A comprehensive health assessment is generally a medical examination of the whole human body with particular interest in the detection of serious health risks whether symptoms are evident or not. It is also carried out to assist in the management of the existing medical conditions. The assessment is undertaken on all people of all ages but particularly to those with a history of some serious conditions such as heart and diabetes in their family lineage. Generally, it is advisable for men and women to undergo regular health assessments in order to identify cancers in their body at the earliest stage possible. Health assessment is overly affected by cultural and development factors in individuals and the society. Taking into consideration the developmental issues is therefore imperative in undertaking a successful comprehensive assessment (Greenspan & Wieder, 2005, p. 15). The essay will complete a comprehensive health assessment based on developmental and cultural factors and their subsequent impacts, and identify the strategies utilized by nurses in conducting assessment in patients from diverse cultures and development stages.
The man aged 55 years is in the middle age category of human development. This period is mainly characterized by conflict that takes the form of generativity and stagnation. Men are particularly susceptible to illnesses due to their declining physiological and psychological output. Episodes of complaints particularly in the genitourinary tract are very common. In this case, the man suffers hematuria and painful urination as a result of the decreasing efficacy of the physiological output of the body systems. The low cardiac output also worsens the situation by decreasing the functioning of the kidney. The body mass index is around 18 which is slightly below normal. Cultural factors that elevate the status of men above women results in their failure to seek treatment. The patient holds back crucial information on his health from the nurse and wife because he does not want to taken as a weakling. Admission of a weakness by a man is tantamount to failure. This leads to the diagnosis of serious conditions at late stages that are difficult to treat. Depression may have resulted from the denial and the pain caused by the medical condition. Recommendation for urinalysis is done to ascertain the cause of hematuria. The man is also advised and referred to a psychiatrist or counsellor for stress management (Greenspan & Wieder, 2005, p. 15). The assessment will help the man seek medical attention thereby making him improve productivity as a craftsman. This will enhance his ability to fully provide for the family while making the family to be more contented with their breadwinner.
The woman aged 52 is a homemaker native of India who leads a sedentary lifestyle. The woman is suffering from high blood pressure (136/90) and obesity denoted by the high body mass index (>27). The failure to adhere to healthy diet and lifestyle serves to worsen the situation. The complaints of shortness of breath could be as a result of inactivity and obesity which are the major predisposing factors. The onset of menopause made the woman add up weight. Cultural values that limit the women to home work and modesty issues are hindrances to the management of medical conditions. Health seeking behaviour that favours traditional herbalists delays the initiation of effective treatment thus worsening the health status of the woman. Influence of men over women decisions on health impacts negatively in seeking medical care. This process will raise awareness on the rights of the woman thereby improving the health seeking behaviour. This will increase the overall health status of the family.
The 10 years old grand daughter was orphaned at a tender age and had to change schools at the middle of the year. Physical examination ruled out physiological causes for complains brought forward by the girl. The death of the parents created a gap in the development process of the girl that the grand parents have failed to fill. More importantly, the transition to a new school proved difficult for the girl considering the mental events occurring in her. The lack of mental strength makes it difficult for the girl to learn new things. Failure to acquire new friends alienates her making her to develop symptoms similar to those of ADHD. Medical history showed persistent headaches at night as a result of stress brought about by the loss of the parents and the new school environment. An analysis of the stress levels indicated the girl was severely affected thus there was need for remedial action. Counselling sessions were recommended. Counselling is imperative to help her overcome the loss of the parents and the new school environment (Greenspan. & Wieder, 2005, p.15). The girl will lead a better life after the counselling. Improvements in the grades and a less stressful family co-existence will occur.
