Building a Health History Essay

Building a Health History Essay

By Day 3 of Week 1

Building a Health History Essay sample 1

Communication and Interview Techniques to Build a Comprehensive Health History 

Taking a comprehensive health history using effective communication skills is the core competency of the advanced practice nurse. The purpose of acquiring necessary and intimate knowledge about the patient, their lifestyle, medical history, social support, and any concerns with the history of presenting illness is the initial focus of the conversation (Ingram, 2017) Building a Health History Essay. It also allows the nurse practitioner to establish a therapeutic relationship with the patient from the onset of the meeting while initiating clinical analysis. Establishing a rapport with the patient during the initial visit is critical to gaining trust and confidence, allowing the patient to communicate his concerns and enable the practitioner to treat him. 

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In the case of a 35-year-old white, morbidly obese male with disabilities in a rural setting, the practitioner should be aware of the patient’s behavior pattern while paying attention to what he is trying to convey without interrupting him is critical in gaining an optimal consultation and formulate a treatment plan. Auckburally et al. (2021) assert that raising the issue of obesity is challenging as it may offend the patient and have a detrimental effect on their relationship with their patients. Active listening skills, when used effectively, can enhance the patient’s feeling of trust and often encourage them to carry their narrative at a higher level. On the other hand, using stigmatizing and undesirable words such as fat, obese, special, and handicapped can create barriers to seeking further medical care and can exacerbate the problem (Auckburally et al., 2021). Building a Health History Essay Using neutral words such as weight, BMI, or person with disabilities promotes respectful communication in non-stigmatizing and offensive remarks (Auckburally et al., 2021).  

Risk Assessment  

Obesity is one of the most common chronic medical conditions associated with an increased risk of multiple comorbidities seen in primary care (Okobi et al., 2021). Risk classification starts with determining the body mass index (BMI), waist circumference, and comorbid conditions. Aside from measuring diagnostic tests such as lipid panel, fasting blood glucose, and basic metabolic panel (BMP), understanding the reasons leading to the patient’s obesity, which in this case could be related to disabilities and living in a rural area, is paramount to designing individualized and targeted care. The obesity risk assessment scale developed by Bhaskar et al. (2021) that incorporates important parameters like age, BMI, physical limitations, comorbidities, mental health, and quality of life can be helpful to patients in understanding their level of obesity, the risk associated with it and guide them in obesity management.  

Targeted Questions 

Some of the targeted questions that the clinician could ask the patient to assist in identifying patient needs include: 

• How can I help you today? 
• What have you tried before to make the change? 
• What do you typically eat for breakfast?  
• Please tell me about your disability? 
• What can you tell me about your support system at home? 
• Is attaining a healthier weight something that you might want to do? 
• What might get in the way of your plans to achieve a healthier weight? 
• Building a Health History Essay

References 

Auckburally, S., Davies, E., & Logue, J. (2021). The use of effective language and communication in the management of obesity: The challenge for healthcare professionals. Current Obesity Reports, 10(3), 274-281. https://doi.org/10.1007/s13679-021-00441-1. 

Bhaskar, A., Peters, A., Jammu, G., Ravikanth, K., Khaitan, M., Raj, P., & Shivaram, H. V. (2021). Obesity risk concept. Diabetes and Obesity International Journal, 6(1). https://doi.org/10.23880/doij-16000238. 

Ingram, S. (2017). Taking a comprehensive health history: Learning through practice and reflection. British Journal of Nursing, 26(18). https://doi.org/10.12968/bjon.2017.26.18.1033. 

Okobi, O. E., Ajayi, O. O., Okobi, T. J., Fasehun, O. O., Diala, C.S., Evbayekha, E. O., Olateju, I. V., Ekabua, J. J., Nkongho, M. B., Amanze, I. O., Taiwo, A., Okorare, O., Ojinnaka, U. S., Ogbeifun, O. E., Chukwuma, N., Nebuwa, E. J., Omole, J.A., Udoete, I. O., … Okobi, R. K. (2021). The burden of obesity in the rural adult population of America. Cureus, 13(6), e15770. https://doi.org/10.7759/cureus.15770. 

Building a Health History Essay sample 2

Every patient that you meet with is going to be different, and as the provider you will have to adjust your interview techniques and topics of interest to fit the patient. Some interviews may be shorter than others, and some longer. With the patient in this scenario, an 85-year-old white female living alone with declining health will probably require a longer interview. When interviewing older adults, it is important to assess if there are barriers to understanding and what if any additional tools you will need to best serve them Building a Health History Essay. With this patient, the interview will be longer due to having to ask more questions about their health and trying to get a full picture of what is going on. As the interviewer you will likely have to simplify words to make sure that the older patient is understanding what you are saying to them.

