NUR3005 Chronic Illness Management In Primary Care
Question:
Case Scenario
Paul is a Koori man in his fifties and lives in a rural area in Victoria with his partner Rodney. Paul has recently had cataract surgery and lives with diabetes, depression and Hepatitis C. In his younger years Paul liked to party but in his forties settled down as he became more mature and realised the impact partying was having on his health. Paul is passionate about being an Aboriginal community member, loves to attend local community events and often picks up friends and family on the way to events in his car. The day after having eye surgery in the city Paul receives a visit from an Aboriginal Health Worker, Eddie, from the local Aboriginal Health Service.
1. Discuss perspectives, and the physical, psychological and social aspects of ageing in the context of health and illness in older people in our community
2. Describe the impact of ageing and chronic illness on clients, families and carers and apply this to discharge planning bridging the transition from acute care to primary care and palliative care
3. Identify the primary care resources for people with issues related to ageing, chronic and life limiting illness in the community.
Answer:
The first health issue identified in the expert’s analysis is the building of trust with Paul as he his identity has been previously denied by the healthcare system. The person-centred goal highlighted to resolve this issue include development of relationship with Paul in order to built trust. According to Kingsley, Townsend, Henderson-Wilson and Bolam (2013) aboriginal people residing in Australia experiences high level of health care disparity coming in the form of social isolation, stigmatization and discrimination. This isolation increases their level of depression and thereby hampering his health and well-being. The first issue of the problem highlighted in the student’s analysis is also depression. However, the main problem highlighted against it is eye problems due to cataract surgery and infection of hepatitis C. Though, lack of proper vision and development of fatal disease infection increases a sense of depression among the people, but in case of aboriginal people social exclusion lack of proper identity are more prone in inflicting a sense of chronic depression. This same concept has been highlighted in the second identified issue in the expert’s analysis. The second issue highlights that social isolation along with temporary loss of vision and feeling blue due o hepatitis C virus is increasing the sense of social isolation. The interventions highlighted in order to manage the sense of depression in aboriginal Paul by the student’s analysis highlighted the use of effective communication as person-centred goal. However, management of lack of vision or hepatitis C infection cannot be done in a significant manner via effective communication. The effective communication can help to manage the sense of depression arising out of social isolation as highlighted in the interventions and actions in the expert’s analysis and the same has been supported by the research conducted by Coventry et al. (2014). In order manage the loss of vision and feeling blue towards the development of Hepatitis B, proper community partnership and proper assistance in the instrumental activities of living (IADL) is important as highlighted in the expert’s analysis. The ISAP of the student highlights lack of proper knowledge about his (Paul) current health issue. The same has been highlighted in the ISAP of the expert. Expert highlighted that he is not taking proper medication due to the lack of proper information in the disease progression and importance of medication. In order provide proper education the expert highlighted the importance of the guidance coming from the community health nurse. The same intervention has been highlighted by the ISAP of the student. According to Ahn et al. (2013), community based interventions helps in proper disease education among the aboriginal workforce.
Thus in the new knowledge identified in relation to the case study is, social isolation and increase level of health inequalities are principal factors underlying the increased sense of depression among the aboriginal members. Another new learning in relation to the case study, people who are suffering from vision loss, assistance in IADL can be proved to be effective in increasing their overall mindset. According to Liu et al. (2013), assistance in daily activities helps to increase the mental health and wellbeing of the visually impaired people Moreover, the expert analysis also help to understand that how self-management of the blood glucose level helps in managing diabetes. This again aligns with the theory of the self-management of both type 1 and type 2 diabetes mellitus (Powers et al., 2017).
References
Ahn, S., Basu, R., Smith, M. L., Jiang, L., Lorig, K., Whitelaw, N., & Ory, M. G. (2013). The impact of chronic disease self-management programs: healthcare savings through a community-based intervention. BMC Public Health, 13(1), 1141. https://doi.org/10.1186/1471-2458-13-1141
Coventry, P. A., Hudson, J. L., Kontopantelis, E., Archer, J., Richards, D. A., Gilbody, S., … & Bower, P. (2014). Characteristics of effective collaborative care for treatment of depression: a systematic review and meta-regression of 74 randomised controlled trials. PloS one, 9(9), e108114. https://doi.org/10.1371/journal.pone.0108114
Kingsley, J., Townsend, M., Henderson-Wilson, C., & Bolam, B. (2013). Developing an exploratory framework linking Australian Aboriginal peoples’ connection to country and concepts of wellbeing. International journal of environmental research and public health, 10(2), 678-698. doi:10.3390/ijerph10020678
Liu, C. J., Brost, M. A., Horton, V. E., Kenyon, S. B., & Mears, K. E. (2013). Occupational therapy interventions to improve performance of daily activities at home for older adults with low vision: A systematic review. American Journal of Occupational Therapy, 67(3), 279-287. doi:10.5014/ajot.2013.005512
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., … & Vivian, E. (2017). Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. The Diabetes Educator, 43(1), 40-53. https://doi.org/10.1177/0145721716689694
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