Hello,

I appreciate your insight into the case study. You touched on two issues that caught my attention: the psychosocial assessment and the subject of confidentiality; both issues are essential in successfully collecting a health history.

First, being that the child is a young adolescent, it is encouraged that the adolescent and the parent(s) or guardian(s) are aware of the importance of confidentiality before the interview process (Marcell, Burstein, & Committee on Adolescence, 2017). The research found adolescents will disclose personal information if they are assured confidentiality; when and if the information shared does not involve physical abuse, sexual abuse, suicide ideation, and homicidal thoughts (Marcell, Burstein, & Committee on Adolescence, 2017). It is essential the patient feels he can trust that any information shared is confidential.

During a HEEADSSS assessment, HEEADSS, an acronym for Home, Education, Eating, Activities, Drugs, Sexuality, Suicide, Safety, are questions that may inform the provider of potential risk factors in adolescent health (Doukrou & Segal, 2018). For instance, inquiring about home life can yield information regarding the patient’s stability, family unit, support system, and safety (Smith, & McGuinness, n.d.). Furthermore, asking about the patient’s education can yield information about the patient’s social circle, academic challenges, and future outlook (Doukrou & Segal, 2018). HEEADSSS is a psychosocial tool to identify risk factors and improve patient outcomes.

Doukrou, M., & Segal, T. Y. (2018). Fifteen-minute consultation: Communicating with young people-how to use HEEADSSS, a psychosocial interview for adolescents. Archives of Disease in Childhood. Education and Practice Edition, 103(1), 15–19. https://doi-org.ezp.waldenulibrary.org/10.1136/archdischild-2016-311553

Marcell, A. V., Burstein, G. R., & Committee on Adolescence (2017). Sexual and reproductive health care services in the pediatric setting. Pediatrics, 140(5), e20172858. https://doi-org.ezp.waldenulibrary.org/10.1542/peds.2017-2858

Smith, G. L., & McGuinness, T. M. (n.d.). Adolescent psychosocial assessment the HEEADSSS. Journal of Psychosocial Nursing And Mental Health Services, 55(5), 24–27. https://doi-org.ezp.waldenulibrary.org/10.3928/02793695-20170420-03

Discussion: Building a Health History

Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

Photo Credit: Sam Edwards / Caiaimage / Getty Images

To prepare:

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

• By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
• How would your communication and interview techniques for building a health history differ with each patient?
• How might you target your questions for building a health history based on the patient’s social determinants of health?
• What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
• Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
• Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
• Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history. 14-year-old biracial male living with his grandmother in a high-density public housing complex

By Day 3 of Week 1

Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days who selected a different patient than you, using one or more of the following approaches:

• Share additional interview and communication techniques that could be effective with your colleague’s selected patient.
• Suggest additional health-related risks that might be considered.
• Validate an idea with your own experience and additional research. 14-year-old biracial male living with his grandmother in a high-density public housing complex

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion