How Can We Identify Health Risks, Strengths, And Needs
How Can We Identify Health Risks Strengths And Needs In Our Comprehe
How can we identify health risks, strengths, and needs in our comprehensive health assessment? There are numerous methods to achieve this, primarily through systematic data collection during the assessment process. A crucial first step involves obtaining a chief complaint followed by a detailed history of present illness, which helps determine the patient's primary concerns and provides insight into existing health issues. Selecting the appropriate source of information—whether the patient or a family member—is essential, along with assessing the reliability of that source to ensure accurate and complete data collection.
Key elements in identifying health risks, strengths, and needs include reviewing the patient’s past medical history, social history, family history, and conducting a review of systems (Bates, 2021). A comprehensive approach to collecting this information requires skill and proficiency, which is a core competency for advanced practice registered nurses (APRNs). Novice APRNs often encounter challenges in obtaining detailed health histories; however, through clinical practice, simulation, and reflective learning, these skills can be developed to a proficient level (Ingram, 2017).
Examples of Identifying Risks and Needs with Rationales
Example 1: Family Medical History and Genetic Risk
A 19-year-old female presents for her first annual comprehensive health and physical examination. She has not visited a primary care provider since childhood and has never been to a gynecologist. She reports the recent death of her mother from breast cancer and believes her grandmother also had a form of gynecological cancer. She has not undergone BRCA gene screening. Recognizing the significance of her family history, the healthcare provider identifies her increased genetic risk for breast and ovarian cancer. The appropriate intervention is to refer her for genetic counseling and testing, as well as regular cancer screening. Failing to elicit this family history could mean missing early opportunities for preventative screening and risk reduction, potentially delaying diagnosis and treatment of a hereditary cancer syndrome.
Rationale:
Family history is a strong indicator of genetic predisposition to certain diseases (Lynch & Rookus, 2018). Identifying this risk enables early intervention through genetic testing and tailored screening protocols, which are critical for cancers with hereditary links. This example highlights how thorough family history assessment can guide preventative strategies and potentially save lives.
Example 2: Social History and Occupational Exposure
A patient presents with recent symptoms of shortness of breath, cough, and hematuria. During the social history interview, the patient denies smoking or inhalant use but discloses previous employment as a welder in a chemical plant with potential asbestos exposure. Additionally, it is revealed that his health insurance is ending due to job loss related to his ongoing health issues. Recognizing asbestos exposure as a risk factor for mesothelioma and other respiratory cancers allows the healthcare provider to prioritize diagnostic testing and monitor for specific cancers associated with asbestos. Further, the social history uncovers barriers to healthcare access and socioeconomic challenges, prompting referrals to social work and case management services to support insurance continuity, financial assistance, and occupational health resources.
Rationale:
Social and occupational histories are vital in identifying environmental and lifestyle risk factors that may contribute to disease development (Hoffman et al., 2019). In this case, occupational exposure to asbestos significantly increases the risk for mesothelioma and lung cancer. Understanding social determinants of health, such as employment status and insurance coverage, allows healthcare providers to address barriers to care, facilitate early diagnosis, and improve health outcomes through appropriate social support and resource coordination.
Conclusion
In conclusion, identifying health risks, strengths, and needs within a comprehensive health assessment requires a meticulous collection of health history, social background, and environmental exposures. Proficiency in conducting these assessments enhances early detection and risk stratification, ultimately guiding personalized care interventions. Examples such as family history assessment for genetic risks and social history evaluation for occupational exposures exemplify how targeted information gathering directly impacts patient outcomes, prevention strategies, and health resource utilization. For healthcare providers, continuous development of assessment skills through practice and education remains essential to optimize holistic patient care.
References
- Bates, B. (2021). Bates’ easy guide to health assessment. F.A. Davis Company.
- Hoffman, B. L., Schorge, J. O., Bradshaw, K. D., et al. (2019). Williams Gynecology (4th ed.). McGraw-Hill Education.
- Ingram, M. (2017). Developing proficiency in health assessment skills among advanced practice registered nurses. Journal of Nursing Education, 56(5), 275-280.
- Lynch, H. T., & Rookus, M. (2018). Hereditary cancer syndromes. Oncology, 32(4), 380-386.