Diversity and Health Assessments

Discussion 2: Diversity and Health Assessments

In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

Subjective Data

CC: “I came for my annual physical exam, but do not want to be a burden to my daughter.”

History of Present Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs.

PMH: hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency and chronic prostatitis

PSH: S/P cholecystectomy

Drug Hx:

Current Meds: Lisinopril 10mg daily, Prilosec 20mg daily, B12 injections monthly, and cipro 100mg daily.

Review of Systems (ROS)

General: + weight loss of 25 lbs over the past year; no recent fatigue, fever or chills.

Head, eyes, ears, nose & throat (HEENT): no changes in vision or hearing, no difficulty chewing or swallowing.

Neck: no pain or injury

Respiratory:

CV:

GI:

GU: no urinary hesitancy or change in urine stream

Integument: multiple bruises on his upper arms and back.

MS/Neuro: + falls x 2 within the last 6 months; no syncopal episodes or dizziness

Psych:

Objective Data

PE: B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8

HEENT: Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, ornasopharynx clear, edentulous.

Lungs: CTA AP&L

Cor: S1S2 without rub or gallop

Abd: benign, normoactive bowel sounds x 4

Ext: no cyanosis, clubbing or edema

Integument: multiple bruises in different stages of healing – on his upper arms and back.

Neuro: No obvious deformities, CN grossly intact II-XII