Respond to at least two of your colleagues who selected a different patient than you, using one or more of the following approaches:

Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

Suggest additional health-related risks that might be considered.

Validate an idea with your own experience and additional research

1) Post by Eri Bress 

• Scenario: A 22-year-old LGBTQIA female Hispanic immigrant living in a middle-class suburb.
• When communicating and interviewing a patient to build a health history, it’s important to consider their individual characteristics and social determinants of health, such as age, gender, ethnicity, and environmental setting. Tailoring communication techniques to these factors can improve rapport, create an environment where she feels valued, understood, and empowered to share important information about her health history (Ball et al., 2022).
• Scenario: A 22-year-old LGBTQIA female Hispanic immigrant living in a middle-class suburb. In the interview, I would approach the patient with an open, nonjudgmental attitude, using the techniques mentioned above. I would acknowledge and respect her identity and cultural background, demonstrating a willingness to learn about her experiences and challenges. As the conversation unfolds, I would use the PRAPARE Tool to systematically address different domains of her life, asking questions related to each area to gain a comprehensive understanding of her health risks, strengths, and needs.

Communication and Interview Techniques:

Given the patient’s Hispanic ethnicity and immigrant status, it’s crucial to approach the interview with cultural sensitivity. Use open-ended questions to encourage the patient to share their beliefs and practices related to health. Since the patient identifies as LGBTQIA, creating an inclusive and nonjudgmental environment is essential (Waryold & Kornahrens, 2020). Use gender-neutral language, and allow the patient to express their gender identity and sexual orientation on their terms. Listening actively and empathetically will help establish trust and rapport. Show understanding and validation for the patient’s experiences, struggles, and perspectives. Utilize appropriate nonverbal cues, such as maintaining eye contact and nodding, to convey your attentiveness and interest in the patient’s story.

Targeted Questions for Health History:

Medical History: “Could you please share any significant medical conditions you’ve experienced so far?”

Cultural Health Practices: “Are there any traditional health remedies or practices that you use from your Hispanic background?”

Gender-specific Health: “Are there any specific health concerns related to your gender identity that you would like to discuss?”

Social Support: “Who are the people you rely on for emotional and practical support?”

Environmental Exposure: “Have you noticed any environmental factors in your suburban area that might impact your health?”

Risk Assessment Instrument:

The PRAPARE Tool (Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences) is applicable here. This tool is designed to address social determinants of health and can help identify any potential risks and strengths in the patient’s life (Luzius et al., 2022). The PRAPARE Tool aligns well with the patient’s diverse background and focuses on social determinants that might affect health. It covers areas such as income, education, living situation, social support, and stressors.

References:

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2022). SEIDEL’S GUIDE TO PHYSICAL EXAMINATION : an interprofessional approach. (pp. 12–34). Elsevier – Health Science.

1. Luzius, A., Dobbs, P. D., Hammig, B., Kirkish, R., & Mojica, M. (2022). Using the PRAPARE Tool to Examine Those Tested and Testing Positive for COVID-19 at a Community Health Center. Journal of racial and ethnic health disparities, 9(4), 1528–1535. https://doi.org/10.1007/s40615-021-01091-8Links to an external site.
2. Waryold, J. M., & Kornahrens, A. (2020). Decreasing Barriers to Sexual Health in the Lesbian, Gay, Bisexual, Transgender, and Queer Community. Nursing Clinics of North America, 55(3), 393–402. https://doi.org/10.1016/j.cnur.2020.06.003
3. 2) Post by Gr Chidin Ezenu 
4. Scenario: Adolescent white male without health insurance seeking medical care for STI
5. Examining the patient’s health is a crucial part of providing care.
   Not only does it create and solidify relationships with reliable people, but it also gives the healthcare professional the vital information required to deliver the highest caliber of treatment. A white male adolescent seeking care for  STI, the patient in this case study is described as being in this circumstance.
   Additionally, it has been stated that the adolescent is uninsured.
   Before they feel comfortable talking, adolescents must be certain that the provider is dependable and will maintain the confidentiality of any information revealed during the health examination.  When evaluating an adolescent patient, it is important to keep in mind that adolescents are prone to become resistant to confrontation.

According to Pathak and Chou (2019), keeping anonymity when providing treatment for teenagers “should be considered a human right and an evidence-based component of quality care.” While examining an adolescent patient, it is important to keep in mind that adolescents are known for being unresponsive to conflict. Receiving private and confidential care is a crucial factor in determining whether adolescents and young adults need healthcare services. It affects young people’s willingness to consult with medical professionals and disclose information, particularly when it comes to sensitive subjects like sexual health, mental health, and drug use (Starship.org, 2022).

