NURS 6512 Week 2 Discussion: Diversity and Health Assessments Sample Essay

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NURS 6512 Week 2 Discussion: Diversity and Health Assessments Sample Essay

NURS 6512 Week 2 Discussion Diversity and Health Assessments Sample Essay

Discussion week 2 Main Post

          Unique communication and effective self-awareness skills are required to improve patient-center care. There are specific socioeconomic, spiritual, lifestyles, and other cultural factors associated with patients throughout the health care arena. Encouraging the patient to communicate sensitive and private has its difficulties. Practitioners and other health care providers have to be non-bias and unconsciously aware of any self-behaviors that limit patients’ ability to disclose information needed to properly diagnose and treat illnesses including non-verbal communication. Developing and using effective diverse communication with all patients increases professional relationships between patients and providers. The patient assigned to me is a 32-year-old pregnant lesbian with vaginal discharge seeking help to mitigate her health disparity. In our course readings by Ball et al. (2019), it was said that LGBT patients should be particularly paid attention to with great detail and care. Ball et al. (2019) went on to say that these patients are unfortunately faced with bias throughout the health care system. Kano et al. (2016) explained how some socioeconomic disparities LGBTQs face is from lack of sufficient resources needed in clinics to be integrated into practice. Having a safe space is another socioeconomic disparity LGBTQ face worldwide. Goh (2018) explained that LGBTQ is faced with homelessness and violence. Rosentel et al. (2020) explained how other lifestyle factors include low-socioeconomic status, that increases LGBTQ risks of higher burdens of health disparities related to less accessible services.

Interviewing these patients, Practitioners must first gain competency in cultural awareness. Ball et al. (2019) explained how incorporating flexible and creative skills increases health care providers’ approach. Be honest with the patient with upfront limitations,  expectations, knowledge base. Apologize when appropriate and encourage an organizational culture with strategies to stop the stigma against the LGBTQ population. I believe that being honest with the patient upfront can set a stage for transparency and credibility.

Five questions I would ask this patient are as follows:

  1. What would you like to be called?
  2. How do you identify yourself?
  3. Are you comfortable talking about this with me?
  4. Do you have a friend or a family member you would like to be present in the interview to make you more comfortable?
  5. Are there any concerns of fear from anyone in your home, neighborhood, school, or work we need to talk about?

NURS 6512 Week 2 Discussion Diversity and Health Assessments Sample Essay References

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.

Goh, K. (2018). Safe Cities and Queer Spaces: The Urban Politics of Radical LGBT Activism. Annals of the American Association of Geographers, 108(2), 463–477. 

Kano, M., Silva-Bañuelos, A. R., Sturm, R., & Willging, C. E. (2016). Stakeholders’ Recommendations to Improve Patient-centered “LGBTQ” Primary Care in Rural and Multicultural Practices. Journal of the American Board of Family Medicine : JABFM, 29(1), 156–160. 

Rosentel, K., VandeVusse, A., & Hill, B. J. (2020). Racial and Socioeconomic Inequity in the Spatial Distribution of LGBTQ Human Services: an Exploratory Analysis of LGBTQ Services in Chicago. Sexuality Research & Social Policy: Journal of NSRC, 17(1), 87–103.

Your post regarding the potential nuances of caring for LGBTQ females was informative.  I also felt that your line of questioning was a good start to get some basic, helpful information related to her health and well-being.  While there is a large quantity of evidence-based research and data surrounding heterosexual pregnant females and their care, the same is not so for LGBTQ patients; although, the information is on the rise given the changes to our culture.  However, it will still be many years before a robust database will be available.  As noted by Malmquist et al. (2019), healthcare providers often still address LGBTQ patients with a heteronormative undertone, that is mother/father directed, especially with forms and pre-printed material.  As a heterosexual female, this is something that could easily be overlooked as offensive because we aren’t looking at patient information from the same lens.  According to Malmquist et al. (2019), as well as others I have read specifically for this discussion post, the experiences in healthcare for LGBTQ patients have been a mix of positive and negative.

Another line of questioning to consider would be her thoughts on the sperm donor profile.  Since the women are permitted to visualize the physical and other attributes of the donor, we can initiate conversation to the thought process behind the chosen donor.  In the future, the child may want to know more about the other, biological side of their genetics. More recently, some information has become available to donor recipients that includes a donor profile including hobbies, education, and character traits, physical description, and even some inclusion of staff perceptions of the donor, a practice that originated in sperm banks that initially served only lesbian couples (Scheib & McCormick, 2016).  Utilizing a sperm bank donor requires that the sperm be frozen which decreases the chances of conception (Scheib & McCormick, 2016).  This may or may not have been her first round of insemination.  This can become a profound source of financial and emotion stress if it’s taken multiple rounds to produce a pregnancy.  There are several more layers to this patient’s pregnancy than surface value that need to be investigated and discussed in order to provide inclusive, well-rounded care.

