Complete Evaluation in Health Care

Complete Evaluation in Health Care
Assessing a person’s health is a key part of the nursing process. It is the process of collecting, confirming, studying, and sharing information about a patient’s health. The health assessment process can be done on people on a regular basis to find any health problems, especially since the number of people with chronic conditions has gone up in recent years. After a health assessment, nurses play a key part in making care plans and deciding what nursing interventions to use. For this process to work, doctors need to have high-level skills that help them make better decisions and keep track of changes in the patient to improve their health. The point of this talk is to show the results of a thorough health assessment of a patient and to make a nursing care plan based on the social determinants of health that affect the patient.

Interview Techniques

Setting up and planning for the environment

The biggest mistake that affects the hiring process is not having enough time to plan. There should be enough planning, which should include writing down important points that support the interview’s specific goal. Second, it is thought that the environment makes up up to 60% of a good interview. (Philips et al., 2017). It is suggested that talks take place in a quiet room so that people can talk better. I made sure that the room we chose for the interview with Carolyn Cross was clean, well-organized, well-lit, and quiet. Personal space was kept well by leaving enough space between people, and I made sure that all of the writing and evaluation materials were within easy reach.

Adaptive questioning to steer the talk

A good interview usually starts with getting to know each other and asking leading questions to get people interested. The interviewer should talk in a helpful and friendly way to make contact easier right away. After getting to know the patient, you should ask them general questions to get them to open up before moving on to more specific questions. I started my interview by telling Carolyn to take a deep breath and telling her how important it was that our talk was private. I then asked her the interview questions and asked more questions based on what she said in answer. This method made sure I was paying attention, and it gave Carolyn the courage to talk more about her health.

Choice of questions was good

An interview is a two-way conversation between the person being interviewed and the person being interviewed. How people answer and talk during an interview depends a lot on the questions that are asked. You should use both open-ended and closed-ended questions to get people involved and to avoid one-way conversation. (Philips et al., 2017). Additionally, open-ended questions allow the patient to speak more giving the assessor time to identify the root of identified health problems. During the conversation with Carolyn, I planned my questions well so that I could ask both open-ended and closed-ended questions. I learned that these questions helped me figure out how the patient felt, what she thought, and how she saw her health.

Skills in listening and talking to people

Interviews need a lot of control to make sure that time is used well and that the conversation doesn’t go off topic. To keep control, the interviewer must listen carefully, give the interviewee time to explain points, and excuse themselves before being interrupted. During an assessment, it is also expected that the person will use both vocal and nonverbal cues to show that they understand and show how they feel. I made sure I paid close attention to Carolyn and used appropriate body language, like nodding, keeping eye contact, and gestures, to keep the talk interesting.

Justification of Key Questions

Economic stability

The first question was about Carolyn’s economic security, which included her job, her finances, and where she lived. The questions about these things were important to find out how stable the patient’s finances were, which is an important factor in health. How would you describe how stable your finances are? Carolyn said that she worked as a learning specialist at a nearby school, but that she was out of work right now because of the COVID-19 spread. She said that her money situation is unstable because she depends on her husband, who is an accountant. She also said that it has been hard for her to pay her bills, including the monthly mortgage on her house, which she hasn’t paid in a month.

Education

A person’s behavior when it comes to getting health care is affected by their level of schooling. During the assessment, the question of Carolyn’s education tried to determine her education level and its effect on her health-seeking habits. What do you know about your schooling? She said that she had just finished from high school and was going to the University of Texas on a full scholarship. She went to college to get a bachelor’s degree in elementary teaching and then went on to get a master’s degree in special education. (M.Ed.). Carolyn talked about how her schooling helped her get a job as a learning specialist in a middle school.

Health care and health

Access to health care services and how often people go to the doctor are important factors in health. The questions on this social determinant were meant to find out about possible barriers to getting health care and the person’s present health. Do you find it easy to get medical care? How often do you go to the doctor? Carolyn said that she lives close to her primary care doctor, but that her visits have been limited by the COVID-19 outbreak. The drugstore close by recently closed, so she now has to drive 20 minutes to get medicine when she needs it. In response to a question about her health, she said that her last breast and cervical cancer screenings were a year ago. She has fibrocystic breast disease, which was found by taking a closer look at her current and past health.

The neighborhood and the way it was built

The health of a person can be affected by where they live and how they treat their friends. The purpose of the evaluation of Carolyn’s neighborhood was to find things that made it hard to be healthy, like how safe it was, how easy it was to get food, and how well people used the resources they had. How would you describe where you live? Is there a problem with getting food, getting medical care, or staying safe? Carolyn thought about how the Coronavirus spread has changed people’s ability to get to basic services because of this question. She said that she lives in Houston, Texas, in a neighborhood with enough food and not too many safety problems. Due to the COVID-19 spread, it was also noticed that she no longer has full access to parks and other places for fun. Concerning safety, Carolyn said that she has never been abused or hurt, and the fact that there is a neighborhood watch system makes things even safer.

Context of Society and Community
The health assessment looks at the person’s well-being, including how they deal with people at home and at work. The purpose of the social and neighborhood context question is to find out who Carolyn knows and how she gets along with other people. Carolyn said that she spends her free time with her family, but the COVID-19 spread has made it hard for her to take care of her mother. Due to the growing needs of the family, she has less time to spend with people outside of the family. Carolyn said that she doesn’t have any problems with unfair treatment at home or at work because she gets along well with other people.

How to Answer Key Questions

Carolyn answered all of the important questions asked during the exam well and made it clear where she has trouble. It was seen that she was financially stable until the COVID-19 outbreak hit her money recently. Her schooling was looked at, and it was found that she has a master’s degree in special education and a good job. Her level of education was important for making good choices about her health, like going to the doctor on time. In terms of health and medical care, it was noticed that she goes to her yearly checkups. But the COVID-19 spread has made it hard for her to get health care, even to see her primary care doctor. On the area and built environment assessment, differences were seen in how easy it was to get around and to work out. The social and community context survey showed that she had trouble getting along with other people and couldn’t take care of her sick mother because of COVID-19 rules. With these answers, it’s up to the nurse to plan care that takes into account problems like health and healthcare, economic stability, and the social and community setting.

Economic stability

Socioeconomic Status

Because of the Coronavirus pandemic, Carolyn is on leave, which has made it hard for her and her family to pay their bills. The family’s finances have been hurt by a lack of money, and she has little left over to pay for other things. Because of the fight, Carolyn has fewer ways to get to the doctor when she needs to and may have trouble getting there.

Employment status

Carolyn worked full-time as a learning specialist in a nearby school until four months ago. Since then, though, schools have closed, so she has stayed at home. Carolyn’s inability to work has made it harder for her to support her family, and she can’t make enough money to pay her medical bills. Because she is out of work and has trouble paying for things, like taking care of her sick mother, she has less access to medical care.

Housing safety

Carolyn’s lack of work has made it harder for her to keep her home, especially since she can’t pay her monthly bill. Since the whole family depends on the husband’s income, some health care needs are hard to pay for. Second, her house is far from the nearest drugstore, which makes it hard for her to get her medicine on time.

Status of Education

It is important to understand how education affects health in order to improve healthcare policies and help people stay healthy. There is a lot of proof that a higher level of education is linked to good health and that a lower level of education is linked to bad health. (Raghupathi & Raghupathi, 2020). People have noticed that education level affects income, access to medical care, and the social tools that can be used to improve health. People with a lot of education are good at fixing problems and thinking things through. This makes them less likely to get sick from things like stress. (Raghupathi & Raghupathi, 2020). Carolyn has a master’s degree in special education and is a very smart woman. She is smart enough to know how her actions affect her health and to go to the doctor right away. At the moment, Carolyn can handle work-related stress, such as money problems, as we’ve already talked about.

Healthcare Obstacles and Chances

Carolyn has a master’s degree and was working until the COVID-19 plague happened recently. With her level of knowledge, she can make good decisions about her health, like getting care when she needs it. But her busy schedule at work makes it hard for her to work out and get to know people in the neighborhood. Her doctor says her health is holding her back, which means she has less time to spend with other people. Carolyn’s schooling can give her a chance to improve her health and deal with what’s going on. She can deal with the stress that comes from her money worries and maybe plan to do something else that will bring in money.

