TJ is a 32-year-old woman expecting a child for the first time in her life. Aside from vaginal discharge, her pregnancy has been without complications. However, there are social barriers to the normal flow of pregnancy. TJ is a lesbian, therefore, she was artificially inseminated. She primarily relies on healthcare from an obstetrician. Moreover, she has a strong family history of diabetes. The patient’s health and sexual background make gathering the pertinent information a delicate task.
The goal is to acquire an accurate medical history without upsetting the patient. The major factor that increases sensitivity is her sexual orientation. McCune and Imborek (2018) write that “sexual minority women are more likely than their heterosexual peers to delay care due to cost and less likely to have a usual place of care”. Heterosexual bias in society predetermines anxiety in homosexual people, thus propelling them to ignore or hide their health issues. Building a rapport with the patient is essential in getting medical history.
The second sensitive issue is the family history of diabetes. It is unknown if the patient herself had diabetes in the past. Yet, even if she had not struggled with the disease, there is a higher chance of complications, like the appearance of Gestational diabetes (Moosazadeh et al., 2017). Therefore, it is critical to know whether she had weight problems, excessive sugar consumption, and other risk factors related to diabetes.
The third delicate aspect of the patient’s condition is conception. She received sperm from a local sperm bank. According to Bartal et al. (2019), conceiving a child by using donor sperm does not necessarily predetermine obstetrics complications. However, it can potentially result in “preeclampsia, preterm labor, and cesarean section” (p. 205). The patient should be made aware of these risks. An especially sensitive, but nonetheless vital question is whether she had chosen the correct sperm donor who is compatible with her health. It is essential that the biological father had no diabetes history or genetic predisposition to it.
Overall, there are three factors comprising the patient’s sensitivity. Her life choices may cause anxiety both in her and in the nurses. Henderson et al. (2016) suggest several strategies for handling delicate issues. However, only two would be appropriate in this case. The first is eliminating prejudice based on cultural diversity. Nurses delivering patient care should take into consideration the patient’s sexual orientation but not make an issue out of it.
The second is eradicating stereotypes about cultural behaviors. The personnel ought to ignore common societal narratives where homosexual people are portrayed as inherently flawed human beings. Altogether, the success of connecting with a patient depends on the open-mindedness, unbiased thinking, and nonaggressive choice of words of a health professional.
With these strategies in mind, there are five appropriate targeted questions to the patient.
- Have you had a medical condition that you would not report to a doctor because of their heterosexual bias?
- Have you personally had a case of diabetes?
- Did you choose a sperm donor who was compatible with your medical history, particularly, the predisposition to diabetes?
- Are you aware that the family history of diabetes can lead to the development of Gestational diabetes during pregnancy?
- Would you consider consulting a health professional if you knew they had no prejudice against homosexual people?
References
Bartal, M. F., Sibai, B. M., Bart, Y., Shina, A., Mazaki-Tovi, S., Eisen, I. S.,… & Schiff, E. (2019). The impact of sperm and egg donation on the risk of pregnancy complications. American Journal of Perinatology, 36(02), 205-211. Web.
Henderson, S., Barker, M., & Mak, A. (2016). Strategies used by nurses, academics and students to overcome intercultural communication challenges. Nurse Education in Practice, 16(1), 71-78. Web.
McCune, K. C., & Imborek, K. L. (2018). Clinical care of lesbian and bisexual women for the obstetrician gynecologist. Clinical Obstetrics and Gynecology, 61(4), 663-673.
Moosazadeh, M., Asemi, Z., Lankarani, K. B., Tabrizi, R., Maharlouei, N., Naghibzadeh-Tahami, A.,… & Khodadost, M. (2017). Family history of diabetes and the risk of gestational diabetes mellitus in Iran: A systematic review and meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 11, 99-104. Web.