NURS 6512 Functional Assessments and Cultural and Diversity Awareness in Health
NURS 6512 Functional Assessments and Cultural and Diversity Awareness in Health
Mono Nu, a 44 year-old Filipino
The assigned case study involves Mono Nu, a 44-year old Filipino patient who wants their blood thinner labs to be drawn. While they have been using them according to the healthcare provider’s recommendation, the assessment shows that the labs as still out of range. According to the patient, they have been doing well, including eating a good diet rich in tofu and fish but the medication is not working. The paper focuses on the specific socioeconomic, lifestyle, spiritual and other cultures factors that could affect the patient’s treatment process. Also, significant sensitive issues that must be considered when interacting with the patient as well as five questions that can be asked to build the patient’s health history and assess their health risks.
Healthcare providers are encouraged to embrace patient’s perspectives during assessment, diagnosis, and treatment process. While assessing the Filipino patient, a nurse practitioner can consider critical socioeconomic factors that could impact their healthcare outcomes. These include any financial status, education, employment, family background, social support and community safety concerns. Martinez et al. (2020) admit that Asian Americans such as Filipinos are among many other ethnic/racial minorities who are likely to lack health insurance, be unemployed, have limited access to quality healthcare, as well as live in poor neighborhoods.
When considering the patient’s spirituality, the nurse practitioner need to be competent about their religious beliefs and practices that could influence their lifestyle, preferences, and perception about their overall health and well-being. Among Filipinos, spirituality is a significant source of coping as well as increased resilience with harsh living conditions and other precarious situations (Caringal et al., 2022). A better understanding of how spiritual factors play a significant role in improved health outcomes can help the nurse increase compliance as well as initiate and involve other important people such as religious leaders to help the patient cope with their condition. Although there is not enough information to understand the patient’s lifestyle, it is clear that they like eating fish and tofu. Encouraging the patient to embrace a well-balanced diet seems critical at this point.
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Other cultural factors include the sense that Filipinos tend to be family-oriented. This denotes the importance of understanding the significance of biological networks within and outside the patient’s family (Coronado et al., 2020). It means the patient is likely to be more comfortable when treated with an Asian American healthcare provider, which could help inform inter-professional collaboration interventions. In case of language barrier or unclear cultural concerns the patient should consult another professional of the same race, ethnicity, or even nationality with the patient.
The patient is eating a lot of tofu and fish, which could be affecting the effectiveness of the blood thinners because of the increase Omega fatty acid and vitamin K in the body. Vitamin K is considered a significant barrier to the efficacy of blood thinners due to enhanced blood clotting (Tan & Lee, 2021). Although the patient should caution the patient about their diet, they must be sensitive to their dietary choices, which could be of significant importance in their family. The nurse should also be sensitive about the patient’s financial status, access to healthcare, documentation status, as well as values and beliefs. They should recommend alternative treatment regimens based on ability to afford, as well as respect the patient’s decision to remove the blood thinners.
The five questions the healthcare provider can use include;
How would you describe yourself and your family background?
Tell me more about your lifestyle and daily activities?
How can you describe your spiritual life and religious practices?
Would you mind talking about your employment status or family income?
What about any alternative dietary choices and practices?