When interviewing this patient, you will want to find out more about their social supports, any environmental supports, obtain a health history to the best of the patient’s ability. I would also want to ask about their finances, and if they have any barriers to getting proper support and medical attention. I would also inquire about where they are living, how they get around, how do they get their medications if they are on any, or if they are worried about anything in their life.

The risk assessments I would use with this patient would be the mini-cog and the geriatric depression scale. The mini-cog is an assessment tool that is a three minute instrument that can increase the detection of cognitive impairment in older adults (Seitz et al., 2021). Building a Health History Essay The mini-cog consists of two components, a 3-item recall test or memory and a simply scored clock drawing test (Seitz et al., 2021). The geriatric depression scale is a 30-item self-report assessment used to identify depression in the elderly (Benedetti et al., 2018). The patient in this scenario would also need to be assessed for fall risk, vision impairments, hearing impairments, and judgment to list a few. Due to the decline in health, the patient should also be assessed for malnutrition, dehydration, and infection.

The five targeted questions I would ask this patient are:

How do you feel overall, and what changes have you noticed in regards to your overall health?

Do you feel safe where you live?

Do you ever feel like you go without food or basic necessities?

Do you use tobacco products?

Do you drink alcohol?

References

Benedetti, A., Wu, Y., Levis, B., Wilchesky, M., Boruff, J., Ioannidis, J. P., Patten, S. B., Cuijpers, P., Shrier, I., Gilbody, S., Ismail, Z., McMillan, D., Mitchell, N., Ziegelstein, R. C., & Thombs, B. D. (2018). Diagnostic accuracy of the Geriatric Depression scale-30, geriatric depression scale-15, geriatric depression scale-5 and geriatric depression scale-4 for detecting major depression: Protocol for a systematic review and individual participant data meta-analysis. BMJ Open, 8(12). https://doi.org/10.1136/bmjopen-2018-026598

Kiely, K. M., Brady, B., & Byles, J. (2019). Gender, Mental Health and Ageing. Maturitas, 129, 76–84. https://doi.org/10.1016/j.maturitas.2019.09.004

Seitz, D. P., Chan, C. C. H., Newton, H. T., Gill, S. S., Herrmann, N., Smailagic, N., Nikolaou, V., & Fage, B. A. (2021). Mini-Cog for the detection of dementia within a primary care setting. Cochrane Database of Systematic Reviews, 2021(7). https://doi.org/10.1002/14651858.cd011415.pub3

Building a Health History Essay response

The elderly makes up a great deal of our population and I strongly believe more time and attention needs paid to their personalized care.  Especially with such high-risk factors such as chronic diseases, polypharmacy, and declining cognitive, physical, and physiological functions.

aging population undergo many physiologic changes, including, molecular and cellular fluctuations, that can modify different pharmacokinetics.  Pharmacokinetics such as absorption, first-pass metabolism, protein binding, distribution, metabolism, and eliminations of the drugs (Shrestha, Shrestha, & Khanal, 2019).

I appreciate and agree with your questions aimed at assessing social, financial, and environmental supports.  Too often these facets of patient’s history are overlooked. I would make sure I get a previous and current medication list. I would also ask detailed questions about her medical, pharmaceutical, and physician history Building a Health History Essay. These questions might be along the line of; have you ever been told by a doctor that you have a certain disease?  Have you treated with any other doctors in the last 5 years?  Have you been to any hospitals in the last 5 years? Do you have any medical records? What pharmacy do you use?  How long have you been going to this pharmacy?  Is this the only pharmacy you use?

Since it is anticipated that the population of the elderly increase remarkably over the coming decades and be followed by the increase of chronic diseases and polypharmacy, assessment, and management of polypharmacy by physicians, pharmacists, and authorities of health-care centers are highly required. Increasedf awareness among physicians, experts, authorities, and families about characteristics of the elderly people and factors affecting polypharmacy can help in the proper and safe use of medications (Hosseini, et al, 2018). Different strategies to help reduce polypharmacy could be incentives to physician for optimization of safe and effective medication management, incorporating clinical pharmacy services, and utilizing an interdisciplinary team.