The 7 years granddaughter experienced episodes of allergies and emotional issues relating to the parent’s death. Physical growth was found to be normal. Cultural factors that encourage the rearing of cats as pets are common in this society. The cats have allergens that trigger reactions in the body of this girl. Allergens include fur and smell emanating from the cat. Physiological causes of the emotional disturbances were ruled out. Laboratory results for urine and blood were found to be within the normal limits. However, an assessment of the stress indicated persistent high levels despite the child been put on medication. Lack of proper encouragement and emphasis of discipline by the grandparents makes the girl to be irresponsible and fail to adhere to the schedule of medicines. Failure to explain to her, the reason for taking the medicines, makes the girl to believe it was a punishment. Counselling was recommended after the assessment of the stress levels. This will imperative to allow the child come into terms with the loss while helping her to mingle with the other children (Greenspan & Wieder, 2005, p. 19).
The comprehensive health assessment will help the whole family to identify the predisposing factors to the prevailing conditions thus creating an impetus to minimise or eliminate them. Positive impacts in terms of increased productivity and cohesion will be observed in the family. The family health seeking behaviour will also be improved since they will embrace the need to have regular health assessments.
Strategies/interventions for conducting a health assessment of patients
Assessment is basically the first task that a nurse is involved in after the patient visits the hospital. It is unarguably an ongoing aspect of the steps in the nursing process. This dynamic and structured process helps the nurses to collect data by interacting with the patient and other health care providers. The data is eventually analysed to guide in the prognosis and care of the patient. The assessments are very useful in guiding revisions of clinical and nursing care. It is worth noting that all individuals, including nurses, are constantly engaging in activities that are aimed at detecting changes in the environment in order to make adjustments. Several strategies are utilised in the assessment of clients by nurses. Observation and interviews are the commonly utilised methods. Examination is applicable when there is need for sophisticated or advanced information about the patient health (Rosales, Balili & Padernal, 2009, p. 11).
Observation is the act of collecting data about the patient by use of the sense. Observation is termed as a deliberate skill which is acquired through a lot of effort combined with an overly structured approach. It entails the closer observation of the behaviour, reactions, physical appearance and association of an individual with others and the environment. This is mainly applicable for young children and terminally ill patients (Rosales, et al, 2009, p. 12).
On the other hand, interview is generally a planned conversation conducted with a sole purpose of getting information about something or identification of specific health problems in an individual. Interviews are also conducted to give a clear understanding of developmental and cultural issues that are vital in guiding counselling or psychological therapy. It assists the nurses to obtain the health history of the patient. The health needs and to a larger extent the risk factors, particularly cultural and developmental issues, are noticed during the interviews. More importantly, the determination of specific changes regarding the wellness and to some extent pattern living is also conducted. Interviews are imperative since they give clear insights on the patient’s health while at the same time gauging their expectations regarding the treatment. An effective interview requires the nurse to be keen, accommodative and utilise structured sequence (Rosales, et al, 2009, p. 4).
Physical examination encompasses the systematic collection of data by relying mainly on observation. This approach is directed by the examiner who either decides to conduct a head-toe or body systems examination. This approach allows the nurse to collect all the needed data about the patient. However, this information is not used in making clinical judgements and conclusions.
The appreciation of cultural identity is imperative in the assessment and eventual treatment of the individuals. Care should be taken when discussing issues regarding spiritual, cultural and developmental malformations to avoid arousing feelings and thoughts that might hinder the participation of the client. The understanding of the impact of culture particularly on the client patient relationship will help in the formulation of the assessment and treatment procedures.
Comprehensive health assessment is important in understanding the developmental and cultural factors that affect the health status of the individuals. Proper utilisation of strategies such as interviews and examination is vital in effective collection of data from patients. The combination of the three approaches should be encouraged in hospitals.
Reference list
Greenspan, I., & Wieder, S. (2005). Infant and Early Childhood Mental Health: A Comprehensive, Developmental Approach to Assessment and Intervention. Washington, DC: American Psychiatric Association. Web.
Rosales, D., Balili, B., & Padernal, M. (2009). Manual on nursing health assessment. General Santos: Dabiangas University.