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Hearing impairedAcutely illUnder influence of street drugs or alcoholThose who must be asked personal questionsSexually aggressiveCryingAngry and threatening violenceAnxiousCulture and Genetics GenderoBeing aware of maintaining cultural norms during interview and examination processoMaintaining privacy and modestySexual orientationoMaintaining neutrality related to patient’s presentation by being mindful of communication patterns oBeing aware of your own personal bias and baggageCross-Cultural Care Probability of miscommunication increases when two people are from different cultural backgroundsCultural backgrounds of both health care professional and patient influence verbal and nonverbal communicationsCultural perspectives on professional interactionsEtiquette Space and distanceOvercoming Communication Barriers
Working with and without interpretersNonverbal cross-cultural communicationTouchoTouching patients is a necessary component of comprehensive assessmentoPhysical contact with patients conveys various meanings cross-culturallyPatient’s significant others may exert pressure on nurses by enforcing culturally meaningful norms in health care settingNonverbal Behaviors Five types of nonverbal behaviors convey information about personoVocal cues: pitch, tone, and quality of voice, including moaning, crying, and groaningoAction cues: posture, facial expression, and gesturesoObject cues: clothing, jewelry, and hairstylesoPersonal space: interpersonal transactions and care of belongingsoTouch: involves use of personal space and actionHealth 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 providerA patient may be literate but not have health literacyInvolves the use of quantitative measurement and memory aspects Tools for determining literacyoTest of Functional Health Literacy (TOFHLA)oRapid Estimate of Adult Literacy in Medicine (REALM)oNewest Vital Sign (NVS) Techniques to Improve Health Literacy Oral teachingUse 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 dataSource of historyReason for seeking carePresent health or history of present illnessPast healthFamily historyReview of systemsFunctional assessment including activities of daily living (ADLs)Biographical Data NameAddress and phone numberAge and birth dateBirthplaceSexMarital statusRaceEthnic originOccupation: usual and presentSource of History Record who furnishes information, usually the person, although source may be relative or friend