Week 1 Discussion: Building a Health History
Communication is the foundation for creating a positive and effective patient-provider relationship. Building rapport with an individual allows for a better understanding of how to tailor one’s communication for effective results Discussion: Building a Health History. Observing and obtaining information on an individual’s education, developmental status, socioeconomic background, perceptions, and needs aid in delivering quality assessment, planning, education, intervention compliance, and overall outcomes. The following will discuss communication techniques, risk assessment instruments, and targeted questions for the case-study patient: Adolescent Hispanic/Latino boy living in a middle-class suburb.
Communication techniques should always be tailored to the individual, this provides a better understanding and positive results. When providing care to an adolescent, it is imperative to analyze the child’s language, to distinguish their reactions and perceptions, and provide consent and empowerment (Peña & Rojas, 2013). The patient in this case study is an adolescent Hispanic/Latino boy living in a middle-class suburb. Adolescents, described by The World Health Organization, is a person “between 10 to 17 years of age” (Organization, n.d., para. 5). This population is in a stage of critical developmental, emotional, and physical growth, which may differ individually Discussion: Building a Health History. The sensitivity of some health-related topics may be a barrier in assessing an adolescent; some youth may not feel comfortable discussing them with a guardian in the room. Confidentiality should take precedence, with an understanding of the importance of reporting safety concerns (Barry Solomon, Jane Ball, John Flynn, Joyce Dains, Rosalyn Stewart, 2017).
In a study on nurse-patient communications, the identified four themes for effective communication; approach, manner, interaction techniques, and both verbal and non-verbal communication skills (O’Hagan et al., 2013). The approach and manner should be patient-focused, empathetic, and sensitive; not task-oriented or busy (O’Hagan et al., 2013) Discussion: Building a Health History. The interaction should include simple non-bias explanations with summarization for clarification (O’Hagan et al., 2013). The verbal and non-verbal communication should be tailored to the individual; patient appropriate language, space management, eye contact, sitting down with the patient and allowing the patient to speak (O’Hagan et al., 2013). These techniques may vary for different individuals based on their communication needs. Discussion: Building a Health History.
In a study evaluating a program focused on communication improvement in an emergency department in Singapore, there was over an 80% decrease in negative feedback from patients after the “I Hear You” program was implemented (Khoo et al., 2020). The stages to this program are I (Introduce, identity, information gathering), Hear (Patient’s perspective/patient’s language), and You (Agreement/closure) (Khoo et al., 2020). This technique helps builds an empowered provider-patient relationship by acknowledgment, respect, and participation.
In this patient interview, I would approach the patient first with an introduction and handshake, then the guardian if available. This gives the adolescent patient a sense of individuality and priority. Once history, medications, and concerns are collected; if the patient is comfortable, with their consent I would request the guardian to exit the room for the assessment. Discussion: Building a Health History.
Discussion: Building a Health History This vulnerable age population, between child and adult, is curious by nature and risky behaviors due to peer pressure, self-esteem, identity, school performance, parent relationships, and susceptibility to media are often adopted (Barry Solomon, Jane Ball, John Flynn, Joyce Dains, Rosalyn Stewart, 2017). Risk assessment screening tools that may be used for an adolescent patient are available to screen for mental health, sexual/physical abuse, substance use, sexuality, and safety (Barry Solomon, Jane Ball, John Flynn, Joyce Dains, Rosalyn Stewart, 2017). PACES (Parents/peers, Accidents/Alcohol/drugs, Cigarettes, Emotional issues, and School/Sexuality), HEEADSSS (Home environment, Education/employment, Eating, Activities/affect, Drugs, Sexuality, Suicide/depression, and Safety from injury/violence)
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