Functional Assessments and Cultural and Diversity Awareness in Health Assessment

 Functional Assessments and Cultural and Diversity Awareness in Health Assessment

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Functional Assessments and Cultural and Diversity Awareness in Health Assessment

Socioeconomic, Spiritual, Lifestyle, and Other Cultural Factors

When all pertinent information is collected for a health evaluation, the optimum result is obtained. Socioeconomic position influences health outcomes globally. Poverty, lack of education, and socioeconomic inequalities can harm the medical care of certain ethnic minorities and women (Ball et al., 2019). I would enquire about her living conditions, nutritional status, financial aids/support, and income. Depending on the patient's ethnicity, religious views, and lifestyle, they are all distinct individuals. For a successful treatment approach, it is critical to know their religious views. People's actions, views, attitudes, language, morality, religion, sexual orientation, education, and life experiences are all examples of culture (Ball et al., 2019). Knowledge of people's specific standards, practices, and perspectives within their cultural settings improves the services provided, resulting in better outcomes (McElfish et al., 2017). As healthcare providers, we must be sensitive to our patients’ socio-economic status, cultural background, spiritual or religious beliefs, and race. In this scenario, there could be several reasons for the patient’s high blood pressure and her lack of medication compliance.

Managing Communication Challenges to Build Health History

 According to Ball et al. (2017), RESPECT (Rapport, Empathy, Support, Partnership, Explanations, Cultural competence, and Trust) is an effective tool for cross-cultural communication to bridge the cultural divide between patients and healthcare providers. A sensitive issue in this scenario is me being an immigrant. According to Ball et al. (2017), it is acceptable to ask the patient if they are uncomfortable with me or my background and if they are willing to talk about it. Lack of trust in the healthcare system is a significant factor for many racial and ethnic minorities in the United States, especially for African American patients. While building the health history, it is essential to know about the patient’s level of understanding about Hypertension and the importance of drug compliance. The patient’s inadequately controlled hypertension is probably worsening glaucoma and, thereby, her vision. She could be demonstrating memory issues because she forgot to bring one medication and has not been taking her medicines as instructed, as can be deduced from the previous year’s leftover medications. Cognition, health literacy, and culture can affect medication adherence (Killic, 2020). I will assess her memory using BIMS (Brief Interview for Mental Status). If she scores between 13-15, I can rule out cognitive impairment. Next is to assess for other factors that can possibly affect her medication compliance.

I will enquire if any of these medications made her feel differently or caused any side effects. A study of medication compliance in the African American patient with hypertension revealed that a lack of understanding regarding what causes hypertension, cultural perceptions of health, dietary preferences, and religious preferences all play a role in whether a patient will maintain medication compliance (Shahin et al., 2019). Health literacy can have beneficial effects on outcomes such as blood pressure control (Killic, 2020). Educating the patient on her level of understanding is essential without making her feel insulted Asking Ms. EB to verbalize her understanding is an excellent way to get feedback. It is also important to rule out if she has any financial difficulties affecting medication compliance.

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Target questions

 I would choose my target questions to understand the patient’s thoughts and concerns to make a more informed decision on her treatment plan and education. 

1. How do you feel right now? (Since the blood pressure is elevated at the time of visit). Can you feel/tell when your blood pressure goes up? 

2. What is your understanding about your health issue, especially high blood pressure, and the importance of taking the medications as prescribed? 

3. Did any of these current medications cause adverse reactions?

 4. Have you ever been hospitalized due to high blood pressure or with any other health problems?

 5. What are your daily activities, routine, dietary intake, and other habits?

 6. Is there anything that you would like to tell me besides all the questions I asked you?

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2017). Seidel's Guide to Physical Examination-E-Book: An Interprofessional Approach. Elsevier Health Sciences.

Kilic, H. F., & Dag, S. (2020). The Relationship between Health Literacy and Medication Adherence in a Hypertensive Patient Population. International Journal of Caring Sciences, 13(1), 101.

McElfish, P. A., Long, C. R., Rowland, B., Moore, S., Wilmoth, R., & Ayers, B. (2017). Improving culturally appropriate care using a community-based participatory research approach: evaluation of a multicomponent cultural competency training program, Arkansas, 2015–2016. Preventing chronic disease, 14, E62.

Shahin, W., Kennedy, G. A., & Stupans, I. (2019). The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review. Patient preference and adherence, 13, 1019.