Social Determinants of Health: Carolyn Cross iHuman Simulation
Introduction
Reflection does help nurses improve their professional skills and knowledge. The main goal of reflective nursing (Patterson et al., 2016) is to help us make better clinical decisions about things that come up in our areas of practice by making us think about what we did and why we did it. To this end, reflections are an important part of all nursing activities and an important part of the nursing curriculum. Reflective nursing is important for all nurses, no matter how much experience they have. Both new nurses and experienced nurses who specialize in different areas do it every day. The main point of this paper is to talk about an interview I had with Carolyn Cross, a middle school learning specialist who lives with her husband and two boys.
Methods of interviewing used during the interview
During a comprehensive health assessment, there are many things that can be done to improve the quality of the data collected. In my interview with Carolyn Cross, I chose to use an appropriate interview location, open-ended questions, adaptive questioning, and the right non-verbal communication cues. (Machlin, S., & Adams., 2017) These also help the nurse build a relationship with the client, which makes the client feel at ease, in charge, and very well cared for.
Appropriate place for an interview
Socially, the place where an interview takes place affects how the interview will go. This may seem like a simple task, but picking the right place for an interview isn’t as easy as it sounds. A good history helps the client feel comfortable talking about information that may be important to the task at hand (Effective nursing health assessment interview techniques., 2020). (Patterson et al., 2016): Making sure the room is clean, organized, and follows the rules for social distance. It should also be quiet and free of any distractions. A smooth interview process is more likely to happen in this kind of setting.
Use open-ended questions.
When Carolyn Cross was asked these kinds of questions, she had to say more than just nod her head. This made her more likely to talk honestly about her health, which gave me more information. She gave thoughtful answers to the questions I asked, which helped me learn more about the client. Carolyn Cross gave me more full information and made my assessment more accurate, which led to the right care for each patient. For example: “How would you describe your health, including your access to health care and how you go about getting care?”” did let the client give information about where she lived, how close it was to her primary care doctor’s office, how much it cost to see her primary care doctor, what tests she had done in the past, and what her health care plan was.
Adaptive questioning
This is a step-by-step plan for any health assessment interview, and it includes a small group of directed questions that make it easier to move from one question to the next during the interview. It also sets up questions in a way that makes sure the health care provider starts with easy questions and moves on to harder ones or ends the interview with sensitive questions (Effective nursing health assessment interview methods., 2020). The interview started with broad questions and then got more specific as a number of questions followed.
Appropriate non-verbal conversation cues.
People often tell more about themselves than they say (Effective nursing health assessment interview methods., 2020). These nonverbal cues include posture, eye contact, and facial expressions. Being aware of the patient’s nonverbal cues helped me fully understand the patient. When I had the chance, proper therapeutic contact, like putting my hand on the patient’s shoulder, helped me remember more about the client’s past.
Why the questions were asked
Health and health care are a social factor.
How would you describe your health, including your access to health care and how you go about getting care?
Justification: As was said earlier, this question did give a sense of how she looked for health care. This question is meant to find out what might be stopping her from getting the health care she needs.
Carolyn Cross’s answers show that she takes care of her health well because she lives close to her doctor’s office and has no trouble getting there when she needs to or for regular checkups.
Social determinant: economic stability
She was asked to explain her financial stability, where she lived, and what she did for a living.
Justification: figuring out how to pay for healthcare needs is very important for everyone. It’s important to find out if the client has health insurance so that she can get the care she needs.
Carolyn Cross said that, as an employee, she is covered by her employer’s insurance because the law says that everyone must have insurance.
Social determinant: Education
Can you tell me about your schooling and how it has helped you get where you are now?
When a healthcare provider knows a client’s educational past, they can get a better idea of what kind of client they are dealing with. The level of education does give the healthcare level a hint about the path to follow or the simplicity of words to use so that they can communicate with the client well.
Carolyn Cross says that she has a college degree and a grade school diploma.
Response to questions.
As people who provide health care, it’s important to include everyone in the process. Patients need to be involved because they are an important part of the team that manages healthcare. As care is given to people, it is important to include them in their care plans. Including taking their info into account as it is given when making decisions. Rowland et al. (2019) say that one way to get patients involved in their care is to teach them about their health, ask for comments, and encourage them to ask questions. The answers Carolyn gives will help make sure that the plan of care made is patient-centered and fits her needs.
An analysis of the patient’s health and how it affects her quality of life
Carolyn has a pretty positive outlook on life. She takes care of her health by getting regular checkups, and she has a good understanding of the world around her because of her education. She is emotionally satisfied because she can take care of her family without worrying because she is insured, and she looks forward to moving up in her education. This gives her a sense of purpose in her life. Having to give her family the best care possible does make her feel good, which is a sign of positive eudemonics.
Stability of the economy and how it affects health care
Social-economic status: This is often based on how much schooling someone has had, what they do for a living, and how much money they make. When people look at these things more closely, they often change how they act when they need health care. People with less money tend to be sicker and have less access to health care than those with more money. (Arpey, Gaglioti, & Rosenbaum., 2017) People with lower socioeconomic level find it hard to get good health care, live in safe areas, eat well, and make healthier decisions. Carolyn Cross can take care of her family because she is in the middle class and has a steady source of money. This means she can take care of her family and help them make healthy decisions.
