Adolescent Hispanic/Latino boy living in a middle-class suburb
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Adolescent Hispanic/Latino boy living in a middle-class suburb
An accurate health history is vital when creating a care plan that is inclusive of the patient’s needs. According to Ball et al. (2018), it is a key component when diagnosing and treating any patient. Gaining trust and allowing for autonomy is crucial with this particular age group. According to Erickson’s stages of development, “finding themselves” is a key area of growth for adolescents (Orenstein, 2020). By creating a relationship in which the adolescent can participate in providing a health history, they will be more inclined to also participate in activities that improve their health.
Communication/Interview Techniques and Targeted Questions
Communication and interview techniques must be tailored based on with whom the provider is working. For example, when interviewing a 75 year old, male Hispanic, I would utilize formal greetings, shake hands and make eye contact. I would use proper terms for anatomical parts, but not necessarily formal medical terminology. For an adolescent, I would utilize techniques that generate involvement from both the patient as well as their parent. For example, I would ask leading questions like “when was the last time you played on your Xbox and when was the last time you played outside. These types of questions acknowledge that mental play and physical play time are equally important. It is important they both feel like they play a role in the health and wellness of the adolescent.
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Social Determinants of Health
Asking targeted questions that are appropriate for the social determinants is important in gaining a trusting relationship. For example, it would not make sense for an adolescent of this socioeconomic standing to be asked if they know where or when their next meal might be. However, asking how many fruits or vegetables they eat per day, would be a more appropriate question. Likewise, obesity is not uncommon in this culture so framing questions that are non-judgmental is important as well. An example might be, “do you know why your body needs healthy foods?” This not only engages them in understanding their own body but allows for education where gaps might be highlighted.
Risk Assessment Tools
According to Ball (2019), understanding the growth and development of adolescents is important when taking a health history. For example, ensuring the individual met all of their development milestones, regardless of their current reason for visiting will help in understanding where the issues might originate. Next, depression and anxiety are becoming more prevalent in this age group, so utilizing a screening tool that is age appropriate would be important. An example of an age appropriate tool would be the Center for Epidemiologic Studies Depression Scale for Children (CES-DE), which is utilized to assess as well as monitor ongoing treatment plans in children and young adults aged 6-23 (Zsamboky et al., 2021). The benefit of this tool is the length of time in which it is appropriate to use. As a result, this is the risk assessment tool I would utilize, primarily because having years of growth and development to review can make creating individualized treatment plans that much easier.
Other Health Related Risks
Obesity and mental health are noted as chronic health related problems afflicting this population (Isasi et al., 2016). It has been well-documented that chronic obesity has psychological consequences. Rankin et al. (2016), finds that obese children are significantly more likely to struggle with psychiatric and psychological disorders than children who are not obese. Additionally, Tamayo et al., (2020) argues that ¼ of Hispanic youths in the U.S. are obese. This is clearly an important health related issue that must be addressed for this population.
Five (+) Targeted Questions
- How many fruits and vegetables do you eat every day?
- How often do you eat breakfast?
- How many cups of water do you drink at school? How big are those cups?
- Do you have a best friend at school?
- How many days in a week do you feel sad or lonely?
- Who do you talk to about feeling sad or lonely?
References
Ball, J., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An Interprofessional approach. Mosby.
Isasi, C. R., Rastogi, D., & Molina, K. (2016). Health issues IN Hispanic/latino youth. Journal of Latina/o Psychology, 4(2), 67–82. https://doi.org/10.1037/lat0000054
Orenstein, G. A. (2020, November 22). Eriksons stages of psychosocial development. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK556096/.
Rankin, J., Matthews, L., Cobley, S., Han, A., Sanders, R., Wiltshire, H. D., & Baker, J. S. (2016). Psychological consequences of childhood obesity: Psychiatric comorbidity and prevention. Adolescent Health, Medicine and Therapeutics, Volume 7, 125–146. https://doi.org/10.2147/ahmt.s101631
Tamayo, M. C., Dobbs, P. D., & Pincu, Y. (2020). Family-centered interventions for treatment and prevention of childhood obesity in hispanic families: A systematic review. Journal of Community Health, 46(3), 635–643. https://doi.org/10.1007/s10900-020-00897-7
Zsamboky, M., Haskell, B., Vick, R., & Schroer, M. (2021). Treating child and adolescent depression and anxiety in primary care. The Journal for Nurse Practitioners, 17(1), 54–59. https://doi.org/10.1016/j.nurpra.2020.08.019
response
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Thanks for your post. In addition to increased risk for obesity and mental health issues, a middle-class adolescent is at higher risk for teen substance abuse. In a study conducted by Patrick et al. (2012), it was noted that there is a higher incidence of substance use among youth from families with higher socioeconomic status. Substances more likely to be abused are alcohol and marijuana (Patrick et al., 2012). In a study by Martin (2019), it was noted that adolescents living in suburban neighborhoods were more likely to abuse drugs or alcohol. This may be due in part to the fact that people in higher socioeconomic groups are more likely to engage in deviant behaviors (Martin, 2019). I would employ the PACES risk assessment tool when interviewing this patient. PACES stands for parents/peers, accidents/alcohol or drugs, cigarettes, emotional issues, and school/sexuality (Ball et al., 2019).
References
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.). Mosby.
Patrick, M. E., Wightman, P., Schoeni, R. F., & Schulenberg, J. E. (2012). Socioeconomic status and substance use among young adults: A comparison across constructs and drugs. Journal of Studies on Alcohol and Drugs, 73(5), 772–782. https://doi.org/10.15288/jsad.2012.73.772
Sample response 2
I enjoyed reading your reply, it was interesting and contained many valid points. It is crucial to understand how to conduct a proper assessment geared towards gathering as much patient history as possible. I agree gaining trust and allowing for autonomy is crucial with this particular age group. It’s important to remember that this age group and ethical background are at risk for having an unhealthy diet. When assessing what the patients diet is its important to ask questions with a non judge mental attitude. “Erikson’s Stages of Psychosocial Development can be utilized by mental health providers when treating patients who are facing periods of adjustment or turning points in life”(Orenstein, G. A. 2020). These stages are also important for nurses to use when conducting an assessment and gaining back ground information. Evaluation for drug use should also be conducted. These turning points in life often cause adolescents to explore and experiment.
References
Orenstein, G. A. (2020, November 22). Eriksons stages of psychosocial development. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK556096/.
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