Resources

Hosseini, S. R., Zabihi, A., Jafarian Amiri, S. R., & Bijani, A. (2018). Polypharmacy among the Elderly. Journal of mid-life health, 9(2), 97–103. https://doi.org/10.4103/jmh.JMH_87_17

Shrestha, S., Shrestha, S., & Khanal, S. (2019). Polypharmacy in elderly cancer patients: Challenges and the way clinical pharmacists can contribute in resource-limited settings. Aging Medicine, 2(1). 42-49. https://doi.org/10.1002/agm2.12051 Building a Health History Essay

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Building a Health History Essay response 2

The practitioner should be able to provide a proactive comprehensive geriatric assessment that combines a population screening strategy with an interdisciplinary multi-domain approach (Rietkerk et al., 2021). I agree that the practitioner should alter their assessment to fit the population being served.It is important to assess the patient’s cognition in a unique way. Asking questions should be added to the conversation. Such as the practitioner starts to write the date and then asks the patient to see if the patient knows the date. Assess their clothes to see if the clothes match the weather. One of the tips I learned was to ask the patient what they like on television and then ask what they remember from the show. It is important to not make the patient feel judged. Assessing the patient depression will help determine if depression needs to be addressed or reevaluated. It is important to give the patient time to be able to report their medical concerns and medical history. Many times, the hospital prescribes medications or a special diet that the patient can not afford. The patient often comes back due to being unable to purchase medications and not adhering to the diet. Eye exams should be completed during each exam. Drivers who are 80 years old and older have 9 times greater fatality rate than drivers aged 25 to 69 (Arms, 2016) Building a Health History Essay.

Arms, T. (2016). The NPs Role of Assessing and Intervening with Older Adult Drivers. Nursing Research and Practice, 2016, 1–7. https://doi.org/10.1155/2016/3254857

Rietkerk, W., de Jonge-de Haan, J., Slaets, J. P. J., Zuidema, S. U., & Gerritsen, D. L. (2021). Increasing Older Adult Involvement in Geriatric Assessment: A Mixed-Methods Process Evaluation. Journal of Aging and Health, 33(7–8), 482–492. https://doi.org/10.1177/0898264321993321 Building a Health History Essay

 

Building a Health History Essay sample 3

Summary of the interview

 The elderly may face some chronic conditions and also a decline in activity levels due to the fear of falling (Graham et al., 2021). The interview in this case scenario entails the white female patient who is 85 years old, living alone with no family in declining health. The woman is in declining health and lives alone. This is one of the serious problems that the elderly face. This woman needs help from the interview conducted Building a Health History Essay. She lives alone and her health in in decline. The fear of falling has contributed to the functional decline in this patient crowned with the declining ability to safely perform tasks. She also lives alone and has no family to support her which has affected her both physically and emotionally         

Communication techniques to be used

The first communication techniques that I would implicate with the patient is to give ample time for communication. This will ensure that we have comprehensive communication on the problem she is experiencing (Zhang et al., 2021). Giving extra time will promote trust and confidence and will give renewed hope (Siddique & Chow, 2021). Building a Health History Essay The second technique that I will use is active listening. The idea will ensure that I grasp the entire medical problem the patient is experiencing and determine the perfect manner of addressing the problem (Hopwood et al., 2021). Consequently, I will give honest feedback and offer solution on how the treatment and recovery can be maximized (Kompa et al., 2021). By providing feedback to the patient, there will be an indication that serious steps are taken to agitate the patient’s recovery.  

Risk assessment instrument

Some of the risk assessment instruments which I will induct for the patient in this case scenario is the decision tree instrument (Raja et al., 2021). The assessment will be effective at it will be possible to provide effective outcomes and consequences, which will facilitate better decision making for the patient recovery procedure (Graham et al., 2021) Building a Health History Essay. This tool will apply to the patient as it will provide the physician with effective strategies to handle the patient’s health condition.  

                                                    Target Questions

1. Describe the problems you are experiencing?
2. What are your medical and surgical histories?
3. What medications are you taking including over the counter medications?
4.  Any adverse reaction to medication?
5. Do you have a history of smoking and taking alcohol or illicit drugs?

                                                                     References

Graham, L. M., Sahay, K. M., Rizo, C. F., Messing, J. T., & Macy, R. J. (2021). The validity and reliability of available intimate partner homicide and reassault risk assessment tools: A systematic review. Trauma, Violence, & Abuse, 22(1), 18-40 Building a Health History Essay.

Kompa, B., Snoek, J., & Beam, A. L. (2021). Second opinion needed: communicating uncertainty in medical machine learning. NPJ Digital Medicine, 4(1), 1-6.

Raja, V., Lakshmi, R. V., Sekar, C. P., Chidambaram, S., & Neelakantan, M. A. (2021). Health risk assessment of heavy metals in groundwater of industrial township virudhunagar, Tamil Nadu, India. Archives of Environmental Contamination and Toxicology, 80(1), 144-163.

Siddique, S., & Chow, J. C. (2021). Machine learning in healthcare communication. Encyclopedia, 1(1), 220-239.

Zhang, J. A., Liu, F., Masouros, C., Heath, R. W., Feng, Z., Zheng, L., & Petropulu, A. (2021). An overview of signal processing techniques for joint communication and radar sensing. IEEE Journal of Selected Topics in Signal Processing. Hopwood, J., Myers, G., & Sturrock, A. (2021). Twelve tips for conducting a virtual OSCE. Medical teacher, 43(6), 633-636.

 

Building a Health History Essay sample response

Thank you for your post in this week’s discussion. Communicating well with elderly patients can be challenging for many clinicians, often complicated by health issues such as hearing loss, vision loss, and memory problems. When patients are older, obtaining a good history, including social circumstance information and lifestyle, in addition to medical and family history, is crucial to good health care (Palmer & Onder, 2018). Given the history that this patient lives alone with no family support, the interview itself can be beneficial. Although we see many patients every day, we may be the only person that this patient is socially engaged with that day. Hence, attention and active listening skills are vital in giving the patient the chance to express concerns to a person that shows interest. It can be therapeutic and build trust Building a Health History Essay. Additionally, older people tend to have multiple chronic conditions; thinking of current concerns rather than a chief complaint may be helpful and encourage the patient to bring a written list of problems or questions on her next visit. For example, ask the patient to talk about her primary concern, “Tell me, what is bothering you the most?” or “Is there anything else?” 

The patient’s level of functioning and any recent significant changes are fundamental to providing appropriate care and influencing which treatment regimen is suitable. The ability to perform activities of daily living (ADL) reflects and affects patient health (Pashmdarfard & Azad, 2020) Building a Health History Essay. Sudden changes in patients’ ADLs and IADLs are valuable diagnostic clues for underlying medical conditions. Moreover, learning about the patient’s home and social circumstances will help the clinician understand aspects of her illness and improve treatment adherence.  

References 

Palmer, K., & Onder, G. (2018). Comprehensive geriatric assessment: Benefits and limitations. European Journal of Internal Medicine, 54, e8-e9. https://doi.org/10.1016/j.ejim.2018.02.016. 

Pashmdarfard, M., & Azad, A. (2020). Assessment tools to evaluate activities of daily living (ADL) and instrumental activities of daily living (IADL) in older adults: A systematic review. Medical Journal of the Islamic Republic of Iran, 34, 33. https://doi.org/10.34171/mjiri.34.33. 

 

Building a Health History Essay sample response 2

I believe that your communication techniques would promote a therapeutic relationship.  Patient-centered communication is associated with improved compliance, patient satisfaction and recall of patient information (Turabian, 2018).  Adapting positive communication techniques is essential especially since many of our older adults suffering from the effects of social isolation (Lively, 2021).

Older adults are at risk for social isolation and loneliness (Lively, 2021).  The World Health Organization defines it as “lack of contact with family, friends or other people” (Ejiri, et al 2021).  This problem increased during SARS-Cov-2 pandemic (Lively, 2021).  Older adults were identified as a high-risk population most likely to suffer adverse results of the virus (Lively, 2021), and as a result, interventions were adopted to secure their physical safety (Lively, 2021).

Isolation and loneliness adversely affected five core domains associated with healthy aging which includes promoting health, by preventing injury and managing chronic conditions, cognitive health, physical health mental health and social engagement (Lively, 2021).  It was determined that social isolation can be as dangerous as smoking fifteen cigarettes a day (Lively, 2021) Building a Health History Essay.  It increased the risk of depression, suicidal thoughts (Lively, 2021), cardiovascular disease, stroke, and the need for long-term care (Ejiri, 2021).

We are still adjusting to the effects of living during a global pandemic and the effects it continues to have on members of our patients.  Performing an assessment to identify those who are currently lonely or socially isolated could help prevent some of the negative consequences.  The Lubben Social Network Scale (LSNS) is a risk assessment which measures the number and frequency of contact with friends and close family members (Ejiri, 2021).  A score less than 12 defines an individual as socially isolated (Ejiri, 2021).

This data could help practitioners develop interventions that promote social interactions and prevent negative outcomes such as cardiovascular disease or suicide (Ejiri, 2021).

References

Ejiri, M., Kawai, H., Ishii, K., Oka, K., & Obuchi, S. (2021). Predictors of older adults’ objectively measured social isolation: A systematic review of Observational Studies. Archives of Gerontology and Geriatrics, 94, 104357. https://doi.org/10.1016/j.archger.2021.104357

Purvis Lively, C. (2021). Social isolation of older adults in long term care as a result of covid-19 mitigation measures during the covid-19 pandemic. Voices in Bioethics, 7. https://doi.org/10.52214/vib.v7i.8526

Turabian, J. L. (2018). Doctor-patient relationship as dancing a dance. Journal of Family Medicine, 1(2), 1–6. https://doi.org/10.14302/issn.2640-690x.jfm-18-2485 Building a Health History Essay