1. Discussion: Diversity and Health Assessments
Do a comment to each post with 2 references each. APA style, with citation and reference
year not older than 2013.Post 1For the record, MR is a 23-year-old Native American male
who reports experiencing anxiety, smoking ‘pot’ and drinking alcohol. MR reports a family
history of diabetes, hypertension, and alcoholism. In addition, MR appears to be religious by
his statement of being afraid that he will not get into Heaven if he persists with his behavior.
According to Espey, Jim, Cobb, Bartholomew, Becker, Haverkamp and Plescia (2014), Native
American has a history of discrimination and has received inadequate healthcare
throughout the years. Tobacco smoking is extremely high in the Native American
community. Native American had a higher rate of alcohol-attributable death in comparison
to Whites (Yuan, Duran, Walters, Pearson & Evans-Campbell, 2014). According to Espey et
al. (2014), there is a high heart disease mortality and diabetes mortality in the Native
American’s community.Arm with the fact that there isn’t a language barrier, the nurse
introduces herself (Ball, Dains, Flynn, Solomon & Stewart, 2015). “My name is Nurse
Brown,” the nurse says while quickly assessing the patient from head to toe. Patient (MR)
appears jittery and appears diaphoretic. It is important to monitor patient’s behavior
(Espey et al., 2014). The nurse asks targeted questions. What brings you to the clinic today?
When was the last time you felt well? When did your symptoms start? What do you believe
brought on this feeling? Was the symptoms the result of alcohol or smoking pot?The ethnic
and racial differences in dealing with depression are rare amongst Black, Latino and Native
American opposed to the White American who would readily address issues of depression
(Ball et al., 2015). However, the nurse still exhibits sensitivity in approaching patient
regarding his reporting of anxiety. The nurse has to determine whether it stems from
something isolated or if there exists a family history of depression. Thus, the nurse will ask
open-ended questions to ascertain a health history of patient’s family background (Ball et
al., 2015). The questions will commence subtly and then gradually increase in
intensity.Anyone in your family drinks alcohol? Anyone does drugs in your family? Are
there any health issues such as heart disease, high blood pressure? Has he ever been
admitted to the hospital? Has he had any blood transfusion? Who does life with? Are you
working? Does he have a private doctor? When was the last time you saw your doctor?
What do you do when you can’t sleep? What is your religious background? Do you have any
other concerns?You need to take into consider the person age, tone, be aware of your eye
contact and give the patient time to think. If there is a language barrier, know how to secure
an interpreter to translate. You must maintain a calm and cool demeanor.ReferencesBall,
2. J.W., Dains, J.E., Flynn, J.A., Solomon, B.S., & Stewart, R.W. (2015). Seidel’s guide to physical
examination (8th ed.). St. Louis, MO: Elsevier Mosby.Espey, D. K., Jim, A. M., 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(53). doi:2105/AJPH.2013.301798.Yuan, N., Duran, B. M., Walters, L.K., Pearson,
R. C., & Evans-Campbell, E. T. (2014). Alcohol misuse and association with childhood
maltreatment and out-of-home placement among urban two-spirt American Indian and
Alska Native people. Intenational Journal of Environmental Research and Public Health. 11.
10462-10479. Doi: 10.3390/ijerph111010461Post 2 Cultural CompetenceCultural
competence is a mindset to not just learn about other cultures, but to learn how to work
with and care for patients from other cultures than ones own. As healthcare providers it is
essential to be able to understand the beliefs in patients lives that affect their health and
how they accept or refuse treatment recommendations. It becomes important to
understand other alternative and complementary medicines that a patient may be using so
as a provider one can help prevent adverse effects and interactions among treatments. This
paper will share socioeconomic, spiritual, and lifestyle of an Asian male that can relate to
health, it will also share issues that require sensitivity when interacting with the patient and
why, provide five questions to ask in building a health history, and the assessment of health
risks for this male patient.Socioeconomic, Spritual, and Lifestyle Effects on HealthThe health
assessment of an 86 year old Asian male who is physically and financially dependent on his
working single daughter (who also has children to care for) has hypertension (HTN),
gastroesophageal reflex disease, b12 deficiency, and chronic prostatitis can require cultural
competence while caring for this patient. One must determine socioeconomic status as this
gives information about nutrition buying ability. Daines, Baumann, and Scheibel (2016)
share assessing environmental concerns as they can affect health risks.Assessing if the
patient has health insurance as this affects the purchase of medications.Spiritual beliefs of
Asians (such as Japanese) hold Budhha as religious practice, and the belief in harmony and
tolerance along with universal compassion per Clobert, Saroglou, Hwang, and Soong (2014).