Employment status: Carolyn Cross is employed and has health insurance. This, along with her retirement benefits, gives her access to good medical care from a wide range of institutions. She is able to see a health care doctor.
Carolyn Cross has a stable place to live. She lives in a nice neighborhood with easy access to grocery stores, pharmacies, and health care services. There have been no reports of violence or abuse in her neighborhood. A area like this is great for hiking and getting in shape.
Status of Education
In the modern world, getting a good education leads to better jobs, which are linked to getting good health care. Rowland et al. (2019) say that people with more education can get better perks, such as better insurance for themselves and their families. With higher salaries, people can live in better neighborhoods, feed their children better, and get to the doctor right away, like Carolyn Cross, who has a lot of education. She has a master’s degree in special education and knows a lot about the past of breast cancer in her family. This is why she is proactive about her health.
Chances and Health Care Problems
Barriers
Some educated people are so busy with government work that they don’t have time to help their communities. They also don’t have much time to exercise, so they are more likely to get lifestyle diseases.People say she isn’t very social because she spends a lot of time on her family and personal life. She might find it hard to get care that fits her culture because services aren’t always available and insurance coverage isn’t always enough.
Opportunities
A good education gives you information and the chance to make healthy choices about what to eat, how to exercise, what medical tests to get, and what preventive and health-promoting steps to take, among other things (Wittink, & Oosterhaven, 2018). This can help you develop a positive health-seeking behavior.People who are well-informed know that they have a right to good health care and are aware of the different insurance plans that cover their care. Carolyn Cross is a well-educated person who takes care of her health and lives in a safe area. Because of this, she is less likely to experience the stress that often comes from being poor, and she can explore networks well enough to make the most gains for society (Wittink & Oosterhaven, 2018). So, she has a better chance of staying healthy. She is also bilingual, which means she can use a wider range of health care services because she can communicate better with doctors and nurses. This makes it easier for Carolyn to get the right health care services and give the same to her family.
How health affects how good life is
Quality of life is seen as a multidimensional aspect that includes physical, social, mental, and emotional domains. As a result, positive aspects of a person’s life, like expressing positive feelings and being happy with life, take center stage. (Shah et al., 2019) say that to be successful, you need to be in good physical and mental health and have a good sense of well-being. Carolyn thinks her health is the most important thing in the world. Because of her good health-seeking habits, she is in great health. A year ago, she got screened for cervical and breast cancer and had a full medical check. This also shows that she is healthy and thinks her health is very important because she lives in a place where it is easy for her to get to her primary care doctor and pharmacies. This makes sure that all of her health needs are met.
Health is affected by health knowledge.
So, low literacy skills are often linked to bad health outcomes, including not going to the doctor enough. People who can’t read or write don’t know much about how medicine works today and can’t easily get medical help in an emergency. Jayasinghe et al. (2016) found that people with low health literacy often don’t understand simple medical information that is usually available to the public. So, not using the preventive services that are offered tends to make people stay in the hospital longer, which makes them spend more money.
The health of a neighborhood and the surroundings
How healthy someone is depends on where they live. The social environment is made up of things like class, immigration, and culture, and the service environment is made up of healthcare, education, and social services. Rowland et al. (2019) say that a person’s access to health is determined by their economic and work setting, which includes their job, income, and any risks they face on the job, as well as community capacity building, community organizing, and civic engineering. Carolyn Cross’s area is safe and has enough parks for fun. It’s also easy for her to get food from the nearby supermarket, which makes it easier for them to get enough to eat.
The health of low-income and high-income
There are differences in health between places with high and low incomes. Inequalities are common when it comes to social factors, people’s school backgrounds, their jobs, and, to some extent, their race and gender. Populations in different societies are different, so the differences are also different (Plamondon et al., 2020). People who live in low-income areas and those who live in high-income areas have very different access to health care. People who live in low-income areas have a high death rate because they have a lot of chronic illnesses. This is made worse by the fact that they don’t know much about health and don’t have health insurance. They also live in terrible conditions, which makes things even worse. Transportation issues and lack of quick access to primary care doctors and pharmacies make it hard for people in low-income areas to get the health care they need. On the other hand, people who live in high-income areas tend to have better health outcomes because they are well educated, have health insurance, and live in areas with good infrastructure. This means they can get great health care services.Lastly, both low-income and high-income areas have some things in common. For example, in both, it is very important to pay attention to the local delivery systems and healthcare workers must be licensed to work (Rosengren et al., 2016).
Access to health care is different in rural and urban places.
With a lot of different ideas about how to get health care, the rural population is often missing out on a lot of services, but the changes are often small. First of all, the reading levels in healthcare services are pretty similar, since most people may find it hard to fully understand medical information, no matter how much schooling they’ve had. (Chen et al., 2019) says that there are shortages of health care workers in both rural and urban places.
