NURS 6512 Week 1 Discussion Building a Health History

NURS 6512 Week 1 Discussion Building a Health History

Walden University NURS 6512 Week 1 Discussion Building a Health History-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University  NURS 6512 Week 1 Discussion Building a Health History assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6512 Week 1 Discussion Building a Health History

Whether one passes or fails an academic assignment such as the Walden University  NURS 6512 Week 1 Discussion Building a Health History depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for  NURS 6512 Week 1 Discussion Building a Health History

The introduction for the Walden University  NURS 6512 Week 1 Discussion Building a Health History is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for  NURS 6512 Week 1 Discussion Building a Health History 

After the introduction, move into the main part of the  NURS 6512 Week 1 Discussion Building a Health History assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for  NURS 6512 Week 1 Discussion Building a Health History

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for  NURS 6512 Week 1 Discussion Building a Health History

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6512 Week 1 Discussion Building a Health History

Being able to obtain a comprehensive health history for a patient is important in developing a treatment plan for them.  The purpose of this discussion post is to discuss interview techniques I would use for an 85-year-old white female living alone with declining health.  I will talk about the risk assessment instrument I would use and why.  Lastly, I will list five targeted questions I would ask to assess her health to start building a health history.

The use of nursing theories is critical to patient care because of the different purposes that they serve. Nursing theories assist in informing every interaction between nurses and patients. Through defining the features of the nurse-patient interaction, these theories shape how nurses develop relationships with patients (Wei et al., 2019). The purpose of most nursing theories is to help nurses identify care needs among patients, articulate what they can do for patients and why they do it, and determine the kind of information to collect to develop care plans. Through theories, nurses can comprehend and evaluate health situations, explain and anticipate certain responses from patients and map out objectives and anticipated outcomes (Bahabadi et al., 2020). These theories also help nurses determine the interventions to deliver, best practices, and selection of productive areas for research. The implication is that nursing theories are fundamental to quality care provision as they help nurses to possess background propositions to offer the best care.

The first meeting with any patient is so important to build a good relationship and partnership from the start (Ball et al., 2019).  With this patient being 85 and living alone there will be a lot to consider when interviewing her.  I will need to establish is she is mentally with it, if she has hearing problems, and how much she understands about her health.  Older adults often assume certain problems are just normal parts of aging and not anything to be considered (Ball et al., 2019).  Often, older adults can also experience agism (Garrison-Diehn et al., 2022).  Even in health care settings older adults experience feelings of incompetence and being a burden (Garrison-Diehn et al., 2022).  It will be important to make sure she feels comfortable speaking to me knowing there is no bias or judgement.

The risk assessment I would do for this patient is the functional assessment.  This is an older lady who lives alone.  It will be essential to figure out how well she is able to function on her own.  One of the biggest risks for older patients is falling.  Falling is associated with adverse outcomes that can lead to a patient not being able to live at home anymore along with increased mortality (Snehal et al., 2020).  The functional assessment would give information regarding how well she can move around the house, is she is able to keep a clean environment, how meals are prepared, how she goes to the bathroom, and keeps good hygiene (Ball et al, 2019).  All these issues are going to contribute to her overall health.  It is important to gather this information to determine what assistance, if any, she will need.

Thank you for your response. This brings to mind King James Bible/New Living Translation 2005, Luke 8:17; For all that is secret will eventually turn to light. I was in Nursing school and happen to be tutoring a nursing student that was a class or two behind me. The student was prepared to take her med-surgical exam; we had reviewed the pathophysiology so that she would be able to look at, for example, be given a scenario regarding a patient’s lab values and know if the patient was in metabolic acidosis. We reviewed the ability to think critically. Prior to her taking the test we, both felt confident that she would pass. Day later she called and asked to come over and when she arrived, she was distraught. I was dumb founded; she explained that she had taken the exam, but it did not go very well because she decided to cheat. A couple of her classmates reassured her that they had the answers to the exam; She did not even read the exam to use anything that we had reviewed as far a critically thinking and using pathophysiology, lab values, and so on to arrive at the answers. I was upset that she had taken up hours and days of my time to prepare for an exam and she just totally threw everything out the window and just put down answers. The class prior to hers had aced the exam, but the instructor and the Director of the Nursing department reviewed the class trends and knew that the class prior to her class should not have scored that many A’s. Therefore, the test was changed and the test that my friend took was different from the one the prior class had taken. On top of that she had to speak with the Director of the Nursing department and was expelled from the program. She needed to at least pass with a C to remain in the program. The class prior had students that were also expelled as well as the students that were in her class. I only knew about this as she confided in me regarding the situation; otherwise, the was emphasis in my class to make sure that all the concepts were understood; if not ask questions during/after lecture and because in clinical we were taking care of patients and need to know why we were administering some as simple as a vitamin E and the side effects. In my practice I have been conscientious regarding patient care. In the Neonatal Intensive Care everything we gave during the time I worked in the unit was doubled checked. If it did not fit into a 1cc syringe it was triple checked.