How health affects how good life is

Quality of life is an idea that depends on things like how well your body, mind, emotions, and relationships are working. According to the health exam that was done, Carolyn is in good shape. But her mental and social functioning might be affected by the fact that she doesn’t have many friends and her family is having money troubles. Research shows that interacting and connecting with other people is important to the quality of life. The CDC tool for measuring the health-related quality of life puts a lot of emphasis on measuring mental health, which includes worry, depression, and emotional problems. (Yin et al., 2016). Carolyn is stressed because she can’t take good care of her sick mother, which has made it hard for her to hang out with her friends. Also, it’s hard for her to take care of her family, pay her bills, and buy all the other things she needs.

Literacy in Health

Health literacy is the ability to find, process, and understand knowledge about health. Because it affects how people make choices, health literacy can be either a risk or an asset for achieving the best possible health. Studies show that not knowing much about health is linked to bad health results. People who can’t read or write well aren’t healthy, don’t know much about medical problems, and make bad decisions in life. (Jayasinghe et al., 2016). Low health literacy also makes it harder to talk to your main care provider and understand the care you get after you leave the hospital. Health literacy makes it easier for people to understand their own health, voice worries, and take care of underlying conditions during routine care.

Effects on the neighborhood and the environment

Carolyn lives in a Texas town where most of the people are middle class. Good transportation made it easy for Carolyn to get to health care, but since the coronavirus hit, it has been hard for her. She has to walk 20 minutes downtown to get to the closest pharmacy, and because of the way things are, she can’t see her general care doctor as much as she used to. Second, the limited number of ways to get around can make it harder to get to a hospital quickly in an emergency. But a safe area can make it easier for people to get to health care services at any time.

How people in low-income and high-income areas get health care

The quality of health care in places with low income and areas with high income is very different. Health care services in high-income places are good because there is good equipment and skilled health care workers. On the other hand, health care facilities in low-income places don’t have the latest tools to provide good services. Even so, both low-income and high-income places are having trouble finding enough healthcare workers because healthcare services are getting more complicated. Due to the large number of people who go to hospitals for health care, it is hard to get care to both places on time.

Access to health care in rural and urban areas

Access to basic healthcare services is a key part of improving people’s health, and it shows how well providers and patients match each other in terms of their traits and expectations. Accessibility is shown by things like the cost of services, the availability of needed services, the location of facilities, and how well people like the services they receive. (Spasojevic et al., 2015). Rural areas have problems like not having enough money to pay for health care and not being close to health care services. There are also not enough places to stay in rural areas, where the level of services doesn’t meet what customers want. In cities, it’s easy to get to services because there are so many places to get medical care and so many ways to get around. Healthcare in cities is also better than healthcare in other places because there are more doctors and nurses and more medical tools and supplies.

Foods that are good for you and close by
Carolyn’s neighborhood has a lot of food shops, including supermarkets, that sell a wide range of foods. Stores and supermarkets are all within five miles of Carolyn, making it easy for her to get good food. But the COVID-19 pandemic has made it hard for Carolyn to get the food because the stores are too crowded. She says that she is afraid to go to streets and parks because she might catch the virus.

Talk about how social factors affect people

Conditions in the places where people are born, live, and work that affect a wide range of health risks and results are called “social determinants.” (Healthypeople.gov, n.d.). When doing a health exam, talking about the social determinants helps the provider figure out what parts of the patient’s life affect their health. Research shows that people are affected by things they don’t realize, and it’s only when they realize these things that they make a change. As the healthcare industry moves toward value-based care, it is important to address social determinants to get a full picture of the patient, encourage better results, and make sure that healthcare institutions are delivering value.

B1 Identification Social Determinants

Plan of Care for a Patient

B2A

Plan Implementation

B2B

Implementation Barriers

B2C

People Who Are Part of the Plan of Care

How well a plan works

Stability in the economy

To help the person deal with their current money situation.