Even though these similarities are clear, there are also differences. People who live in rural areas are more likely to be uninsured, engage in risky behaviors, and be at risk for chronic diseases because it is hard to get access to improved tests for chronic diseases (Chen et al., 2019). Because there aren’t many jobs in rural areas, most people who live there don’t take care of their health and instead use the money to take care of their families. This makes it hard for them to pay for basic health care. Because of this, they are likely not to have insurance, which will increase the cost of health care for these people.
The most important social factors
Social determinants should be taken into account because they affect a person’s entire surroundings and can lead to a wide range of health risks and outcomes. When these factors are looked into quickly, the healthcare worker can make plans for how to care for the client at hand. It lets the healthcare provider get a full picture of the patient’s health (Plamondon et al., 2020). Carolyn Cross thinks that health and health care, social and neighborhood context, and economic stability are the most important social determinants.
Plan of care for a patient
Who needs to be part of the care plan?
Health and healthcare: Carolyn can join a neighborhood gym to help her stay active, and her husband can also help her keep up with her exercise schedule. This will give her and her family even more reason to live a healthy life. In this case, the husband is working with the doctor who is putting together a food and exercise plan for them.
People say that Carolyn isn’t very social because she only cares about her family and her own life. This can change if she joins a local women’s group. This will help her make more positive contributions to the community and keep her mental health in good shape. The women in her community can also push her to get out and do things. As a health care provider, you can suggest some social groups she can join and check up on her later.
Stability in the economy: Since the economy is always changing, it is smart to have her open a savings account to help her plan for the future. She should work with her husband to make sure that they both save enough for retirement early so that they can continue to support their growing family. One way to go is to save money every month. Before making this choice, she needs to make sure that her husband is on board with it.
Putting the nursing plan of care into place
Having her go on different morning and evening runs with the help of the husband, making sure she joins a local women’s group and does activities that promote good health, opening a savings account and planning with the husband how they will save money to make sure the family has a stable financial future.
Barriers: Her work schedule might make it hard for her to work out every day because it might limit the amount of time she has. Her constant involvement with her family might make her less likely to join the women’s group, and her husband’s lack of support stands out as a social determinant that makes it hard to put the plan of care into action.
Evaluation of the plan’s success: At the end of a certain amount of time, preferably at her next visit to the hospital, Carolyn should be able to say that she has kept a healthy weight with a normal BMI, that she is actively involved in the community by joining a women’s group or a church fellowship group, and that she and her husband have opened a bank account and made a plan to save money. When she goes for her next check-up, it will also be a good sign if her husband goes with her.
The effect of the social factors
For Carolyn Cross, the most important social factors that affect her well-being are her health and health care, her social and neighborhood environment, and her economic stability. They are signs of a family that has chosen to live a healthy lifestyle. She has a stable source of income and wants to continue her education. She takes care of her health and lives in a place where she can easily get the services she needs. Because she has a job and insurance, she can pay for healthcare services and has a good family support system.
References
Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status affects patient perceptions of health care: a qualitative study. Journal of Primary Care & Community Health, 8(3), 169-175.
Chen, X., Orom, H., Hay, J. L., Waters, E. A., Schofield, E., Li, Y., & Kiviniemi, M. T. (2019). Differences in rural and urban health information access and use. The Journal of Rural Health, 35(3), 405-417.
Effective nursing health assessment interview techniques. (2020, May 29). Retrieved from https://www.waldenu.edu/online-bachelors-programs/bachelor-of-science-in-nursing/resource/effective-nursing-health-assessment-interview-techniques
Jayasinghe, U. W., Harris, M. F., Parker, S. M., Litt, J., van Driel, M., Mazza, D., … & Taylor, R. (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(1), 68.
Machlin, S. R., & Adams, S. A. (2017). Expenses for office-based physician visits by specialty, 2013.
Patterson, C., Moxham, L., Brighton, R., Taylor, E., Sumskis, S., Perlman, D., … & Hadfield, L. (2016). Nursing students’ reflections on the learning experience of a unique mental health clinical placement. Nurse education today, 46, 94-98.
Plamondon, K. M., Bottorff, J. L., Caxaj, C. S., & Graham, I. D. (2020). The integration of evidence from the Commission on Social Determinants of Health in the field of health equity: a scoping review. Critical Public Health, 30(4), 415-428.
Rosengren, A., Smyth, A., Rangarajan, S., Ramasundarahettige, C., Bangdiwala, S. I., AlHabib, K. F., … & Gupta, R. (2019). Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study. The Lancet Global Health, 7(6), e748-e760.
Rowland, P., Anderson, M., Kumagai, A. K., McMillan, S., Sandhu, V. K., & Langlois, S. (2019). Patient involvement in health professionals’ education: A meta-narrative review. Advances in Health Sciences Education, 24(3), 595-617.
Shah, K. K., Murtagh, F. E., McGeechan, K., Crail, S., Burns, A., Tran, A. D., & Morton, R. L. (2019). Health-related quality of life and well-being in people over 75 years of age with end-stage kidney disease managed with dialysis or comprehensive conservative care: a cross-sectional study in the UK and Australia. BMJ open, 9(5), e027776.
Wittink, H., & Oosterhaven, J. (2018). Patient education and health literacy. Musculoskeletal Science and Practice, 38, 120-127.
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