Diversity and Health Assessments NURS 6512 Week 2 Example 1Enhancing Cultural Competence in Health A

Diversity and Health Assessments NURS 6512 Week 2 Example 1

Enhancing Cultural Competence in Health Assessment

Cultural competence is a crucial aspect of nursing practice, especially in health assessments. Functional assessments and cultural and diversity awareness play a critical role in health assessments, contributing to the delivery of effective and patient-centered care. Understanding the significance of these elements is essential for healthcare professionals, particularly nurses. Functional assessments go beyond traditional medical evaluations, focusing on a patient’s ability to perform activities of daily living (Ball et al., 2018). This includes assessing mobility, self-care, communication, and cognitive functions.

Understanding a patient’s functional status provides a holistic perspective on their health and helps identify areas requiring intervention or support. Incorporating cultural and diversity awareness ensures that healthcare providers recognize the influence of cultural, spiritual, and lifestyle factors on an individual’s health. This holistic understanding allows for more accurate health assessments that consider the whole person within their cultural context.

Issues in Health Assessments

As a nurse, I have encountered various instances where the diversity of patients has played a crucial role in healthcare delivery. It is importance to recognize and address diversity issues in health assessments. These issues encompass socioeconomic, spiritual, lifestyle, and cultural factors, emphasizing the need for personalized and culturally sensitive care.

Considering Paloma Hernandez, a 26-year-old Spanish-speaking patient, several specific factors must be taken into account. Socioeconomically, her ability to access healthcare and afford medications might be influenced. Spiritually, cultural beliefs may impact her understanding of illness and treatment (Ball et al., 2018). Lifestyle factors, including diet and daily habits, could contribute to her abdominal pain.

Building a Culturally Sensitive Health History

To develop a health history for Paloma, sensitivity to her background, lifestyle, and culture is paramount. The five targeted questions that I would ask to gather comprehensive information and assess potential health risks are:

• Cultural and Spiritual Beliefs:

Can you share any cultural or spiritual beliefs that influence how you perceive your current health condition? This may include any home remedies or traditional practices you follow.

• Diet and Lifestyle:

Could you describe your typical daily diet and any specific cultural preferences in your food choices? Additionally, are there any lifestyle factors, such as work or daily activities, that might contribute to your abdominal pain?

• Family Involvement:

In your culture, how involved is the family in health-related decisions? Do you typically rely on family members for support or assistance with healthcare matters?

• Communication Preferences:

Considering the language barrier during the first visit, I want to ensure effective communication. Is there a preferred language for our interactions, and would you like any family member, like your daughter, to be involved in translation?

• Financial Considerations:

I understand that healthcare costs can be a concern. Are there any financial challenges or constraints that may impact your ability to follow through with recommended treatments or medications?

Challenges and Strategies for Communication

Language barriers between healthcare providers and patients can impede effective communication. To overcome this, implementing professional interpreters is a crucial strategy. By ensuring accurate transmission of information, professional interpreters enable a clearer understanding of the patient’s health concerns and treatment options. This approach fosters effective communication and helps build trust between the healthcare provider and the patient.

Variations in cultural norms may lead to misunderstandings or discomfort during communication. Nurses should engage in regular cultural sensitivity training. This equips them with the skills to navigate diverse communication styles, fostering mutual understanding and trust. By being aware of and respecting cultural differences, healthcare providers can create a more inclusive and patient-centered communication environment (Dains et al., 2019).

Differences in health literacy levels impact the patient’s comprehension of medical information. To empower patients with varying health literacy levels, nurses can provide written materials in the patient’s preferred language and use visual aids. This promotes health literacy, enabling patients to actively engage in their care and make informed decisions about their health.

Family involvement expectations differ across cultures, influencing decision-making processes. Respecting and incorporating cultural norms related to family involvement in healthcare discussions is a critical strategy. This ensures holistic care planning and decision-making, recognizing the importance of family dynamics in the patient’s healthcare journey.

Strategies for Effective Cross-Cultural Communication

Nurses can prioritize culturally sensitive questions during health assessments to gather pertinent information. This approach acknowledges the influence of cultural factors on health and provides a comprehensive understanding of the patient’s background (Dains et al., 2019). By tailoring assessments to the patient’s cultural context, nurses can better address the patient’s unique healthcare needs.

Utilizing active listening techniques and employing open-ended questions are effective communication strategies. These techniques encourage patients to share their perspectives and concerns, facilitating a deeper understanding of their unique cultural context (Coleman, 2019). By actively engaging with patients and allowing them to express themselves, nurses can build trust and enhance communication.

Paying attention to non-verbal cues, including body language and facial expressions, is crucial in cross-cultural communication. Interpreting non-verbal cues enhances the nurse’s ability to gauge the patient’s comfort levels and emotional state. This contributes to a more empathetic and patient-centered interaction, bridging the gap created by language and cultural differences.

