Assignment Prompt & Instructions
Please respond to at least 2 of your peer’s posts. To ensure that your responses are substantive, use at least two of these prompts:
– Do you agree with your peers’ assessment?
– Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
– Share your thoughts on how you support their opinion and explain why.
– Present new references that support your opinions.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
### Reply from Kionne Brooks
**Introduction**
One of the most important aspects of nursing care is obtaining a comprehensive medical history. However, there are situations when collecting a health history becomes more challenging, such as with newborns, young children, or elderly patients who cannot communicate for themselves. This difficulty is also common when caring for individuals with developmental disabilities or patients who speak a different language than the provider. In these situations, nurses need to adapt by using different strategies to gather accurate and complete information so that the patient still receives safe, high-quality care.
**Strategies & Rationale**
1. **Involve Family Members, or Caregivers**
Caregivers can be used as a source of obtaining information. Important information on medicine, behavioral changes, and developmental milestones can be obtained from parents and guardians. This approach is essential for infants, young children, and elders with dementia (Edwards et al., 2024).
1. **Use Professional Interpreters and Translation Services**
Using qualified medical interpreters instead of family members enhances accuracy, reduces bias, and protects patient confidentiality. It is considered best practice for non-English-speaking patients (Lauridsen et al., 2024).
1. **Use Behavioral Cues and Nonverbal Communication**
For nonverbal or developmentally disabled patients, observing facial expressions, body language, and behaviors provides insight into discomfort or needs. Tools such as picture boards or yes/no cue systems help elicit responses. NICE guidance emphasizes using tailored communication and nonverbal cues to ensure patient-centered care (National Institute for Health and Care Excellence [NICE], 2021).
1. **Create a Supportive, Comfortable Environment**
Especially for pediatrics, creating a friendly environment (e.g., using toys, sitting at eye level, speaking calmly) helps lower anxiety and increases cooperation during history taking (WriteUpp, 2024). Creating a welcoming environment (e.g., utilizing toys, sitting at eye level, speaking gently) helps reduce anxiety and increases cooperation during history taking (WriteUpp, 2024).
1. **Apply Standard Assessment Tools and Genograms**
Validated assessment tools, such as nonverbal pain scales or cognitive screening instruments, provide structured data collection when verbal communication is limited. Genograms also help capture family health history patterns (Sabater‑Gárriz et al., 2024).
**Conclusion**
When patients are unable to respond, it takes flexibility, creativity, and reliance on multiple information sources to get a comprehensive medical history. A complete assessment can be achieved by combining information from caregivers, the use of interpreters when needed, observation of nonverbal cues, creating supportive environments, and using standardized assessment tools. Despite communication barriers, these strategies help maintain accuracy while also supporting patient-centered care.
**References**
Edwards, R. C., et al. (2024). Capturing the complexity of child behavior and caregiver insights: The value of caregiver reports in developmental surveillance. Capturing the complexity of child behavior and caregiver-child interactions in the HEALthy Brain and Child Development (HBCD) study using a rigorous and equitable approach. _Developmental Cognitive Neuroscience, 69_, Article 101422. [https://doi.org/10.1016/j.dcn.2024.101422Links to an external site.](https://doi.org/10.1016/j.dcn.2024.101422)
Lauridsen, I.G., Terkildsen, M.D. & Sørensen, L.U. A systematic review of whether the number of linguistic errors in medical interpretation is associated with the use of professional vs ad hoc interpreters. _Arch Public Health_ 82, 235 (2024). [https://doi.org/10.1186/s13690-024-01461-8Links to an external site.](https://doi.org/10.1186/s13690-024-01461-8)
National Institute for Health and Care Excellence. (2021). _Communication by healthcare staff: Babies, children and young people’s experience of healthcare: Evidence review B_. NICE. [https://www.ncbi.nlm.nih.gov/books/NBK574976/Links to an external site.](https://www.ncbi.nlm.nih.gov/books/NBK574976/?utm_source=chatgpt.com)
Sabater‑Gárriz, Á., Molina‑Mula, J., Montoya, P., & Riquelme, I. (2024). _Pain assessment tools in adults with communication disorders: Systematic review and meta‑analysis._ _BMC Neurology, 24_(1), 66. [https://doi.org/10.1186/s12883‑024‑03539‑wLinks to an external site.](https://doi.org/10.1186/s12883%1e024%1e03539%1ew)
WriteUpp. (2024, August 26). _Mastering pediatric history taking: Strategies for effective communication_. [https://www.writeupp.com/blog/paediatric-history-takingLinks to an external site.](https://www.writeupp.com/blog/paediatric-history-taking?utm_source=chatgpt.com)
**Atija McCadney**
Liebermann et al. (2022), identified barriers to family history at the individual patient level, at the interpersonal communication level, and at the organizational level. An identified barrier on the individual patient level was the perception that Hispanic patients had limited health literacy. An identified barrier on the interpersonal level included patients and providers variations in dialect and country- specific Spanish language. An identified barrier on the organizational level included time constraints.
A complete health history is an essential component needed to provide care. When dealing with patients who aren’t able to provide a complete health history there are several strategies to utilize. One barrier to collecting a health history include patients who speak a language you do not know. The use of a translator or interpreter service for a patient who speaks a different language than you ensures accurate communication and understanding. Patients are giving the ability to choose between face-to-face interpretation; in-person and videoconferencing or telephone interpretation. According Kwan et al. (2023), the use of interpreter services increased patient’s satisfaction, and decreases hospital readmission rates. The use of interpreter services is recommended over utilizing family members.
**References**
Kwan, M., Jeemi, Z., Norman, R., & Dantas, J. A. R. (2023). Professional Interpreter Services and the Impact on Hospital Care Outcomes: An Integrative Review of Literature. _International journal of environmental research and public health_, _20_(6), 5165. [https://doi.org/10.3390/ijerph20065165Links to an external site.](https://doi.org/10.3390/ijerph20065165)
Liebermann, E., Taber, P., Vega, A. S., Daly, B. M., Goodman, M. S., Bradshaw, R., Chan, P. A., Chavez-Yenter, D., Hess, R., Kessler, C., Kohlmann, W., Low, S., Monahan, R., Kawamoto, K., Del Fiol, G., Buys, S. S., Sigireddi, M., Ginsburg, O., & Kaphingst, K. A. (2022). Barriers to family history collection among Spanish-speaking primary care patients: a BRIDGE qualitative study. _PEC innovation_, _1_, 100087. [https://doi.org/10.1016/j.pecinn.2022.100087](https://doi.org/10.1016/j.pecinn.2022.100087)