They further share there is less intolerance of others in this religion compared to Western
religion that may be perceived as a way to maintain control among believers.Lifestyles of
Asians may differ in that as one ages the family becomes the caring unit for the patient and
includes many blended households. Talaie (2018) shares the Japanese healthcare system
utilizes females as head of households and are responsible for caring for family members.
He further shares this belief will cost Japan to have a shortage of caregivers of 370,000
workers as they do little to support the incoming of foreign care workers, and have
stringent criteria these workers must pass testing wise to be caregivers that leave many
without prospects in Japan. So Mr. JC understands the burden placed on his daughter with
his comment of “do not want to be a burden to my daughter”. Many of these families do not
put their loved ones in nursing homes. This author’s spouse is Japanese/American and his
mother lived with his sister after the fathers death until she also passed. She acquired
dementia and oxygen but his sister continued to care for her at home.These issues of
socioeconomic, spiritual, and lifestyle relate to health as not only his beliefs affect his
healths but the behaviors of his daughter as well. JC’s daughter being the financially
3. responsible person, has the power of nutrition purchases, meal selections, and cooking.
Lifestyle and meal selections can affect his blood pressure with the use of soy sauce, and
other marinade sauces used in Asian cooking. JC may require options to alleviate these
factors if his blood pressure is not controlled. Another thing these three have in common
with cultural competence is for the provider to be aware of biases they may have in relation
to single mothers, elderly without financial independence, differences in religious beliefs,
and cultural differences. The United States Department of Human & Health Services (U.S.
DHHS, 2016) shares providers can improve quality of health care services for diverse
populations by learning to be aware of their own cultural beliefs and be more responsive to
those of their patients.Issues Requiring SensitivityWhile Daines, Baumann, and Scheibel
(2016) share in the United States people tend to speak loudly and are direct in conversation
the Japanese are the opposite use indirection, and place emphasis on attitudes and feelings
instead. Being sensitive to the patients beliefs, and discretion it would be important to ask
questions of health related treatments and if he would like his daughter involved. Assessing
if there is anything to patient would not like to speak about in regard to his health would be
beneficial as well. The health risk assessment would be helpful in determining the
participation the patient has in his care. The United States DHHS (2016) shares healthrisks
for Asians are gastric cancer, with Asians being two times as likely as non- Hispanic Whites
and two times moer likely to die from complications of the disease. Another would be liver
disease which is the fifth cause of death and Asians are two times as likely to die, while 50
percent are less likely to die of hear disease Mr. JC is on antihypertensives so adjusting his
care is important as it may not follow recommended guidelines and patient centered care is
recommended. Important for Mr. JC’s age is immunizations such as the flu vaccine and
pneumococcal the United States DHHS further shares 47 percent of Asians receive the
pneumococcal vaccine while 72 percent recive the flu vaccine after the age of 65, it also
shares suicide is the ninth cause of death in this population so more clarification needs to be
sought to Mr. JC’s comment about “not being a burden”. These subjects while important to
address may present discomfort on the patients part if he does not have adequate finances
to cover healthcare, medications, and dietary requirements for his HTN. It will also be
important to address urinary problems related to the chronic prostatitis and if the patient is
experiencing any difficulty.5 QuestionsThe five questions that may be beneficial would
be:Tell me about your diet, what do you like to eat?What is your spiritual heritage?Do you
participate in religious groups? Is there someone there you can talk to for support?Have you
tried any other methods for your hypertension, gastroesophageal reflux, or prostatitis?Can
you explain what you mean when you say you do not want to be a burden to your
daughter?SummaryIn summary, cultural competence is important for advanced nurses to
perfect, and when unsure to ask the patient rather than assume or stereotype populations.
Some patients can be of another race, but have been born and raised in America without
cultural influence, and assuming they follow the cultural norms can cause distrust and
anger at excluding them from the American culture. When building a relationship with the
patient it is important to address concerns of religion, socioeconomic status, religion, health
risks, and preventions the patient may or may not participate in. Setting goals with the
patient for his health promotion will help the patient buy into their care and help increase
4. responsibility for their healthcare. Through the assessment of patients healthcare providers
will have a better picture of health inequalities that can lead to addressing barriers to care.
