NURS-6512 Week 1 Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

Photo Credit: Getty Images/Caiaimage

This Week’s Discussion Board

1. 26-year-old Lebanese female living in graduate-student housing

2. 14-year-old biracial male living with his grandmother in a high-density public housing complex

3. 38-year-old Native American pregnant female living on a reservation

4. 40-year-old black recent immigrant from Africa without health insurance

- 1 Last names starting with A-C
- 2 Last names starting with D-H
- 3 Last names starting with I-O
- 4 Last names starting with P-Z

Please make sure that you answer all of the required info in your post:

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.

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
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.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:

Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
Suggest additional health-related risks that might be considered.
Validate an idea with your own experience and additional research.

Submission and Grading Information

Example Papers – NURS-6512 Week 1 Discussion: Building a Health History

Communication / Interview techniques

I will conduct my interview on a 14-year old biracial male in his grandmother’s presence as a guardian must be present when talking to a teenage patient (Sacks, & Westwood,2003). I would create an open and caring relationship with my interviewee to earn his trust; I would start by introducing myself and create a welcoming environment for my client. I would ensure the interview environment is conducive, comfortable, and enhance the privacy of my client. I would adopt a communication approach relevant to the boy’s age, race, and social status. Effective communication is a critical tool to address the needs of the patient. Acknowledging the patient’s cultural background and designing the communication approach relevant to the race indicates cultural competency, which is a tool for health care providers to recognize diversity among patients and adopt a patient-centered communication approach, thus winning the patient’s trust (Ball et al. 2019). I will design the interview questions in an open-ended form and allow the patient enough time to respond to ensure the client understands that I am concerned about his health issue. I would ask the boy what the name he prefers me to call him and address him by the name throughout the interview to confirm the client is comfortable and create a healthy relationship. I would also listen to the client when he talks, and I will pay attention to the details to understand critical issues to the patient.

The 14-year-old is in the adolescent stage; therefore, I would consider a HEADSS tool to guide the interview. The topics addressed by the HEADSS tool include; Home, Education, Activities, Drugs, Sexuality, Suicide/Self-image/Depression, and Safety (Neinstein, n.d.). However, I would be keener on risky health behaviors like drug abuse, smoking, sexual activities, depression, and alcohol. I will let him express how he feels about life. I will give him honest and open feedback about the health issues of concern. I will inform him about the preventive measures against the risky health behaviors and use the teach-back technique to assess his understanding and identify areas which I should reinforce. I will ask him about the school, life at home, and interactions with his peers. Moving forward, I will allow the patient to choose an interview approach he deems fit and ask him if he prefers when I ask questions or if he may wish to tell me a story. I will ask him If he is comfortable if I ask sensitive issues in his grandmother’s presence, or I should ask her to leave the room.

Risk Assessment

A health Risk assessment is a questionnaire to address an individual’s health status and feedback on corrective action to reduce the health risks(PDHI, 2019). The screening tool that helps address a wide range of factors among the adolescent patient is the HEADSS; This is a risk assessment tool for the adolescents’ risk factors and protective factors. Risk factors are actions that drive adolescents to engage in health risk behaviors. In contrast, protective factors are actions that promote resilience and builds the ability of adolescents to cope with a challenging situation. The HEADSS risk assessment tool allows the health care provider to assess the following psychological realms of the patient; Home, Education, Activities, Drug, Sexuality, Suicide/Self Image/Depression, and Safety (Neinstein, n.d.)

Five Targeted Questions

How are are you doing in school?
In the past year, have you smoked, consumed alcohol, or abused any drugs?
Do you feel abused or unsafe in your home neighborhood?
How is your relationship with your peers at school?
Do you talk to your grandmother when faced with a difficult situation?

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Neinstein, L. S. Interviewing and communicating with adolescents (A4).

PDHI What Is a Health Risk Assessment? (2019, February 15). Retrieved August 30, 2020, from https://www.pdhi.com/ncqa/what-is-a-health-risk-assessment/.

Sacks, D., & Westwood, M. (2003). An approach to interviewing adolescents. Paediatrics & child health, 8(9), 554-556.

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

Rubric

	Excellent	Good	Fair	Poor
Main Posting	45 (45%) – 50 (50%) “Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	40 (40%) – 44 (44%) “Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.	35 (35%) – 39 (39%) “Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors.	0 (0%) – 34 (34%) “Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness	10 (10%) – 10 (10%) Posts main post by Day 3.	0 (0%) – 0 (0%) N/A	0 (0%) – 0 (0%) N/A	0 (0%) – 0 (0%) Does not post main post by Day 3.
First Response	17 (17%) – 18 (18%) “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	15 (15%) – 16 (16%) “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	13 (13%) – 14 (14%) “Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 12 (12%) “Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Second Response	16 (16%) – 17 (17%) “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English.	14 (14%) – 15 (15%) “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	12 (12%) – 13 (13%) “Response is on topic and may have some depth. Responses posted in the Discussion may lack effective professional communication. Responses to faculty questions are somewhat answered, if posed. Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.	0 (0%) – 11 (11%) “Response may not be on topic and lacks depth. Responses posted in the Discussion lack effective professional communication. Responses to faculty questions are missing. No credible sources are cited.
Participation	5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.	0 (0%) – 0 (0%) N/A	0 (0%) – 0 (0%) N/A	0 (0%) – 0 (0%) Does not meet requirements for participation by posting on three different days.

Total Points: 100