NURS 6512 Week 2 Discussion Diversity and Health Assessments Sample Essay References:

Malmquist, A., Jonsson, L., Wikstrom, J., & Nieminen, K.  (2019).  Minority stress adds

Additional layer to fear of childbirth in lesbian and bisexual women, and transgender

People.  Midwifery, 79, 1-7.

Scheib, J. & McCormick, E.  (2016).  Sperm donor, choosing a.  In Goldberg, A. (Ed.),

The SAGE Encyclopedia of LGBTQ Studies (pp. 1109-1113).  SAGE Publications.

DOI:

week 2 main post
JC’s Case Study
JC, the octogenarian Asian patient, is financially constrained and is dependent on his low-paid daughter. It is significant to assess how the patient plans to fund healthcare services since he is unemployed, and his daughter has less to offer. In this case, social workers can be instrumental in directing the patient where to seek assistance, especially on the available social programs (Biegel, Farkas & Wadsworth, 2021). The cultural inclinations of some Asian patients tend to border on the avoiding public cry for help, especially among the low socioeconomic persons.Moreover, culturally rooted Asian patients may seek conventional treatment when the traditional methods fail. According to Chinese culture, a person may opt-out to seek a doctor when the patient feels better without treatment (Ko & Turner, 2017). Acupuncture, cupping, herbal medicine, and other therapies are what some Asian patients resort to when faced with an illness. Therefore, it is important to address the specific cultural factors for a patient to provide care appropriately.The physician-patient verbal engagement is probably one of the most critical in providing health care (Drossman & Ruddy, 2020). In this case, the patient should be considered, especially when in contact with a practitioner, since there could be communication barriers such as language. An interpreter may come in handy in such a scenario while through a video call or a phone call since professional interpreters are not readily available on demand. Also, Asian non-verbal cues may be contextually different from how Western cultures communicate non-verbally. As a health provider, I would be more adept in considering the patient’s heritage, socioeconomic status, and cultural background to achieve .My five targeted questions will entail evaluating JC’s emotional wellness, accessibility to care, safety status at home, and medicine availability. These questions would be:

Are you able to perform personal tasks such as cleaning or cooking food?

Can you consider seeking the services of a social worker based in our institution?

Are you aware of the social services available for you?

Are you okay/ I mean, do you feel isolated and sad?

Are you able to discern the various medication prescribed to you?

When prescribed medication, are you able to take medicine, or do you need assistance?

NURS 6512 Week 2 Discussion Diversity and Health Assessments Sample Essay References

Ko, A., & Turner, J. (2017). Culturally sensitive care for Asian immigrants: Home healthcare perspectives. Home healthcare now, 35(9), 507-513.

https://pubmed.ncbi.nlm.nih.gov/28953541/

Drossman, D. A., & Ruddy, J. (2020). Improving patient-provider relationships to improve health care. Clinical Gastroenterology and Hepatology, 18(7), 1417-1426.

https://theromefoundation.org/wp-content/uploads/Drossman_Ruddy_Improving-PPR-to-improve-health-care_CGH-2020.pdf

Biegel, D. E., Farkas, K. J., & Wadsworth, N. (2021). Social service programs for older adults and their families: Service use and barriers. In Services to the Aging and Aged (pp. 141-178). Routledge.

https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.890.645&rep=rep1&type=pdf

Week 2 Main Post

My case study covers a 32-year-old female TJ, being seen for an annual physical exam.  She is currently pregnant without complications from receiving sperm at a local sperm bank.  She has a family history of diabetes and is presently experiencing vaginal discharge. She has been currently being seen by an obstetrician for prenatal care.  Current medications include prenatal vitamins and occasional Tylenol for pain. Her sexual orientation is lesbian, and her pregnancy history is Gravida1; Para 0; Abortions 0.

Patients that identify as lesbian or bisexual tend to participate in more risky behaviors such as smoking or occasional alcohol use compared to heterosexual women (Gonzales, G., Quinones, N., & Attanasio, L., 2019). Lesbian and bisexual individuals experience discrimination and stigma and may delay care related to fear (Fagan, M. P., & Ireland, C. L., 2020). Mental health factors are a concern related to depression, suicide ideation, and self-harm (Fagan, M. P., & Ireland, C. L., 2020).  Sexual orientation may place the patient at a higher risk for sexually transmitted diseases and HIV, but testing should only be based on the level of risk, not orientation (Fagan, M. P., & Ireland, C. L., 2020).  Patients within the LBGT community have increased health disparities due to the lack of insurance and physician care due to fear of bias and discrimination (Anticuar, S., 2021).  Should a patient come out to disclose sexual orientation, it should be acknowledged, but sexual behavior should not be assumed (Fagan, M. P., & Ireland, C. L., 2020).

The following questions may be asked to develop a without regard to sexual orientation.

“Currently, how many weeks pregnant are you? Or How many weeks along are you?”

“Current due date?” “When was your last Obstetrician appointment?”

“Is there a significant other involved with the pregnancy?”

“Can you tell me how long you have had vaginal discharge? Color? Consistency? Any Odor?”

“Have you had any other symptoms?” Burning with Urination? Vaginal pain or itching?”

“Do you smoke or drink?”

Anticuar, S. (2021). Examining Health Disparities Among Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Adults in Davidson County, Tennessee.

Fagan, M. P., & Ireland, C. L. (2020). Guide for Providing Care for Lesbian, Gay and Bisexual Patients in Primary Care Quick Reference Guide.

Gonzales, G., Quinones, N., & Attanasio, L. (2019). Health and access to care among reproductive-age women by sexual orientation and pregnancy status. Women’s Health Issues, 29(1), 8-16.

Your post regarding the potential nuances of caring for LGBTQ females was informative.  I also felt that your line of questioning was a good start to get some basic, helpful information related to her health and well-being.  While there is a large quantity of evidence-based research and data surrounding heterosexual pregnant females and their care, the same is not so for LGBTQ patients; although, the information is on the rise given the changes to our culture.  However, it will still be many years before a robust database will be available.  As noted by Malmquist et al. (2019), healthcare providers often still address LGBTQ patients with a heteronormative undertone, that is mother/father directed, especially with forms and pre-printed material.  As a heterosexual female, this is something that could easily be overlooked as offensive because we aren’t looking at patient information from the same lens.  According to Malmquist et al. (2019), as well as others I have read specifically for this discussion post, the experiences in healthcare for LGBTQ patients have been a mix of positive and negative.

Another line of questioning to consider would be her thoughts on the sperm donor profile.  Since the women are permitted to visualize the physical and other attributes of the donor, we can initiate conversation to the thought process behind the chosen donor.  In the future, the child may want to know more about the other, biological side of their genetics. More recently, some information has become available to donor recipients that includes a donor profile including hobbies, education, and character traits, physical description, and even some inclusion of staff perceptions of the donor, a practice that originated in sperm banks that initially served only lesbian couples (Scheib & McCormick, 2016).  Utilizing a sperm bank donor requires that the sperm be frozen which decreases the chances of conception (Scheib & McCormick, 2016).  This may or may not have been her first round of insemination.  This can become a profound source of financial and emotion stress if it’s taken multiple rounds to produce a pregnancy.  There are several more layers to this patient’s pregnancy than surface value that need to be investigated and discussed in order to provide inclusive, well-rounded care.

References:

Malmquist, A., Jonsson, L., Wikstrom, J., & Nieminen, K.  (2019).  Minority stress adds

Additional layer to fear of childbirth in lesbian and bisexual women, and transgender

People.  Midwifery, 79, 1-7.

Scheib, J. & McCormick, E.  (2016).  Sperm donor, choosing a.  In Goldberg, A. (Ed.),

The SAGE Encyclopedia of LGBTQ Studies (pp. 1109-1113).  SAGE Publications.

DOI:

Cultural diversity is a person’s beliefs, traditions, values, behaviors, and ideas passed down through generations. That affects our decisions and how we think and live (Young & Guo, 2016). Numerous studies indicate that health professionals are not prepared to communicate effectively regarding cultural sensitivity. There is a need for cultural diversity education to provide the skills necessary to provide quality and culturally competent care (Young & Guo, 2016; Brooks et al., 2018). Patients and their families are less likely to follow recommended care plans when cultural sensitivities have not been addressed or communicated. This can lead to poor outcomes and adverse events (Brooks et al., 2018). When communicating, we need to be actively listening and be respectful of their beliefs and practices. It is essential to encourage the patient and their key individual(s) to be open about their culture and how it will impact their care (Brooks et al., 2018).

My case study this week is a 32 yr old pregnant lesbian whom I am seeing for her annual physical. She is receiving prenatal care from an obstetrician. She received her sperm from a local sperm bank. She is currently taking prenatal vitamins. There is a strong positive family history of diabetes.

Questions that I would ask her:

I would ask if she had any religious or cultural practices that would impact her health care. I feel this is a safe open-end question that provides a way to start a healthy communication regarding her culture.

Asking about her support system and whom she lives with. This helps identify if there is a significant other and who will be her support once the baby is born.

The information provided states that she is lesbian. I would ask how she identifies herself and how she would like to be addressed. Getting to know/understand her partner will be important if she is in a relationship. As this person may be a parent to her unborn child and will help make decisions regarding her care and the child.

Since she is expecting, asking about her dietary practices will be necessary. I will want to ensure she is getting adequate nutrition and calories. Asking questions if she can eat from all the food groups and if she had any practice on how food is prepared.

Even though she has an obstetrician, I would want to know if she has any beliefs are practices that would impact her pregnancy, childbirth, and childrearing. This will provide an understanding of parenting style and practices that may impact health care decisions regarding her child.

Also, asking if she is experiencing any financial burdens that may affect her and the child’s health. If so, provide resources that would be available to her to help meet her needs. (Ball et al., 2019)

 

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.

 

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391.

 

Young, S., & Guo, K. L. (2020). Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice. The Health Care Manager, 39(2), 100–108.

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