After introducing myself and establishing how the patient would like to be addressed, I would start by simply asking “What brings you in today?”  This is a way to find out what her chief complaint is for coming in.  My second question would be “When did this start?”  This brings the patient back to the beginning and prompts them to tell the whole story regarding why they came in.  My third question would be “What medications do you take on a regular basis and what are they for?”  In my experience patients may or may not even know what they are taking, let alone why they are taking them.  It can also lead to her discussing if she is compliant with her medications.  To follow that, my fourth question would be “What medical problems do you have?”  Before going through a formal review of systems, this can give a clue to what she considers to be important in her history.   My last question would be “How well do you feel you are able to take care of yourself at home?”  This is an open-ended question to gain some insight on the functional assessment.  If the patient’s initial chief complaint is not urgent it is okay to give the patient some time while understanding the time constraints of you as the provider (Ball et al., 2019).

Establishing a relationship with patients and getting a thorough health history can be a daunting task for providers.  It is key to tailor interviewing skills to meet patient specific needs.  Modifying interview skills to the individual will eliminate communication barriers between the provider and patient (Bass et al., 2019).  Creating a strong relationship with the patient will allow the nurse practitioner to obtain the most comprehensive health history and provide the best possible care to clients.

References

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.

Garrison-Diehn, C., Rummel, C., Au, Y. H., & Scherer, K. (2022). Attitudes toward older adults and aging: A foundational geropsychology knowledge competency. Clinical Psychology: Science and Practice, 29(1), 4–15. https://doi.org/10.1037/cps0000043

Snehal, K., Rashmi, G., & Aarti, N. (2020). Risk factors for fear of falling in older adults in India. Journal of Public Health, 28(2), 123-129. doi:https://doi.org/10.1007/s10389-019-01061-9

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

Photo Credit: Sam Edwards / Caiaimage / Getty Images

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NURS 6512 Discussion comprehensive health history for a patient is important in developing a treatment plan for them

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
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 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:
• Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
• Suggest additional health-related risks that might be considered.
• Validate an idea with your own experience and additional research.
• Discussion Week 1
•
• Case G Pre-school-aged white female living in a rural community
•
• Summary of the interview and a description of the communication techniques you would use with your assigned patient. Five targeted questions you would ask the patient.
• To provide a summary of the interview and communication techniques I would use with a preschooler age child from a rural community would be getting down to the level of the child, briefly evaluating the family dynamics and the overall support within the home. Likely the child will be accompanied by an adult or caregiver.
• Five target questions I would ask are:
• 1. If there are several concerns that bring you hear today; what problem concerns you most?
• 2. Can you tell me what happen?
• 3. Why do you think it happened?
• 4. Do you feel safe in your home?
• 5. Is there anything else that you want me to know?
• Explain why you would use these techniques
• Many children love it when you get down on the floor to play with them. They often have anxieties and fears that must be eased (Ball et al., 2019). I would use these techniques to allow the preschool age child to feel comfortable and decrease anxiety. I would also provide the patient with a coloring paper or something to allow her to feel interested in what we were discussing. I could use this as a distraction tool while asking question to her guardian and her. At some point within the interview I would discuss safety hazards related to her age group such as falls, chocking, burns, and poisoning (Ball et al., 2019).
• Identify the risk assessment instrument you selected and justify why it would be applicable to the selected patient
• Many risk assessments instruments have been developed to improve child welfare workers’ decision making (Vial et al., 2021). For this patient I would complete and organize the health record by SOAP ( subjective ,objective ,Assessment, Plan) (Ball et al., 2019). The screening tool I would use is HEEADSSS (home environment, education, eating, activities, drugs, sexuality, suicide/depression, and safety from injury/violence) (Ball et al., 2019). I would use this tool to both review with the patient as well as parent to get and overall understanding of the concerns for the visit. The collection of family health history information is part of routine healthcare interactions and can inform clinical decision making and preventive services (Lushniak, 2015). This as well would be an area to focus my assessment.

