Diversity and Health Assessment Discussion week 2
Case Study 1
John Green, the 33-year-old Caucasian male, presents to the office to establish himself as a new patient. John’s natal sex is female, but he identifies as a male. He transitioned from female to male, 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has obtained testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smoking 3-6 marijuana joints every weekend (has an active green card), and does suffer from depressive episodes. He has been HIV-positive for the last 3 years. But remains viral suppression at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks, which prompted him to move back home with his parents. He takes Biktarvy once daily which comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and being unemployed, he will be a burden on his family, and he thinks his health may be declining.
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 of the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture?
When preparing a medical history for Case Study 1 Mr. J.G.
The gender-affirming approach would be prioritized. Ensuring the right name and pronouns are used during our interview. Affirmation of gender is necessary to confirm the manner in which the patient wishes to be identified in social interactions (Ball. J, et al, 2019) Diversity and Health Assessment Discussion week 2. Regardless of gender presentation, the physical examination should be pertinent to the existing anatomy and free of any presumptions about identity or anatomy. Cultural Knowledge related to comprehending the numerous and unique changes and peculiarities in the context of hormone therapy and surgical interventions, a sensitive history taking is necessary. Mr. J.G. is a transgender man. Transgender males are females who identify as males. As the provider, I will need to ask sensitive questions regarding Mr. J.G. Sex partners and sex practices. The article by Brittany Base and Hassan Nagy entitled “Cultural Competence in the Care of LGBTQ Patients”. Indicates that domestic violence is more frequent in transgender patients. Issues regarding domestic violence will need to be addressed. In addition, access to health care and financial concerns will need to be addressed. Also assessing his support system since he returned home.
Develop five targeted questions you would ask the patient to build his or her health history and assess his or her health risks.
- How many sexual relationships have you had?
- What is the gender of your sex partners?
- Are you currently having sex?
- Can you tell me when you were diagnosed with HIV?
- What was your most recent CD4 count?
- What illicit drugs have you experienced?
- Diversity and Health Assessment Discussion week 2
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 pertinent information?
Cultural awareness is always necessary to gain a better understanding of my practice as an NP. Self-reflection allows me to provide patient-centered care that is nonjudgmental, respectful, and attentive to the patient’s concerns and preferences. This includes informing patients about their condition and allowing them to participate in their care. As a nurse practitioner, I am responsible for providing quality care to all patients under my care using cultural humility.
Mr. J.G has lifestyle can raise stereotypes judgments or prejudices against him, because he is an immigrant, transgender, substance abuse, and has an HIV status history. His health beliefs and cultural diversity can be overlooked if he has someone that does not respect his cultural differences. This is why it is important that I be culturally competent to avoid using judgment when caring for patients. As a future nurse practitioner, it is essential that all the dimensions of cultural competence be used with all patients. It’s working with patients to understand their concerns and helping them make health care choices
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.
Bass B, Nagy H. Cultural Competence in the Care of LGBTQ Patients. (Updated 2022 Oct 3). In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Retrieve from: https://www.ncbi.nlm.nih.gov/books/NBK563176/ Diversity and Health Assessment Discussion week 2