Comprehensive Health Assessment for Patients and Populations.
Comprehensive health assessment revolves around the evaluation of various elements of health that surrounds individuals and the general population. The process takes into account the fact that the health of an individual gets impacted by a range of factors; therefore, a holistic approach gets employed (Nash et al., 2015).
In a comprehensive assessment, the care provider aims at determining any element that impacts the patient’s health and responds to ensure optimum health gets achieved. This paper dwells on a comprehensive assessment of a patient which various aspects of evaluation being explored to assist the patient in promoting their well-being.
- 1) Interview techniques in Comprehensive Health Assessment for Patients and Populations.
During assessment and history taking, I utilized a range of interview techniques. These included active listening, where I fully paid attention to the patient’s verbal and non-verbal cues (Tomas-Aragones, Voicu & Marron, 2017). I also employed adaptive questioning, which revolves around inquiries guided by the information provided and the aim of the assessment. This technique allowed me to explore the social setting of the patient that had a direct effect on his health. Besides, it allowed and encouraged the patient to exhibit expression with limited interruptions between the interview sessions. Another analytical technique that was useful in the process was applying transitions and empowerment to minimize the patient’s fears. It was done through empowerment, letting him know the significance of the information provided and how it would get used for decision-making to enhance his health. The other technique used in the process was empathy and reassurance, where I demonstrated them to establish a therapeutic relationship (Tomas-Aragones, Voicu & Marron, 2017). I also validated the patients feeling to reassure them that the obtained information would be useful in his management.
- a) Justification of key questions in Comprehensive Health Assessment for Patients and Populations.
In assessing the patient, various questions about the social determinants got posed. The questions encompassed: what is your racial/ethnic affiliation? Gathering a fact as a response from this question will get essential in recalling the illnesses or diseases an individual gets predisposed to on the racial or ethnic background. For example, African- Americans have a higher prevalence of diabetes than any other race in the USA since obesity remains an issue in the African-American populations. How old are you? It reminds the assessor that health issues seemingly arise as individual ages, in most cases, when there is an inherited illness reported in family history like prostate cancer. What is your education level? The provided answer will enable evaluation of the level of education and information that is critical for health promotion. Being knowledgeable includes making healthy choices, having knowledge on modes of treatment, and having insight on the directions for healthcare from a clinician. Do you work? What do you do if you work? The question is crucial to determine if the client has a job, which is a source of stable income. What hazards do you get exposed to, if you work? Whom do you live with at home? The response informs whether the client has dependents for care provision. Again, it gives critical feedback to the healthcare provider to evaluate for further assistance (Adler et al., 2015).
- b) Responses to Key Questions
Based on the questions, the patient responded appropriately to them. “I am a 34-year-old, African American. I have attained a degree in engineering and am currently undertaking various engineering jobs which form my sources of income. Concerning the support from the surrounding, the social support system is relatively poor.” These responses are essential in the planning of care since they reveal his e level education as well as consideration of various health exposures concerning the profession.
2) Economic stability
Economic stability influences access to healthcare services. It directly impacts the ability of one to meet healthcare costs and other components that improve health, such as attending regular age-related screenings and nutritious foods (Adler et al., 2015). The client’s socioeconomic status is considered favorable. Being a working engineer, the patient can afford various forms of health care services as well as other elements of health, including access to quality and adequate nutrition. At the same time, the patient has sufficient shelter; thus, he dwells pleasing surrounding that supports health. However, working in an engineering plant may predispose him to a variety of occupational health hazards.
3) Educational status
An individual’s level of education is vital in the promotion of health. An appropriate education level correlates with the adequacy of knowledge on contemporary health issues. It also prompts an individual to outline measures for seeking healthcare services and adopt good health-seeking behavior. (Marmot, 2018). The patient, in the end, will adhere to various health requirements, including meeting nutritional needs such as balanced diet, engaging in physical activities and observation of safety at work and when engaging in recreational activities. In this case, the patient is an educated young man with vast knowledge concerning his health status. He demonstrates the ability to communicate clearly regarding individual health concerns and remains liberal to gain relevant expertise for further health promotion. His education has impacted him positively since he acknowledges the effects of stress on health; therefore, demonstrates the ability to arrive for healthcare support.