 References

• Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). In Seidel’s guide to
• physical examination: an interprofessional approach (9th ed., pp. 58–59). essay, Mosby.
• Lushniak, B. D. (2015). Family Health History: Using the past to Improve Future Health. Public
• Health Reports, 130(1), 3–5. https://doi.org/10.1177/003335491513000102
• Vial, A., van der Put, C., Stams, G. J., Dinkgreve, M., & Assink, M. (2021). Validation and
• further development of a risk assessment instrument for child welfare. Child Abuse &
• Neglect, 117, 1–11. https://doi.org/10.1016/j.chiabu.2021.105047
• Reply Quote Email Author

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Sample Answer 2 for NURS 6512 Week 1 Discussion Building a Health History

The patient in this scenario is a 14-year-old biracial male. The first step in interacting with the patient is to build a trustworthy rapport with the patient and determine his fluency in communication and speaking the English language, as any language barriers can hinder the effectiveness of the communication, it is important to ensure the client understands the language of communication (Brooks et al., 2019). Effective communication is required needed in any patient-healthcare provider interaction. The language assessment is important in making communication easier.

Communication Techniques

Furthermore, the use of verbal techniques will be ensured in the communication process (Wang et al., 2018). However, caution will be taken not to offend the client in the conversation. The meaning and interpretation of the non-verbal techniques tend to vary from one cultural group to another (Sullivan, 2019). Therefore, considering that the client is from another cultural group and young, understanding their values would be necessary to reduce the conflicts in the communication process. I will also be empathetic to the client (Ball et al., 2019).

Subsequently, active listening is also important when interacting with the patient. Listening actively help the healthcare provider to capture important information about the patients and their possible health needs (LeBlond et al., 2014). On the other hand, some clients may be too talkative and so the healthcare provider must be able to control and ensure that the relevant information is obtained from the interaction. Controlling the conversation also helps in managing the time used in the interaction. The HEEADSSS risk assessment tool will be used when interviewing the patient because it will help in understanding the client’s home environment and education experiences among other areas of interest.

Target Interview Questions

1. Whom do you live with at home?
2. What is your relationship with the parents and siblings?
3. What is it that makes you happy about your family?
4. Who is your best friend?
5. What do you like doing during your free time?

Conclusion

Finally, communication is important in the interaction between the patient and the healthcare providers. Both verbal and non-verbal communication matters in the interaction. Cultural values vary from one patient to another and this could be a major hindrance to effective interaction between the patient and the healthcare providers. Therefore, the nurses must demonstrate cross-cultural competencies and interact with their clients accordingly without judging them or looking down upon their cultural values.

References

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.

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383-391. https://doi.org/10.1016/j.colegn.2018.09.007

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw- Hill Medical.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Wang, Y., Wan, Q., Lin, F., Zhou, W., & Shang, S. (2018). Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Sciences, 5(1), 81-88. https://doi.org/10.1016/j.ijnss.2017.09.007

Sample Answer 3 for NURS 6512 Week 1 Discussion Building a Health History

I really liked the way you presented your discussion post; it was very organized and thought out. However, as a PMHNP student, I was inclined to read through a few articles and I came across the following Risk assessment tools that would assess the psychological issues associated with one’s LGBTQIA status.

The Gender Minority Stress and Resilience Scale (GMRS) is used to measure the difficulties associated with identifying as a gender minority and protective factors for psychological well-being.The 58 items were adapted from other measures and compiled into the GMRS to measure nine different constructs, including Gender-related Discrimination, Gender-related Rejection, Gender-related Victimization, non-affirmation of Gender Identity, Internalized Transphobia, Negative Expectations for Future Events, and Nondisclosure (Shulman et al., 2017).

Strength of Transgender Identity Scale (STIS)This assesses how strongly an individual identifies as transgender and how important transitioning is to them. Although largely related to identifying transgender people, it contains items that may be relevant to understanding someone’s gender identity and how that might change in therapeutic interventions. The STIS has six questions and no factors were identified in the original validation study. Example items include “I identify as trans,” “It is important to me that people I am close to know I transitioned,” and “The fact that I transitioned is important to who I am.”

Transgender Adaptation and Integration Measure (TG AIM) measure the stresses associated with being transgender and the individual’s efforts to cope with stress. The TG AIM has 15 items, and three factors were identified in the initial validation study that is scored as subscales: Coping and Gender Reorientation Efforts, Psycho social Impact of Gender Status, and Gender-related Fears. A fourth factor, Gender Locus of Control, was also identified but was not recommended for use due to poor internal consistency. Example items of the three recommended factors include “I fear discrimination,” “I take/have taken hormones,” and “Being transgender causes me relationship problems.”

