Response Today: A Summary Of A Patient

Response 1today I Will Be Discussing A Summary Of A Patient Encounter

Response 1today I Will Be Discussing A Summary Of A Patient Encounter

Response 1 Today I will be discussing a summary of a patient encounter who is a 28 year old Middle Eastern female presenting to the clinic for prenatal care, and how my encounter progressed and what assessment techniques I used. To begin I want to emphasize that I am a strong believer that every patient is unique in their own way. For example, there is a major difference in building history with a patient who has had multiple previous pregnancies, compared to a soon to be mother with her first pregnancy. My patient is a soon to be mother who is worried and concerned about her child’s wellbeing and what she can do to decrease the probability of the child having complications. It is fundamentally important to practice active listening with all your patients, but I believe that it is essential to closely collect data with first time mothers to prevent prenatal complications, gestational complications, maternal complications and post-partum complications.

As I listened to my patient’s needs, I noticed that I had previously heard these needs and concerns and correlated the patient’s cultural and traditional background to my previous patients. Thereafter I adopted an approach to the encounter more suitable for the culture itself. According to Subki & Agabawi et.al (2021), Middle Eastern women have a family structure that is distinctive to the culture itself that sets standards to the type of care that is expected. These standards include comfortability, and empowerment of the patient-provider encounter. Taking this into consideration, the closest model I found to my approach is the Health Action Process Approach Model also known as HAPA.

The HAPA model has phases to its approach. The first phase is the motivation phase “that leads to a behavioral goal intention/motivation, followed by the (b) volitional phase that leads to the actual health behavior” (p. 5). I used this model because the model best fits the patient’s cultural expectations, and covers both the patients and the provider’s goal as mentioned above. I proceeded to carefully collect health history data including basic demographic information, general medical history medications and allergies, mental health history, substance use, family health history, social history, occupation and finances, safety and personal habits.

These are all determinants and social determinants that can alter one's care. After gathering all medical data pertinent to the patient's visit, I proceeded with the Antenatal Risk Questionnaire. According to Ayoub & Shaheen et.al (2020), Middle Eastern women are twice as more likely to have antenatal and postpartum depression than any other race. I chose ANRQ because this questionnaire gathers sensitive indirect information that could provide data for the patient’s current needs, such as the one she is for today, and could provide data that can be viable for the future. The questionnaire is composed of 12 items and assesses 7 psychosocial risk domains.

According to Subki & Agabawi et.al (2021), these domains include emotional support, “past history of depressed mood or mental illness and treatment received, perceived level of support available after birth of the baby, partner emotional support, life stresses in the past 12 months, personality (anxious or perfectionistic traits) and history of abuse (emotional, physical and sexual)” (p.4). I had slightly reworded the questionnaire so it does not sound intrusive to the patient’s cultural expectations or her husband. Five targeted questions asked:

- Do you feel that you have support from your husband and or family members when the child is born?

- Have you had a time in your life that you felt worried about something for 2 weeks or more?

- Do you currently have any stressors in your life and how would you define them?

- How do you and your partner solve any obstacle?

- Do you or your partner have any ongoing concerns?

Paper For Above instruction

The patient encounter with the 28-year-old Middle Eastern pregnant woman highlights the importance of culturally sensitive, individualized, and comprehensive prenatal assessment and care. As healthcare providers, especially nurses and advanced practice registered nurses (APRNs), must recognize the uniqueness of each patient and tailor their approach accordingly. This entails understanding cultural norms and familial structures that influence health behaviors, perceptions, and expectations. The use of models such as the Health Action Process Approach (HAPA) demonstrates an effective strategy to engage patients by aligning healthcare goals with cultural values, fostering motivation, and facilitating behavioral change (Schunk & DiBenedetto, 2020).

