Hearing impaired acutely ill under influence of

Hearing impaired
 Acutely ill
 Under influence of street drugs or alcohol
 Those who must be asked personal questions
 Sexually aggressive
 Crying
 Angry and threatening violence
 Anxious
 Culture and Genetics
 Gender
o Being aware of maintaining cultural norms during interview and examination process
o Maintaining privacy and modesty
 Sexual orientation
o Maintaining neutrality related to patient’s presentation by being mindful of communication patterns
o Being aware of your own personal bias and baggage
 Cross-Cultural Care
 Probability of miscommunication increases when two people are from different cultural backgrounds
 Cultural backgrounds of both health care professional and patient influence verbal and nonverbal
communications
 Cultural perspectives on professional interactions
 Etiquette
 Space and distance
 Overcoming Communication Barriers

 Working with and without interpreters
 Nonverbal cross-cultural communication
 Touch
o Touching patients is a necessary component of comprehensive assessment
o Physical contact with patients conveys various meanings cross-culturally
 Patient’s significant others may exert pressure on nurses by enforcing culturally meaningful norms in health care
setting
 Nonverbal Behaviors
 Five types of nonverbal behaviors convey information about person
o Vocal cues: pitch, tone, and quality of voice, including moaning, crying, and groaning
o Action cues: posture, facial expression, and gestures
o Object cues: clothing, jewelry, and hairstyles
o Personal space: interpersonal transactions and care of belongings
o Touch: involves use of personal space and action
 Health Literacy
 This is more than just the ability to read but rather includes understanding and following directions that lead to
effective communication between the patient and the health care provider
 A patient may be literate but not have health literacy
 Involves the use of quantitative measurement and memory aspects
 Tools for determining literacy
o Test of Functional Health Literacy (TOFHLA)
o Rapid Estimate of Adult Literacy in Medicine (REALM)
o Newest Vital Sign (NVS)
 Techniques to Improve Health Literacy
 Oral teaching
 Use of written materials based on standard educational levels
 Teach back or use of return demonstration

 Chapter 4 - The Complete Health History
 The Health History Sequence
 Biographical data
 Source of history
 Reason for seeking care
 Present health or history of present illness
 Past health
 Family history
 Review of systems
 Functional assessment including activities of daily living (ADLs)
 Biographical Data
 Name
 Address and phone number
 Age and birth date
 Birthplace
 Sex
 Marital status
 Race
 Ethnic origin
 Occupation: usual and present
 Source of History
 Record who furnishes information, usually the person, although source may be relative or friend
