Diversity and Health Assessments

Diversity and Health Assessments

CASE STUDY:
EB is a 68-year-old black female who comes in for follow-up of hypertension. She has glaucoma and her vision has been worsening during the past few years. She lives alone and is prescribed four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL 200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily ). She brings in her medication bottles and she has some medication bottles from the previous year full of medications. She is missing one medication she had been prescribed and says she may have forgotten it at home. Her BP in clinic today is 182/99 with HR of 84.

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?

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.

Solution

Diversity and Health Assessments

Cultural Factors: Socioeconomic, Spiritual, Lifestyle

Understanding a patient’s culture and beliefs is essential to achieve the best outcomes. Culture can be defined as a person’s behaviors, beliefs, attitudes, language, morals, religion, sexual orientation, education, and experiences in life (Ball, J.W., Dains, J.E., Flynn, J.A. Solomon, B.S., and Stewart, R.W. 2019). Every patient is unique based on their experiences in life and should be assessed as an individual. We must listen and understand our patient’s cultures to provide proper care. Respecting your patient’s culture will help build excellent communication and rapport. Socioeconomic status determines variations in health outcomes throughout the world (Williams, D.R. Priest, N., & Anderson, N.B. 2016). Also, a patient’s spirituality/religion can play a role in their adherence to a medication regimen (Abel, W.M., & Greer, D.B. 2017). Considering a patient as a whole and identifying any factors that may influence their care should be addressed by building trust and open communication.

Despite dramatic changes, among the minority groups, significant gaps still exist. There is a likelihood that the level of education for EB is low. Racial discrimination and socioeconomic deprivation are associated with higher psychological stress. According to Braveman et al. (2017), partially, wealth explains ethnic and racial differences in hypertension and depression. Zero net worth, negative net worth, and not owning a home in adulthood are associated with depression and hypertension.

Sensitive Issues

Several sensitive issues need to be addressed with the patient. Finances are a sensitive topic but essential to assess the patient’s ability to pay for medication. Is the patient not taking the medication as prescribed due to cost? Some patients will take medication every other day so that it will last longer. Another sensitive issue is the patient’s education level. Health literacy needs to be assessed. African Americans are more likely to have low health literacy due to education, culture, and the healthcare system (Melton, C., Graff, C., Holmes, G., Brown, L., and Bailey, J. 2014). It is essential to be aware of these statistics but to not stereotype someone based on their race (Ball, J.W., Dains, J.E., Flynn, J.A. Solomon, B.S., and Stewart, R.W. 2019). 

The patient should be assessed as a unique individual based on their culture and beliefs. The patient may not understand the importance of taking the medication as prescribed, as evidenced by the high blood pressure and old medication in the bottles. Educating the patient on their level of understanding is essential without making them feel uneducated. Using words and phrases that they would use to describe things should be assessed. Asking the patient to state their understanding of what you teach them is an excellent way to make sure they are receiving the information in a way they understand.

Targeted Questions

Targeted questions help to build the health history of a patient and assess his or her health risks, the following questions are critical;

  1. What is your physical activity and diet regimen like?

This question is essential in establishing the reason why the patient chooses some foods and the kind of physical activities that he or she is involved in, thus making appropriate recommendations.

  1. Have you been taking your medicine?

It is crucial to know whether the patient has been taking the medications he or she was given. It is vital to know if the medication is not working or inappropriate dosage.

  1. Do you smoke, drink alcohol, or use any drug?

This question is important because smoking cigarettes, drinking alcohol, and drug abuse serve as risk factors for many conditions such as heart disease and hypertension?

  1. Have you ever been admitted to the hospital?

This question is vital in establishing the seriousness of the condition that the patient is suffering from.

  1. How do you fund your medication?

This question is essential in establishing whether the patient can fund his or her medication. 

References

Abel, W.M., & Greer, D.B. (2017). Spiritual/Religious Beliefs & Medication Adherence in Black Women with Hypertension. Journal of Christian Nursing: A quarterly Publication of Nurses Christian Fellowship, 34(3), 164-169. https//doi-org.ezp.waldenulibrary.org/10.1097/CNJ0000000000000333

Ball, J.W., Dains, J.E., Flynn, J.A. Solomon, B.S., & Stewart, R.W. (2019). Seidel’s guide to physical examination: An interprofesssional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2017). Socioeconomic disparities in health in the United States: What the patterns tell us. American Journal of Public Health, 100(S1), S186-S196. DOI:10.2105/AJPH.2009.166082.