Engaging in ongoing cultural competence training and self-reflection is a continuous and essential process. Continuous learning and self-awareness foster cultural competence, enabling nurses to adapt their practices to meet the evolving needs of diverse patient populations (Coleman, 2019). By embracing cultural competence as a lifelong commitment, healthcare providers can contribute to a more inclusive and equitable healthcare environment.

Conclusion

Cultural competence is integral to providing patient-centered care, particularly in health assessments. The case study of Paloma Hernandez emphasizes the importance of understanding cultural nuances, acknowledging diversity, and employing effective communication strategies. By incorporating targeted questions and employing culturally sensitive approaches, nurses can enhance their ability to assess and address the health needs of patients from diverse backgrounds.

Diversity and Health Assessments NURS 6512 References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2018). Seidel’s Guide to Physical Examination: An interprofessional approach. Mosby. https://www.amazon.com/Seidels-Guide-Physical-Examination-Interprofessional/dp/0323481957

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

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced Health Assessment and Clinical Diagnosis in Primary Care (6th ed.). Mosby. https://www.amazon.com/Advanced-Assessment-Clinical-Diagnosis-Primary-ebook/dp/B07M6FWXB3

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DIVERSITY AND HEALTH ASSESSMENTS NURS 6512 WEEK 2 INSTRUCTIONS

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).

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 for Diversity and Health Assessments NURS 6512:

• 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?

BY DAY 3 OF WEEK 2

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

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 Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!   

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 2

Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.

LEARNING RESOURCES

Required Readings

• Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.
  • Chapter 1, “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”
• Centers for Disease Control and Prevention. (2020, October 21). Cultural competence in health and human servicesLinks to an external site.. 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 careLinks to an external site.. 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 diversityLinks to an external site.. Journal of Hospital Librarianship, 19(4), 330–338. https://doi.org/10.1080/15323269.2019.1661734
• Young, S., & Guo, K. L. (2016). Cultural diversity trainingLinks to an external site.. The Health Care Manager, 35(2), 94–102. https://doi.org/10.1097/hcm.0000000000000100

Required Media

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).

TARA HARRIS: Hello. This is Dr. Harris. I’m your coordinator for Advanced Health Assessment. Today we will discuss Module 2, which includes both week 2 and 3. During these two weeks, we will discuss functional assessments and assessment diagnostic tools. You have several required readings and articles within this module. You also have a required media video, which will assist you in learning how to take a health history.

Your first Shadow Health overview should be conducted during this time. You will also be able to complete the lab components within Shadow Health. During week 2, your discussion board initial post is due by day 3, and your final responses are due by day 6. You should also began working on your overview of Shadow Health Clinical Experience. During week 3, you have
several assignments.

Assignment 1 is a case study assignment that will be assigned by your instructor. You will need to write three to four pages within this assignment, and this does not include your title and your reference page. This assignment is due for submission by day 6 of week 3.

Your assignment 2 during week 3 will be your first Shadow Health history assessment. Please review the guidelines for this assignment. Please review your grade and rubric. Please start reviewing Shadow Health so that you are familiar with what you need to do to pass the assignment. So during week 4, this is when your health history is due. Please complete the orientation and all the requirements for this assignment.

As mentioned earlier, please review your grade and rubric. Remember, you must also document within Shadow Health as part of your grade. We are requiring that you document your information or your provider note on a Word document and submit that. Please also remember that your digital clinical score that you submit via the lab pass is not your final score. Your final grade will be composed of two components, your digital clinical score, as well as your documentation.

You must pass this assignment with a total score of 80% or more in order to pass this course. You will not be allowed any more attempts after day 7. The late policy will apply for any late submissions. Please reach out to your instructor if you need any clarity, concerns, or further discussion. Thank you.

Functional Assessments and Cultural and Diversity Awareness in Health Assessment – Week 2 (10m)

DR. LACHANDA BROWN: Hello, everyone, and welcome to Advance Health Assessment. I’m Dr. LaChanda Brown, and I’m one of the contributing faculty members in the course. For week two, we will focus on functional assessments with cultural diversity awareness. By the end of the week, you should be able to analyze diversity considerations in health assessments and apply concept theories and principles as it relates to cultural diversity in health assessment.

So what is diversity in health care and why is it so important? As a health care provider, we should be diverse, if not more diverse than the patient’s base they are treating. This helps to ensure that no matter what, no matter who walks in that door, we can effectively communicate with them and better serve their needs. We can do this be being cultural sensitive. So what is cultural sensitivity and why is it important?

Cultural sensitivity is being aware that there are cultural differences and similarities between people without assigning them a value. There’s no right or wrong, there is no better or worse, and there is no positive or negative. Again, this allows us to be able to function in other cultures, being able to understand or try to relate to being able to be that detective as previously mentioned in week one to find the correct answers, to try to solve their health problem, or help to treat their problem.

Also being culturally diverse. Cultural diversity is about appreciating that the individuals
and society are made up of different groups. That have different interests, skills, talents. It also means that being culturally diverse is being aware that there are different religious beliefs other than yourself. You may not accept those. Different sexual orientations other than yourself, but you respect that. You may not have the same belief, but you respect that, and you are non-biased for us with treatment of that patient.

So with that being said, there is always some risk of problems if there is not diversity in healthcare. And one of the issues is communication breakdown. Oftentimes, we may have individuals that may come into our practice that may have a language barrier, a different philosophy, or different cultural norms. Trying to be able to communicate, to fully communicate the needs or the issues of that patient is very important.

Also being aware of sometimes people can have lack of healthcare diversity, or you can have
limited perspectives. You may have never been around someone that may speak a different language or may have a different sexual preference or a different religious belief. And again, being able to be aware that even though this is something that you’re not familiar with, being able to try and come up with the best plan for that patient and being non-biased.

By being culturally sensitive, it provides patient-desired care, provides empowerment of the patient. The patient is aware that you are sensitive to their needs, which gives them the ability to be able to communicate and relate what is going on with them to provide better health care. I’ve also attached a video, Understanding Cultural Diversity in Healthcare- the four C’s.

Please take a look at this video. It has some very important tips on how to understand cultural diversity. So again, for this week’s assignment, you will have a case study. With that case
study, you’re going to reflect on your experience as a nurse on the information that was provided in this week’s learning resource on diversity in health issues.

Please be aware of the socioeconomic, spiritual lifestyles and other cultural factors that may be considered. Consider how you will build a health history. Again, like we discussed previously in week one, what other concepts that you need to build a good health history? What type of questions you would ask? Think about challenges, sparse with communication, and ways that you can help to relieve those communication barriers.

So again, I want to still reiterate Shadow Health assignment. Shadow health– please purchase as soon as possible. You do not have an assignment due this week for Shadow Health, but I would suggest to go ahead and practice on Shadow Health. Please get familiar with the areas in Shadow Health. If you haven’t purchased it, like I said before, you can purchase it through Walden bookstore only. You will receive an email– a confirmation
email with a code.

You do not need a PIN number from your instructor for access in Shadow Health. There is also a Shadow Health video. Just information about Shadow Health and navigation. Also attached is the Shadow Health IT. If you ever have any issues with logging in or not being able to access Shadow Health, you can click on this link and it should connect you to Shadow Health. There’s a number as well as a website to be able to contact. And then just tips for us
with Shadow Health success, starting on day one and getting familiar with Shadow Health accessing it, and just getting in the mode of Shadow Health practicing.

I cannot stress that enough. Practice, practice, practice on Shadow Health. You must have at least an 80% on Shadow Health, on all your Shadow Health, which is a combination of your DCE score as well as your documentation notes. And on those links, it will tell you about how to document. You want to be aware of the documentation that is essential. What is subjective
versus objective data? Subjective is what the patient states, what is going on with them.

Objective data is what you see or what you hear, your physical examination. So you want to
make sure that you know what is going on with your patient as far as with Shadow
Health and as far as how to document Shadow Health. Again, you must have
a 80% total combined score in Shadow Health, which is a combination of your DC score list where’s your documentation notes. And there is a link on here that can tell you how to document in your notes in Shadow Health. Again, you will start working in Shadow Health in week three.

Your first assignment is not due until week four for Shadow Health, Tina Jones. But, like I stated previously, get started with Shadow Health as soon as possible. Do not wait till
the last minute. You can practice in Shadow Health as many times as you like on up
until day seven. After day seven, you will not be able to access and it would be counted off as
late, unless you have an excuse and you previously discussed it with your instructor. But please get started on Shadow Health and get familiar. Watch the video, be aware of the IT, successful tips, and documentation tutorial. Thank you.

• Walden University. (n.d.). Instructor feedback

Diversity and Health Assessments NURS 6512 – Enhancing Cultural Competence in Health Assessment Example 2

Diversity and Health Assessment

Individuals from racial and ethnic minority groups may speak English “less well” or “not at all” and are thus classified as Limited English Proficient (LEP). Because of their limited ability to communicate their health information, ethnic minorities are vulnerable to significant health disparities. As a result, healthcare providers must be culturally competent to care for such individuals. Paloma’s case, a 26-year-old Spanish-speaking female patient who presented to the clinic for the second time in two days with abdominal pain, demonstrates the cultural influence on health. An in-depth discussion of the socioeconomic, spiritual, lifestyle, and other cultural factors influencing the patient’s health is provided below.