- a) Healthcare barriers and opportunities
Being a university graduate, he can read, interpret, and understand health information in health articles, such as reading prescriptions. Therefore, he demonstrates an opportunity to adhere to various health guidelines and enhance self-care. The education will also assist the patient in making decisions about health options (Adler et al., 2015). The education also increases economic and social resources, which are likely to improve health. A potential barrier to health is the work he does, which purportedly contributes to stress he undergoes. The patient being a university graduate, the fact remains that he is not a medical professional. Therefore, he requires help in managing stress due to its debilitating effects on the overall health. Again, his knowledge on the occupational hazards at the workplace remains potentially limited to their effects on his health. Therefore, health care interventions remain critical for optimum health promotion.
4) Effect of health on quality of life
With the patient exhibiting adequate knowledge regarding his health status, it is evident that he is having improved quality of life. He also demonstrates a positive attitude towards his overall wellbeing. These parameters of health can also impact his quality of life in the form of improved life expectancy, a better measure of an individual’s health, and curbing various causes of morbidities and morbidities. Stress affects the quality of life of an individual since health encompasses a complete state of physical, mental, and social wellbeing, not merely the absence of disease or infirmity. Stress would potentially lower his immunity, alter the rest and sleeping patterns, act as leeway for chronic illnesses such as heart disease, and predispose him to weight loss or obesity. The patient will then have positive emotions as wells life satisfactions, which are both indicators of the wellbeing of an individual (Marmot, 2018).
- a) Health literacy
Health literacy revolves around access and having adequate information among individuals which they understand and can use them to make a decision that best fits their health. Health literacy encourages an individual to seek information that is related to various aspects of health, diseases, situations, outcomes as well as conditions. Such individuals will, therefore, get endowed with adequate knowledge about health. The individual will adhere to practices that impact all dimensions of living for positive health (Marmot, 2018). An individual also empowers society through transmitting knowledge, thus positively impacting the health of others. The positivity towards being knowledgeable concerning health will also keep the individuals updated on various contemporary issues in healthcare.
- Neighborhood and environmental impacts
The patient lives in the city, which is crucial as it impacts his health. There exists a range of medical centers within the city, and this makes the patient able to access them for assessment and routine check-ups. The transport system is also good within the city, thus improving the accessibility of healthcare facilities. The impact of quality infrastructure makes an evaluation and prompt management of ill-health possible. Moreover, the adequacy of modern healthcare equipment and diagnostic technology within facilities in the city makes access to the advanced form of healthcare services possible. Relatively, the healthcare services in the neighborhood are of low quality in term of buildup, thus impairing healthcare services access and provision. Healthcare Resources in the neighborhood remain limited, including emergency services.
- a) Healthcare received in low-and high-income areas
Individuals, especially those with healthcare needs in a low-income area, usually struggle with insufficient healthcare services. In contrast, those in high-income areas promptly seek medical attention from a healthcare provider. Besides, most of those in high-income areas have health insurance covers with relatively low co-pay. In circumstances where clients lack health insurance schemes, they pay outright or using credit cards, which are the only two options for most of those in low-income areas. Again, having a low-income job usually contributes to low chances of being healthcare insurance.
Moreover, individuals in low-income areas find it costly to access health care services, for example, without insurance; you pay over $ 100.00 as consultation fees for a physician excluding medication costs. Without money, the only resort is visiting the emergency department, which usually takes several hours waiting in queues, and the bill presented at the end of the services is more costly. There is also poor transport in low-income environments hence access to a physician remains unlikely.
- b) Rural versus urban healthcare access in Comprehensive Health Assessment for Patients and Populations.
Accessibility to healthcare is relatively better in urban settings. This claim can be related to the adequacy of infrastructure in the form of medical equipment, health care providers, and specialists. Good transport networks necessitate access to healthcare facilities. Opposed to the cases in rural areas where the transport system may be poor, thus curbing access to health facilities. Rural areas usually have fewer clinicians, emergency services, and specialists. Accessibility of health information and specialists is much easier in the urban setting prompting people to seek healthcare services. The rural areas dwellers ought to travel far to access adequate care, especially a specialist like an oncologist (Mberu et al., 2016). The education levels remain lower in people in rural areas than their counterparts in urban areas, thus impairing the process of seeking health information and their health-seeking behavior.
- c) Neighborhood healthy food options for Comprehensive Health Assessment for Patients and Populations.
