Fatmata Diaby 26-year-old Lebanese female COLLAPSE History Taking and Risk Assessment Developing an appropriate rapport is necessary when evaluating patient’s health needs as well as their risk assessment for the development of various debilitating conditions. An effective patient-practitioner rapport has been linked to improved patient health-care outcomes. A health care professional should have the intellectual capacity to internalize their patient’s feelings and emotional concerns aiming at maintaining the appropriate respect for their individual patients. In the case scenario provided, the patient is a 26-year-old Lebanese female living in a graduate-student housing requiring a health risk assessment. The initial step that should be taken by the health care professional is to introduce themselves to the patient to eliminate any possible ambiguity about their current care giver. The next step is to commence a rapport while making sure to maintain sociocultural sensitivity for extraction of precise and optimal details that will promote the formulation of an appropriate treatment plan for the patient. Use of open-ended questions is integral when obtaining a thorough history as it avoids omission and clinician-based bias (Tanwani, 2016). Empathy is exercised during practice as it allows the patient to feel understood and facilitates promotion of an effective patient-clinician rapport. Listening is a communication skill commonly overlooked but has a crucial role when attempting to narrow in on a diagnosis following an elaborate history of presenting illness. Health Risk Assessment Instrument of Choice The patient is a 26-year-old student living in the graduate-student housing. She is currently of child bearing age and is prone to contracting sexually transmitted diseases. This evokes the need for a Sexually transmitted disease (STD) risk assessment which involves diseases such as Human immunodeficiency virus infections among other STDs. Obtaining a sexual history from patients can at times seem challenging but should be carried out thoroughly with empathy and a non-judgmental attitude. Patient-practitioner confidentiality should also be assured for comfort and ease of assessment (Barrow, Ahmed, Bolan & Workowski, 2020). Women of child bearing age that are engaged in sexual intercourse should be frequently screened for STDs via history taking and physical examination. Moreover, culture and socioeconomic status play a major role in STD acquisition predisposition as various individuals have different practices as well as beliefs. Targeted Questions Specific sexual history questions should be asked in reference to the patient’s health assessment. The frequency and modes of sexual pleasure should be documented alongside the number of sexual partners involved with the patient. Multiple sexual partners are highly associated with a higher risk of STD acquisition. In addition, multiple sexual practices can greatly increase the risk of developing.

1. Fatmata Diaby
26-year-old Lebanese female
COLLAPSE
History Taking and Risk Assessment
Developing an appropriate rapport is necessary when evaluating
patient’s health needs as well as their risk assessment for the
development of various debilitating conditions. An effective
patient-practitioner rapport has been linked to improved patient
health-care outcomes. A health care professional should have
the intellectual capacity to internalize their patient’s feelings
and emotional concerns aiming at maintaining the appropriate
respect for their individual patients. In the case scenario
provided, the patient is a 26-year-old Lebanese female living in
a graduate-student housing requiring a health risk assessment.
The initial step that should be taken by the health care
professional is to introduce themselves to the patient to
eliminate any possible ambiguity about their current care giver.
The next step is to commence a rapport while making sure to
maintain sociocultural sensitivity for extraction of precise and
optimal details that will promote the formulation of an
appropriate treatment plan for the patient. Use of open-ended
questions is integral when obtaining a thorough history as it
avoids omission and clinician-based bias (Tanwani, 2016).
Empathy is exercised during practice as it allows the patient to
feel understood and facilitates promotion of an effective
patient-clinician rapport. Listening is a communication skill
commonly overlooked but has a crucial role when attempting to
narrow in on a diagnosis following an elaborate history of
presenting illness.
Health Risk Assessment Instrument of Choice

2. The patient is a 26-year-old student living in the graduate-
student housing. She is currently of child bearing age and is
prone to contracting sexually transmitted diseases. This evokes
the need for a Sexually transmitted disease (STD) risk
assessment which involves diseases such as Human
immunodeficiency virus infections among other STDs.
Obtaining a sexual history from patients can at times seem
challenging but should be carried out thoroughly with empathy
and a non-judgmental attitude. Patient-practitioner
confidentiality should also be assured for comfort and ease of
assessment (Barrow, Ahmed, Bolan & Workowski, 2020).
Women of child bearing age that are engaged in sexual
intercourse should be frequently screened for STDs via history
taking and physical examination. Moreover, culture and
socioeconomic status play a major role in STD acquisition
predisposition as various individuals have different practices as
well as beliefs.
Targeted Questions
Specific sexual history questions should be asked in reference
to the patient’s health assessment. The frequency and modes of
sexual pleasure should be documented alongside the number of
sexual partners involved with the patient. Multiple sexual
partners are highly associated with a higher risk of STD
acquisition. In addition, multiple sexual practices can greatly
increase the risk of developing a sexually transmitted disease.
History of previous STDs is expected to be inquired as patients
with a positive history of disease are at a higher risk of
recurrence owing to their sexual practices. Physiologic
alterations in the patient’s genitalia such as abnormal bleeding,
pain and foul discharge should be inquired about as they are
common signs and symptoms associated with STDs (Barrow et
al., 2020). Methods of contraception that are undertaken, if any,
by the patient should be documented for assessment of patient
education and self-care involvement. Other social parameters

