SDOH Case Study

Introduction

Social determinants of health (SDOH) are a necessary consideration in providing complete, holistic, quality care. This paper provides comprehensive plan of care for Sequoia Rain Song, a 54-year-old Native American woman. The plan considers her health literacy needs as well as the SDOH that affect her case, and presents appropriate interventions backed by clinical reasoning.

Sequoias Data

Health History

Sequoia Rain Song has no documented history of surgeries or hospitalizations. She has reported occasional episodes of fatigue, which have impacted her job performance as a guide at a Native American heritage museum. She has also gained weight over the past year and has given concern about her energy levels.

Medications

There is no specific mention of medications. However, given her hypertension (BP: 138/84) and high cholesterol levels (total cholesterol: 202 mg/dL, LDL: 160 mg/dL), it is possible she might be on antihypertensive and cholesterol-lowering medications, but further information is needed for confirmation.

Physical Assessment Findings

During Sequoia Rain Songs physical assessment, several key findings were noted. Her vital signs revealed a blood pressure of 138/84 mmHg, a heart rate of 90 beats per minute, a respiratory rate of 20 breaths per minute, and an oxygen saturation of 99% on room air. Her temperature was recorded at 37.7C, and her body mass index (BMI) was calculated to be 28, which falls into the overweight category.

The laboratory tests from one week prior to her wellness visit showed that her complete blood count (CBC) was within normal limits. Her blood glucose level was 93 mg/dL, blood urea nitrogen (BUN) was 15 mg/dL, and creatinine was 1.2 mg/dL, all within their respective normal ranges. Electrolyte levels were also normal, with sodium at 135 mEq/L, potassium at 3.8 mEq/L, and chloride at 101 mEq/L.

The total protein level was slightly elevated at 8.0 g/dL. Liver function tests indicated an aspartate aminotransferase (AST) level of 25 units/L and an alanine aminotransferase (ALT) level of 48 units/L, with the ALT being slightly above the normal range. Lipid profile results showed a total cholesterol level of 202 mg/dL, an LDL cholesterol level of 160 mg/dL, and an HDL cholesterol level of 40 mg/dL, indicating dyslipidemia with elevated LDL and total cholesterol and low HDL levels.

Social Determinants of Health and Culture

Economically speaking, Sequoia is in a challengingly difficult position because of the fact that she earns minimum wage working as a guide at a Native American heritage museum. This means she has a very limited income, which is necessarily going to have an impact on her ability to seek or to think about getting any necessary healthcare services she may need. It is going to impact her purchasing decisions, particularly when it comes to obtaining healthy, nutritious food, and other helpful items for maintaining a healthy lifestyle, since pre-packaged (but not good for you) items are more readily available and generally cheaper to buy (Lacko et al., 2021).

Her healthcare access is also an SDOH that impacts her, as access to care for her is definitely on the restricted end of the spectrum. Although Sequoia makes it a point to visit the clinic annually for her wellness check, her access to additional healthcare services is not wide open, considering her financial situation. This limitation is going to be a barrier in terms of getting timely medical advice, especially as she limits her healthcare appointments to one per year. This is not a good way to manage chronic conditions effectively.

Details about Sequoias dietary habits are not explicitly clear, but cultural dietary practices may play a substantial role in her life. As a Native American, traditional foods might be a natural part to her diet, and this would...

…her care planning is also important so as to promote self-care and overall support the plan's success. The nurse must respect her cultural beliefs and bring those into the care plan whenever possible. There should be shared decision-making so that Sequoia sees the plan as her own and so that it reflects her values. This is the essence of person-centered care and it should be part of the plan for improving her health literacy level, too.

Interprofessional Team Members

A comprehensive care plan for Sequoia means involving interprofessional team members. Physicians can help with managing her medical conditions and coordinating care. Social workers can address her economic stability and connect her with community resources that offer financial assistance or support services. Therapists can give mental health support and help her manage stress through counseling. Dietitians can develop a culturally appropriate diet plan. Community health workers can hep with access to healthcare services.

Communication Strategies for Holistic Care

Effective communication strategies can also help. There will need to be interdisciplinary meetings so the healthcare team can discuss Sequoias progress and make any adjustments along the way, and here EHRs can be very helpful as well as telehealth technology in case there are any time and space barriers. All team members should have access to up-to-date information, for coordinate care purposes. They should strive to give Sequoia motivational interviewing to improve her motivation to follow the care plan and make the needed positive health changes.

Conclusion

Developing a comprehensive plan of care for Sequoia Rain Song involves addressing her health literacy needs and SDOH. It involves working backward from her outcomes to the solutions. The care plan outlined here will help with understanding the contributing factors and allow for the creation of targeted interventions. Bringing together interprofessional team members and using effective communication strategies are all part of the…