The scenario is that of an 86-year-old Asian male patience that depend on his daughter for financial assistance, and in taking care of him . However, his daughter is a widow without enough resources or the ability to fully take care of her father. She is poor herself. Improving the quality of life for the old Asian male by identifying his most important health needs and recommendation through thorough health assessment is key. Older adults being more vulnerable to diseases due to low immunity, should be considered for a safe socioeconomic, cultural, spiritual and lifestyle that may prolong their life.
The first step is for the Nurse Practitioner to develop a respectful and trusting relationship with the patient, in other to obtain a detailed and accurate health history, making sure to use available translator if the patient does not speak English. The future PMHNP should engage in effective communication, such as patience and active listening because the Patient may need more time to process information before answering questions. Also, the NP should not use judgmental or non-patronizing language, in other to develop a connection with the patient (Ball, 2015).
Specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient
Socioeconomic factors: The 86 year old man is financially unable to provide for himself, and is dependent on his daughter, who is a widow and is financially unable to provide for her father, therefor, the patient is socio-economically poor, and may lack a good living standard in relation of having balanced diet, meeting medical expenses and other maintenance that may improve his quality life. The NP has to consider these socio-economic factors while assessing the Patient.
Lifestyle Factor: due to low income status, and lack of financial support from his daughter, the 86 year old Asian man most like lives a low and poor quality of life, which may have contributed to his detoriating health status, lack of of constant medial care, good nutrition and clean healthy environment. The treatment and recommendation from the NP should factor the patient’s lifestyle during treatments.
Cultural factors: Culturally, Asians are known to be very reserved and secretive when it comes to personal health. Such strong cultural factor may influence the patient’s decision is not open about his needs to his daughter and subsequently, to a healthcare professional, The NP must figure out a way to gain his trust. Also, culturally, Asians are mostly group-oriented people that place importance on family connection as the primary source of identity (Carteret, 2010). Asian children are also known to take care of their elderly parents, but in this scenario, the patient’s daughter is equally poor and has difficulty fulfilling her role of a provider and may create emotional burden both for both parties. Religious and cultural practices such as Buddhism for Asians should also be incorporated in managing health.
The Nurse Practitioner may need to make referral to community resources to additional financial and physical needs for the patient and his daughter. The NP should maintain cultural sensitivity while assessing the patient.
Applying cultural competency and diversity are two important factors to consider in treating patients. As an NP, we should have knowledge of different cultural backgrounds, and apply it to the unique needs of the patients while delivering high-quality care. Being culturally competent helps in developing a trusting relationship between the patient and health care provider. This includes being reflective and aware of your own feelings, biases, experiences, and lack of knowledge (Ball, 2015). Cultural competence in nursing involves being curios of, and respect for a patient’s beliefs and values (Ball, 2015).
Targeted questions:
- Can you tell me about your current medical history and concern?
- What is your source(s) of income?
- Have you inquired with the county offices regarding additional financial and medical resources?
- What specific things make you feel like you are being a burden?
- Do you need assistance with activities of daily living such as eating, bathing, toileting, or getting dressed?
References:
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Carteret, M. (2010). Cultural Values of Asian Patients and Families. Divi. Retrieved from
Centers for Disease Control and Prevention. (2015). Cultural competence. Retrieved from
https://npin.cdc.gov/pages/cultural-competence
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
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