Diversity and Health Assessments Essay

Diversity and Health Assessments Essay

Diversity and Health Assessments Essay

The case study depicts TJ, a 32-year-old pregnant lesbian, a para 0+0, gravid 1. She is on an annual physical exam and has vaginal discharge. TJ received sperm from a local sperm bank and has had no pregnancy complications. She has a positive family history of diabetes. The cultural factors specific to this patient include her bisexual status. There are unique cultural considerations related to lesbians and couples seeking parenthood. National organizations call for the delivery of culturally competent care for sexual-minority patients. Lesbian-specific anticipatory guidance is essential for preconception, pregnancy, and postpartum care. Besides, some of the attributes lesbian mothers seek from a care provider include provider comfort in caring for lesbians, knowledge of conception options, and providers demonstrating concern for the mother’s expectations (Gregg, 2018).

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When interacting with a lesbian pregnant woman, the provider should be sensitive to creating a culturally competent obstetrical practice. The provider should have an open and safe environment by having lesbian mothers represented in the antenatal office décor. Besides, the provider should avail lesbian-friendly reading material, pamphlets, and resources within the facility (Tian & Shen, 2019). Bush and Romero (2018) explain that when counseling lesbian couples, the provider should use statements such as “nothing inside the vagina” as opposed to “avoid sexual intercourse” since the latter may not be precise enough and can be assumed to be dismissive of lesbian sexuality. Furthermore, when asking a lesbian mother about her sexual and obstetrical history, the provider should explain their medical context and communicate that obtaining a comprehensive sexual history is standard for obstetrical care (Bush & Romero, 2018).

Targeted questions to ask the patient include:|

1. Do you have a history of STIs? If yes, which one did you have, and how was it treated?
2. Have you had sexual intercourse with men, women, or both in the past year?
3. Have you ever been pregnant before? If yes, tell me about the prior pregnancies.
4. Which illicit drug substances do you or have you ever used?
5. Do you have a history of severe physical abuse by an intimate partner?

References

Bushe, S., & Romero, I. (2018). Lesbian Pregnancy: Care and Considerations. Seminars in Reproductive Medicine, 35(05), 420–425. doi:10.1055/s-0037-1606385 

Gregg, I. (2018). The health care experiences of lesbian women becoming mothers. Nursing for women’s health, 22(1), 40-50. https://doi.org/10.1016/j.nwh.2017.12.003

Tian, S. H., & Shen, M. H. (2019). The Implementation of the Right to Equality in the Care of a Vulnerable Medical Population: Pregnant and Postpartum Lesbians. Hu li za zhi The journal of nursing, 66(5), 65-71. DOI: 10.6224/JN.201910_66(5).09

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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.
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?

CASE STUDY: TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes over the counter Tylenol for aches and pains on occasion. She has a strong family history of diabetes. Gravida 1; Para 0; Abortion 0

Learning Resources

Required Readings (click to expand/reduce)

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.

• Chapter 1, “The History and Interviewing Process” (Previously read in Week 1)
This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.

• Chapter 2, “Cultural Competency”
This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

• Chapter 2, “Evidenced-Based Clinical Practice Guidelines”

Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi:10.3109/02770903.2014.906605
Credit Line: Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis by Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J., in Journal of Asthma, Vol. 51/Issue 7. Copyright 2014 by Taylor & Francis, Inc. Reprinted by permission of Taylor & Francis, Inc. via the Copyright Clearance Center.

The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.

Centers for Disease Control and Prevention. (2020, October 21). Cultural competence in health and human services. Retrieved from https://npin.cdc.gov/pages/cultural-competence
This website discusses cultural competence as defined by the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website.

United States Department of Human & Health Services. Office of Minority Health. (n.d.). A physician’s practical guide to culturally competent care. Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.

Coleman, D. E. (2019). Evidence based nursing practice: The challenges of health care and cultural diversity. Journal of Hospital Librarianship, 19(4), 330–338. https://doi.org/10.1080/15323269.2019.1661734

Young, S., & Guo, K. L. (2016). Cultural diversity training. The Health Care Manager, 35(2), 94–102. https://doi.org/10.1097/hcm.0000000000000100

Required Media (click to expand/reduce)

Module 2 Introduction
Dr. Tara Harris reviews the overall expectations for Module 2. Consider how you will manage your time as you review your media and Learning Resources for your Discussion, Case Study Lab Assignment, and your DCE Assignment (3m).
Accessible player
Functional Assessments and Cultural and Diversity Awareness in Health Assessment – Week 2 (10m)
Accessible player

Walden University. (n.d.). Instructor feedback. https://cdn-media.waldenu.edu/2dett4d/Walden/WWOW/1001/pulse_check/instructor_feedback/index.html#/

RUBRIC:
Excellent Good Fair Poor
Main Posting 45 (45%) – 50 (50%)
“Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) – 44 (44%)
“Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) – 39 (39%)
“Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 34 (34%)
“Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness 10 (10%) – 10 (10%)
Posts main post by Day 3. 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
Does not post main post by Day 3.
First Response 17 (17%) – 18 (18%)
“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 15 (15%) – 16 (16%)
“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 13 (13%) – 14 (14%)
“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 12 (12%)
“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response 16 (16%) – 17 (17%)
“Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 14 (14%) – 15 (15%)
“Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English. 12 (12%) – 13 (13%)
“Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. 0 (0%) – 11 (11%)
“Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
N/A 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on three different days.