References
Cariñgal, K. S., Medina Jr, M. F., & Umali, M. J. P. S. (2022). A study on the association of perceived spiritual beliefs, practices, and well-being of breast cancer patients in a tertiary general hospital. Acta Medica Philippina, 56(3), 106-112. https://doi.org/10.47895/amp.vi0.3172
Coronado, G., Chio-Lauri, J., Cruz, R. D., & Roman, Y. M. (2021). Health disparities of cardiometabolic disorders among Filipino Americans: implications for health equity and community-based genetic research. Journal of Racial and Ethnic Health Disparities, 1-8. https://doi.org/10.1007/s40615-021-01190-6
Martinez, A. B., Co, M., Lau, J., & Brown, J. S. (2020). Filipino help-seeking for mental health problems and associated barriers and facilitators: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 55, 1397-1413. https://doi.org/10.1007/s00127-020-01937-2
Tan, C. S. S., & Lee, S. W. H. (2021). Warfarin and food, herbal or dietary supplement interactions: A systematic review. British Journal of Clinical Pharmacology, 87(2), 352-374. https://doi.org/10.1111/bcp.14404
I agree with you, the emphasis should be more on the patient cultural background. Generally, when interacting with this patient, the patient’s condition, race, culture, life experiences, and beliefs; should be put into consideration (Ball, Dains, Flynn, Solomon, & Stewart, 2019). Cultural beliefs played a key role in patient health. In this case study, Mono Nu is from the Philippines and has a culture that has been known for the traditional use of plant medicines. There are several factors that the healthcare professional should consider when assessing patients with different cultural backgrounds. First, this professional should consider the patient’s socioeconomic status since they are likely to affect the patient’s health literacy, perception of healthcare, health-seeking behavior, ability to afford medical services, and the risk factors that patients face (Arpey et al., 2017; McMaughan et al., 2020).
with this, in mind, the health care professional will assess the patient’s drug history and make sure to ask about herbal supplements. Many herbal plant decreased the effectiveness of the medicine and block the action of blood thinners. Warfarin for instance role is to prevent clot formation, a diet rich in VitK decreased the effectiveness of the medication and may lead to severe health consequences (Rosenthal and Burchum, 2018). Also, it’s important that the healthcare professional educate patient Mono Nu about the importance of blood thinners and emphasize more the diet low with vitk.
References
Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status affects patient perceptions of health care: A qualitative study. Journal of Primary Care & Community Health, 8(3), 169–175. https://doi.org/10.1177/2150131917697439
Ball, J.W., Dains, J.E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination. (9th ed.). St. Louis, MO: Elsevie Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice nurse and physicians assistant. St. Louis, MO: Elsevier.
Many transgender people experience stigma and discrimination in their day-to-day lives which can affect access to healthcare (CDC,2022). This patient has a lot of different factors that play a role in his current mental state. The patient is currently unemployed, has multiple diagnoses, and currently not feeling his best. The patient has also been transitioning, which is the biggest phase of this patient’s life. Transgender people may also have unique needs and concerns when interacting with the healthcare system (CDC, 2022). You are correct about using the proper pronouns when referring to the patient, that shows that you respect the patient’s wishes and current state of mind during this transition. We must also consider how this patient feels about moving with his parents after becoming unemployed. It is important for the health care provider to build a trusting relationship with this individual to provide the best care.
The strategies that you have chosen will best fit this scenario, asking open-ended questions, and involving the patient in care would help the patient to lead care and be actively involved in care. Everything that the patient is currently dealing with can cause him to struggle mentally. It would be safe to do a thorough mental exam, it would be important to build a trusting relationship because you would want to make sure that the patient is being 100% honest about his mental state. Recent changes in living situations, death, relocation of friends or family members, or changes in physical health (Ball & et al, 2019). I would be sure to ask the patient if he has any feelings about harming himself or anyone else or if he has had any feelings recently about harming himself since the recent changes in his life. This patient could be a good candidate for a thorough mental health exam.
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.
Centers for Disease Control and Prevention. (2022, February 18). Patient-centered care. Centers
for Disease Control and Prevention. Retrieved December 10, 2022, from
https://www.cdc.gov/hiv/clinicians/transforming-health/health-care-providers/affirmative-
Diversity is not about how we differ. Diversity is about embracing one another’s uniqueness.
—Ola Joseph
Countless assessments can be conducted on patients, but they may not be useful. In order to ensure that health assessments result in the necessary care, health assessments should take into account the impact of factors such as cultures and developmental circumstances.
Learning Objectives
Students will:
Analyze diversity considerations in health assessments
Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment
Learning Resources
Required Readings (click to expand/reduce)
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.
Chapter 1, “The History and Interviewing Process” (Previously read in Week 1)
This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.
Chapter 2, “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”
Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi:10.3109/02770903.2014.906605
Credit Line: Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis by Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J., in Journal of Asthma, Vol. 51/Issue 7. Copyright 2014 by Taylor & Francis, Inc. Reprinted by permission of Taylor & Francis, Inc. via the Copyright Clearance Center.
