence health. Therefore, advanced practice nurses must identify how cultural, socioeconomic, lifestyle, and spiritual factors influence health outcomes (Ball et al., 2016). According to Ball et al. (2016), cultural awareness plays an instrumental role in ensuring the delivery of holistic, patient-centered care. As such, the purpose of the discussion post is to explore the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with a 54-year-old Caucasian male who presented to the clinic after experiencing a seizure related to alcohol withdrawal. The post will also include sensitive issues to consider when interacting with the patient, including targeted questions. Diversity and Health Assessments Discussion

Cultural Factors Related to the Patient

Culture does not have a major effect on the patient’s health outcomes considering that he does not belong to the ethnic/racial minority group. The point of argument is that minority groups have poorer health outcomes compared to Whites/Caucasians because of institutional racism and discrimination (Adepoju, Preston, & Gonzales, 2015). Nevertheless, socioeconomic factors and lifestyle have a profound influence on the patient’s health and wellbeing. The patient has a low socioeconomic status considering that he is currently homeless and living in a homeless shelter. Homeless persons have limited access to primary care because of their socioeconomic conditions. Furthermore, homeless persons do not receive comprehensive, patient-centered care even when they make contact with primary care facilities. Poverty, lack of health insurance, and unstable housing are the foremost barriers to accessibility (Kiser & Hulton, 2018). Consider the example where the patient has no supply of amlodipine 10 mg, which is critical for the treatment of the underlying hypertension. The issue reinforces the lack of accessibility to primary health care. Diversity and Health Assessments Discussion

Social determinants of health are also a significant issue for the patient, especially on his lifestyle choices. The patient is hypertensive and currently abstaining from substance use disorders (SUDs). Unavailability of the amlodipine 10 mg means that the patient does not have access to primary care, including preventive services. The patient’s hypertension will worsen and become either an emergency or crisis unless he has access to integrated, patient-centered care, including medication and lifestyle interventions. On the other hand, the patient was recently hospitalized after experiencing a seizure related to alcohol withdrawal. Additionally, he smokes cigarettes as a coping strategy for alcohol and cocaine withdrawal oblivious of the adverse effect of smoking on hypertension outcomes. The two examples show that the patient has limited access to supportive services, specifically rehabilitation services. Ponce et al. (2018) have found that service providers often focus on crisis management rather than the long-term needs of homeless populations. Thus, it would be difficult to promote healthy living unless the client has access to integrated care, stable housing, and supportive resources in the community. Diversity and Health Assessments Discussion

Sensitive Issues to Consider

Homelessness and substance use are the two most sensitive issues for the patient. Research findings have shown that homeless persons often experience stigma and shame when accessing healthcare services (Purkey & MacKenzie, 2019). According to Purkey and MacKenzie (2019), the negative experiences often lead to the avoidance or abandonment of health care services. Therefore, it is necessary to be sensitive when talking about the patient’s homeless situation and the use of drugs. For example, it would be insensitive to blame the patient for his homeless status or inability to adhere to both medication and lifestyle interventions without considering the underlying issues. The best approach is to assess the needs of the patient and then ensure that he has access to integrated and well-coordinated care. The achievement of this goal is essential considering that homeless persons have many unmet needs because of the current level of fragmentation of critical health and social services. Substance use is one of the area where fragmentation is pervasive (Kiser & Hulton, 2018). Integrating primary care and treatment for SUDs will significantly improve patient outcomes.

Targeted Questions

Posing the right questions to the client will be key in developing a comprehensive care plan. The targeted questions will include the following: Diversity and Health Assessments Discussion

1. How long have you been diagnosed with hypertension?
2. Were you diagnosed with hypertension before or after being homeless?
3. Where do you receive care for the hypertension?
4. What issues do you face when accessing health care?
5. How has being homeless affected your access to health care?
6. Do you think that the situation would be different if you were not homeless?
7. Are you currently enrolled in any supportive service for substance use? What has been your experience with substance use treatment?

References

Adepoju, O. E., Preston, M. A., & Gonzales, G. (2015). Health care disparities in the post-Affordable Care Act era. American Journal of Public Health, 105(5), S665–S667. https://doi.org/10.2105/AJPH.2015.302611

Ball, J.W., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2015). Seidel’s guide to physical examination (8th ed.). Elsevier Mosby.

Kiser, T., & Hulton, L. (2018). Addressing health care needs in the homeless population: A new approach using participatory action research. SAGE Open, 8(3), 215824401878975. https://doi.org/10.1177/2158244018789750

Ponce, A. N., Brown, M., Cunningham, A., & Rowe, M. (2018). Stakeholder perspectives on integrated services for people who experience chronic homelessness. Journal of Distress & Homelessness, 27(2), 126-134. https://doi.org/10.1080/10530789.2018.1501947 Diversity and Health Assessments Discussion