Socioeconomic, Spiritual, Lifestyle, and Other Cultural Factors affecting the Patient’s Health Status

An individual’s socioeconomic status influences their ability to access and use healthcare services. Poverty, health insurance, education, and employment are all important socioeconomic factors influencing Hispanic health. One in every four Hispanics in the United States lives below the poverty line (CDC, 2020). Furthermore, approximately one-third of Hispanic immigrants who have been in the United States for more than ten years had a college degree in 2018 (Noe-Bustamante, 2020). As a result, only a few people, including Paloma, have the financial means to access healthcare services.

Spiritual beliefs also influence an individual’s health status. The majority of Hispanics are Christian Catholics who seek comfort and relief from life’s stresses through prayer (Johnson & Farquharson, 2019). They believe in praying to God or having faith as a coping strategy when they are sick. This, along with seeking medical attention, may help Paloma heal. In terms of lifestyle, both Hispanic men and women report a lower prevalence of regular physical activity (41.9%, 40.5%) than their non-Hispanic counterparts (52.3, 49.6), making them vulnerable to a variety of chronic illnesses (Bantham et al., 2021). 

Furthermore, in 2020, 8.0% of Hispanic adults in the United States smoked cigarettes (CDC, 2022), and it is estimated that 9.5% will have alcohol dependence at some point in their lives (National Institute of Health, 2021); these are risk behaviors that increase the individual’s risk of developing chronic illnesses. As a result, for Paloma to maintain a healthy lifestyle, she should be advised on healthy lifestyle changes. Language is a potent cultural determinant of health as well. Language influences both how a patient communicates and how a clinician perceives health information (Dains et al., 2015; Melton et al., 2014). Being an LEP, she is accompanied by her younger bilingual daughter; however, this proxy reporting of symptoms may not depict the true illness of the patient and may explain why she visits the hospital twice in two days for the same illness.

Sensitive Issues while interacting with the Patient

The patient has been to the clinic two days in a row with similar complaints. She is accompanied by her younger bilingual daughter, who may not fully comprehend all of the details of her illness. One might wonder why the patient is not with an older person, such as her husband or older children, who appear to have a better perception of health. This patient may have marital problems or some form of discord, which a clinician should be aware of to design appropriate, helpful interventions. She was also discharged on Omeprazole but was told she could get it over the counter. 

Could the patient afford the medication? This could explain why she is seeking care on the second day with worsening symptoms. Poverty rates among Hispanics in the United States are staggering, with one in every four living in poverty (CDC, 2020); this may explain Paloma’s inability to afford the drugs. In addition, I would be cautious about the language I use when addressing the patient. Park et al. (2018) recommend using simple pleasantries, clear explanations, and active listening when speaking with LEP individuals to build a bond with them.  While history taking is an important aspect of health assessment, the clinician must understand the patient’s situation outside of the hospital to understand the nature of the patient’s illnesses.

Targeted Questions to build the Health History and to Assess Health Risks

1. You state that you have abdominal pain; when was the onset?
2. In which part of the abdomen is the pain located?
3. What is the character of the pain, and are there aggravating or relieving factors?
4. How severe is the pain, and does it occur at different times?
5. Have you ever had peptic ulcer treatment?
6. Do you consume alcoholic beverages or smoke cigarettes?
7. Have you recently received NSAID therapy?
8. Has any member of your family ever had an abdominal malignancy?

Conclusion

History taking and physical examination are critical assessment steps in healthcare.  A clinician gains essential information from the history and physical examination that aids in making a diagnosis and, consequently, designing an appropriate treatment plan. However, challenges such as language barriers may arise during the initial patient assessment, resulting in a suboptimal assessment and treatment. Paloma, for example, is Spanish-speaking and comes in the company of her bilingual-speaking younger daughter. To solve the medical problems of LEP patients, clinicians may resort to alternatives such as enlisting the assistance of a translator.

Diversity and Health Assessments NURS 6512 References

Bantham, A., Taverno Ross, S. E., Sebastião, E., & Hall, G. (2021). Overcoming barriers to physical activity in underserved populations. Progress in Cardiovascular Diseases, 64, 64–71. https://doi.org/10.1016/j.pcad.2020.11.002

Centers for Disease Control and Prevention. (2020, January 3). Hispanic health. Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/hispanic-health/index.html

Centers for Disease Control and Prevention. (2022, August 9). Burden of cigarette use in the U.s. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/campaign/tips/resources/data/cigarette-smoking-in-united-states.html

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced Health Assessment & Clinical Diagnosis in Primary Care-E-Book. Elsevier Health Sciences. https://www.uk.elsevierhealth.com/advanced-health-assessment-clinical-diagnosis-in-primary

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