22 hours ago Lysa Del Grosso
Main post Wk 1
Building a Comprehensive Health History
When beginning new services or an initial assessment, the provider should begin with building trust by listening carefully to what the patient’s needs and or concerns are, regardless of ethnicity, culture, age, gender, criminal, or mental health background (Ball et al, 2019). The provider needs to be self-aware of conflicting interest when caring for a person. If the provider cannot commit to this patient wholeheartedly, then the provider needs to see if another provider would be able to care for the patient prior to meeting with them. Careful using indirect and closed ending interviewing may cause the process to be difficult when receiving appropriate information. Open-ended and direct questioning highly recommended such as “What brings you in today or Have you been feeling suicidal or wanting to kill yourself?” Although these may seem too direct, when interviewing patients in any field, especially mental health, it is extremely appropriate to ask such direct questions to better help them. The following interview is based on a 55-yr. old Asian female currently living in a high-density public housing complex. The interview process is to determine the reason for the visit, as well as, retrieving background health history to modulate any health risks. The health risk assessment determines what the patient could be at risk for and help in reducing the risk with early interventions (Wu & Orlando, 2015).
The patient is of Asian descent born and raised in the United States, due to her cultural background Asian Americans are more prevalent in Cardiovascular Disease (CVD) and Mental health diagnosis. The National Latino Asian American Study (NLAAS) determined the different aspects of the Asian culture from migrated population and American born to show the difference and similarities in lineage from the culture. The determination of factors for CVD were mostly due to being Americanized and living the American culture and linked to Asian American who experience poor mental health are not addressing their risk for CVD (Appel et al, 2011).
To determine mental health status for the patient’s age and socioeconomic background the provider would be inclined to begin measurements using the DSM-5, depression scales and or Mini-Mental Status Exams (MMSE) to test for early-onset dementia if the patient was presenting with any memory issues (Appel et al, 2011). Among these assessments, the provider would also include questions regarding annual mammograms and pap smears for the prevention of breast and cervical cancers. If the provider is the gynecologist, the evaluation would already have included these assessment tools. BRCA screenings can also be used to determine the genetics/family history of breast cancer (Sullivan, 2019). Evaluation targeted questions to determine health risk would look like the following:
How often do you seek medical attention?
Do you or a family member have a history of cardiovascular disease?
Is there any history of mental health (anxiety, depression, bipolar, schizophrenia, suicidal or homicide ideations or attempts) or with a family member?
Do you feel your living environment is safe?
Any history of Tobacco, caffeine, alcohol, or illicit drug use?
Appel, H. B., Huang, B., Ai, A. L., & Lin, C. J. (2011). Physical, behavioral, and mental health issues in Asian American women: results from the National Latino Asian American Study. Journal of women’s health (2002), 20(11), 1703–1711. https://doi.org/10.1089/jwh.2010.2726
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). The History and Interviewing Process. Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.
Sullivan, D. D. (2019). The Comprehensive History and Physical Exam. Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis
Wu, R. R., & Orlando, L. A. (2015). Implementation of health risk assessments with family health history: Barriers and benefits. Postgraduate Medical Journal, 91(1079), 508. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1136/postgradmedj-2014-133195
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