Functional Assessments and Cultural and Diversity Awareness in Health Assessment

Functional Assessments and Cultural and Diversity Awareness in Health Assessment

Socioeconomic, Spiritual, Lifestyle, and other Cultural Factors

The patient is an African-American man who is homeless, has experienced alcohol withdrawal seizures, has run out of medication, lives in a shelter, and needs to smoke to calm down and function. A socioeconomic issue affecting this patient is homelessness, which affects his consistent healthcare and a stable environment in which he can thrive. According to Bedmar et al. (2022), homelessness is a complex issue that affects beyond the lack of a place to live. It leads to poor health conditions and premature death because of the limited access to healthcare and resources for those affected. Homeless individuals are also at risk of developing communicable diseases and foot infections, which tend to have a low adherence to pharmacological treatments (Bedmar et al., 2022). There is also an increased risk of cardiovascular and neurological diseases, including diabetes, which are the most prevalent. Hepatitis and HIV positivity (Bedmar et al., 2022). Given this patient’s homelessness condition, it is evident that the patient in this scenario is already suffering from some of the consequences, such as low drug adherence, as he runs out of his medication. This patient lacks understanding of his medication and needs to follow up with his cardiologist to refill his prescription Functional Assessments and Cultural and Diversity Awareness in Health Assessment.

A spiritual issue affecting this patient could be a lack of support from a religious group such as a church, a mosque, or any other affiliation, leading him to turn to smoking as therapy to calm down. The patient is struggling with functioning and stress. Spiritual support could offer him a reprieve and reduce the need to use substances for stress management and as a coping mechanism.

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Lifestyle factors affecting this patient include substance use, medication adherence, and, likely, diet and exercise, given his hypertension. From the case information, the patient has a history of alcohol dependence that led to seizures from withdrawal. Additionally, drug adherence is difficult because of unstable living conditions. Lastly, limited access to healthy food, stress, and safe spaces for physical activity are likely to have limited the patient from observing a healthy diet and exercise, leading to his hypertension.

Culturally, African Americans tend to experience healthcare inequality and disparities, leading to reduced trust in the healthcare system. Worse, the patient is a homeless African American male, which exposes him to a higher risk of discrimination in the healthcare system, according to a study by Willison et al. (2023) that found that African Americans are four times more likely to be homeless and discriminated against in the healthcare system compared to their white counterparts.

Sensitive Issues

An issue that a healthcare provider should be sensitive to when handling this patient is judgment and stigma. The healthcare worker must avoid using judgmental language or words considered racial slurs or inappropriate. It is also important to empathize with the patient’s homelessness, addiction, and smoking habits. The goal is to ensure that the patient develops trust in the healthcare worker. Additionally, African Americans tend to experience discrimination in healthcare settings because of their race, according to Willison et al. (2023); therefore, it is necessary to ensure that this experience is not replicated in this patient’s case.

Another sensitive issue to consider when interacting with this patient is their privacy and dignity. The healthcare worker should ensure their discussions are private and confidential, remain respectful, and observe the patient’s dignity despite their socioeconomic status. Maintaining privacy and confidentiality is an ethical principle in healthcare that should be upheld regardless of a patient’s background, age, and condition.

Communication Techniques

A communication technique ideal when interacting with this patient is active listening, which entails paying close attention, being present, and asking questions for clarification (Kwame & Petrucka, 2021). Active listening is essential in this case because it encourages the patient to continue sharing important information that could be useful in their management, helps develop nurse-patient trust, and promotes patient-cantered care (Kwame & Petrucka, 2021). It is also essential to be empathetic during the interaction with the patient so that they can feel heard and develop trust towards the healthcare worker. Another ideal communication technique in this interaction is asking the patients open-ended questions, encouraging them to openly share their experiences without being judged. Using open-ended questions is essential in this case because it would encourage patient-centered care based on the information provided by the patient.

Health History Interview

1. What is your recent experience with alcohol withdrawal and other health issues you have been dealing with?

Asking this question would help the healthcare worker understand the severity and context of the alcohol withdrawal and seizures, as well as other health concerns.

2. How do you manage your blood pressure without medication? Do you have any other symptoms? Functional Assessments and Cultural and Diversity Awareness in Health Assessment

This question is essential in assessing the impact of operating without hypertensive medication to identify immediate health risks.

3. How do you feel about your current living situation, and do you have any support?

This question aims to gauge the patient’s emotional support system, crucial for his recovery and care.

4. How does your typical day look like? What substances are you using?

Asking this question helps to develop a comprehensive view of the patient’s lifestyle choices and how they affect their health. This information would be crucial in tailoring interventions for him.

5. Do you experience any barriers when accessing healthcare or medication?

This question establishes the specific obstacles preventing this patient from accessing consistent healthcare. The healthcare worker could have helpful information on how to circumvent these obstacles for the patient.

Risk Assessment Instrument

An appropriate risk assessment instrument to use on this patient is the alcohol use disorders identification test (AUDIT). This instrument is a 10-item tool developed by the World Health Organisation (WHO) (Brummer et al., 2023). It covers aspects such as drinking behaviors, frequency, and alcohol-related problems. The responses ranged from 0 to 4 in scoring, which made the highest possible score of 40. It is a valuable tool in identifying harmful drinking patterns and can help identify drinking as the cause of the illness presented to a patient (Brummer et al., 2023). It also provides a robust framework for risky drinkers to reduce their alcohol consumption and its impact.

            AUDIT would be ideal to use on this patient because the patient has a history of alcohol withdrawal seizures, which imply heavy alcohol use. It is, therefore, critical to assess his relapse risk and continued alcohol use using this risk assessment tool. Another reason for using AUDIT is that it is comprehensive in that it covers essential aspects of alcohol use, such as frequency, dependency, and effects. This information helps develop effective interventions for the patient.

References

Bedmar, M. A., Bennasar-Veny, M., Artigas-Lelong, B., Salvà-Mut, F., Pou, J., Capitán-Moyano, L., García-Toro, M., & Yáñez, A. M. (2022). Health and access to healthcare in homeless people: Protocol for a mixed-methods study. Medicine, 101(7), e28816. https://doi.org/10.1097/MD.0000000000028816

Brummer, J., Bloomfield, K., Karriker-Jaffe, K. J., Pedersen, M. M., & Hesse, M. (2023). Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study. Addiction (Abingdon, England), 118(1), 86–94. https://doi.org/10.1111/add.16034

Kwame, A., & Petrucka, P. M. (2021c). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00684-2

Willison, C., Unwala, N., Singer, P. M., Creedon, T. B., Mullin, B., & Cook, B. L. (2024). Persistent Disparities: Trends in Rates of Sheltered Homelessness Across Demographic Subgroups in the USA. Journal of racial and ethnic health disparities, 11(1), 326–338. https://doi.org/10.1007/s40615-023-01521-9  Functional Assessments and Cultural and Diversity Awareness in Health Assessment