Concerning where one lives, plays a huge role in determining the choices made to acquire nutritious food, including healthy vegetables and fruits. Living in an urban area gives limited chances to acquire a piece of land to grow food. In most instances, such foods remain accessed in groceries. However, a lot of urban dwellers have no financial prowess to afford. Most of them tend to go for alternative processed foods. For example, a bachelor would opt for cheese and macaroni for a dollar instead of purchasing a fruit that costs the same price. Dwelling in rural areas increases the chances of growing foods and access nutritious foods since buy seeds, and seedlings remain cheap. Earning high-income increases the likelihood to purchase nutritious food like fruits, unlike low-income earners who usually resort for affordable processed foods.
My patient reports facing a lot of challenges to access healthy surplus food. Living in the city contributes to high priced healthy fruits and vegetables. He sometimes purchases them, but a lot of the times he opts for the cheaply accessed processed food. Occasionally, he orders bulky of fruits and vegetables from upcountry and finds it challenging to preserve them and staying fresh for an extended period.
Discussion of Social Determinants
Social determinants to health encompass a range of elements which includes unequal access to healthcare, poverty, lack of education, stigma, social exclusion, racism, and other forms of discrimination. These conditions get shaped by situations surrounding the distribution of money, resources, and power (Marmot, 2018). It is import to assess the social determinant of health in a population in that they tend to be key contributing factors that lead to health inequities. Upon their determination, interventions can be put in place to bridge the gap that exists between them.
1) Identification of social determinants
Luckily, my client has adequate finance for healthcare access with a single-family home in an urban neighborhood and access to healthcare providers. However, the three social determinants that potentially affect his health include sparse social support networks, discrimination, and stress that are work-related. Discrimination manifested in the form of racism and social exclusion. As an African-American, he reported social exclusion from the community and the working environment social groups. The Blacks at the workplace and in the city were out-populated by the dominant Whites’ population. The love and belonging aspect were relatively compromised. Environmental stressors have played a huge role in affecting his emotional wellbeing with regular stress episodes. Expectations for productivity at work, which prompt long working hours, remain a conspicuous contributor to stress. Besides, inadequate social support systems manifest with the limited chances connect to family, friends, colleagues at the workplace and community members. He is expected to work throughout the week with only two days off once in three months. All these factors have, over time, lured him to engage in alcoholism; however, based on his level of knowledge, resorting for health care and counseling got the better part of him.
2) Patient plan of care and implementation
During the patient assessment, the patient did not mention any social support expect from his wife. To enhance social support, his spouse would get involved to assist in developing therapeutic friendships and networks within the community. The nurse will strive to increase patient participation in social activities like engineering fairs and conferences. Additionally, community involvements like social groups, exercise programs are essential to improve social support networks and reduce work environment stressors or psychological hazards.
Additionally, as a nurse, weekly appointments would get established with the patient’s convenience for regular visits both at the workplace and at home. Regular visits pioneered by a nurse ensures collaboration with authority to outline effective stress management strategies by restructuring the working schedule for optimum rest and sleeping patterns achievement for the patient. The visits will also enable the nurse to identify other potential risk factors to affect the client’s health. By so doing, the nurse will remain the patient’s advocate in the social aspect, ensuring he achieves optimum health. Psychological support will also get provided during the visits. Above all, in the event of stress persisting, the nurse will consider a referral plan to a relevant psychiatric nurse for further interventions.
- b) Implementation Barriers
Barriers to active social support may involve patient withdrawal from participating in community activities and socialization. Conjunctively, restrictions to minimize working stressors would range from strict workplace rules and regulations and policies. Uncooperative leaders may push for . (Moore et al., 2017). Regarding scheduling regular visits with the patient, it may get challenging to find a workable solution since the working schedule for my patient lacks day-offs. There is also an impending uncooperative authority in the engineering plant that my patient works.
- c) Individuals involved in Interventions
Strategies to help the patient with the social determinants identified, various players would need to be involved in their management. Social service providers, including workplace top management, workmates, social group leaders, and community activity coordinators will remain instrumental in forming a support system for him to reduce psychological hazards and stress. A nurse would utilize an approach to offer comprehensive and holistic care through routine visits at the workplace and at home to address discrimination issues and provide emotional support. The strategy to boost self-esteem and reduce stress will get developed in collaboration with the patient by developing a plan with expected goals specified with a timeline. The nurse will provide oversight on the relevance and appropriateness of the social groups and activities the clients will participate in as part of therapy. The family and community members’ involvement, where the spouse plays a significant role for love and belonging is crucial for the patient.
