Case Study- Adolescent white male without health insurance seeking medical care for STI
The patient selected is an adolescent white male seeking medical care for an STI. In this case, a healthcare provider should approach the patient with sensitivity and empathy due to the sensitive and potentially embarrassing nature of the topic. In the communication, it should entail getting to the patient’s level, introducing myself as the nursing practitioner (Price, 2017), and since they might be anxious, using terms that they can understand to decrease their fear and anxiety. Since the patient can be limited in communication, the questions can be directed towards the caregiver. As a doctor, I need to ask specific questions about the patient’s sexuality, gender identity, housing status, healthcare access, and insurance coverage in order to obtain a full picture of their health (Fagundes et al., 2022).
Communication and Interview Techniques
During the patient interview, I would initially approach the patient with an introduction and a handshake, followed by the guardian if present (Price, 2017) Case Study- Adolescent white male without health insurance seeking medical care for STI. This approach aims to convey to the adolescent patient that they are being given individual attention and importance. Approaches of gathering a patient’s medical history via conversation should vary according to the individual’s age, gender, race/ethnicity, and culture. For example, in this case, since the patient is an adolescent male seeking care for an STI, I should provide a private and comfortable environment for him to discuss sensitive topics (Ball et al., 2021), and use age-appropriate language when discussing sexual health. I should also be aware of any cultural or language barriers that may impact communication.
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Targeting Questions Based on Social Determinants of Health
I need to ask specific questions about the patient’s socioeconomic determinants of health to get the most useful information. For example, I should ask about the patient’s sexual orientation and gender identity, as these factors may impact the patient’s risk for STIs (Ball et al., 2021, p. 47). I should also ask about the patient’s living situation, access to healthcare, and insurance coverage (Christian, 2022). Tailoring questions based on social determinants of health is crucial to providing comprehensive and equitable healthcare. By taking into account these factors, as a healthcare provider I can better understand a patient’s unique situation and provide more personalized care (Price, 2017). Case Study- Adolescent white male without health insurance seeking medical care for STI
Risk Assessment Instruments
To assess the patient’s risk for STIs, I may use various risk assessment instruments. In this case, I may consider using the Sexual Health History Questionnaire (SHHQ) to assess the patient’s sexual risk behaviors (Ball et al., 2021). In addition to the SHHQ, I may also consider using the CDC screening recommendations for sexually active adolescents and young adults based on their sexual behaviors and demographic factors to further evaluate the patient’s risk for STIs (Fagundes et al., 2022).
Potential Health-Related Risks
The patient is a young man, and it is crucial to remember that teenage males are at higher risk for STIs than adults because of inadequate sexual education and the absence of widespread condom usage (Ball et al., 2021). Additionally, the patient’s lack of health insurance may lead to delays in seeking medical care and potentially more severe health outcomes. As a healthcare provider, I should provide appropriate guidance on safe sex practices, as well as information on affordable or free healthcare options available in the community (Price, 2017).
To ensure effective communication, I would begin by identifying the patient’s communication preferences, which may include their preferred language, educational level, developmental status, and personal comfort level. Based on the SHHQ, I would ask the following targeted questions to assess the patient’s sexual risk behaviors:
- Have you ever had unprotected sex?
- Have you ever had a previous STI diagnosis?
- Do you have multiple sexual partners?
- Have you had sex with someone who has an STI?
- Do you use condoms consistently during sexual activity?
- Case Study- Adolescent white male without health insurance seeking medical care for STI
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2021). Seidel’s Guide to Physical Examination-E-Book: An Interprofessional Approach. Elsevier Health Sciences.
Fagundes, C. P., Wu-Chung, E. L., & Christian, L. M. (2022). Special issue: Social Determinants of Health: What we still need to know. Psychoneuroendocrinology, 140, 105713. https://doi.org/10.1016/j.psyneuen.2022.105713
Price, B. (2017). Developing patient rapport, trust and therapeutic relationships. Nursing Standard, 31(50).
Great post. This is a very sensitive topic for some people. It would definitely be helpful to know the age of the white male because I think that makes a difference on how I would interview him. I know typically healthcare providers try not to ask questions about sexual activity in front of parents. It is likely that they would not answer honestly due to not wanting to be truthful in front of their parents, as their parents might not know. The National Coalition for Sexual Health offers great ways to ask questions about sexual health. It gives great examples of how to ask a question without making the conversation uncomfortable (NCSH, 2022). There are 3 questions that are recommended to be asked annually at a regular exam: Have you been sexually active in the last year? Have you ever been sexually active? What types of sex do you have (oral, vaginal, anal, other)? With men, women, both, or another gender identity? These are right on target with the targeted questions you came up with. I might also try to ask some open ended questions that might make the patient talk and open up a little more to the provider. Case Study- Adolescent white male without health insurance seeking medical care for STI It was great that you mentioned asking about insurance, because according to the CDC (2022), not having insurance or transportation can make it more difficult for young people to access STD testing.
Centers for Disease Control and Prevention. (2022, April 12). Adolescents and stds. Centers for Disease Control and Prevention. Retrieved March 4, 2023, from https://www.cdc.gov/std/life-stages-populations/stdfact-teens.htm
For healthcare providers: NCSH. National Coalition for Sexual Health. (2022). Retrieved March 4, 2023, from https://nationalcoalitionforsexualhealth.org/tools/for-healthcare-providers Case Study- Adolescent white male without health insurance seeking medical care for STI