Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned
CASE STUDY
John Green, 33 year-old Caucasian male, presents to the office to establish as a new patient. John’s natal sex is female but he identifies as a male. He transitioned from female to male 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has been obtaining testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smokes 3-6 marijuana joints every weekend (has an active green card), and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks which prompted him to move back home with his parents. He takes Biktarvy once daily that comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and unemployed he will be a burden on his family, and he thinks his health may be declining.
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
DISCUSSION BOARD 1
Understanding cultural diversity is necessary in healthcare to bridge communication gaps and promote a trustworthy environment for patients. For this week’s discussion, I was assigned a 33-year-old named John, whose natal sex is female but identifies as male. The patient transitioned years ago and moved home due to socioeconomic and mental health problems. The patient also smokes two packs of cigarettes a day, marijuana joints on weekends, and is HIV positive. Navigating the complexities of John’s life requires a delicate approach that respects his experiences and current identity. His unemployment status shows John’s socioeconomic factors and concerns about burdening his family. The financial challenges of being unemployed can affect John’s ability to seek healthcare, adding high stress levels to his current situation. Spiritually, John’s transgender journey potentially clashes with social norms and beliefs, which can negatively affect his mental and emotional well-being. John may face microaggressions and harassment his social interactions. To improve his experience, healthcare providers must prioritize gender-affirming care, backed by deep understanding and commitment to sensitive and inclusive practices (Bhatt et al., 2022). In terms of lifestyle, the fact that he engages in regular marijuana use and smoking emphasizes the importance of addressing health risks associated with substance use. It is widely acknowledged that heightened stress and uncertainty often correlate with an uptake in the consumption of substance use (Kalin, 2020). Approaching John’s substance use with a tailored and culturally sensitive intervention strategy, such as support groups or counseling sessions, is crucial for fostering effective and sustainable progress in addressing his unique challenges. Additionally, John’s HIV status requires a compassionate and inclusive approach to addressing any concerns he may have. A non-judgmental stance on John’s medical and emotional aspects can promote openness and guide holistic care. The five questions I would use to build a health history on John are as follows:
1. How has transitioning impacted your overall mental health and well-being?
2. In what ways do you cope with stress?
3. Are there specific health goals or concerns you have that you would like to address during our interview?
4. What sources of support do you draw strength from, and are there trusted friends or family members you feel comfortable talking to when needed?
5. Can you share more about your experiences with marijuana and cigarette use and how you feel these habits may be influencing your overall well-being?
By valuing diversity, conducting self-assessment, and continually evolving to meet cultural contexts, healthcare providers can contribute to better outcomes and enhance individuals’ overall quality of care (Centers for Disease Control and Prevention, 2020). Genuinely acknowledging John’s identity and experiences can lay the foundation for a relationship built on trust and respect with him.
References
Bhatt, N., Cannella, J., & Gentile, J. P. (2022). Gender-affirming Care for Transgender Patients. Innovations in Clinical Neuroscience, 19(4-6), 23–32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341318/
Centers for Disease Control and Prevention. (2020, October 21). Cultural competence in health and human servicesLinks to an external site.Links to an external site.. Retrieved from https://npin.cdc.gov/pages/cultural-competenceLinks to an external site.
Kalin, N. H. (2020). Substance Use Disorders and Addiction: Mechanisms, Trends, and Treatment Implications. American Journal of Psychiatry, 177(11), 1015–1018. https://doi.org/10.1176/appi.ajp.2020.20091382
DISCUSSION BOARD 2
Socioeconomic, Spiritual, Lifestyle, and Cultural Factors
The case study I was presented with is a 33-year-old Caucasian individual born female but identifying as male. Some issues that my patient may experience are that transgender people’s capacity to maintain financial stability can be impacted by employment options and workplace inclusion (Carpenter et al., 2020).Career choices and possibilities may be influenced by factors such as educational accessibility and institutional approval. The patient’s acceptance of their gender identity and spiritual path may be guided by personal beliefs. For transgender people to be happy and well overall, they need to have access to mental health and healthcare treatments that are gender affirming. Cultural perspectives on gender identification can range greatly throughout cultures and geographical areas (Carpenter et al., 2020).The way transgender people are portrayed in the media and in popular culture can have an impact on how society views and accepts them. Depending on the nation and area, transgender people may have different legal rights and protections. An individual’s experiences in a variety of spheres of life can be influenced by the existence or nonexistence of anti-discrimination regulations (Carpenter et al., 2020). Discrimination and stigmatization experiences can have an impact on mental health. For people to be well, supportive settings and mental health treatments are essential (Carpenter et al., 2020).The process by which a person comes to embrace and identify who they are is a crucial component of their overall mental health. An individual’s well-being can be significantly impacted by having friends and family as part of a supportive social network (Carpenter et al., 2020). The given scenario also states that the patient has HIV. This adds yet another level of concern. Stigmatization and discrimination can be exacerbated by cultural beliefs on HIV and gender identity. It’s critical to promote cultural sensitivity and education. Adverse experiences pertaining to gender identity and HIV status may be causative factors in mental health disorders. Support for mental health is essential.