The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.
Centers for Disease Control and Prevention. (2015). Cultural competence. 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 care. 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.
Espey , D. K., Jim, M. A., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(Suppl 3), S303–S311.
The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives.
Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., & Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers. Southeast Asian Journal of Tropical Medicine and Public Health, 47(1), 109–120.
The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving healthcare services at primary healthcare centers.
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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).
Functional Assessments and Cultural and Diversity Awareness in Health Assessment – Week 2 (10m)
Walden University. (n.d.). Instructor feedback. https://mym.cdn.laureate-media.com/2dett4d/Walden/WWOW/1001/pulse_check/instructor_feedback/index.html#/
Discussion: Diversity and Health Assessments
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).
Photo Credit: Getty Images
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:
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 “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 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.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 2 Discussion Rubric
Post by Day 3 of Week 2 and Respond by Day 6 of Week 2
To Participate in this Discussion:
Week 2 Discussion
What’s Coming Up in Week 3?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Next week, you examine assessment techniques, health risks and concerns, and recommendations for care related to patient growth, weight, and nutrition. You will also begin your first DCE: Health History Assessment which will be due in Week 4. Plan your time accordingly.
Overview of Digital Clinical Experiences (DCE) and Lab Components
Throughout this course, you are required to not only complete your standard course assignments and discussions, but you will also complete DCE and Lab Components that are either structured as optional or required assignment submissions. Please take the time to review your DCEand Lab Components for this course that are required submissions. See the table below and the attached table for specific DCE and Lab Components for the course.
Note: Each Shadow Health Assessment may be attempted and reopened as many times as necessary prior to the due date to achieve a total score of 80% or better, but you must take all attempts by the Day 7 deadline. You must pass BOTH the Health History and Comprehensive (head-to-toe) Physical Exam of at least a total score of 80% in order to pass the course.
Week
Digital Clinical Experiences
Lab Components
Module 1: Comprehensive Health History
Week 1: Building a Comprehensive Health History
Module 2: Functional Assessments and Assessment Tools
Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment
Week 3: Assessment Tools, Diagnostics, Growth, Measurement, and Nutrition in Adults and Children
DCE: Health History Assessment (assigned in Week 3, due in Week 4)
Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children
Module 3: Approach to System Focused Advanced Health Assessments
Week 4: Assessment of the Skin, Hair, and Nails
DCE: Health History Assessment
Lab Assignment: Differential Diagnosis for Skin Conditions (SOAP Note for differential diagnosis)
Week 5: Assessment of Head, Neck, Eyes, Ears, Nose, and Throat
DCE: Focused Exam: Cough
Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat (Episodic SOAP Note)
Week 6: Assessment of the Abdomen and Gastrointestinal System
Lab Assignment: Assessing the Abdomen (Analyze SOAP Note)
Week 7: Assessment of the Heart, Lungs, and Peripheral Vascular System
DCE: Focused Exam: Chest Pain
Week 8: Assessment of the Musculoskeletal System
Discussion: Assessing Musculoskeletal Pain (Episodic SOAP Note)
Week 9: Assessment of Cognition and the Neurologic System
DCE: Comprehensive (head-to-toe) Physical Assessment
Case Study Assignment: Assessing Neurological Symptoms (Episodic SOAP Note)
Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal
Lab Assignment: Assessing the Genitalia and Rectum (analyze SOAP Note)
Module 4: Ethics in Assessment
Week 11: The Ethics Behind Assessment
Lab Assignment: Ethical Concerns
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Week 2: Functional Assessments and Cultural and Diversity Awareness in Health Assessment
Diversity is not about how we differ. Diversity is about embracing one another’s uniqueness.
—Ola Joseph
Countless assessments can be conducted on patients, but they may not be useful. In order to ensure that health assessments result in the necessary care, health assessments should take into account the impact of factors such as cultures and developmental circumstances.
Learning Objectives
Students will:
Analyze diversity considerations in health assessments
Apply concepts, theories, and principles related to examination techniques, functional assessments, and cultural and diversity awareness in health assessment