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

Williams, D.R. Priest, N., & Anderson, N.B. (2016). Understanding associations among race, socioeconomic status, and health: Patterns and prospects.  Health Psychology, 35(4), 407-411. https://doi-org.ezp.waldenulibrary.org/10.1037/hea0000242

 

Diversity and Health Assessments

 

Sample Solution

Media is considered an integral part of daily life as we are constantly subject to being an audienc Diversity and Health Assessments e to different forms of media platforms. Through market forces the media system is economically structured in such a way that it produces systemic biases, causing journalist and reporters to internalize presuppositions about the world producing ideological conformity without the need of coercion. The propaganda model attempts to explain the relationship between the so called ‘free press’ and the media elites. This essay contends to unravel the relevance of the five filters of the propaganda model and how applicable this theory it in contemporary society as opposed to when it was first introduced. Edward Herman and No Diversity and Health Assessments am Chomsky’s 1988 book titled ‘Manufacturing Consent’ claimed that media behavior is driven by a variety of variables that exten Diversity and Health Assessmentsd from both institutional and political pressures in a profit-driven system. As a direct contrast to the liberal standpoint that suggests journalism is incompatible  Diversity and Health Assessments and adversarial to the influence of elitism and established power. The propaganda theory introduced in 1988 maintains that media content will undeniably “serves the ends of  Diversity and Health Assessments the dominant elite” (Herman & Chomsky 1994, 1). As one of the most notable books of its time, ‘Manufacturing Consent’ contested the widespread belief of the impartial nature of the media. To remove the degree of democracy, the official structure of the propaganda theory stems from the agenda setting of corporate power selling audiences to different established power. When the theory was first introduced, it was considered ludicrous to imply large media institutions including CBS news, The New York Times and Time were vessels of propaganda that “depend heavily on elite information sources” (Herman, 2003, 114). In today’s modern society mistrust, disinformation and propaganda pervades the media, where there is a strong emphasis on denouncing the myth of democratic western media. The propaganda model when it wa Diversity and Health Assessments s first introduced recognized patterns of media dependence supplied by official sources, for instance media reliance on military or government officials. Media circulated around fortifying a degree of public support particularly in cases of war, for example the 2003 media frenzy surrounding the false speculation of destructive arsenal in Iraq was all politically motivated to support the rise of the freedom agenda after the 9/11 attack on America or the US invasion of Iraq. Through the use of the five selective filters in the propaganda model: corporate ownership, the role of advertising, the media elite, flak by established power and anti-communism as a form of ideological control, it becomes clear that the role of the United States media in the 19th century was more pertinent to the implementation of the filters as opposed to today. The five filters featured in the opening chapter of ‘Manufacturing Consent’ play a crucial role in demonstrating the corruptive nature of the so c Diversity and Health Assessments alled ‘democratic’ media system. The notable censorship and enforcement of selective agenda setting and framing enabled established power to contro>

 

Media is considered an integral part of daily life as we are constantly subject to being an audience to different forms of media platforms. Through market forces the media system is economically structured in such a way that it produces systemic biases, causing journalist and reporters to internalize presuppositions  vDiversity and Health Assessments about the world producing ideological conformity without the need of coercion. The propaganda model attempts to explain the relationship between the so called ‘free press’ and the media elites. This essay contends to unravel the relevance of the five filters of the propaganda model and how applicable this theory it in contemporary society as opposed to when it was first introduced. Edward Herman and Noam Chomsky’s 1988 book titled ‘Manufacturing Consent’ claimed that media behavior is driven by a variety of variables that extend from both institutional and political pressures in a profit-driven system. As a direct contrast to the liberal standpoint that suggests journalism is incompatible and adversarial to the influence of elitism and established power. The propaganda theory introduced in 1988 maintains that media content will undeniably “serves the ends of the dominant elite” (Herman & Chomsky 1994, 1). As one of the most notable books of its time, ‘Manufacturing Consent’ contested the widespread belief of the impartial nature of the media. To remove the degree of democracy, the off Diversity and Health Assessments icial structure of the propaganda theory stems from the agenda setting of corporate power selling audiences to different established power. When the theory was first introduced, it was considered ludicrous to imply large media institutions including CBS news, The New York Times and Time were vessels of propaganda that “depend heavily on elite information sources” (Herman, 2003, 114). In today’s modern society mistrust, disinformation and propaganda pervades the media, where there is a strong emphasis on denouncing the myth of democratic western media. The propaganda model when it was first introduced recognized patterns of media dependence supplied by official sources, for instance media reliance on military or government officials. Media circulated around fortifying a degree of public support particularly in cases of war, for example the 2003 media frenzy surrounding the false speculation of destructive arsenal in Iraq was all politically motivated to support the rise of the freedom agenda after the 9/11 attack on America or the US invasion of Iraq. Through the use of the five selective filters in the propaganda model: corporate ownership, the role of advertising, the media elit Diversity and Health Assessments e, flak by established power and anti-communism as a form of ideological control, it becomes clear that the role of the United States media in the 19th century was more pertinent to the implementation of the filters as opposed to today. The five filters featured in the opening chapter of ‘Manufacturing Consent’ play a crucial role in demon Diversity and Health Assessments strating the corruptive nature of the so called ‘democratic’ media system. The notable censorship and enforcement of selective agenda setting and framing enabled established power to contro>

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