Health and Health Promotion

Much like archaeologists sift through sand to identify artifacts of interest, nurse practitioners must devote time and effort to interviewing patients, sifting through facts to identify relevant information that can be pieced together to create a relevant patient history. These efforts have their own unique challenges and approaches based on the characteristics of the patient, including sex, age, culture, and more.

Female patient interviews have their own unique characteristics. Sensitive matters related to sexual health, physical and/or emotional abuse, pregnancy, menstruation, and other topics may leave patients uncomfortable and create challenges to productive conversations.

For this week, you will examine the role of the patient interview in health promotion. You also will practice approaches to building a patient history by interviewing a volunteer by creating a script which you use to conduct a mock patient interview with the volunteer.

Learning Objectives

Students will:

  • Analyze professional interests of study
  • Analyze the different roles related to the a CRNP (certified registered nurse practitioner), a CNM (certified nurse midwife), and a PA (Physician Assistant)
  • Create scripts for taking a health history to include difficult questions
  • Develop patient health histories related to difficult questions

*These Learning Objectives are introduced this week and assessed in Week 2.

Learning Resources

 

Required Readings (click to expand/reduce)

 

Schuiling, K. D., & Likis, F. E. (2022). Gynecologic health care (4th ed.). Jones and Bartlett Learning.

·         Chapter 1, “A Feminist Perspective of Women’s Health” (pp. 3–10)

·         Chapter 3,” Women’s Growth and Development Across the Life Spans) pp. 39–49)

·         Chapter 4, “Using Evidence to Support Clinical Practice” (pp. 55–69)

·         Chapter 5, “Health Promotion” (pp. 75–86)

·         Chapter 7, “Gynecologic History and Physical Examination” (pp. 99–124) 

·         Chapter 11, “Gynecologic Health Care for Lesbian, Bisexual, Queer Women, and Transgender and Nonbinary Individuals” (pp. 173–210)

Guideline Resources

 

American Nurses Association (ANA). (n.d.). Scope of practice. https://www.nursingworld.org/practice-policy/scope-of-practice/

 

American College of Obstetricians and Gynecologists. (2020). Well-woman visit (Number 755) [Committee Opinion]. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/10/well-woman-visit

 

American Society for Colposcopy and Cervical Pathology (ASCCP). (2014). Algorithms: Updated consensus guidelines for managing abnormal cervical cancer screening tests and cancer precursors. https://www.asccp.org/Guidelines

 

Competency Resources 

 

The National Organization of Nurse Practitioner Faculties (NONPF). (2017). Nurse Practitioner Core Competencies Content. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/2017_NPCoreComps_with_Curric.pdf

 

American Academy of Physician Assistants (AAPA) (2013). Competencies for the Physician Assistant Profession. https://www.aapa.org/wp-content/uploads/2017/02/PA-Competencies-updated.pdf

 

Ethics Resources

 

American Nurses Association (ANA). (n.d.). View the code of ethics for nurses with interpretive statements. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

 

 

Keuroghlian, A. S., Ard, K. L., & Makadon, H. J. (2017). Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments. Sexual Health, 14, 119–122. https://doi.org/10.1071/SH16145

 

 

Fredriksen-Goldsen, K. I., Hoy-Ellis, C. P., Goldsen, J., Emlet, C. A., & R, N., Hooyman. (2014). Creating a vision for the future: Key competencies and strategies for culturally competent practice with lesbian, gay, bisexual, and transgender (LGBT) older adults in the health and human services. Journal of Gerontologic Social Work, 57(0), 80–107. https://doi.org/10.1080/01634372.2014.890690

 

Screening Tools and/or Apps

As you download and consider using the following screening tools and/or apps on your mobile device, be mindful that if should you have any technical difficulties, please access technology support from the tool or app you are needing help with.

 

U.S. Preventive Services Task Force. (2018). Information for health professionals. https://www.uspreventiveservicestaskforce.org/Page/Name/tools-and-resources-for-better-preventive-care/

 

Ewing, J. (2004). Cage questionnaire. https://www.uspreventiveservicestaskforce.org/Home/GetFileByID/838

 

American Society for Colposcopy and Cervical Pathology (ASCCP). (2020). New guidelines. New App. www.asccp.org/mobile-app   Note: This app will become available in 2020 and may require a fee for purchase. Please be mindful that you are not required to purchase the app for this course. However, it may be an app that will be useful for your professional practice.

 

Harvard Medical School and Brigham and Women’s Hospital (n.d.). Women’s Health Study. https://whs.bwh.harvard.edu/index.html

 

Taking a Health History: Building a Health History: Asking Difficult Questions

Much of an archeologist’s work is done under the mantra “proceed with caution.” Archeologists must dutifully secure permissions to access sites. They also must exercise extreme caution when excavating or analyzing in a lab to avoid potential damage to historical artifacts.

