critique

1. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions.

2. Explain whether any of the questions would apply to your patient, and why.

Diversity among patient populations for providers is a common occurrence, no matter the location of the practice. Advanced practitioners must possess a keen skillset of cultural competence (Ball et al., 2019).  According to the Centers for Disease Control and Prevention (2015), cultural competence can be referred to as a particular set of behaviors, attitudes, and policies that work together to enable effective work in cross-cultural situations. The provider caring for the patient in the case study needs to take a moment to reflect on self-awareness to ensure cultural competence in treating the individual.

The patient in the case study is a 54-year-old Caucasian male with a past medical history of alcohol abuse, substance abuse, and hypertension. The patient is currently homeless. The patient reports smoking cigarettes as a means to “calm down” and abstain from alcohol. While smoking is overwhelmingly advised against within the healthcare community, the alternative of alcohol and cocaine use is of more concern. Treating the patient for alcohol and drug abuse is a more pressing matter compared to smoking (Aryanpur et al., 2015).

 When discussing specific socioeconomic, lifestyle, and other cultural factors, it is essential to maintain a nonjudgmental and biased viewpoint while caring for the individuals (Ball et al., 2019). The patient has a significant history of alcohol abuse. Mental health disorders and alcohol abuse remain at a higher prevalence among Americans of lower socioeconomic status (Glei & Weinstein, 2019). Understanding the association between individuals belonging to a lower socioeconomic status and alcohol and substance abuse can provide the practitioner with an awareness of issues and other comorbidities to be alert for when assessing an individual.

With the patient being homeless, sensitivity is necessary when interacting with the patient and discussing self-care and lifestyle factors. It is important to maintain trust and rapport with the individual and not offend them (Ball et al., 2019). The patient is currently living at a homeless shelter, which can present challenges when abstaining from alcohol and drug use. Housing instability is associated with engaging in risky behaviors, such as drug use (Santa Maria et al., 2018). As a practitioner, it is critical to openly discuss the challenges that the patient may be facing to discuss preventative measures to alleviate the chance of relapse.

Five targeted questions to ask the individual when building the health history include:

1. Can you tell me about your support system?

2. Over the past month, have you often been bothered by feeling sad, depressed, or hopeless?

3. During the past month, have you often been bothered by little interest or pleasure in doing things?

4. Do you have any symptoms that you are concerned about?

5. When was your last drink?

References

Aryanpur, M., Sharifi, H., Hessami, Z., Heydari, G. R., Aryan, M. R., Vaseghnia, A., & Jamaati, H. R. (2015). Overlapping causes of starting smoking and substance abuse. European Respiratory Journal, 46. https://doi- /10.1183/13993003.congress-2015.PA1189

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel's guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby