AG is a 54-year-old Caucasian male who was referred to your clinic to establish care after a recent hospitalization after having a seizure related to alcohol withdrawal. He has hypertension and a history of alcohol and cocaine abuse. He is homeless and is currently living at a local homeless shelter. He reports that he is out of his amlodipine 10 mg which he takes for hypertension. He reports he is abstaining from alcohol and cocaine but needs to smoke cigarettes to calm down since he is not drinking anymore AG is a 54-year-old Caucasian male – NURS 6512 discussion post.
Socio-Economic, Spiritual, Lifestyle and Cultural Factors
Ball et al. (2019), explain that patients age differently and their knowledge, cognitive abilities, personality, and experience will influence how the interview is conducted by a provider. There could be a multitude of reasons as to why an older adult can become homeless. This includes unemployment due to corporate age discrimination as told by Murphy and Eghaneyan (2018). AG’s drug and alcohol use could be a reason as to why he lost his employment and due to financial constrains, was unable to pay rent or mortgage. It is the responsibility of the nurse practitioner to gather information from the patient and not make assumptions about situations. The socioeconomic factors we are looking at are employment, education, and income per Coogle and Owens (2015).
An individual’s income plays an important role in the determinant of health according to Mullen (2015). Having a higher income enables better nutrition, housing, health care, and recreation per Tsai (2018). On the other hand, poverty has a strong detrimental effect on health and is normally associated with unhealthy or risky behaviors as reported by Tsai (2018). People with low income have been observed to have more association with the consumption of unhealthy goods, like tobacco, alcohol and illicit drug use according to Tsai (2018). AG has no income and therefore has fewer chances of seeking healthcare resources or preventative services. These services could mean the difference between having a manageable health condition versus late stage multiple diagnosis and treatment. AG smokes, uses drugs and alcohol which shows his lack of health promoting behaviors AG is a 54-year-old Caucasian male – NURS 6512 discussion post.
Education is one of the focal determinants of health and is an indicator of a person’s socio-economic status per Mullen (2015). People who are better educated have fewer morbidities than their counterparts according to Hook and Markus (2020). We do not know AG’s level of education and therefore we cannot draw any conclusions. AG’s lifestyle is contributing to his present status which is having a negative effect on his health. From his chosen lifestyle, AG can end up having a heart attack or death from uncontrolled hypertension and the use of illicit drugs. Cigarette smoking can also increase cardiovascular problems as well as cause cancer.
AG needs support and education in the management of his illness. Due to the socioeconomic factors unfolding in his life, he may become depressed and without help, may contemplate suicide. Inquiring about AG’s mood like depression or anxiety can allow the NP to analyze what resources are appropriate. There is no mention of any religious preferences and this could be a question that the NP can ask during patient interviews.
Drug users and homeless individuals experience severe health inequalities and barriers to accessing healthcare. It is the duty of the healthcare workers to change their perception of others and be receptive to other people’s cultures as O’Donnell et al. (2019) explain.
Sensitive Issues while Interacting with Patient
AG may have reservations about speaking about his adversities with a new provider for fear of being judged or prejudice. As a nurse practitioner, one should be cautious about how questions are posed to the patient as Coogle and Owens (2015) explain. A tone that is accusatory will not yield pertinent information. The NP should make sure that they are not passing judgement or being prejudice against any patient that they encounter per Ball et al. (2019). The nurse practitioner should listen carefully to AG during the information gathering process AG is a 54-year-old Caucasian male – NURS 6512 discussion post. The nurse practitioner should also be careful of the non-verbal cues they present. How a clinician controls their emotions is also a strong communication skill that is very important during the interview process.
AG did not choose a healthy lifestyle and therefore the nurse practitioner
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