CASE STUDY 1
John Green, 33 year-old Caucasian male, presents to the office to establish 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 been obtaining 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, smokes 3-6 marijuana joints every weekend (has an active green card), and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed 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 that 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 unemployed he will be a burden on his family, and he thinks his health may be declining.
BY DAY 3 OF WEEK 2
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
BY DAY 6 OF WEEK 2
Respond on or before Day 6 on 2 different days to at least two of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.
DIVERSITY AND HEALTH ASSESSMENT
John’s unemployment which is a socioeconomic aspect may impact his ability to afford healthcare and other basic needs. He may also feel like a burden on his family, affecting his mental health (Amiri, 2022). His use of internet-sourced testosterone suggests he may be attempting to self-treat due to financial limitations or lack of access to proper healthcare. John’s smoking history and use of marijuana could have adverse effects on his health, especially when combined with his HIV status. His depression episodes may also impact his ability to maintain a healthy lifestyle. His recent weakness could also affect his physical activity levels and diet. As a transgender individual, John may have faced discrimination and challenges accessing healthcare services (Westwood, 2022). He may also be concerned about finding a healthcare provider knowledgeable and respectful of his gender identity.
When interacting with John, it is essential to respect his chosen gender identity and use appropriate pronouns (Brummett & Campo-Engelstein, 2021). It is also essential to approach discussions of his health history and behaviors in a non-judgmental and supportive manner. Additionally, sensitivity should be given to John’s potential financial constraints and concerns about burdening his family. Targeted Questions:
- Can you describe your gender identity and any experiences you have had accessing healthcare as a transgender individual?
- How has your recent unemployment affected your ability to maintain your health?
- Can you discuss your smoking and marijuana use and any concerns you have about the impact on your health?
- Have you experienced any symptoms related to your HIV status or medication regimen?
- How have your recent experiences affected your mental health and emotional well-being?
Brummett, A., & Campo-Engelstein, L. (2021). Conscientious objection and LGBTQ discrimination in the United States. Journal of public health policy, 42(2), 322-330.
Amiri, S. (2022). Unemployment associated with major depressive disorder and depressive symptoms: A systematic review and meta-analysis. International journal of occupational safety and ergonomics, 28(4), 2080-2092.
Westwood, S. (2022). Religious‐based negative attitudes towards LGBTQ people among healthcare, social care, and social work students and professionals: A review of the international literature. Health & Social Care in the Community, 30(5), e1449-e1470.