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An interview with a 14-year-old biracial male in the clinic is performed. This male adolescent resides with his grandmother in a public housing complex that is very populated. It is essential to collect information needed to assess and diagnose health issues during the interview. The individual receives the knowledge to deal effectively with these health issues. The interview summary would develop a health risk assessment (HRA) that focuses on evaluating the individual’s risk for the disease to improve the overall health and safety in their home and personal environment. While establishing rapport with the adolescent, trust must be formed. When trust is not present, the patient may not feel that the relationship is safe, consequently contributing to a feeling of judgment which might, in turn, result in unproductive and unreliable care that lacks the needs most essential to be addressed.
Communication is a fundamental clinical skill that, if performed competently and efficiently, facilitates establishing a relationship between medical staff and the patient, building a therapeutic alliance (Chichirez & Purcarea, 2018). Because effective communication can vary in individuals according to stages of psychosocial development, it is essential to maintain a general understanding of proper communication strategies that focus on establishing a connection necessary to obtain vital data in the establishment of a diagnosis. Every effort to maintain confidentiality must be made, and discussions regarding a clear need for confidentiality must be made known (Ball et al., 2019). Although privacy is highly regarded during the interview, situations that include abuse and danger to self or others are a couple of examples of conditional confidentiality that must be discussed and do not reduce the rates of disclosure. Although it is common for adolescents to have problems understanding and expressing their thoughts, behaviors, and feelings, which can decrease their communication skills, open-ended questions assist adolescents with their quest for autonomy without feeling like their answers are forced (Pires et al., 2021). Because adolescents are vulnerable and need to show that they are mature and can “handle things themselves,” respect must be established to gain the trust and confidence needed to obtain essential information. Respect, trust, and therapeutic understanding are components that intertwine to benefit the patient and enhance the interaction, guaranteeing the patient’s needs are placed first and in a nonjudgmental environment (Phillips et al., 2017).
Risk Assessment Tool
Alcohol and drug use are prevalent in adolescence and a time of physical, emotional, and psychological maturation; it is also a time for independence and experimentation, unfortunately sometimes risky. Not only is alcohol and drug use strongly transmitted within families, but these syndromes can be attributed to socioeconomic risk factors that act and interact over-development (Kendler et al., 2020). Therefore, the risk assessment instrument utilized for this teenager is the CRAFFT questionnaire. The CRAFFT questionnaire is a screening tool for alcohol and substance abuse in adolescents. The acronym stands for C(ar), R(elax), A(lone), F(orget), F(riends), and T(rouble). The screening questionnaire consists of questions that connect adolescents and their involvement in riding in a car with someone under the influence of drugs or alcohol, use of drugs or alcohol to feel better or fit in, use of drugs or alcohol alone, forgetfulness while under the influence of drugs or alcohol, acknowledgment by family or friends that drinking or drug use should be decreased, and trouble that has been a result of alcohol or drug use (Pilowsy et al., 2017). Since the case study is regarding an adolescent, studies have shown that adolescents prefer paper forms and computerized questionnaires over face-to-face interviews; therefore, the CRAFFT questionnaire is an appropriate risk assessment tool to utilize.
Five Targeted Questions
Initiating open-ended questions allows the interviewer to identify areas where issues may need to be explored.?Five targeted questions that promote the initiation of an exploratory interview and remain open-ended include (Ball et al., 2019):
??????? How are things at home?
??????? How is school?
??????? Tell me about your friends.
??????? How would your friends describe you?
??????? Why types of activities or sports are you involved in?
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The nurse practitioner would begin the assessment with the goal of developing a favorable patient-nurse connection in the assigned case study (Ball et al, 2019). Ultimately, the idea is to build a relationship with the youngster in question. To ensure the safety of the kid, the nurse practitioner should be seated close to the parent, who should also be standing nearby on the exam table or in the parent’s lap (Ball et al, 2019). If we go by the definition of healthychildren.org, a preschooler is between the ages of three and five years old. As this child moves from infancy into the preschool years, we may anticipate to observe some significant changes in intellectual, social, and emotional development (healthychildren.org, 2019). Preschool children’s cognitive development varies, and the practitioner must be aware of numerous communication approaches in order to assess each individual patient on their unique level.
Using the CAGE Questionnaire, a health risk assessment used by nurse practitioners, we’ll go through the following topics: Chief Concern; Current Illness History; Past Medical History (Wu &Orlando, 2015). Using open ended questions and ensuring that both the kid and the adult (parent) are included as primary interview issues, the nurse practitioner can speak directly to the patient (Ball et al, 2019). Adopted or foster children with little or no prior history could have particular difficulties in this interview (Ball et al, 2019). If the youngster is under the age of 18 and comes to the office with someone other than a custodial parent or guardian, consent by proxy may be an issue (Ball et al, 2019). Each time, the practitioner must be familiar with and follow all relevant protocols and procedures for the particular health care facility they’re working with.
In addition, open-ended questions will be used to gather information about the condition, allergies, prescriptions, and vaccines. Consideration must be given to the child’s socioeconomic situation (which affects his or her ability to receive high-quality healthcare) and the fact that they live in a remote area when compiling their medical history and subsequent treatment plan.
? Where does your child live and spend most of his/ her time?
? Is there a smoker in the family?
? What kind of physical activity does your kid get on a daily basis?
? What kind of relationship do you have with your child?
? What is the ailment or condition that you’re most concerned about?
? Do you have any worries about your child’s emotional, behavioral, or developmental well-being?
? Is the child allergic to anything? If this is the case, what is the exact reaction?
? Do you know if your child has had all of her recommended vaccinations? Do you have any documentation to show?
? What prescription or over-the-counter drugs, hormones, vitamins, or dietary supplements does the child take?