Case Study Assigned: 38-year-old Native American pregnant female living on a reservation
- How would your communication and interview techniques for building a health history differ with each patient?
- How might you target your questions for building a health history based on the patient’s social determinants of health?
- What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
- Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
- Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
- Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient. Keep in mind cultural differences that may apply.
**Include 3 sources
Expert Solution Preview
Introduction:
As a medical professor, it is important to equip medical college students with the skills and knowledge to effectively communicate with patients and obtain comprehensive health histories. To this end, this case study presents a pregnant Native American female living on a reservation, which provides an opportunity to explore various communication techniques, risk assessment instruments, and potential health risks that may be relevant to the patient’s age, gender, ethnicity, or environmental setting.
1. How would your communication and interview techniques for building a health history differ with each patient?
Communication and interview techniques may vary depending on the patient’s demographics, cultural background, health concerns, and personal preferences. For instance, when dealing with a pregnant Native American female living on a reservation, it is important to demonstrate cultural sensitivity, respect, and openness to the patient’s unique experiences and perspectives. Some recommended communication techniques include active listening, avoiding assumptions or stereotypes, being non-judgmental, and using clear and simple language. The interview should also cover relevant topics such as pregnancy history, medical history, family history, social history, and environmental exposures, among others.
2. How might you target your questions for building a health history based on the patient’s social determinants of health?
Social determinants of health refer to the social, economic, environmental, and cultural factors that contribute to individuals’ health outcomes. To target questions for building a health history based on these determinants, medical students should consider various factors such as the patient’s housing, education, income, occupation, social support, access to healthcare, and cultural beliefs. For instance, for a pregnant Native American female living on a reservation, the interview questions may focus on the patient’s access to prenatal care, nutrition, substance abuse, and traditional healing practices.
3. What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Risk assessment instruments are tools or questionnaires used to identify individuals’ risk factors for certain health conditions. For a pregnant Native American female living on a reservation, some appropriate risk assessment instruments may include the Modified Checklist for Autism in Toddlers (MCHAT), the Edinburgh Postnatal Depression Scale (EPDS), or the Alcohol Use Disorders Identification Test (AUDIT). Alternatively, medical students may ask questions relating to the patient’s personal and family history of medical conditions, lifestyle habits, and environmental exposures.
4. Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Pregnant Native American females living on reservations may face several health-related risks based on their age, gender, ethnicity, and environmental setting. For instance, they may have higher rates of gestational diabetes, hypertension, preterm labor, and low birth weight infants than other populations. Also, they may experience more environmental exposures to toxic substances such as lead, mercury, and pesticides due to proximity to mining operations or agricultural activities. Additionally, they may face social and cultural barriers to healthcare access, such as limited transportation, language barriers, or distrust of Western medicine.
5. Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
For this case study, we would use the Edinburgh Postnatal Depression Scale (EPDS) as a risk assessment instrument for the pregnant Native American female living on a reservation.
6. Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
To assess the patient’s risk of postnatal depression using the EPDS, medical students may ask the following questions:
1. Have you felt sad or miserable in the past week?
2. Have you been anxious or worried lately?
3. Do you feel guilty, inadequate, or hopeless about your ability to care for your baby?
4. Have you lost interest in activities or people you used to enjoy?
5. Have you had any thoughts of harming yourself or your baby?
It is important to ensure that these questions are culturally sensitive and non-intrusive to promote an open and honest exchange of information between the medical student and the patient. Additionally, medical students should develop strategies for addressing any potential mental health concerns identified during the interview, such as referral to mental health services or support groups.
