Culture and Health: Interviewing a 19-year old Female College Student
Introduction
The patient is a 19-old female college student of Asian American descent. Adolescence is a challenging time of rapid sexual, physiological, psychological and social development. Teens of this age strive for autonomy and independence in their utilization of healthcare (Zhao et al. 2016). They also express concern about confidentiality issues and therefore failure to develop trust can cause huge gaps when interviewing. This paper explores the strategies to use when interviewing and assessing adolescent patient from dissimilar cultural background and the healthcare support system available for such an adolescent.
Culture
Asian American teens tend to have low amount of communication with healthcare professionals concerning sexual health matters. They tend to have a normative cultural value of conservative perceptions and attitudes towards sex. Therefore, they desire to have the health professional start discussions about sexual health topics as they are usually embarrassed to bring up the topic. They also frequently lie to health professionals keep their history secret from their parents (Zhao et al. 2016).
Interviewing Strategies
Effective interviewing needs establishing rapport and relationship with that improves communication between the patient and interviewer. The adolescent opens to give sensitive information when the relationships fosters trust and respect. As the interviewer I needs to outline the rules of privacy and confidentiality at the initial visit or at the start of the interview to both the adolescent patient and parent. Patient history is be taken in a private room without the presence of the parent unless the patient decides so. After developing trust with the patient and initiating small dialogue to ease anxiety, set the stage for inquiring about those sensitive issues about sexual activity, drugs, and lifestyle. Assure the adolescent that her responses are confidential: will not be shared with the parent or anyone without her consent unless there is harm to self or others. The HEADSSS is the often used screening tool for risk assessment. Adolescents are concerned with confidentiality and disclosure of health behaviors. Assuring the patient of confidentiality increases the willingness to disclose sensitive information.
Make the interview non-judgmental by avoiding making assumptions. There is no doubt that the healthcare professionals are not immune from cultural beliefs and may hold belief systems that can result in them making judgmental assumptions about adolescents. For stance, because Asian American adolescents have the lowest amount of communication with health providers on topics relating to sexual health, the physicians may assume adolescents of this particular ethnic group have lower risk (Zhao et al. 2016). It is best that the examiner asks non-judgmental questions and makes no assumptions. It is important to target the interview to the experiential and developmental level of patient. Keep in mind that cultural and personal norms are essential to prompting an accurate history. The examiner needs to discuss with adolescent healthy sexual practices, such as pregnancy prevention, contraception and STIs in a culturally sensitive manner that considers religious, cultural and language preferences of Asian Americans. Ask well defined, direct questions not abstract questions. For example, the examiner can ask: “have you ever had sex?” rather than, “Are you sexually active?” it is also important to use gender neutral language and to use third person.
Healthcare Support System
There are several platforms available in Houston to offer health services to adolescents, including schools, private and public facilities, youth centers and mobile clinics. Harris Health’s school-based clinics provide adolescents with services like physical exam, development assessments, screenings, mental and physical health (Harris Health System, 2020). The bureau of youth and adolescent health within Houston Health Department partners with local communities and organizations to improve adolescents’ wellbeing and health (Houstontv.Gov, 2020).
References
Harris Health System. School-Based Clinics. Retrieved on November 22, 2020 https://www.harrishealth.org/locations-hh/Pages/school-based-clinics.aspx
Houstontv.Gov. Houston Health Department: Bureau of Youth and Adolescent Health. Retrieved on November 22, 2020 http://www.houstontx.gov/health/Youth/index.html
Zhao, J. et al. (2016). Communication between Asian American Adolescents and Health Care Providers about Sexual Activity, Sexually Transmitted Infections, and Pregnancy Prevention. Journal of Adolescent Research, 32(2), 1-22
