NURS 6512 Week 2 Discussion: Diversity and Health Assessments

Today’s healthcare model has persistent challenges with ethnic, gender, racial disparities, and cultural competency. Many factors determine health beyond the healthcare setting, commonly referred to as the SDOH (Social Determinants of Health). They include housing, education, access to care, and healthy nutrition among others. Nair & Adetayo (2019) estimates that by the year 2050, up to 50% of the US population will be ethnic minorities, yet currently, there are cultural, ethnic, and racial disparities. Healthcare disparities hinder access to quality healthcare services, which leads to graver health issues, ED visits, a high likelihood to develop cardiovascular illnesses, cancer, diabetes, and mental illnesses.
According to Ball et al., (2015), cultural competence is one strategy for addressing health disparities and improving the quality of care for ethnically and culturally diverse groups. Cultural competence recognizes and addresses the linguistic and cultural barriers to health to ensure that patients receive high-quality care. This paper examines the specific spiritual, socio-economic, lifestyle, and cultural factors associated with a 38-year-old Native American pregnant female living on a reservation.NURS 6512 Week 2 Discussion: Diversity and Health Assessments.  It also discusses the sensitive issues to consider during the nurse-patient interaction and target questions that can help to assess healthcare risks and build a health history

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Socioeconomic, Spiritual, Lifestyle, And Other Cultural Factors
Native Americans comprise 1.7% of the US population and the majority live in western states in non-reservation areas. Spiritually, most Native Americans believe that all creations are equal and that there is one just and loving Creator. This creator has given men and women a special gift for mediating between the earthly and spirit world on spiritual renewal and healing. They value relationships, community, and family, which comprises of the community members, close family members, and extended family members, and elders play a huge role in making decisions. Reciprocity, connectedness, completeness, and balance define their overall health and well-being. Families pass on culture, morals, ethics, values, and beliefs through oral traditions and ceremonies.
Issues to Be Sensitive To When Interacting With the Patient
To provide culturally competent care to this patient, it will be important to be sensitive to issues associated with the patient’s sexual orientation, heritage, cultural background, ethnicity, and socio-economic situation (Ball et al., 2015). The most significant cultural issues are those associated with language, spirituality, and healthcare. Most Native Americans are skeptical about receiving care from a doctor since they do not believe in the healthcare system. It is for this reason that the majority use home and herbal remedies. However, as stated by Wachtel-Galor & Benzie (2018), some of these remedies can be harmful or interact with drugs causing adverse drug events.
Therefore, during the nurse-patient interaction, it is important to refrain from statements or comments that express mistrust in the healthcare system. It is also important to establish whether the client can communicate effectively in English, failure to which, a translator must be availed. Talking in high voices and direct eye contact is non-verbal communication signs of rudeness while long periods of silence between conversations are a sign of active listening. To assess the extent to which this client identifies with her heritage, it will be important to use the Heritage Assessment Tool.
Targeted Questions to Ask the Patient Build Her Health History
Targeted questions to build this clients health history should focus on why she lives on the reservation, how she is fairing on with her pregnancy, whether she is taking any herbal or over the counter medications, whether she has social or familial support, and is she can easily access healthcare services, and healthy foods.
 What is your living situation?
 How are you coping/progressing with your pregnancy?
 How safe are you at home? NURS 6512 Week 2 Discussion: Diversity and Health Assessments.
 Can you readily access healthcare services and healthy foods?
 Are you taking any herbal or OTC supplements currently?

References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Nair, L., & Adetayo, O. A. (2019). Cultural Competence and Ethnic Diversity in Healthcare. Plastic and reconstructive surgery. Global open, 7(5), e2219. https://doi.org/10.1097/GOX.0000000000002219
Wachtel-Galor S., & Benzie I.F. (2018). Herbal Medicine: An Introduction to Its History, Usage, Regulation, Current Trends, and Research Needs. In: Benzie IFF, Wachtel-Galor S, editors. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis; 2018. Chapter 1. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK92773/

Discussion: Diversity and Health Assessments

May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

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Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion. NURS 6512 Week 2 Discussion: Diversity and Health Assessments.

To prepare:

• Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
• Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

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By Day 3 of Week 2

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned(in order 223390). 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.NURS 6512 Week 2 Discussion: Diversity and Health Assessments.

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.

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NURS 6512 Week 2 Discussion: Diversity and Health Assessments