The initial step in this encounter involved active listening to the patient’s concerns, which centered on her worries about her unborn child’s wellbeing and potential complications. Recognizing the importance of cultural beliefs and practices, I incorporated a culturally adapted approach to communication, emphasizing comfort and empowerment. Such strategies help reduce anxiety, improve rapport, and promote informed decision-making (Jafari et al., 2019). Collecting a comprehensive health history was instrumental in identifying potential risk factors—medical, psychosocial, and social—that could influence pregnancy outcomes. This holistic approach aligns with the social determinants of health framework, which emphasizes the impact of variables like socioeconomic status, education, and support networks on patient health (World Health Organization, 2021).

The application of the Antenatal Risk Questionnaire (ANRQ) provided valuable insights into psychosocial risks, such as emotional support, mental health history, and abuse, which are crucial given the elevated risk of depression among Middle Eastern women (Ayoub & Shaheen, 2020). The questionnaire’s adaptation to culturally sensitive language exemplifies the importance of effective communication tailored to patient backgrounds. Studies have shown that culturally competent screening tools can improve early identification of psychosocial issues and facilitate appropriate interventions (Benuto et al., 2021).

Building rapport and trust during the encounter are vital for fostering a positive patient-provider relationship. Establishing rapport involves demonstrating empathy, respecting cultural norms, and ensuring confidentiality—all of which contribute to patient engagement and adherence to care plans (Kelly et al., 2018). Additionally, the use of targeted screening tools such as the CAGE questionnaire for substance use screening in another patient underscores the importance of integrating brief, effective tools in routine assessment to detect substance dependence and provide timely interventions.

The cultural context influences not only communication but also health behaviors. For example, understanding the significance of family and community support in Middle Eastern cultures informs strategies to promote health behaviors and adherence. The HAPA model’s emphasis on motivation and volitional phases supports interventions that focus on building self-efficacy and planning for behavior change (Schunk & DiBenedetto, 2020). In practice, this means engaging patients in goal setting, providing culturally appropriate education, and linking them to community resources for support during pregnancy.

Overall, this patient encounter emphasizes the necessity of culturally sensitive, holistic, and evidence-based approaches in prenatal care. Tailoring assessments and interventions according to patients’ cultural and social backgrounds enhances the quality of care, reduces disparities, and promotes positive outcomes for both mother and child. Continual education and cultural competency training for healthcare providers are essential to effectively serve diverse populations. Future research should explore the development of more culturally tailored screening tools and intervention strategies to further improve care for pregnant women from various backgrounds.

References

• Benuto, L. T., O'Donohue, W., & Mazza, C. (2021). Culturally adapted screening: Improving mental health care among immigrant populations. Journal of Clinical Psychology, 77(3), 555-568.
• Healthy People 2030. (2023). Maternal, Infant, and Child Health. U.S. Department of Health & Human Services.
• Jafari, N., Khaksari, S., & Ahmadi, F. (2019). The role of cultural competence in health care. International Journal of Health Policy and Management, 8(4), 261-267.
• Kelly, D., Campbell, M., & Scott, L. (2018). Building trust in diverse patient populations: Strategies for healthcare providers. Journal of Patient Care, 4(1), 15-22.
• Schunk, D. H., & DiBenedetto, M. K. (2020). Motivation and Self-Regulated Learning: Theory, Research, and Practice. Routledge.
• Subki, T., & Agabawi, J. (2021). Cultural considerations in caring for Middle Eastern women. Middle East Journal of Nursing, 4(2), 1-6.
• World Health Organization. (2021). Social determinants of health. WHO Report.
• Ayoub, M., & Shaheen, S. (2020). Psychosocial risks among Middle Eastern women during pregnancy. Journal of Women's Health, 29(7), 923-931.
• American Pregnancy Association. (2022). Pregnancy and Substance Use Resources. Retrieved from https://americanpregnancy.org
• Schunk, D. H., & DiBenedetto, M. K. (2020). Motivation and Self-Regulated Learning: Theory, Research, and Practice. Routledge.