Cultural Competence In The Health History And Physical Examination

The process and content

Cultural awareness embraces learning about the cultures of clients whom the health-care professional will be working; moreover, this includes familiarizing with patients' preferred language, cultural and religious practices, and beliefs. For this reason, the health history and physical examination process should be approached in a professional manner; moreover, health-care professionals should “be alert to cues regarding eye contact, personal space, time concepts, and understanding of the recommended plan of care” (Silvestri, 2017, p. 34). When health-care professionals are culturally competent, they can successfully perform valuable health histories; thus, increasing patient satisfaction. Moreover, culturally competent health histories can be accomplished by taking into consideration the following data categories: '(1) biographical data, (2) chief complaint, (3) current health status, (4) past health history, (5) family history, (6) personal and social history, (7) medication history, (8) allergy history, (9) review of systems, (10) developmental considerations, and (11) psychosocial profile' (Nurse Key, 2017).

In biographical data, the professional nurse is obtaining information such as the patient’s “age, gender, occupation, marital status, and source of referral” (Nurse Key, 2017). After this step, chief complaint is expressed by the patient with his or her own words; moreover, chief complaint includes “one or more symptoms or concerns causing the patient to seek care” (Nurse Key, 2017). Subsequently, current health status “includes patient’s thoughts and feelings about the developing symptoms” (Nurse Key, 2017). According to Nurse Key (2017), family history “outlines age and heath, or age and cause of death, of siblings, parents, and grandparents.” Personal and social history usually includes patient’s “educational level, family of origin, children, and lifestyle” (Nurse Key, 2017).

Then, the professional nurse can proceed by asking medication and allergy history, which include prescriptions and over-the-counter medications, and allergies to certain medications and foods. Afterwards, review of systems can be obtained by the professional nurse; moreover, this step will document “presence or absence of common symptoms related to each major body system” (Nurse Key, 2017).

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Biocultural variations in common laboratory tests

Biocultural variations in common laboratory tests include (1) body mass index (BMI), (2) complete blood count, (3) lipid panel, (4) hemoglobin A1C, (5) serum transferrin, and (6) prothrombin time. There are many individual and subcultures such as African Americans, Asian Americans, and Hispanic and Latino Americans whom vary in these laboratory tests. For example, African Americans’ health risks include “(1) sickle cell anemia, (2) hypertension, (3) heart disease, (4) diabetes mellitus, and (5) obesity” (Silvestri, 2017, p. 32). These risks will reflect different laboratory results in CBC and serum transferrin; for example, “an individual with normal hemoglobin usually have a hemoglobin level around 12 g/dL, and an individual with sickle cell disease have lower hemoglobin levels, usually between 6–11 g/dL” (St. Jude Children’s Research Hospital, 2017). One of Asian Americans’ health risks is Thalassemia, and one of Hispanic and Latino Americans’ health risks is diabetes mellitus.

Biocultural variations in health and illness

Cultural values and preferences profoundly affect members of society’s perception about health and illness. For this reason, it is imperative for health-care professionals to 'assess each individual for cultural preferences because there are many individual and subculture variations” (Silvestri, 2017, p. 32). Some subculture variations include African Americans, Amish, Asian Americans, and Hispanic and Latino Americans, which all differ in health and illness. According to Silvestri (2017), citizens or residents of African American descent’s “religious beliefs and church affiliation are sources of strength” (p. 32). Moreover, “religious beliefs profoundly affect ideas about health and illness” (Silvestri, 2017, p. 32). For example, African Americans’ view on good health equates to prosperity and fortune, and their view on illness equates to negative, tribulation, and deprivation. This subculture is prone to hypertension, heart disease, and obesity because of its food preferences. Furthermore, “food preferences include such items as fried foods, chicken, pork, greens such as collard greens, and rice” (Silvestri, 2017, p. 32). When it comes to seeking health care, “members may be late for an appointment because relationships and events that are occurring may be deemed more important than being on time” (Silvestri, 2017, p. 32).

When it comes to health and illness, “most Amish need to have church (bishop and community) permission to be hospitalized because the community will come together to help pay the costs” (Silvestri, 2017, p. 34). According to Silvestri (2017), Amish usually “do not have health insurance because it is a “worldly product” and may show a lack of faith in God” (p. 34). Also, “some of the barriers to modern health care include distance, lack of transportation, cost, and language (most do not understand scientific jargon)” (Silvestri, 2017, p. 34). According to Silvestri (2017), health risks for Amish are “genetic disorders, nonimmunization, and sexual abuse of women” (p. 34).The Asian American subculture’s view on health is “a gift from the ancestors” (Silvestri, 2017, p. 34). Moreover, “illness may be viewed as an imbalance between ying and yang” (Silvestri, 2017, p. 34). Asian Americans are prone to health risks such as cancer, lactose intolerance, and Thalassemia.

Hispanic and Latino Americans’ view on health is “a reward from God or a result of good luck” (Silvestri, 2017, p. 35). According to Silvestri (2017), “some members believe that health results from a state of physical and emotional balance; however, illness is viewed as a result of God’s punishment for sins” (p. 35). Hispanic and Latino Americans’ health risks include “(1) hypertension, (2) obesity, (3) diabetes mellitus, and (4) parasites” (Silvestri, 2017, p. 35).

References

1. Nurse Key. (2017, March 16). Overview: Physical Examination and History Taking. Retrieved September 18, 2019, from https://nursekey.com/1-overview-physical-examination-and-history-taking/
2. Silvestri, L. A. (2017). Cultural Awareness and Health Practices. In Saunders Comprehensive Review for the NCLEX-RN Examination (7th ed., pp. 32–37). St. Louis, Missouri: Elsevier, Inc.
3. St. Jude Children’s Research Hospital. (2017). Blood Counts and Sickle Cell Disease. Retrieved September 18, 2019, from https://www.stjude.org/treatment/patient-resources/caregiver-resources/patient-family-education-sheets/hematology/blood-counts-and-sickle-cell-disease.html