4-Year-Old Biracial Male Living with His Grandmother in A High-Density Public Housing Complex

The communication and interview techniques used for patient health history assessment vary for each patient. Communication enables the clinician to develop a positive relationship with the patient through trust and help the patient be more confident (Ball et al., 2018). First, I would consider interviewing the grandmother on issues that concern the child, such as the background information and history. The grandmother may be more open and informative and may understand most of the questions compared to the child. I would also ask the grandmother whether she gets help with house activities and the child’s education. Secondly, I would try to engage the child by using a language easily understandable to him. I would use dolls and other props to enable the child to communicate on any underlying family, environment, or health issues.

The patient’s social determinants of health comprise the social environment he resides, ethnicity, housing quality, and age. Therefore, in building up the questions, I will most likely focus on the health risks associated with such social determinants. One of the health risks may include emotional and psychological disorders. Psychological problems may also be attributed to being biracial, which may have exposed the child to racial discrimination. Additionally, as an assessor, I should find out why the child is under the grandmother’s care and his parents’ whereabouts. Finding out about his parents may help determine the psychological and emotional effect it has on the child. Since the child is under the care of his grandmother, the relationship may affect both of them. Therefore, I would also target my questions towards the grandmother’s social determinants of health, such as parenting pressures, social and house responsibilities, and the possible burden of education and child care.

The health risk assessment instruments or questions I would use to assess the patients’ health risks would be based on their background information and their present illness. For instance, for the 4-year old biracial male, I would use the Behavioral Assessment System for Children (BASC) assessment tool. The BASC is used to examine the changes in a child’s behavior and emotional states concerning the underlying factors such as social environment and parenting (Hill, 2021). The respondents for this assessment tool would be the grandmother and the child, and they would also assess the structured development history (SDH). I would use the Parenting Stress Index (PSI) for the grandmother. The PSI is used primarily to identify any problem faced by the child or parent evaluates the sources of stress such as the social environment, parenting stress, and child characteristics (Lange et al., 2019). The scale may help identify the competence, isolation, health status, role restriction, and possible depression faced by the grandmother and the child’s hyperactivity, mood, and adaptability.

The patient may have health-related risks based on his age, gender, environmental setting, and ethnicity. In terms of age, some of the health-related dangers may include mental issues, which may arise from lack of parental care from the child’s birth parents, lack of parenting attention from his grandmother, and social status. Ethnicity may also affect the child’s cognitive processes by facing discrimination since he is biracial. The environmental setting may also put the child at risk of several health issues (Ball et al., 2018). For instance, the public high-density housing may signify a low-income neighborhood, putting the child at risk of public health issues such as air pollution, poor learning abilities, infectious disease, and health behaviors. These issues should be examined and tested to accurately identify possible underlying medical conditions in the child and illness history.

Questions to the Child

1. Does your grandmother beat you when you make mistakes?
2. How many friends do you have?
3. Do other children treat you in any bad way or hit you?
4. Are you feeling any pain in your body?
5. Are you bored at home and in school?