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CASE STUDY 1

As a healthcare clinician, we must be able to adapt and adjust to various cultures that we encounter. African Americans are living with or dying of many conditions typically found in white Americans at older ages (Hossain, 2013). Chronic diseases and some of their risk factors may be silent or not diagnosed during these early years. Older adults, adolescents, people with low income and educational levels, and racial and ethnic minorities are disproportionately affected regarding their health care status (Berkman, 2011).

Firstly, blacks have lower incomes and may lack the resources to move into suburbia’s larger, newer homes leaving them residing in the urban community. Many of our African American males are still living with their parents (if alive) or a family member due to unforeseen circumstances or criminal background. Majority of our black mothers tend to think their sons are still babies and want to protect them with any means necessary. In the case of the 76 year old man in the urban community, most likely he is being cared for by a family member. Black males tend to despise seeking medical treatments unless it is life/death. Many of our men later are diagnosed with chronic conditions that could have been prevented if medical attention was giving.

Trying to communicate with men, any men regarding their health is like communicating with a child, they will not comply. In order to complete a physical examination, I will have to demonstrate on a stuff animal to show him what I will be performing. Since he has a disability, I will present as if he was a child to ensure we have established some trust. When utilizing the S.O.A.P method; Objective- performing a yearly physical, obtain vital signs with lab work such as CBC, BMP, urine culture, HBA1C, lipid panel, CMP, etc. Subjectively, I will have patient/family identify any problem/concerns regarding his health. Assessment- perform a head to toe assessment, no abnormal findings despite his cognitive status. Planning- schedule a follow-up appointment if applicable.

Moreover, ensuring the health of adolescents is an important social priority that requires the engagement of parents, healthcare providers, schools, and young people themselves. Every state allow minors to consent for their own healthcare in various circumstances—based either on their status or the services they are seeking, to encourage them to seek care (U.S Dept. 2010).

With adolescents, it is important to be straight forward. The Hispanic population has a tendency to be very close and are the largest minority group in the USA. Clinicians have the opportunity to assist young people to communicate with parents regarding their health status. This population is very family-oriented, they will all communicate with each other to ensure their safety and wellbeing. In order to complete my assessment, I would first ask the youth whether or not he wants his parent(s) in the room while assessing. Adolescents are able to make decisions based on their health status and it is their decision to inform their parent. I would perform a complete blood workout involving a CBC, BMP, HGBA1C, CMP, and a urine and blood collection for STI’s. Address any concerns the adolescent may be experiencing and schedule the appropriate examination.

When using the S.O.A.P method, subjective- allow the youth to address any concerns as they complete their physical exam. Objective- fully exam the youth and obtain vital signs, while A- assessing him from head to toe. Plan/schedule any additional procedures that needs to be addressed. Confidential consultation with a healthcare provider can play an essential role. Adolescence is a critical transitional period that includes the biological changes of puberty, developmental tasks and learning to be independent.

References:

Berkman, N. D., Sheridan, S. L., Donahue, K. E., Halpern, D. J. & Crotty, K. (2011). Low health literacy and health outcomes: An updated systematic review. Annals of Internal Medicine, 155(2), 97–107 doi:10.7326/0003-4819-155-2-201107190-00005 [CrossRef] PMID:21768583

Committee on Adolescence American Academy of Pediatrics. Achieving quality health services for adolescents. Pediatrics. 2008; 121: 1263-1270

Hossain, W. A., Ehtesham, M. W., Salzman, G. A., Jenson, R. & Calkins, C. F. (2013). Healthcare access and disparities in chronic medical conditions in urban populations. Southern Medical Journal, 106(4), 246–254 doi:10.1097/SMJ.0b013e31828aef37 [CrossRef] PMID:23558412

U.S. Department of Health and Human Services. (2010). National action plan to improve health literacy. https://health.gov/communication/HLActionPlan/pdf/…