Patient Complaints and Rationale Behind the Interview
Discussing sensitive topics, such as one’s sexual history, requires the clinician to pay attention to how questions are asked and how new information is presented to the patient. In the considered case, a 21-year-old Filipino college student comes into the office wanting to learn more about different birth control options. Here, the interview will be based on the five Ps of sexual history: partners, practices, protection from, history of sexually transmitted infections (STIs), and pregnancy prevention (Ball et al., 2023).
Thus, the interview will start with general questions about the current sexual activity and the gender of the patient and their partners. Then, the questions will include asking about STIs in the past and present, as well as the techniques the patient uses to prevent them. Finally, as the patient wishes to know about contraception, questions about their pregnancy plans and health conditions related to different methods of contraception will be asked.
Sexual Health Risks and Ethical Considerations
Sexual health may be challenging for the patient to talk about, mainly because they are a young student from another country. Thus, communication should be reassuring and straightforward, using non-medical terms to explain different methods and their outcomes. It is essential to make the patient comfortable by saying that other young people also have similar concerns and that their questions are not unusual (Centers for Disease Control and Prevention [CDC], 2022). Furthermore, it may help the patient if asked about their past experiences with sexual activity and contraception. I would focus on talking in short sentences and asking the patient if they understood my explanation. A friendly tone is another effective way to build rapport with the patient.
For different patients, some individual risks to their physical health may exist. For example, the patient’s age determines whether it is safe to be sexually active. Other factors, such as gender, sexual orientation, and ethnicity, may be linked to people’s awareness of different sexual practices. Sexual minorities may have higher chances of abuse in their households or other settings, and their environment should be examined during the visit (Ball et al., 2023; Sullivan, 2019). Another issue is that people with uteruses are at risk of pregnancy and irregular or painful menstruation.
A risk assessment instrument that can be used for the selected patient is the questionnaire for using hormonal contraceptives. This standard tool requires the patient to answer several questions to determine whether they are suitable for using these pharmaceuticals. It includes information about allergies, history of contraception, pregnancy, menstruation, and medical history (Chapman University, 2022). It would apply to patients with uteruses – both cisgender and transgender – who wish to use hormonal contraceptives. This risk assessment instrument considers many potential dangers, such as blood clots, liver and gallbladder conditions, incompatible medications, and more. Thus, it can become a starting point for choosing the right contraceptive option for the patient.
Questions
As noted above, the targeted questions for the patient must be based on the five P’s of sexual health. For instance, the first question about partners is, “Are you currently having sex of any kind with anyone?” (CDC, 2022). Next, the patient may talk about specific characteristics of their partners, “What is the gender of your sexual partner or partners?”
Third, the nurse may inquire about the types of sex the patient engages in: “What body parts are involved when you have sex?” (CDC, 2022). The fourth question concerns STI prevention: “What type of prevention methods do you use, if any?” Finally, another example of a question asks about STI history – “Have you ever been tested for STIs?” These targeted questions help one start developing the patient’s sexual health history.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). Elsevier Mosby.
Centers for Disease Control and Prevention. (2022). A guide to taking a sexual history.
Chapman University. (2022). Hormonal contraceptive self-screening questionnaire.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). F. A. Davis.