3. are also included in the STD risk assessment tool such as
whether or not the patient has exchanged money for sexual
intercourse. Drug use including cigarette smoking, chronic
alcohol use and other forms of intravenous drug use are greatly
linked to STD acquisition hence require probing as part of the
assessment tool in routine care (Jenkins et al., 2019).
References
Barrow, R. Y., Ahmed, F., Bolan, G. A., & Workowski, K. A.
(2020). Recommendations for providing quality sexually
transmitted diseases clinical services, 2020.
MMWR. Recommendations and Reports
,
68
(5), 1-20. doi:10.15585/mmwr.rr6805a1
Jenkins, W. D., Vohra, S., Grundy, S., & Choat, L. (2019).
Incentivized screening to reduce sexually transmitted infection
risk and prevalence.
Sexually Transmitted Diseases
,
46
(10), 654-656. doi:10.1097/olq.0000000000001049
Tanwani, R. (2016). Communication skills in clinical practice.
The Skills of History Taking (for Medical Students and
Practitioners)
, 196-196. doi:10.5005/jp/books/12827_18
Adebukola Aladesanmi
RE: Discussion - Week 1
COLLAPSE

4. Health assessment is an important exercise that assists
clinicians to identify people at risk of certain health problems
such as chronic diseases, abuse, alcoholism, and other
unfavorable health outcomes. Techniques used in health
assessment to gather a comprehensive health history of an
individual differ from population to population depending on
factors such as age. In this health assessment, my case scenario
is a 26-year-old female from Lebanon.
I would start an interview by creating a conducive environment
that is friendly and welcoming for the client. For example, I
would warmly welcome them to the office and ask them to feel
comfortable. To promote comfort, I would sit on the same level
as the client as opposed to being separated by a desk. Given that
the client is a young adult, having a desk between might be
intimidating while on the other hand, sitting together with her
will make the patient less anxious. This enhances trust and the
ability to build rapport (Kim & White, 2018). The second
technique I will apply is using a person-centered or culturally
appropriate approach, for instance, asking the client which
language she is comfortable with. Given that the patient is
Lebanese, she may not fully understand English and might
require an interpreter. Similarly, I would assure them of the
privacy and confidentiality of any information they share.
Building rapport is important for establishing a therapeutic
relationship with the client. I would apply communication
techniques such as interpersonal relations, empathy, respect,
and active listening when interviewing the patient. These
techniques will help in building trust as the patient knows that
the therapist is not only listening, but also understands their
experiences and feelings through empathy. I will also employ
open-ended questions especially at the beginning of the
interview to allow the patient to provide as much information as
possible, which can be used to evaluate any possible health
concerns.

5. The client is a young female adult and at this age, she is
exposed to various health issues such as potential abuse from
her partner, gender discrimination, racial discrimination, as well
as peer pressure. Moreover, the client leaves in graduate
housing indicating a background of low socioeconomic status.
Low-socioeconomic status is associated with poor health
outcomes because of lack of adequate income to provide
necessities, proper/healthy diet, clean environment, and safe
neighborhood. As such, the client is exposed to several risk
factors including an unhealthy lifestyle, the possibility of
developing chronic diseases, smoking, effects of crime, and
abuse (Nagasu & Yamamoto, 2020). Additionally, given that the
client belongs to a minority group, they may not be having a job
or working menial jobs and extra shifts to make ends meet, or
working and studying, which poses the risk of psychological
health issues due to distress and burnout (Kulsoom & Afsar,
2015).
For risk assessment, I would use the CRAFFT questionnaire,
which assesses potential involvement in alcohol and substance
abuse. The assessment tool has 6 targeted questions each
examining a component of the CRAFT (Car, Relax, Alone,
Forget, Family/Friends, and Trouble). The rationale for
examining alcohol abuse is because the client lives in a
residential place for students. In this case, there is a high
probability of peer pressure and involvement in alcohol and
substance abuse because of the environment where most people
engage in such habits. I would also use the YouthCHAT
screening tool to assess any mental health issues and risky
behavior manifesting in the patient (Goodyear-Smith, et al.,
2017). Given the age and cultural background, the client is
exposed to several issues that might cause anxiety, depression,
or any other mental health issue. For example, lack of
employment, difficulties adjusting to the environment,
experience from the home country, and balancing education and

6. work among others.
Targeted Questions
What language are you comfortable with?
What challenges have you encountered with accessing health
services?
Do you have any other family members in this country?
What is your understanding of abuse, have you experienced it?
Are you involved in any routine physical activity? What is your
daily diet like?
References
Goodyear-Smith, F., Martel, R., Darragh, M., Warren, J.,
Thabrew, H., & Clark, T. (2017). Screening for risky behavior
and mental health in young people: the
YouthCHAT program.
Public Health Rev, 38, 20
. https://doi.org/10.1186/s40985-017-0068-1.
Kim, B., & White, K. (2018). How can health professionals
enhance interpersonal communication with adolescents and
young adults to improve health care outcome?: a systemic
literature review.
International Journal of Adolescence and Youth
, 23(2), 198-218. Doi:10.1080/02673843.2017.1330696.
Kulsoom, B., & Afsar, N. (2015). Stress, anxiety, and
depression among medical students in a multiethnic setting.
Neuropsychiatr Dis Treat
, 11, 1713-22. Doi: 10.2147/NDT.S83577.

7. Nagasu, M., & Yamamoto, I. (2020). Impact of socioeconomic-
and lifestyle-related risk factors on poor mental health
conditions: A Nationwide
longitudinal 5-wave panel study in Japan.
PlosOne
. https://doi.org/10.1371/journal.pone.0240240.
respond to each discussion with 3 sources