Learn how to spend your money wisely to keep costs down.

counseling and giving them help.

Unemployment for a long time.

Uncertainties like a family member getting sick

Members of a family. The client’s husband will be around to help plan how money will be spent and give emotional support during this hard time.

The public health nurse might be able to talk to you about your health.

A financial planner can help a family figure out how to plan for the future.

(Talevski et al., 2020) The patient should orally show that he or she understands and use the teach-back method to show possible ways to make money.

Health care and health

Because the patient has a history of fibrocystic breast disease, she needs to know more about breast cancer.

Educating, screening, and giving out educational materials.

When a person has a bad family background, it can be hard to predict how well they will do in the future.

Carolyn’s husband will be there to support her and help make sure the training programs are followed.

The primary care doctor should be involved in providing services for preventive care.

Verbal proof that you understand the material. (Talevski et al., 2020) The client will be asked to do teach-back for the knowledge given, which will include ways to prevent breast cancer.

Context of Society and Community

To take part in community events and talk with other people.

Joining

Not enough time.

Restrictions due to COVID-19

The women who lead the group will help the client find online and neighborhood groups to join.

The leaders of the church will help the person find groups within the church.

The public health nurse will be available to help people find events at the community center or in the town hall.

Both active involvement in community activities and a growing interest in those activities are important.

The results of a plan to make sure the client joins at least one social group in the neighborhood should be good. (Crocker et al., 2015).

How social factors affect things
Carolyn is in great shape physically, but she isn’t doing a good job of dealing with the COVID-19pandemic. Her money situation has changed, and she can no longer pay her bills. These changes have caused more stress, which could be bad for your health. Carolyn is a smart woman who can make good choices and knows how important it is to get medical care. Concerning health and access to health care, the COVID-19 pandemic has made it harder for her to get medical care, like going to her general care doctor regularly. Carolyn has trouble getting along with other people because she is so worried about her family, especially her sick mother. Based on the evaluation, Carolyn’s physical health is good, but she needs counseling and help during these hard times.

References
Crocker, J. B., Crocker, J. T., & Greenwald, J. L. (2012). Telephone follow-up as a primary care intervention for postdischarge outcomes improvement: A systematic review. The American Journal of Medicine, 125(9), 915-921.

https://doi.org/10.1016/j.amjmed.2015.01.035

Healthypeople.gov. (n.d,). Social determinants of health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health

Jayasinghe, U. W., Harris, M. F., Parker, S. M., Litt, J., van Driel, M., Mazza, D., Del Mar, C., Lloyd, J., Smith, J., Zwar, N., Taylor, R., & Preventive Evidence into Practice (PEP) Partnership Group (2016). The impact of health literacy and life style risk factors on health-related quality of life of Australian patients. Health and Quality of Life Outcomes, 14, 68.

https://doi.org/10.1186/s12955-016-0471-1

Phillips, A., Frank, A., Loftin, C., & Shepherd, S. (2017). A detailed review of systems: an educational feature. The Journal for Nurse Practitioners, 13(10), 681-686. https://doi.org/10.1016/j.nurpra.2017.08.012

Raghupathi, V., & Raghupathi, W. (2020). The influence of education on health: An empirical assessment of OECD countries for the period 1995–2015. Archives of Public Health, 78, 1-18. https://doi.org/10.1186/s13690-020-00402-5

Spasojevic, N., Vasilj, I., Hrabac, B., & Celik, D. (2015). Rural – urban differences in health care quality assessment. Materia Socio-medica, 27(6), 409–411. https://doi.org/10.5455/msm.2015.27.409-411

Talevski, J., Wong Shee, A., Rasmussen, B., Kemp, G., & Beauchamp, A. (2020). Teach-back: A systematic review of implementation and impacts. PloS One, 15(4), e0231350. https://doi.org/10.1371/journal.pone.0231350

Yin, S., Njai, R., Barker, L., Siegel, P. Z., & Liao, Y. (2016). Summarizing health-related quality of life (HRQOL): Development and testing of a one-factor model. Population Health Metrics, 14, 22. https://doi.org/10.1186/s12963-016-0091-3

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