Comprehensive Health Assessment

. Interview Techniques
There are 2 parts to this section. First, you are required to identify and discuss your approach to
asking your social determinants questions. You must select 4 evidence-based interviewing
techniques and provide a scholarly source for this discussion. For example, “During the
assessment, social determinants were discussed to determine the social status of the patient.
Social determinants are important for determining access to health care, ability to afford care,
and ability to maintain health and well-being. The questions were presented in a non-threatening,
face-to-face format, which allows for improved interpretation of verbal and non-verbal cues and
were mostly open-ended to provide an opportunity for the patient to describe and expand on the
answers. The patient’s answers help determine if the patient can afford, have access to, and
understand importance of healthcare and disease prevention.”
The rubric states that this section must be “well-supported by a scholarly source,” so you should
cite at least one source to support your interview methodology. Consider reviewing the chapter
on interviewing techniques in your Bates eText.
A1a. Justification of Key Questions
In this section, you are required to discuss and justify the reasons for the key questions that are
appropriate for a healthcare setting to effectively assess each of the five social determinants:
economic stability, education, social and community context, health and healthcare, and
neighborhood and built environment. List each question you used and give a brief statement as
to why you chose that question. Also list the patient’s responses to each question.
A1b. Responses to Key Questions
This section requires you to discuss the patient’s responses to each of the social determinants
questions and how each answer will promote your thinking in regards to how you will want to
change or add to his/her plan of care. Later in the paper, you actually choose the 3 highest
priority determinants for which to create a plan of care; however, in this section, it is still
important to state how you might address each response. For instance, if the patient says, “My
social support system consists of my wife, my parents, and a handful of close friends, all of
whom we hang out with on a fairly regular basis.” You can now ascertain that the patient seems
to have a solid social support system. You might then suggest that the patient choose one as an
accountability partner for nutrition and exercise since social support is an integral part of
following through with wellness activities. If the patient has good access to healthcare, you may
suggest that he/she receive annual flu vaccines and be proactive about getting preventive care
for which health insurance reimburses. Be creative because most of the assessed “patients” are
healthy and have very few priority social determinants. Most of our suggestions and plan of care
will focus on prevention. Remember, social determinants do not have to be negative! They can
even influence patients positively.
A2. Economic Stability
This section requires you to provide a logical and accurate interpretation of the relationship
between the patient’s economic stability and access to healthcare. Start this section with how
economic stability impacts access to healthcare in general and then narrow down to your specific
patient and make a clear connection as to how his or her economic stability impacts his/her
access to healthcare. As noted in the task directions, as you’re describing your patient’s
economic stability, you should include socioeconomic status, employment, and housing
stability. You may find that you are repeating yourself a bit from the section before, but that is
expected and acceptable.
A3. Educational Status
Your discussion of this item should demonstrate a clear understanding of the patient’s
educational status and the ways in which it affects his/her health. The analysis should be clearly
articulated and well-supported by a scholarly source. Again, you should begin by discussing how
education affects access to healthcare for anyone and then make a clear connection to the ways
education impacts your patient’s access to healthcare. You might think about how a high school
education impacts health differently from a college education. If your patient was able to graduate
from college and acquire a good job with health benefits, this certainly impacts health positively.
Also, generally speaking, any advanced degree usually means the person had some type of
nutrition/physical education course(s), which may expand their thinking in terms of health and
wellness. This section of the rubric requires the analysis to be “well-reasoned and well
supported,” so be sure to include at least one reference to support your comments.
A3a. Healthcare Barriers and Opportunities
Under this item, you are required to discuss specific, plausible healthcare barriers, as well as
opportunities the patient might face because of his or her educational status. Begin with a
general discussion and end with your specific patient. Remember, barriers occur even for healthy
people. If someone is highly educated, that may serve as a positive opportunity, but it may also
prevent the individual from adequately addressing health issues. Think about opportunities a
person may have due to higher education (a good job with health benefits, access to better
healthcare providers/specialists). Also, think about opportunities education provides – ability to
read and understand health information and ability to understand the importance of healthcare
and self-care. Think about barriers, as well. If your patient is a healthcare worker, what barriers
may he/she possess? Maybe the patient is too embarrassed to ask questions because the
provider is aware of his/her employment in the healthcare field and assumes a certain level of
understanding and health literacy without further explanation. Opportunities and barriers exist for
all people! We each have unique motivators and perspectives. Think about how you are able to
access healthcare and how you perceive your education to help and/or hinder you. Your patient
may not be that different! Again, your discussion must be well-supported, so include at least one
reference.
Note: You are asked to include both opportunities and barriers. The term ‘Both’ implies plural,
indicating the need to address two or more of each.
A4. Effect of Health on Quality of Life
Your analysis in this section should demonstrate a clear understanding of how the patient’s
health/healthcare status affects quality of life. The analysis should be well-reasoned and
supported by evidence in the form of a scholarly resource. Again, start with a general discussion
(as stated in the sections above) and end with your specific patient.
A4a – Health Literacy
Your discussion of this item should demonstrate a clear understanding of the patient’s health
literacy and how it affects his/her health. Again, begin with the general discussion of the ways in
which anyone’s health literacy impacts access to healthcare and then end with a clear connection
between your specific patient’s health literacy and its impact to access to healthcare. If your
patient is a healthcare worker, think about how this impacts his/her ability to navigate the
healthcare system and understand health information. If your patient has no college education,
does this impact his/her health literacy, and if so, how? Sometimes patients without advanced
education haven’t learned to read/write at a higher level and may find health information difficult
to comprehend or interpret. They may also have trouble communicating their health needs. This
section of the rubric requires the analysis to be “well-reasoned and well supported,” so be sure to
include at least one scholarly reference to support your comments.
A5. Neighborhood and Environmental Impacts
In this section, you are required to discuss how the patient’s neighborhood and environment
affects access to health, ensuring that your analysis is both logical and clear. As in other
sections, begin with a general discussion and end with your specific patient.
A5a. Healthcare Received in Low- and High-Income Areas
Your discussion of this item should highlight the similarities and differences in the healthcare a
patient receives in low- and high-income areas. Your comparison should be both clear and
effectively articulated. Make sure that at the end of this section you include the specifics related
to your patient– do he/she live in a high- or low-income area and how does this impact him/her?
For your discussion of similarities in healthcare received in low- and high-income areas, think
about how healthcare settings provide care, to whom they provide it, and the guidelines they
follow. Also, think about emergency services and to whom/how they respond. For differences in
healthcare received in low- and high-income areas, think about healthcare services offered in
high-income areas. Consider how provider offices/hospitals look, what specialties are offered,
and whether services are covered by health insurance. What type of clinics does one find in lowincome areas, and what type of services do they provide? How are these clinics staffed, and how
well are they maintained? Is it possible that someone in a high-income area and one in a low
income area prioritize health care in the same way? Just some ideas…
Note: You are asked to include both similarities and differences. Both are plural, indicating the
need to address two or more of each.
A5b. Rural versus Urban Healthcare Access
Your discussion should logically address how access to healthcare differs for patients living in
rural versus urban areas, and the discussion should be well-supported – and then you should
add relevant information specific to your patient in this category – rural or urban – and how this
impacts him/her.