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Summary of Interview In building a health history for a 40-year-old recent immig

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Summary of Interview
In building a health history for a 40-year-old recent immigrant from Africa without health insurance, many factors need to be considered. The clinician must assess barriers to learning, environment, cultural variances, socioeconomic status, as well as a medical and mental health history. With a recent migration to the states, the current health status, living arrangements, native language, and mobility should be considered. Ingram (2017) points out, a health history is not only an importance source of information, but the beginning of a therapeutic relationship between the patient and clinician. The patient may require a translator to establish an accurate exchange of information due to language barrier. Throughout the interview, the patient’s questions and concerns will be addressed, detailing the health resources available in his unique situation.
Communication Techniques
The APRN would need to use effective communication to establish a good rapport with the patient. Therapeutic communication is a profound skill used to facilitate conversations between patients and the clinician. Amoah et al. (2019) states, therapeutic communication consists of a face to face contact with the patient that emphasizes the physical and emotional well-being of the patient. A multitude of communication techniques have been identified in encouraging a healthy interaction. The need for a language interpreter would be assessed and provided if necessary. A single question would be asked, allowing the patient to provided a clear answer without an overload of information coming from the APRN. Therapeutic communication promotes the usage of asking open ended questions that encourages the patient to express concerns and clarify information. The APRN should incorporate layman’s terms to educate and explain things to the patient that may also be relayed through an interpreter. According to Koo et al. (2016), nurse practitioners reported the frequent use of simple language, the teach back method, and the use of interpreter to effectively communication with patients. Another skill that could lead to favorable patient outcomes is active listening. Jahromi et al. (2016) explains that active listening is highest level of listening and focuses on the content, intent, and feeling of the speaker. The APRN should provide a patient-centered interview that supports the comfortability and security of the patient.
Risk Assessment Instrument
The Patient Health Questionnaire-2 (PHQ-2) is a risk assessment tool used as a precursor screening for depression. This tool could be useful in assessing the patient’s current mental stability while recently migrating from Africa with minimal resources. As an APRN trying to establish a rapport, it is essential to identify patient needs that can lead to proper diagnosis and treatment. Miramontes et al. (2015) points out that recent immigrants are typically healthier than the general public when they first arrive, however; their health may decline once they are settled in to the new environment. With unfamiliar social conditions, the prevalence of infectious disease, and limited access to health care resources, the patient could be at risk for depression as a result of a general health deterioration. Another risk assessment tool that could be useful is the CAGE questionnaire for detecting alcoholism. It is important for the clinician to collect baseline data about the patient’s exposure to substances, in order to provide the necessary resources and education. In this particular scenario, the patients recent move could be traumatic, stressful, or out of necessity which can contribute to risk factors for a decrease in overall health.
Targeted Questions
The targeted questions will navigate the comprehensive health assessment and encourage the patients express concerns and allow the APRN to gain information needed for a therapeutic treatment plan. Some of the targeted would include:
During the past month, have you had feelings of sadness, hopelessness, or helplessness?
Do you have family or neighbors that are willing to support you in your transition to this new environment?
Was there a particular health concern that prompted you to seek care?
When was your last health examination?
Tell me about your living arrangements?
Amoah, V.M.K., Anokye, R., Boakye, D.S., Acheampong, E., Budu-Ainooson, A., Okyere, E…& Afriyie, J.O. (2019) A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients. BMC Nursing.
Ingram S. (2017) Taking a comprehensive health history: learning through practice and reflection. The British Journal of Nursing;26(18):1033-1037. doi: 10.12968/bjon.2017.26.18.1033. PMID: 29034702.
Jahromi, V. K., Tabatabaee, S. S., Abdar, Z. E., & Rajabi, M. (2016). Active listening: The key of successful communication in hospital managers. Electronic physician, 8(3), 2123–2128.
Koo L.W., Horowitz, A.M., Radice, S.D., Wang, M.Q., Kleinman, D.V. (2016) Nurse practitioners’ use of communication techniques: Results of a Maryland oral health literacy survey. PLOS ONE 11(1): e0146545.
Miramontes, L., Pottie, K., Jandu, M. B., Welch, V., Miller, K., James, M., & Roberts, J. H. (2015). Including migrant populations in health impact assessments. Bulletin of the World Health Organization, 93(12), 888–889.

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