Healthcare professionals must assess age-appropriate education levels. Additionally, Barch et al. (2018) emphasize the importance of patient comprehension and retention of knowledge. The tool aids practitioners in starting conversations by establishing a health history. The patient’s absence of health insurance may cause scheduling complications. A lack of insurance prevents adolescents from receiving necessary annual examinations and doctor appointments. The healthcare practitioner can begin by providing a pre-visit screening tool, such as a questionnaire, to let patients jot down issues or concerns they may be afraid to share in person. For teens and adults, discussing STI concerns can be uncomfortable. Healthcare professionals must be empathetic and use open-ended questions to address patients’ socioeconomic challenges. By using open-ended questions, practitioners can assess adolescents’ structured responses (Ku?demir, 2020). 

Patient age is a risk factor. Young people often engage in risky activities for many reasons. Ball et al. (2019) cite peer pressure, low self-esteem, and internet, social media, and commercial influences as examples. Age increases danger due to poor decision-making and ignorance.
Young people often participate in dangerous activities such as binge drinking, drug use, poor diet, inactivity, and unprotected sexual activity. 

The HEADSSS system is the risk assessment screening instrument employed. To engage teenagers and address their concerns, consider using the HEEADSSS system review (Smith & McGuinness, 2017).
HEEADSSS risk assessment screening includes Home Environment, Education/Employment, Eating, Activities/Affect/Ambitions/Anger, Drugs, Sexuality, Suicide/Depression, and Injury/Violence Safety. This tool focuses on adolescent difficulties. Young people with chronic health conditions are more likely to participate in risky behaviors and have greater rates of mental health issues compared to healthy individuals. Working with health professionals may address many aspects of young people’s health and welfare, not just physical health issues. Use these encounters for health promotion, prevention, and education (Starship.org, 2022). To assist young people feel more comfortable communicating, this technique begins with less intrusive issues and progresses to more difficult topics.
This test effectively screens teenagers for risks and difficulties. Asking patients such questions is vital while seeking STI therapy, as they may experiment, engage in dangerous activities, or be abused.

HEEADSS Screening Tool Targeted Questions

H – Home life, family, relationships, and stability:
Where do you live? Who lives with you? Is another family nearby?
How is your family’s culture? Is church vital to your family?
What are home relationships like?
Who is your home closest? You can chat to who at home?
E -Education/ Employment – sense of belonging at school/work and relationships with
teachers/peers/workmates; changes in performance; identify possible bullying:
What do you like or dislike about school/work?
What are you good at?
Your plans?
Tell me about schoolmates.
E – Eating and Exercise – how they look after themselves, eating and sleeping patterns:
Breakfast, lunch, and dinner: What do you generally eat?
Stress can cause overeating or undereating. Do you ever catch yourself performing either of these?
A – Activities and Peer Relationships: Social interactions, risk-taking, and self-perception.
What do your family and friends do for fun? Which social media do you use? Have you ever been bullied online? How often do you share personal information on social media?
D – Drug use/Cigarettes and Alcohol
Some of your peers dabble with cigarettes/drugs/alcohol. Do any of your friends have tried these?
Do you use any? Just how much? Is it frequent? Along with whom? How do you accept them?
How does smoking, drinking, or drugging affect you? What do you and your pals do when using drugs or alcohol?
S – Sexuality – Knowledge, understanding, experience, gender identity, sexual orientation and sexual practices:
Your age group may become romantically intrigued. Do you feel attracted to others? Is that guys or girls?
Are any of your relationships sexual?
What is “safe sex”?
How many sexual partners?
What’s your contraception? Is it frequent?
Are condoms used? Have you ever sex unsafely?
S – Suicide/Self-harm/Depression/Mood – Risk factors, coping strategies, and support:
Can you rate your mood from 1-10?
When have you struggled to regulate your temper or anger?
S -Safety – Risk-taking behaviors and environment:
Have you been seriously hurt?
Has a drunk or high driver ever driven you?

Post-HEEADSSS actions

Using HEADSSS assessment answers can assist in identifying a young person’s developmental stage: early, middle, or late adolescence. Additionally, it will identify culturally specific demands. You must learn which adults they trust. Practitioners should emphasize their support role and provide contact information for the clinic or specific specialist.