Health Promotion

POST #2: by Jenifer

The current pandemic has shifted our focus on the critically ill COVID-19 patients. Patients that need routine care or non-urgent care have had their appointments rescheduled for a later date. For the most part, this has been a safe option for most patients. However, there is a vulnerable population that has been seen during this pandemic. Some patients that do not understand their chronic illness or acute illness signs and symptoms of deterioration are waiting too long to seek medical attention. This vulnerable population is coming to the hospital in a critical state. Per Elam and Holcombe (2020), this vulnerable population is scared that they will catch COVID-19 in a hospital, however, this is “leading to more detrimental effects on their health.”

     The characteristics of this vulnerable population includes the homeless, the chronically ill, and the elderly. Diversity, poverty, and socioeconomic factors can also impede this vulnerable population (Pender et al., 2015). This population is vulnerable due to change in available resources to monitor these patients. Before the pandemic, these patients might have been seen at urgent cares, emergency rooms, or frequent follow-up appointments. Now, patients are scared to seek help or are being asked to have larger gaps in between appointments. APRNs, as well as all providers, need to advocate for this vulnerable population. Pullen discusses the paternalism in our healthcare system (De Chesnay and Anderson, 2020). This vulnerable population might have depended on their providers to monitor signs and symptoms of deteriorating health before it was evident to the patient. This leaves the patient uneducated on their own health and health goals.

     As a patient advocate, instead of paternalism, all providers need to educate their patients to increase autonomy in this time of social distancing. It is important to educate patients on the definition of a patient advocate. Also, understanding the patients’ preference on how to be taught regarding their health as well as how to ask a health question will increase the patients’ health promotion (De Chesnay and Anderson, 2020). The providers must decipher the most optimal communication for their vulnerable population.  While collaborating with different healthcare teams, cultural beliefs and values, as well as the level of literacy, need to be included while determining the best approach to this vulnerable population (Pender et al., 2015). 

     Telehealth and Safe Haven shelters are available to this vulnerable population. APRNs need to utilize these services to educate and advocate for these patients. However, the APRN must ensure there are means to receive health education. This vulnerable population needs to have the availability to access telehealth. As a patient advocate, setting up shelters and other locations with cell phone and tablet access as well as ensuring the homebound patients have cell phones or tablets will need to be implemented. 

     Shelters, clinics, and home health services will need to be equipped with appropriate health education materials. NIH’s language access service will ensure patients are linked to translators to provide education in their language (NIH Language Access Services: Translation and Interpretation,” 2017). APRNs must educate and provide the National Institute of Health resources to their patients. The APRN should use the HRSA’s guidelines of health literacy when educating their patients to increase the patients’ understanding. This program trains providers to ensure the patients understand the medical language and assist the patients on health care decisions. Once the provider can understand the patient’s level of health literacy, the provider can adjust their communication as well as provide information in order of priority. Also, repeating the same information as well as including a teach back method should be included for this vulnerable population (“Health Literacy,” 2019).  This will increase their health literacy and increase their health promotion.

     Increasing health promotion for this vulnerable population will need to include increasing resources. Even though social distancing is required during this pandemic, resources are still needed for most patients. As a patient advocate, the APRN must reach out to shelters and ask what they need to increase health promotion as well as increase disease prevention. Adding social work visits to shelters as well as incorporating them into telehealth will decrease the gaps on patient’s health and financial needs. As De Chesnay and Anderson (2020) state, advocacy is a large part of the social work profession. Implementing social work has been proven to increase many aspects of health promotion. In a study by Burg (1994), social workers were seen as the means for homeless people to work towards better health. Many homeless people want their own housing and a job. Social work has the means to make these dreams realistic. It was found in this study, that once homeless people could meet these needs, they were able to view their health as a priority. Social workers also have the skills to recognize where there are gaps in the patient’s health care (Burg, 1994). Having social work involved can be an important link from patients to APRNs. The social worker and APRN can work as a team and can increase the chances of health promotion especially during this unprecedented time.

     Advocating for our community’s vulnerable patient populations include many aspects of their lives. This vulnerable population must have the resources as well as the means, the team, and the appropriate health literacy education to achieve optimal health promotion. Patient participation is one way to understand what is needed in this population. As APRNs, the lens that we use to evaluate and interact with this vulnerable population must be open, accepting and non-judgemental. Also, we must ask different teams, disciplines, and our community how to successfully give our vulnerable populations the best chance at health promotion and disease prevention. 

                                                                        Reference

Burg, M. A. (1994). Health Problems of Sheltered Homeless Women and Their Dependent Children. Health & Social Work, 19(2), 125-131. doi:10.1093/hsw/19.2.125

Chesnay, M. D., & Anderson, B. A. (2020). Caring for the vulnerable: Perspectives in nursing theory, practice, and research. Burlington, MA, MA: Jones & Bartlett Learning.

Elam, S., & Holcombe, M. (2020, April 21). Los Angeles County hospitals say people are waiting too long to seek treatment over coronavirus fears. Retrieved May 11, 2020, from https://www.cnn.com/2020/04/21/health/los-angeles-hospitals-coronavirus-waiting-treatment/index.html

Health Literacy. (2019, August 13). Retrieved May 11, 2020, from https://www.hrsa.gov/about/organization/bureaus/ohe/health-literacy/index.html

“Language Access in Clear Communication.” National Institutes of Health, U.S. Department of Health and Human Services, 1 Dec. 2017, www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/language-access-clear-communication.

Pender, Nola J., et al. Health Promotion in Nursing Practice. 7th ed., Pearson Prentice-Hall, 2015.