References,

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.

Shulman, G. P., Holt, N. R., Hope, D. A., Mocarski, R., Eyer, J., & Woodruff, N. (2017). A review of contemporary assessment tools for use with transgender and gender nonconforming adults. Psychology of Sexual Orientation and Gender Diversity, 4(3), 304–313. https://doi.org/10.1037/sgd0000233Links to an external site.

Effective nursing health assessment interview techniques. (n.d.). Walden University. https://www.waldenu.edu/online-bachelors-programs/bachelor-of-science-in-nursing/resource/effective-nursing-health-assessment-interview-techniquesLinks to an external site.

Sample Answer 4 for NURS 6512 Week 1 Discussion Building a Health History

Effective quality care begins with obtaining a detailed medical history for the patient. This, therefore, requires developing a therapeutic relationship with the patient to foster trust, which allows the patient to divulge information to build an accurate health history.

Brief summary of interview

The patient in the scenario is an 80-year-old white male with angina who lives on a farm 80 miles away from a healthcare center. The patient present with a complaint of worsening chest pain and a feeling of heavy weight on his chest. He reports a squeezing pain and tightness in the chest that worsen when he does activities around his farm but goes away with rest. Past medical history includes type 2 diabetes, hyperlipidemia, and hypertension. He reports he takes Metformin, Atorvastatin, and lisinopril medication in the morning and evening. He is allergic to penicillin. The patient reports both parents are deceased, but his mother was hypertensive and died from a stroke at 70 years old, while his father had diabetes. The patient reports he smokes 1/2 pack of cigarettes daily, chew tobacco and drinks 1-2 beers with dinner.

Communication technique

Every patient is different, and as such special consideration and care should be taken to identify and address factors that can affect the ability to gather information from the patient. The patient in the scenario is an elderly male, and with older patients, careful attention should be given to the communication techniques used. According to Ball et al. (2019), Communication can be more difficult with the older patient due to the changes in cognitive abilities and sensory deficits. Therefore, in the interview with this patient, communication techniques include speaking clearly and slowly. This allows the patient to gain a better understanding of what is being asked and be able to provide answers. Additionally, identifying if the patient has a hearing deficit and which ear is the stronger side allows for better positioning to ensure the patient can still see the provider’s face and have easier hearing. Sitting close to the patient and providing a quiet area for the interview can enhance the communication process. Older adults may have difficulties with memories or get confused easily, therefore, it is important to use short open-ended questions that are uncomplicated and free from medical jargon when assessing the patient. It also helps the gain collateral information from a relative or caregiver of the patient once permission is obtained, as this can gain greater accuracy and yield more information.

Risk assessment instrument

One risk assessment instrument applicable for this patient is obtaining a personal and social history. Personal and social history helps to obtain information on the patient’s lifestyle habits. This includes nutrition and diet patterns, smoking, and alcohol use, along with self-care habits such as exercise. This assessment instrument must be included as these lifestyle factors are major contributors to the patient’s angina condition. According to Ruan et al. (2018), risk factors such as smoking, alcohol drinking, fruit/vegetable intake (diet), and physical activity (exercise) influence the risk of angina across different ethnic groups. Furthermore, the information is crucial to treating the patient’s condition as he reports smoking and alcohol use. Therefore, providers must establish a baseline of these lifestyle factors to suggest and plan for modifications that can improve the patient’s condition. Significant priority should be placed on optimizing lifestyle factors in addition to preventive medications to reduce complications associated with angina (De Lemos, 2021.) As patient’s get older it is important to have good access to health care resources as their health is at greater risk to deteriorate. The personal and social history consist of the assessment of the patient’s access to care. The patient in the scenario lives far away from the health center. It is important then to assess the patient’s ability to access transportation for care, his regular pattern in seeking care and identify and address any worry the patient might have in regards to his access to care to manage his existing conditions and his present complaint of angina.

Target questions to be addressed to the patient includes:

1)What is the reason for your visit? When did these symptoms start, and is there anything that makes it worse or better?

Do you have any existing medical conditions? Does anyone else in your family has/had these conditions?

Do you smoke/chew tobacco? If yes, what do you smoke, and how much per day?

Do you drink alcohol? How much per day?

How physically active are you on an average day?

What type of diet do you follow at home and outline your average meal for the day.

