NURS 6512 week 1 Discussion: Building a Health History
In the case of interviewing an adolescent Hispanic/Latino boy from a middle-class suburb, the first step is to create a comfortable and trusting environment. Sometimes, adolescents may not want their parents to know everything, or they might feel embarrassed to answer certain questions. In such cases, it can be helpful to ask the parent to step out so the patient can be more open. If an interpreter is needed, it’s crucial to use a professional one. However, in this case, there’s no need for an interpreter.
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When communicating with the patient, it’s essential to follow some key techniques. According to Ball et al. (2019), choose a comfortable setting, make eye contact, introduce yourself, and explain your role. Use open-ended questions that allow the patient to provide detailed answers, and avoid confrontational questions (Ball et al., 2019).
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Communication Techniques
Once the patient is comfortable, using open-ended questions is vital. These questions encourage the patient to explain their thoughts and feelings instead of just giving yes or no answers. It’s important to allow the patient enough time to respond, especially when questions might be sensitive or embarrassing. Preparation is key. Edgemon et al. (2020) suggest that asking appropriate questions shows that the interviewer has prepared for the interview, which can lead to more targeted answers (Edgemon et al., 2020). Maintaining eye contact and having good posture builds trust with the patient and allows the interviewer to pick up on any signs of discomfort or hesitation, giving the patient space to express themselves. Nonverbal communication, like body language, should also be appropriate and supportive during the interview to encourage cooperation.
Risk Assessment Instrument
The chosen risk assessment tool is the Structured Interview of Family Assessment Risk (SIFAR). As described by Santos & Alberto (2016), SIFAR is a structured professional judgment tool designed to assess family risk in adolescent offenders. It covers various aspects, including physical health, mental stability, substance abuse, education, employment, housing, legal issues, violence, social factors, and more (Santos & Alberto, 2016). This assessment tool is ideal because it addresses most of the important areas for assessing both medical and psychiatric information.
Targeted Questions
Here are some questions to ask the adolescent:
– Where do you live, and who do you live with?
– Are you attending school, and what grade are you in?
– Do you have any medical conditions or health problems?
– Have you been feeling unusually sad or down lately?
– Do you use tobacco or any illegal drugs?
References
Edgemon, A. K., Rapp, J. T., Brogan, K. M., Richling, S. M., Hamrick, S. A., Peters, R. J., & O’Rourke, S. A. (2020). Behavioral skills training to increase interview skills of adolescent males in a juvenile residential treatment facility. Journal of Applied Behavior Analysis, 53(4), 2303–2318. https://doi-org.ezp.waldenulibrary.org/10.1002/jaba.707
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.). Elsevier Mosby.
Santos, D., & Alberto, I. (2016). Developing a Family Risk Assessment Tool in Adolescent Offenders: An Exploratory Study. Child & Adolescent Social Work Journal, 33(2), 103–113. https://doi-org.ezp.waldenulibrary.org/10.1007/s10560-015-0409-1
Discussion: Building a Health History
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
Photo Credit: Sam Edwards / Caiaimage / Getty Images
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
- By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
- How would your communication and interview techniques for building a health history differ with each patient?
- How might you target your questions for building a health history based on the patient’s social determinants of health?
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
- Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
- Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:
- Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
- Suggest additional health-related risks that might be considered.
- Validate an idea with your own experience and additional research.
Your post was quite informative. It’s clear that dealing with adolescents, who are typically between the ages of 10 and 24, involves understanding their unique needs and preferences. They tend to place a significant emphasis on social interactions and peer relationships, which can greatly affect how they respond to healthcare providers.
In addition to technical skills, like assessment, emotional intelligence plays a critical role when dealing with adolescents. This means understanding and connecting with their feelings and emotions is just as important as medical knowledge (Emanuel & Gudbranson, 2018).
Research has shown that peer acceptance and influence are vital for adolescents. Isolation, whether physical or social, can have a profound impact on their well-being. It’s a reminder of how crucial it is to address social aspects during interviews with adolescents (Orben et al., 2020).
While using an interpreter is a helpful tool, it’s also essential to be culturally competent and sensitive when dealing with this adolescent. Making them feel comfortable and understood is key to effective communication.
The Racial Socialization Competency Scale (RaSCS), also known as the Racial Encounter Coping Appraisal and Socialization Theory (RECAST), is a useful tool. It assesses racial socialization competency in three dimensions: stress, skills, and confidence. While it primarily focuses on racial socialization stressors, it can also address other health-related issues (Anderson et al., 2020).
There are various screening tools available for assessing adolescent health. The HEEADASSS tool covers home environment, education, employment, activities, drugs, sexuality, safety from injury, and violence. The PACES screening tool addresses parents, peers, accidents, alcoholism/drugs, cigarette smoking, emotional issues, and school and sexuality (Ball et al., 2019). The CRAFFT tool, which stands for Cars, Relax, Alone, Forget, Friends, Trouble, addresses issues related to car driving, relaxation, solitary activities, friends, and troubles adolescents might encounter (Ball et al., 2019).
When dealing with Hispanic adolescent boys, there are specific health-related risks to consider. These include cardiovascular disease, often linked to dietary choices, binge drinking, and drug use (Assari et al., 2019). It’s important to craft questions that encourage more detailed responses and avoid simple yes or no answers, as this can hinder effective communication. Your questions to this young boy are vital and should be structured to facilitate open and informative dialogue.
References
Anderson, R. E., Jones, S. C., & Stevenson, H. C. (2020). The initial development and validation of the Racial Socialization Competency Scale: Quality and quantity. Cultural Diversity and Ethnic Minority Psychology, 26(4), 426-436. doi:10.1037/cdp0000316
Assari, S., Farokhnia, M., & Mistry, R. (2019). Education Attainment and Alcohol Binge Drinking: Diminished Returns of Hispanics in Los Angeles. Behavioral Sciences, 9(1), 9. doi:10.3390/bs9010009
Ball, J., 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: Mosby.
Emanuel, E. J., & Gudbranson, E. (2018). Does Medicine Overemphasize IQ? Jama, 319(7), 651. doi:10.1001/jama.2017.20141
Orben, A., Tomova, L., & Blakemore, S. (2020). The effects of social deprivation on adolescent development and mental health. The Lancet Child & Adolescent Health, 4(8), 634-640. DOI:10.1016/s2352-4642(20)30186-3
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