therapeutic relationship development
Adolescent Hispanic/Latino boy living in a middle-class suburb
Building a therapeutic relationship requires effective communication, one of the most crucial components. Finding out if the patient speaks and understands English is vital since, in this case, communication hurdles may arise because the patient is Hispanic. It may be possible to enhance patient outcomes by effectively disseminating complex medical information to various patient populations. The patient’s age is a substantial obstacle to effective communication in this situation; thus, they may have low health literacy. The patient must articulate the agreed-upon plan, and the engagement must be easily understood. Teenagers are typically at the age when risky activities are explored.
Additionally, these patients are more reluctant to speak; maintaining confidentiality is crucial. Consequently, it is necessary to clarify the boundaries of secrecy. For the patient to communicate their requirements privately during the interview, the parent or caregiver should be asked to leave the room (Ball et al., 2019).
How would your communication and interview techniques for building a health history differ with each patient?
To build the trust necessary to help patients to disclose sensitive and personal information, breaking social challenges and working with them to find solutions is very important. The healthcare professional needs to accept people from all cultural backgrounds and avoid stereotyping by realizing that individual variation within groups is frequently more pronounced than the variation between groups (Anderman, Pang, & Newton, 2016). Effective communication establishes a successful provider-patient relationship during the initial consultation with the patient. The patient will comprehend that the physician is accessible, adaptable, and eager to assist with queries while clarifying the care provided. That the goal is to learn what matters to this patient in terms of concerns and expectations, and this is accomplished when the physician demonstrates sincere interest, curiosity, and relationship-building (Ball et al., 2019)
How might you target your questions for building a health history based on the patient’s social determinants of health?
Both parties can better grasp the challenges and issues that should be prioritized for the patient when the healthcare professional builds a relationship with the patient through development and familiarization with the patient’s health history. According to the World Health Organization (WHO 2020), social determinants of health include “a wider variety of elements and institutions that have an impact on the conditions of daily life, as well as the circumstances under which people are born, grow, work, live, and age.”
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Van et al., Stated that by the time adolescents reach adulthood, they are “12 times more likely to have attempted suicide, seven times more likely to be exposed to alcohol, and ten times more likely to have injected street drugs” than their peers who have not experience multiple forms of abuse. Such as domestic violence or growing up in a home where family members are mentally ill, substance abusers, or have been imprisoned (2014). The answers to the risk-related questions would rely on several variables, including how peer pressure, a loosening of parental bonds, a lack of school attendance, and low self-esteem (Ball et al., 2019).
Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
According to Ball et al. (2019), the main problem, a brief statement explaining why the patient has come in for help, can be addressed after the identifiers are out of the way. The practitioner wants to know more about how this worries the patient so much that they are seeking assistance rather than just putting up with it and going about their everyday lives. Finding out how long this issue has been affecting the patient’s life and collecting direct quotes from them are beneficial. The next step is to gather information on the current topic, any prior medical issues, family history, and personal and social history. Understanding the current issue requires a step-by-step analysis of the facts surrounding the primary cause of this patient’s need for assistance. Any previous medical or surgical procedures are included in the past medical history since they help provide a clearer picture of the patient’s overall health. The patient’s family history may contain hints about potential genetic causes for their issues. Carefully consider the patient’s work patterns, family relationships, and interactions with coworkers while asking about their personal and social experiences. Finally, a system review needs to be finished (Ball et al., 2019).
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
HEEADSS is a screening assessment instrument that would be effective for adolescents. Using this evaluation tool can help the healthcare professional discover the following:
“What’s going on at home?
“Are you working? “How is school going?”
“Describe your friends to me.”
“What sort of after-school activities do you engage in?”
“What are your strengths?”
To encourage the patient to provide more information later, start by asking them open-ended inquiries. However, several technologies have been created focusing on health promotion and prevention to enhance healthcare interactions with young people. These include the Event History Calendar and the Guidelines for Adolescent Preventive Services (GAPS), the current standard of care (EHC). The GAPS was created to provide a screening tool for routine examination of adolescent psychosocial difficulties, health risk behaviors, and biological problems.
Andermann A, Pang T, Newton J. (2016). Evidence for health III: producing evidence for improving health and reducing inequities. Health Res Policy Syst 2016;14:18
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. Low LK. (2003). Guidelines for adolescent preventive services (GAPS) Journal of Midwifery & Women’s Health. 2003;48:231–233.
Van Niel C, Pachter LM, Wade R, Jr. (2014). Adverse events in children: predictors of adult physical and mental conditions. J Dev Behav Pediatr 2014;35:549–51
World Health Organization. (2020). What are the social determinants of health? Geneva: www.who.int/social_determinants/sdh_definition/en/