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Diversity and Health Assessment Discussion week 2
In this discussion, we will focus on Case Study 1, which revolves around John Green, a 33-year-old Caucasian male who identifies as a male but was assigned female at birth. He transitioned from female to male two years ago, and he has recently moved back home and is currently unemployed. John has a history of smoking two packs of cigarettes per day for the last decade, occasional marijuana use, and experiences depressive episodes. He has been HIV-positive for three years but maintains viral suppression. Lately, he’s been feeling weak, which led to his decision to move back home and live with his parents. He takes medication for HIV and testosterone.
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Diversity and Health Assessment Discussion Week 2 – Case Study 1
Let’s reflect on various factors related to John’s health, such as his socioeconomic status, spirituality, lifestyle, and cultural background. These aspects can significantly impact his health.
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To build a comprehensive health history for John, we need to approach it in a gender-affirming manner, ensuring that we use the right name and pronouns during the interview. This is vital to respect his identity (Ball. J, et al, 2019). Our physical examination should be sensitive to his existing anatomy without making assumptions about his identity. Considering the unique changes related to hormone therapy and surgical interventions is crucial.
Since Mr. J.G. is a transgender man, we should ask sensitive questions about his sexual partners and practices, as well as address potential issues related to domestic violence, which is more common among transgender individuals (Base & Nagy, “Cultural Competence in the Care of LGBTQ Patients”). Access to healthcare and financial concerns should also be discussed, along with an assessment of his support system since he returned home.
To collect pertinent information and assess his health risks, we could ask questions like:
1. How many sexual relationships have you had?
2. What is the gender of your sexual partners?
3. Are you currently sexually active?
4. Can you tell me when you were diagnosed with HIV?
5. What was your most recent CD4 count?
6. Have you used any illicit drugs?
When communicating with patients from diverse populations, it’s essential to be culturally sensitive. Strategies to achieve this as a nurse include:
– Developing cultural awareness and self-reflection to provide nonjudgmental and respectful patient-centered care.
– Informing patients about their conditions and involving them in their care decisions.
– Practicing cultural humility by respecting cultural differences and avoiding judgment.
– Employing all dimensions of cultural competence, especially when caring for patients like John, whose diverse backgrounds can lead to stereotypes, judgments, or prejudices.
As a nurse practitioner, it’s our responsibility to offer quality care to all patients, regardless of their cultural, lifestyle, or health status differences, and to work collaboratively with them to address their concerns and make informed healthcare choices.
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.
Bass B, Nagy H. Cultural Competence in the Care of LGBTQ Patients. (Updated 2022 Oct 3). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Retrieve from: https://www.ncbi.nlm.nih.gov/books/NBK563176/ Diversity and Health Assessment Discussion week 2
Diversity and Health Assessment Discussion week 2
Diversity and Health Assessment Discussion week 2
Case Study 1
John Green, the 33-year-old Caucasian male, presents to the office to establish himself as a new patient. John’s natal sex is female, but he identifies as a male. He transitioned from female to male, 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has obtained testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smoking 3-6 marijuana joints every weekend (has an active green card), and does suffer from depressive episodes. He has been HIV-positive for the last 3 years. But remains viral suppression at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks, which prompted him to move back home with his parents. He takes Biktarvy once daily which comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and being unemployed, he will be a burden on his family, and he thinks his health may be declining.
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 of the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture?
When preparing a medical history for Case Study 1 Mr. J.G.
The gender-affirming approach would be prioritized. Ensuring the right name and pronouns are used during our interview. Affirmation of gender is necessary to confirm the manner in which the patient wishes to be identified in social interactions (Ball. J, et al, 2019) Diversity and Health Assessment Discussion week 2. Regardless of gender presentation, the physical examination should be pertinent to the existing anatomy and free of any presumptions about identity or anatomy. Cultural Knowledge related to comprehending the numerous and unique changes and peculiarities in the context of hormone therapy and surgical interventions, a sensitive history taking is necessary. Mr. J.G. is a transgender man. Transgender males are females who identify as males. As the provider, I will need to ask sensitive questions regarding Mr. J.G. Sex partners and sex practices. The article by Brittany Base and Hassan Nagy entitled “Cultural Competence in the Care of LGBTQ Patients”. Indicates that domestic violence is more frequent in transgender patients. Issues regarding domestic violence will need to be addressed. In addition, access to health care and financial concerns will need to be addressed. Also assessing his support system since he returned home.
Develop five targeted questions you would ask the patient to build his or her health history and assess his or her health risks.
- How many sexual relationships have you had?
- What is the gender of your sex partners?
- Are you currently having sex?
- Can you tell me when you were diagnosed with HIV?
- What was your most recent CD4 count?
- What illicit drugs have you experienced?
- Diversity and Health Assessment Discussion week 2
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 pertinent information?
Cultural awareness is always necessary to gain a better understanding of my practice as an NP. Self-reflection allows me to provide patient-centered care that is nonjudgmental, respectful, and attentive to the patient’s concerns and preferences. This includes informing patients about their condition and allowing them to participate in their care. As a nurse practitioner, I am responsible for providing quality care to all patients under my care using cultural humility.
Mr. J.G has lifestyle can raise stereotypes judgments or prejudices against him, because he is an immigrant, transgender, substance abuse, and has an HIV status history. His health beliefs and cultural diversity can be overlooked if he has someone that does not respect his cultural differences. This is why it is important that I be culturally competent to avoid using judgment when caring for patients. As a future nurse practitioner, it is essential that all the dimensions of cultural competence be used with all patients. It’s working with patients to understand their concerns and helping them make health care choices
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.
Bass B, Nagy H. Cultural Competence in the Care of LGBTQ Patients. (Updated 2022 Oct 3). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Retrieve from: https://www.ncbi.nlm.nih.gov/books/NBK563176/ Diversity and Health Assessment Discussion week 2
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