Comprehensive Health Assessment for Patients and Populations – C350

Comprehensive Health Assessment for Patients and Populations
C-350
Sherri Bailey
Western Governor's University
August 30, 2020
Comprehensive Health Assessment for Patients and Populations C-350
A. Reflect on the comprehensive health assessment you preformed on the virtual patient Carolyn Cross in iHuman Patients by doing the following:
1. Discuss four evidence-based interview techniques you used to assess Carolyn's social determinants. Include a scholarly source in your discussion.
"Interviewing is both a skill and an art." (Bickley, 2016, p. 65). During my iHuman comprehensive health assessment of Carolyn, I utilized four evidence-based interview techniques. First and foremost, I introduced myself, my role, asked her how she would like to be addressed, explained what to expect and the time frame in which to expect completion of the interview, and finally advised her our interview would be confidential. Once we were settled in a private area, she was comfortable, and I made sure there would be no interruptions, I proceeded to the next interview technique, active listening. I was being present, at the moment, actively listening to her responses. I noted her body language, as well as her verbal responses to my questioning, and encouraged her to expand on her symptoms and circumstances related to any symptoms she may have.
Third, I acknowledged and validated her concerns by letting her know she was heard and helped her realize what she was feeling was normal. I provided empathetic responses and reassured her I would address her problems and concerns.
Lastly, I made sure to summarize her responses to indicate I understood and allowed her to correct anything I may have missed. Followed by, a summarization of our conversation, thus hoping to impress upon her my commitment to our professional relationship.
"High-quality patient-clinician communication has also been shown to improve patient outcomes, decrease symptoms, and improve functional status, reduce litigation, and decrease errors" (Bickley, 2016, p. 65).
* Justify the questions you used to assess each of the five social determinants of Carolyn, and include her responses.
Economic Stability
To identify Carolyn's economic stability I would ask: Are you employed? What type of work do you do? Are you married? Is your husband employed? These questions are to determine if Carolyn can afford healthcare and if she has income to afford her copay, deductibles, prescriptions, and other healthcare-related items.
Carolyn answered she is married and has two sons. She is employed full-time as a learning specialist at a local middle school, and her husband is employed full time as an accountant at a local firm. Both have healthcare and retirement benefits. Their combined incomes afford Carolyn and her family a socioeconomic status above the poverty level, with disposable income after their monthly expenses are met. Carolyn lives in a single-family home in a middle-class neighborhood not far from her. She relays no difficulty making the monthly mortgage payments on her home and has enough money to pay other bills as well. Carolyn's ability to meet her expenses and provide for her family along with her husband determines her economic stability.
Education
I asked Carolyn about her education. Did I inquire as to her highest level of schooling? What is her primary language? How comfortable she is with speaking, reading, and writing English? 4 Carolyn responded though her primary language is Spanish, she speaks both English and Spanish fluently. She graduated from the University of Texas with a Bachelor's degree in Elementary Education, followed by a Master's degree in Special Education. She works as a middle-school learning specialist, evaluating as well as teaching children with disabilities. Because the patient is bilingual and holds a graduate degree I was able to determine she is well-educated and has high levels of literacy indicating no need for simplification of the healthcare education process. If it was determined, Carolyn had minimal education or learning disabilities, healthcare education would be provided in a manner she could better understand.
Health and Healthcare
* Explain how Carolyn's answers to the questions will inform her nursing plan of care.
Carolyn has excellent access to all of her healthcare needs because she resides near pharmacies and a primary care physician. Aside from being near, she also has access to good transportation to be able to go to hospitals. Carolyn explained that she has insurance and can afford the additional treatment that is not included in the insurance policy.
In the mentioned aspects, we were able to assess some factors that may affect the patient’s decision-making such as Carolyn’s potentials (i.e., financial capabilities and transportation means). These pieces of information can help in the nursing plan of care by allowing the health provider to set the specific hospital or refer the patient to her personal primary care physician who will tend to her essential health needs. Furthermore, the health provider can exclude finances and transportation as barriers to healthcare access. Therefore, in cases where Carolyn becomes hesitant to go to the hospital, we can find other factors that she may be considering (Slade & Sergent, 2019).
Slade & Sergent (2019) also suggested that understanding the patient’s risk factors is significant in forming the healthcare plan. In the interview, Carolyn mentioned her annual mammogram and pap smear three years ago which are negative for pathology. She also had a family history of breast cancer (mother) and she had a history of fibrocystic heart disease. In the nursing plan, it is important to refer Carolyn for an annual check-up for her reproductive health due to her strong family history and a personal risk factor.
Carolyn also stated that she is technology-literate and has no disabilities which may hinder her in the understanding of the nursing plan. Because of this, the nurse can provide a plan that can be accessed through a computer, cellphone, or any form of technology. Moreover, the nurse can provide a plan that is measurable based on the patient’s level of understanding (Slade & Sergent, 2019).
2. Explain how Carolyn's economic stability affects her access to healthcare, including the three following factors:
socioeconomic status
employment status
housing stability
Carolyn has a stable job as an educator, which allows her to afford all her daily and health needs. Moreover, she has an advantage for reimbursements due to her insurance. Carolyn also lives in a neighborhood with good access to all of her everyday needs and does not have any difficulty in paying her monthly dues.
Socioeconomic and employment statuses and housing stability are included in the social determinants of health. Because of all of these factors, Carolyn can focus on providing herself a good healthcare plan and access to it. She will be able to afford her health maintenance without worrying about other expenses CITATION Hea20 \l 13321 (Healthy People, 2020).
3. Analyze how Carolyn's educational status affects her health. Include a scholarly source to support your analysis.
a. Discuss the healthcare barriers and opportunities Carolyn might experience because of her educational status.
Sukys et al. (2019) state that education is vital in promoting the ability of health-seeking information on activities like exercise and other behaviors that improve health. People with higher education are more likely to become health literate than others. Furthermore, health-literate individuals tend to have a better behavioral transformation to health.
Carolyn graduated with honors in high school and h...