You are required to identify 3 highest priority social determinants. These should be accurate logical as well as relate to the patient. Again you will need to be creative and will probably
need to focus on prevention for most of your patients which will consist of educating them.
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A1. Strategy
Under this item you are required to discuss how you went about asking your social determinants questions. For example: During the assessment social determinants were discussed to determine the
social status of the patient. Social determinants are important for determining access to health care ability to afford care and ability to maintain health and well-being. The questions were
presented in a non-threatening face-to-face format which allows for improved interpretation of verbal and non-verbal cues and were mostly open-ended in order for the patient to describe and
expand on the answers. The patients answers help determine if the patient can afford have access to and understand importance of healthcare and disease prevention.
A1a. Discussion of Key Questions
Here you are required to identify and discuss key questions that are appropriate for a healthcare setting to effectively assess five social determinants. Name each question you used and give a
brief statement as to why you chose that question.
A1b. Responses to Key Questions
State the patients responses to each of the social determinants questions and give a brief statement as to how each answer will promote your thinking as to how you will want to change or
add to his/her plan of care. Later in the paper you actually choose the 3 highest priority determinants for which to create a plan of care; however you still want to in this section state how
you might address each response. For instance if in response to a question about the patients social support system the patient says My social support system consists of my wife my parents
and a handful of close friends all of whom we hang out with on a fairly regular basis you can now ascertain that the patient seems to have a fairly solid social support system. You might then
suggest that since the patient seems to be so well-supported he can choose one as an accountability partner for nutrition and exercise since social support is an integral part of following through
wellness activities. If the patient has good access to healthcare you may suggest that he/she receive annual flu vaccines and be proactive about getting preventive care for which health insurance
reimburses. Be creative because most of our students patients are healthy and have very few priority social determinants. Most of our suggestions and plan of care will focus on prevention.
A2. Economic Stability
You are required to provide a logical and accurate interpretation of the relationship between the patients economic stability and access to healthcare. You should endeavor to address each of the
points that you provide. You may find that youre repeating yourself a bit from the section before but thats ok. Start this section with how economic stability impacts access to healthcare in
general and then narrow down to your specific patient and how his or her economic stability impacts his/her access to healthcare.
A3. Educational Status
Your discussion of this item should demonstrate a clear understanding of the patients educational status and how it affects his or her health. The analysis should be clearly articulated and
well-supported. Again youll want to start with how education impacts access to healthcare for anyone in general and then narrow down to how education impacts your patients access to
healthcare.
A3a. Health Literacy
Your discussion of this item should demonstrate a clear understanding of the patients health literacy and how it affects health. Again start with how anyones health literacy impacts access to
healthcare and then end with how your specific patients health literacy impacts access to healthcare.
A3b. Educational Opportunities and Barriers
Under this item you are required to discuss specific plausible healthcare barriers as well as opportunities the patient might face because of his or her educational status. Again start
general (as stated in the sections above) and end with your specific patient.
A4. Effect of Health on Quality of Life
Your analysis here should demonstrate a clear understanding of how the patients health/healthcare status affects quality of life. The analysis should be well-reasoned and supportable. Again
start general (as stated in the sections above) and end with your specific patient.
A5. Neighborhood and Environmental Impacts
Here you are required to discuss how the patients neighborhood and environment affects access to health ensuring that your analysis is both logical and clear. Again start general (as stated
in the sections above) and end with your specific patient.
A5a. Healthcare Received in Low- and High-Income Areas
Your discussion of this item should highlight the similarities and differences in the healthcare a patient receives in low- and high-income areas. Your comparison should be both clear and
effectively articulated. Make sure that at the end of this section you add where your own specific patient falls do they live in a high- or low-income area and how does this impact them?
A5b. Rural versus Urban Healthcare Access
Your discussion should logically address how access to healthcare differs for patients living in rural versus urban areas and the discussion should be well-supported and then you should add
where your specific patient falls in this category rural or urban and how this impacts him/her.
A5c. Neighborhood Healthy Food Options
The discussion of this item should provide specific plausible reasons for how a patients neighborhood
affects his or her access to healthy food options. Your reasons should be logical and supportable. At the end of this section you want to bring it back to your specific patient and how his/her
neighborhood food options impact his/her ability to eat healthy foods.
B. Discussion of Social Determinants
Under this item you are required to provide an accurate interpretation of why social determinants need to be addressed in the comprehensive health assessment.
B1. Identification of Social Determinants
You are required to identify 3 highest priority social determinants. These should be accurate logical as well as relate to the patient. Again you will need to be creative and will probably
need to focus on prevention for most of your patients which will consist of educating them. For instance you might use access to
healthcare and focus on educating your patient on identifying whether or not your patient understands the importance of prevention and educating your patient on finding out what incentives his/her
insurance offers in the way of participating in wellness programs. For neighborhood/home environment you might educate your patient on importance of home safety i.e. having handrails on
stairwells non-skid rugs next to showers and tubs and smoke alarms in place as well as developing a fire evacuation plan.
B2. Patient Plan of Care
The patient plan of care that you develop should be logical and should plausibly address the three priority social determinants. See above for ideas about your plan of care. You can use a table
and can use nursing diagnoses if you want but just a generic plan is acceptable and is used by many students. Any plan that is logical and presents a plausible plan implementation has worked for
many students.
B2a. Plan Implementation
Your discussion should address implementation of the plan based on the social determinants that you identified. Your implementation does not need to be fancy. Maybe your plan will just consist of
verbally educating your patient and/or printing out the information in handouts so that information can be reviewed at home.
B2b. Implementation Barriers
The barriers that you identify should be discussed in detail. Your discussion should be logical as well as relevant to the interventions discussed in part B2. Again these dont need to be
fancy. Many times our implementation barriers are time constraints a patients lack of interest or lack of assigning importance to issues.
B2c. Individuals Involved in Interventions
Your discussion should provide an accurate analysis of who needs to be involved in the interventions. Also the ideas that you present should be logical and well supported. Typically
interventions are most effective when we include the closest members of the patients social support system.
B3. Plan Effectiveness
Your discussion of this item should demonstrate an accurate evaluation of the effectiveness of the patients plan of care. The discussion should be well supported and relevant. There is no need
to develop elaborate evaluation plans for this section. You might just use the teach-back method to evaluate education.
B4. Summation of the Impact of Social Determinants
Your summary should be logical and relevant; it should also demonstrate an accurate understanding of the impact of social determinants on the patients overall well-being.
C. Sources
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