Likewise, nurse practitioners must proceed with caution when building a patient’s health history. Important questions can be difficult for both nurse and patient. Care must be taken to approach such questions with dignity, tact, and respect to create an environment conducive to productive conversations. 

 

For this Assignment, you will develop a script to be used to interview a volunteer serving in the role of patient. 

To prepare:

  • Review the Ewing (2004) questionnaire found in this week’s Learning Resources and consider the difficult questions you might have to ask when you take a patient’s health history.
  • Review the screening tools found in the Learning Resources and consider how you might use an app or tool to assist in screening.
  • Review the media programs related to a vaginal exam, pap test, and breast exam.
  • Review the health history guide presented in Chapter 7 of the Schuiling & Likis (2022) text and consider how you would create your own script for building a health history. (Note: You will also find the Health History Form in Chapter 7)
  • Describe the components of a complete gynecologic health history.  Include  considerations for special populations such as  LGBTQ+ individuals.
  • What health maintenance guidelines should be  included for initial and follow up  might be needed for follow-up assessments?  (i.e., bone density test, Gardasil vaccine, shingles, etc.)?
  • What questions would you consider in your patient’s assessment? For example
  • Create your own script for building a health history and use the Health History Template for guidance (consider the type of language you would use to help your patient be more comfortable). As you create your script, consider the difficult questions you want to include in your script. There is no sample template to provide to you. You are the one to develop the script. Think of it as you are writing a movie and you need to write the script for the movie. What lines would you provide for the actor to utilize when sitting down with a patient to perform a COMPLETE Medical History which also entails those DIFFICULT GYN questions. You do not need to provide the answers to the questions however, if you find that beneficial, you may do so.
  •  

Assignment: (1- to 2-page reflection)

  • In addition to your script for building a health history for this assignment, include a separate section called “Reflection” that includes the following:

 

Rubric Detail

 

  •  

 

Excellent

Good

Fair

Poor

Describe the components of a comprehensive gynecologic complete health history. Include considerations for special populations such as LGBTQ+ individuals. What health maintenance guidelines should be included during the initial and follow up assessments. (i.e., bone density test, Gardasil vaccine, shingles, etc.)?

27 (27%) – 30 (30%)

The response provides clear, complete, and appropriate descriptions of a comprehensive gynecologic complete health history. Health maintenance guidelines are clear and complete.

24 (24%) – 26 (26%)

The response provides clear, complete, and most of the components of a comprehensive gynecologic complete health history. Most health maintenance guidelines are included and appropriate.

21 (21%) – 23 (23%)

The response provides components of the gynecologic health history but they are incomplete, vague or inaccurate. Health maintenance guidelines are somewhat complete or inappropriate applied.

0 (0%) – 20 (20%)

The response provides unclear, incomplete, or inappropriate components of the gynecologic health history. Health maintenance guidelines are missing, incorrect, or inappropriate applied.

Building a Health History: Asking Difficult Questions <br Create your own script for building a health history. Consider the type of language you would use to help your patient be more comfortable). Ensure you include the difficult questions required to complete a thorough health history.</br

22.5 (22.5%) – 25 (25%)

The script contains a complete set of questions, including difficult questions, necessary to build a health history. Questions are phrased in a manner that supports the patients comfort.

20 (20%) – 22 (22%)

The script contains a mostly complete set of questions, including difficult questions, necessary to build a health history. Most questions are phrased in a manner that supports the patients comfort.

17.5 (17.5%) – 19.5 (19.5%)

The script containing some relevant questions, including a few difficult questions. Information collected provides a cursory health history. Questions are not phrased in a supportive tone.

0 (0%) – 17 (17%)

The script contains few or no relevant questions, including few or no difficult questions. Information collected is not sufficient to provide an adequate health history. Questions are not phrased in a supportive tone.

In addition to your script for building a health history for this assignment, include a separate section called “Reflection” Briefly reflect and provide a summary of your experiences in developing your script during your health history.

27 (27%) – 30 (30%)

The response provides an accurate, clear, and complete summary of experiences in developing the script during the health history

24 (24%) – 26 (26%)

The response provides an accurate summary of experiences in developing the script during the health history

21 (21%) – 23 (23%)

The response provides a vague, inaccurate, or incomplete summary of the experiences in developing the script during the health history

0 (0%) – 20 (20%)

The response provides a vague, inaccurate, or incomplete summary of the experiences in developing the script during the health history, or the summary is missing.

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.

0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided.

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

4 (4%) – 4 (4%)

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 (0%) – 3 (3%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 (5%) – 5 (5%)

Uses correct APA format with no errors.

4 (4%) – 4 (4%)

Contains a few (1 or 2) APA format errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains several (3 or 4) APA format errors.

0 (0%) – 3 (3%)

Contains many (≥ 5) APA format errors.

Total Points: 100

Name: NRNP_6552_Module1_Assignment_Rubric

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