Sensitivity Needs
It’s important to treat transgender HIV-positive patients with respect, understanding, and sensitivity when engaging with them. It’s crucial to respect the patient’s gender identity and preferred pronouns in order to assure sensitivity (Vermeir et al., 2018). It is appropriate to inquire about the patient’s preferred pronouns if you are unsure. If the patient’s name is different from their legal name, use the name they feel most comfortable with. It is a crucial component of their gender identity affirmation (Vermeir et al., 2018). Recognize and honor the differences among transgender people. Individuals may differ in their needs, experiences, and cultural backgrounds. Learn about the particular health inequalities and difficulties that my patient is facing (Vermeir et al., 2018). In order to treat transgender patients with knowledge and dignity, I should be trained in transgender health issues. It’s critical to understand the possible effects of discrimination and stigma on mental health and to put my patient in touch with mental health resources. I must comprehend the patient’s particular requirements and preferences and involve them in their healthcare decisions and treatment plans (Vermeir et al., 2018).
Five Questions to Facilitate Obtaining a Health History
There are several questions I could ask my patient based off of what I do know about the patients health history. It is crucial to close the knowledge gap between practicing clinicians and nurse practitioner faculty by offering evidence-based guidance on how to care for this population (sciencedirect.com, 2019). 1. Could you elaborate on any care that you have received, or are receiving, that is gender affirming? This covers surgeries, hormone therapy, and other gender identity-related treatments. 2. How would you characterize the state of your mind and emotions? Have you ever struggled with mental health issues like depression or anxiety because of your gender identity or other factors? 3. Do you engage in sexual activity? If so, what precautions do you take now? Furthermore, have you had any recent sexual health examinations or counseling tailored to your unique requirements as a transgender person? 4. Could you tell me about your general health habits, such as your diet and exercise routine, as well as any particular health issues you may be facing? Comprehending your lifestyle as a whole can assist in customizing healthcare advice. 5. How would you characterize your experience getting healthcare, taking into account any difficulties you might have had? Have you had routine examinations and screenings? Are there any particular health issues you’d like to talk about or concentrate on more?
Summary
In conclusion, since every person is different, it’s critical to treat every patient with compassion and candor. Continual education and cultural humility are essential to offering patients inclusive, compassionate care.
References
A toolkit on patient centered transgender care for nurse practitioner faculty and Clinicians. (2019). The Journal for Nurse Practitioners, 15(7), 502–505. https://doi.org/10.1016/j.nurpra.2019.03.021Links to an external site.
Carpenter, C. S., Eppink, S. T., & Gonzales, G. (2020). Transgender status, gender identity, and socioeconomic outcomes in the United States. ILR Review, 73(3), 573–599. https://doi.org/10.1177/0019793920902776Links to an external site.
Mikulak, M., Ryan, S., Ma, R., Martin, S., Stewart, J., Davidson, S., & Stepney, M. (2021). Health professionals’ identified barriers to Trans Health Care: A qualitative interview study. British Journal of General Practice, 71(713). https://doi.org/10.3399/bjgp.2021.0179Links to an external site.
Vermeir, E., Jackson, L., & Marshall, E. (2018). Improving healthcare providers’ interactions with trans patients: Recommendations to promote cultural competence. Healthcare Policy | Politiques de Santé, 14(1), 11–18. https://doi.org/10.12927/hcpol.2018.25552Links to an external site.
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