- 3) Plan Effectiveness in Comprehensive Health Assessment for Patients and Populations.
According to Markkanen, et al. (2014), evaluation of psychological hazards resolution relies on the partnership with the co-workers and the management on positive adopted health behaviors at work like reporting to duty, improved productivity and good coordination and socialization with colleagues and zero instances of dozing off at work. Social support evaluation will entail monitoring the number of events attendance, workplace fairs involved, and through the connection with the physician’s annual appointment. Interaction sessions and sleeping patterns will also get included in the plan to assess the impact. About social discrimination, the patient will be able to demonstrate improved self-esteem at the workplace and his home. The program will demonstrate effectiveness if the patient will withdraw from occasional alcohol taking and demonstrate appropriate emotional affect during interactions.
- 4) Impact of social determinants in Comprehensive Health Assessment for Patients and Populations.
Poverty, to some extent, is influenced by the level of education, and it impacts limited access to quality health services, health foods, and housing (CDC, 2016). Mostly, social determinants have an outcome on an individual’s overall wellbeing. My patient’s discrimination concerns, workplace stressors, and poor social support got identified as the social determinates which potentiate adverse health outcomes. Poor social determinants reveal a detrimental effect on the emotional stability of an individual leading to escalated stress levels. Inadequate coping mechanisms due to stress lead to the development of health problems and disorders. Obesity and eating disorders, mental health issues such as personality disorders, cardiovascular diseases, and sexual dysfunction are some of the effects. As a healthcare provider, finding constructive and applicable models of care to eliminate the problem would significantly improve a patient’s life in all aspects that define health.
Conclusion of Comprehensive Health Assessment for Patients and Populations.
A range of factors impacts the health of individuals. These include spiritual, physical, economic, social, and emotional factors. Social determinants regarding income, occupation, housing, and social support system outlined for my patient were adequate. However, with the patient being impacted immensely by stress, social discrimination, and inadequate social support systems, the intervention related to improving the social interaction, improving the network relationship and routine weekly visits with adherence with a behavioral therapy plan, will lead to overall positive health outcomes.
Adler, N. E., Cutler, D. M., Jonathan, J. E., Galea, S., Glymour, M., Koh, H. K., & Satcher, D. (2016). Addressing social determinants of health and health disparities. Vital Directions for Health and Health Care Initiative: National Academy of Medicine Perspectives
Markkanen, P., Quinn, M., Galligan, C., Sama, S., Brouillette, N., & Okyere, D. (2014). Characterizing the nature of home care work and occupational hazards: a developmental intervention study. American journal of industrial medicine, 57(4), 445-457.
Marmot, M. (2018). Social Determinants, Capabilities and Health Inequalities: A Response to Bhugra, Greco, Fennell and Venkatapuram.
Mberu, B. U., Haregu, T. N., Kyobutungi, C., & Ezeh, A. C. (2016). Health and health-related indicators in slum, rural, and urban communities: a comparative analysis. Global health action, 9(1), 33163.
Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M., & Wolf, A. (2017). Barriers and facilitators to the implementation of person‐centred care in different healthcare contexts. Scandinavian journal of caring sciences, 31(4), 662-673.
Nash, D. B., Fabius, R. J., Skoufalos, A., & Clarke, J. L. (2015). Population health. Jones & Bartlett Publishers
Tomas-Aragones, L., Voicu, C., & Marron, S. E. (2017). THE CLINICAL INTERVIEW AND ASSESSMENT: GENERAL CONSIDERATIONS. Romanian Journal of Clinical and Experimental Dermatology, 4(1).
CDC. (2016, February 29). Sources for data on social determinants of health. Retrieved January 23, 2017, from https://www.cdc.gov/socialdeterminants/data/index.htm
- Carolyn Cross-Comprehensive Health Assessment for Patients and Populations
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- Title: Diverse Populations, Age and Interprofessional Health Promotion Resources
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- Assignment 1: Practicum Experience – Comprehensive SOAP Note #3