How often do you seek medical attention and follow up with your doctor?

Explain any alternative therapy or home herbs used to manage presenting symptoms?

References

Ball, J. W., Danis, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s Guide to Physical Examination: An Interprofessional Approach. St. Louis, MO: Elsevier, Inc.

De Lemos, J. A. (2021). Diagnosis and management of stable angina. JAMA, 325(17), 1765. https://doi.org/10.1001/jama.2021.1527Links to an external site.

Ruan, Y., Guo, Y., Zheng, Y., Huang, Z., Sun, S., Kowal, P., Shi, Y., & Wu, F. (2018). Cardiovascular disease (CVD) and associated risk factors among older adults in six low-and middle-income countries: results from SAGE Wave 1. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5653-9Links to an external site.

Sample Answer for NURS 6512 Week 1 Discussion Building a Health History

Accurate patient history is essential for APRNs to develop appropriate care plans and comprehensively understand their previous health concerns (Ding et al., 2020). The provided case study presents a 33-year-old Caucasian individual who identifies as male despite being assigned female at birth. Three years ago, the individual transitioned from female to male while residing in Florida. Now, he has returned to his home in Texas and is openly sharing his complete transition with his family and social circle. He is currently without employment and lacks access to further hormonal replacement for suppression. The individual has a documented history of depression, is living with HIV, and engages in the use of cannabis. The paper demonstrates my role as the APRN in communicating effectively and building the patient’s health history described above.

Socioeconomic, Spiritual, Lifestyle, and other Cultural Factors

The various factors related to a patient’s socioeconomic status, spirituality, lifestyle, and culture can significantly affect their access to healthcare, financial burdens, and decision-making processes. B.C. is currently without employment and lacks access to further hormonal replacement for suppression. Unemployment can impact individuals’ access to healthcare and ability to afford necessary medications or treatments. Transitioning may also incur financial expenses (Sbragia & Vottero, 2020). In addition to his medical history, he has a diagnosis of depression, is living with HIV, and uses cannabis. The patient’s spiritual beliefs can impact their coping mechanisms, support systems, and decision-making regarding healthcare. Individuals who are HIV positive and engage in cannabis consumption may experience effects on their overall well-being, necessitating the need for proper care and assistance. Transitioning from female to male, particularly in conservative regions such as Texas, can pose difficulties concerning acceptance, discrimination, and the availability of transgender-affirming healthcare (Friley & Venetis, 2021).

Sensitive Issues

As an APRN, it is crucial to recognize the significance of respectful interactions with B.C. This includes honoring his gender identity, acknowledging his journey, maintaining a non-judgmental attitude towards his HIV status and cannabis use, respecting his privacy and confidentiality, and fostering a safe environment that encourages open communication. It is clear that B.C. is currently facing personal, economic, and emotional challenges, and it is crucial to address these concerns professionally. It is crucial to offer comprehensive counseling and educate patients about appropriate treatment for HIV while ensuring a stigma-free environment (Boyd et al., 2022). Addressing the sensitive issue of hormonal replacement therapy requires respectful consideration, ensuring that the patient’s dosage is appropriate. B.C. should be informed about the health risks associated with smoking marijuana and encouraged to quit. In order to prevent any potential victimization based on B.C. appearing as a male, it is essential to approach the situation professionally and ensure that he feels treated with the same level of respect as everyone else.

Communication Techniques

In order to establish effective communication with B.C., it is crucial to utilize affirming language and pronouns that correspond to the patient’s gender identity. Additionally, active listening, empathy, and allowing the patient to lead the conversation are essential. Employing open-ended questions and delivering apparent explanations further contribute to successful communication. It is crucial to employ communication techniques prioritizing respect for identity, cultural sensitivity, a non-judgmental attitude, and empathy (Kronk et al., 2021). It is essential to prioritize the patient’s autonomy by allowing them to guide the conversation, share information at their preferred speed, and employ open-ended questions to delve into their needs and objectives. As a nurse practitioner, it is crucial to communicate with patients clearly and compassionately, avoiding using complex medical terminology.

