Social Determinants of Health Among the Female Population

Reflection

Building a comprehensive history is elemental as it sets the foundation for accurate diagnosis and treatment. Additionally, a comprehensive history enables clinicians to understand their patient’s healthcare needs, which enhances patient-centered care (Micieli et al., 2020). Consequently, clinicians must be well-equipped with techniques and skills to facilitate the gathering of appropriate information.

Social Determinants of Health Among the Female Population

A guide to obtaining a comprehensive health history is building a script. The script provides an overview and highlights the crucial areas to be inquired about. Additionally, the script also increases the confidence of the interviewer.

My encounter was with a 17-year-old African American female living with her grandmother in a public housing facility. The subsequent paragraphs discuss my experience during the development and implementation of my script during the health history, what I found difficult and what I would have done differently.

My Experience

Developing and implementing a script for building a comprehensive health history is quite challenging. It is vital to understand that patients are usually diverse and the techniques will vary with each patient and their stage of development. I must say that my encounter with the adolescent was challenging. Firstly, I did not have background knowledge concerning this age group which is usually very sensitive and in the transition period to adulthood (Orben et al., 2020).

However, I managed to employ techniques such as active listening, asking questions, maintaining eye contact, and talking slowly. Initially, the patient was anxious. I had to reassure her and allow her to take a deep breath. After establishing a good rapport and assuring confidentiality, she calmed down and readily shared her health concerns.

Establishing a good rapport promotes sharing of information as it develops trust. Active listening ensured that I captured all the information. Meanwhile, I used open-ended questions to ensure that my client is not limited with her responses as well as targeted questions to gather distinct information. Moreover, I was precise and used the simplest language to ensure that my client comprehended all the questions. Finally, I noted and documented all the vital information before thanking the patient.

What I found difficult

Despite the array of techniques demonstrated above, I must say I encountered a number of difficulties. Firstly, it was challenging to establish trust with my patient initially. She was unwilling to share the information, particularly regarding sensitive matters such as her sexuality and reproductive history. She was also unwilling to address her social circumstances, such as housing, home support, insurance, and relationships.

She felt stigmatized, but after reassurance, she readily expressed her concerns. Additionally, the adolescent was very apprehensive and irritable and was not ready to share information regarding common adolescent problems such as drug use and alcohol. Finally, it was difficult to obtain a corroborative history in the absence of her grandmother.

What I will do differently

Taking a health history is a skill that I will continue to refine throughout my career. Given this case again, I will make the process dynamic to comprise a complex interplay between gathering and synthesizing information. Furthermore, I will try as much as possible to avoid cognitive biases, particularly visceral and confirmation biases.

Visceral bias involves permitting negative or positive feelings toward a patient to influence the completeness of the health history, while confirmation bias involves paying attention to specific aspects of the history (Bhatti, 2018). Additionally, I will observe the patient keenly since body language communicates a lot of information. Finally, I will keep on learning since gathering adequate health history necessitates that the clinician has adequate background knowledge.

References

Bhatti, A. (2018). Cognitive bias in clinical practice – nurturing healthy skepticism among medical students. Advances in Medical Education and Practice9, 235–237. https://doi.org/10.2147/amep.s149558

Micieli, A., Joundi, R., Khosravani, H., Hopyan, J., & Gladstone, D. J. (2020). History taking. In The Code Stroke Handbook (pp. 1–13). Elsevier. https://doi.org/10.1016/b978-0-12-820522-8.00001-6

Orben, A., Tomova, L., & Blakemore, S.-J. (2020). The effects of social deprivation on adolescent development and mental health. The Lancet. Child & Adolescent Health4(8), 634–640. https://doi.org/10.1016/S2352-4642(20)30186-3

Social determinants Community DQ5

Read the five domains of social determinants of health here: https://health.gov/healthypeople/priority-areas/social-determinants-health. What are they, and how do they affect the development of disease? Describe the chain of infection. What are some ways community health nurses can break this chain? Provide specific examples.

DQ1 UMBO – 2, 4