Building Trust with a Native American Pregnant Female: Best Communication Practices

Introduction

My patient is a 38-year-old Native American pregnant female living on a reservation, and I would differ my communication and interview techniques to build a good health history from the patient because of their condition. The first step is to develop the right level of trust by creating a caring and open relationship with them (Leung et al., 2018). I would do this by making a warm introduction, which is for the best chance of making the patient comfortable. The environment across the examination room should also be conducive with privacy and air conditioning. The communication should be free to avoid social and ethnic aspects affecting the consultation (Leung et al., 2018). I will be keen to know how the patient would want me to address them. It is the right way of building the relationship. My target questions will be open and direct enough to get the details.

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Target Questions

Are there any severe past health conditions? Do they have any disabilities that affect their daily life? Do they a stable support system and who are part of it, like family or friends? Do they use hearing aids or eyeglasses, or both? Are they currently on any medication and suffering from any disease at the moment? How is their living condition at the reservation?

Potential Health Risks

The 38-year-old Native American pregnant is at risk of various health problems. It is because of their pregnancy condition and their living area. They live in the reservation, which is characteristic of poor environmental conditions because they are highly likely to be financially disadvantaged. The significant health risks include iron deficiency because of poor nutrition, high blood pressure because of pregnancy, miscarriage because of lack of medical services and horrible living conditions, and depression or anxiety because of the pressures they face because of their condition, for example in finances (Jackson & Vaughn, 2018).

Risk Assessment instrument

I would use the HEeADSSS assessment tool to understand the behavior, relationships, and safety of the 38-year-old Native American pregnant female living in a reservation. The HEeADSSS stands for home (H), educations or employment (E), eating and exercise (E), activities and peer relationships (A), drug use (D), sexuality (S), suicide, or mood (S), and safety (S) (Richardson et al., 2018). They seek different information on patients and have their specific questions as follows.

'Home' reveals the stability that one has at the place they live, including relationships with family and friends (Richardson et al., 2018). The patient lives in the reservation, and it can be a harsh environment. Target questions can be the following. How is their family relationship? Since they are native, what language do they converse with while at home? Who do they trust and converse with most of the time at home? 'Employment' is useful to show how the patient performs at work concerning their pregnancy (Richardson et al., 2018). The target questions can be as follows. Has their condition affected their work? Is the workplace safe to support their condition? Do they skip work sometimes or for lengthy periods?

'Eating and Exercise' is vital to establish their sleeping, eating, and exercise schedules, if any (Ho et al., 2019). What is the food they take, and how frequent? Is there any notable change in weight? Do they exercise, and how often? 'Activities and relationships' reveal the risks in attitude, behavior, and relationships with the people around them (Ho et al., 2019). 'Drug and alcohol use' reveals whether there is any case of risk behaviors. Sexuality is crucial to understand their orientation and knowledge of safe sex practices (Ho et al., 2019). 'Suicide and mood' reveals underlying psychological problems and their risk factors. A target question can be, for example, whether there is any change in mood since the pregnancy? 'Safety' shows the environmental conditions that the patient lives in (Ho et al., 2019).

References

Ho, J., Fong, C. K., Iskander, A., Towns, S., & Steinbeck, K. (2019). Digital psychosocial assessment: An efficient and effective screening tool. Journal of Paediatrics and Child Health, 56(4), 521-531. https://doi.org/10.1111/jpc.14675

Jackson, D. B., & Vaughn, M. G. (2018). Maternal medical risks during pregnancy and childhood externalizing behavior. Social Science & Medicine, 207, 19-24. https://doi.org/10.1016/j.socscimed.2018.04.032

Leung, C. C., Pun, J., Lock, G., Slade, D., Gomersall, C. D., Wong, W. T., & Joynt, G. M. (2018). Exploring the scope of communication content of mechanically ventilated patients. Journal of Critical Care, 44, 136-141. https://doi.org/10.1016/j.jcrc.2017.10.044

Richardson, A., Cooper, M., & Wood, D. (2018). G10 Are we using the heeadsss assessment to screen for psychosocial risks when young people are admitted to hosital? Young People’s Health Special Interest Group. https://doi.org/10.1136/archdischild-2018-rcpch.10