Health History Interview

As an APRN, I will proficiently do a health history interview with B.C. using active listening, open-ended inquiries, reassurance, and cooperation. Active listening entails attentively observing the patient’s reactions, asking more inquiries, and motivating them to divulge further details about their encounters. Open-ended questions promote confidentiality and foster patient engagement in decision-making processes. Here are some specific questions I would ask the patient (Mikulak et al., 2021):

1. Could you please provide a detailed account of your transition process and highlight any obstacles you encountered during this period? This inquiry recognizes the patient’s progression and offers an understanding of their encounters and requirements.
2. How are you coping with your HIV diagnosis, and are you now doing treatment? This inquiry evaluates the patient’s ability to effectively manage their HIV condition and adhere to the prescribed treatment regimen while also identifying any obstacles that may hinder their access to healthcare.
3. Could you elaborate on your use of cannabis and how often you engage in its use? Have you encountered any adverse consequences? This inquiry delves into the patient’s patterns of drug use and the possible health hazards linked to cannabis.
4. Do you have significant spiritual or cultural beliefs crucial to your health and well-being? This question acknowledges the impact of spirituality and culture on the patient’s healthcare choices and strategies for dealing with difficulties.
5. What is the specific effect of transitioning on your mental health, specifically about depression? This inquiry pertains to the patient’s psychological well-being and the possible need for assistance or intervention.

Risk Assessment

The Patient Health Questionnaire-9 (PHQ-9) is a risk assessment tool that applies to B.C. since it may evaluate symptoms of depression, track changes in mood over time, and inform treatment choices, thereby making it a significant resource for this patient’s care. The patient has a documented history of depression, is now jobless, openly communicating their complete gender change to both family and society, has tested positive for HIV, and engages in cannabis use, all of which are recognized risk factors for depression. The PHQ-9 is a very accurate and consistent instrument for diagnosing Major Depressive Disorder, with a sensitivity rate of 88% and a specificity rate of 88% (Costantini et al., 2021).

Conclusion

APRNs rely on precise patient history to formulate treatment plans and get insight into previous medical issues. Age, gender, ethnicity, and living environment influence a patient’s health. Proficient communication and interviewing strategies are crucial for acquiring information. The male patient in the given case study is transitioning from female to male. Several aspects, such as socioeconomic status, spirituality, lifestyle, and cultural background, influence this change. These factors affect the patient’s ability to access healthcare, the financial expenses involved, and the decision-making process. Effective communication requires respectful interactions, the use of affirming words, active listening, empathy, and the use of open-ended inquiries.

References

Boyd, I., Hackett, T., & Bewley, S. (2022). Care of Transgender Patients: A General practice Quality Improvement approach. Healthcare, 10(1), 121. https://doi.org/10.3390/healthcare10010121

Costantini, L., Pasquarella, C., Odone, A., Colucci, M. E., Costanza, A., Serafini, G., Aguglia, A., Murri, M. B., Brakoulias, V., Amore, M., Ghaemi, S. N., & Amerio, A. (2021). Screening for depression in primary care with Patient Health Questionnaire-9 (PHQ-9): A systematic review. Journal of Affective Disorders, 279, 473–483. https://doi.org/10.1016/j.jad.2020.09.131

Ding, J. M., Ehrenfeld, J. M., Edmiston, E. K., Eckstrand, K., & Beach, L. B. (2020). A model for improving health care quality for transgender and gender nonconforming patients. Joint Commission Journal on Quality and Patient Safety, 46(1), 37–43. https://doi.org/10.1016/j.jcjq.2019.09.005

Friley, L. B., & Venetis, M. K. (2021). Decision-making criteria when contemplating disclosure of transgender identity to medical providers. Health Communication, 37(8), 1031–1040. https://doi.org/10.1080/10410236.2021.1885774

Kronk, C. A., Everhart, A. R., Ashley, F., Thompson, H. M., Schall, T. E., Goetz, T. G., Hiatt, L., Derrick, Z., Queen, R., Ram, A., Guthman, E. M., Danforth, O. M., Lett, E., Potter, E., Sun, D., Marshall, Z., & Karnoski, R. (2021). Transgender data collection in the electronic health record: Current concepts and issues. Journal of the American Medical Informatics Association, 29(2), 271–284. https://doi.org/10.1093/jamia/ocab136

Mikulak, M., Ryan, S., Ma, R., Martin, S., Stewart, J., Davidson, S., & Stepney, M. (2021). Health professionals’ identified barriers to trans health care: a qualitative interview study. British Journal of General Practice, 71(713), e941–e947. https://doi.org/10.3399/bjgp.2021.0179

Sbragia, J. D., & Vottero, B. (2020). Experiences of transgender men in seeking gynecological and reproductive health care: a qualitative systematic review. JBI Evidence Synthesis, 18(9), 1870–1931. https://doi.org/10.11124/jbisrir-d-19-00347