Full Answer Section

Spiritual factors:

• Unexplored:The patient’s spiritual beliefs are unknown. Understanding his spirituality may provide comfort or motivation for positive health changes.

Lifestyle factors:

• Alcohol dependence:His recent hospitalization for alcoholic withdrawal seizures suggests a history of alcohol abuse. This can have significant health consequences.
• Smoking:His reliance on cigarettes to manage stress can worsen his overall health, particularly his cardiovascular health.

Cultural factors:

• African American health disparities:African Americans have higher risks for hypertension and other chronic conditions. Being culturally sensitive is crucial.

Sensitivity During Interaction:

• Unconscious bias:Acknowledge potential biases about race, socioeconomic status, or addiction.
• Respectful communication:Use respectful language, avoid judgment, and actively listen to his concerns.
• Empathy:Acknowledge his challenges and express empathy for his situation.
• Collaboration:Frame the conversation as a collaborative effort to improve his health.

Communication Techniques for Sensitivity:

• Open-ended questions:Encourage him to share his experiences and perspectives. (e.g., “Can you tell me more about how you manage stress?”)
• Avoidance of judgmental language:Focus on understanding his situation, not criticizing his choices. (e.g., “How long have you been experiencing these cravings?”)
• Validation:Acknowledge his difficulties and his efforts to manage his health. (e.g., “It sounds like you’re trying to find healthy ways to cope.”)
• Culturally competent communication:Be mindful of potential cultural nuances in communication styles or health beliefs.

Health History Interview:

1. “Can you tell me a bit about your experience with alcohol withdrawal seizures? How often did they occur?”(Understanding the severity of his alcohol dependence helps assess risks and treatment needs.)
2. “For how long have you been diagnosed with hypertension? Are there any specific triggers you’ve noticed for your blood pressure to rise?”(Knowing his hypertension history guides medication decisions and self-management strategies.)
3. “Have you tried any methods to quit smoking in the past? What were the challenges and successes you encountered?”(Assessing his smoking cessation efforts helps tailor interventions and support.)
4. “Living in a shelter can be stressful. What healthy coping mechanisms do you currently use to manage stress?”(Identifying existing coping skills helps build upon them and explore healthier alternatives to smoking.)
5. “Is there anything specific that prevents you from taking your medications regularly? How can we work together to address those barriers?”(Understanding medication adherence challenges allows for solutions like dose adjustments or reminders.)

Risk Assessment Tool: AUDIT-C

The AUDIT-C (Alcohol Use Disorders Identification Test, Consumption) is a suitable risk assessment tool for this patient. It’s a brief, validated tool specifically designed to identify potential alcohol use disorders. Given his recent hospitalization for alcohol withdrawal, screening for continued dependence or relapse risk is crucial. The AUDIT-C results will help determine the severity of his alcohol dependence and guide treatment recommendations.

By considering these factors and employing sensitive communication techniques, you can build rapport with the patient and gather valuable information to create a comprehensive care plan that addresses his medical and social needs.