Identify individual and societal supports and barriers which aid and impair chronic illness management.
A chronic illness can be defined as the human health condition that is not only persistent but also exhibits long lasting conditions. Usually they affect the life of the patients in ways by which their quality of life is affected. These also make them suffer from additional stress (Ali et al., 2018). Moreover, it is also seen that such ailments affect the health of the patients by taking away their capabilities of conducting activities of daily lives. They also make them dependent on others forever throughout their lives. Therefore, it is the responsibility of the healthcare professionals to understand the various issues faced by patients suffering from chronic illness and thereby try to gain more knowledge from their narratives and develop interventions accordingly.
Mrs. Mitchell Collins was a patient of 70 years old and she was suffering from osteoarthritis. She seemed to be a very depressed soul as she was quoted saying, “I have no zeal to live anymore. This is not called a life. I am praying god everyday to own me. Sometimes my pain gets so high that I feel like dying. However, I cannot embrace death as it is against Jesus will. So I am waiting for the right time”. This helped to understand that the patient had not been able to cope up with her symptoms and signs of osteoarthritis. She was suffering for about last ten years as she was diagnosed with the disorder since her age at 60. It was seen that her conditions like swelling of the joints and her stiffness of the joint she had really given her a very hard time. She complained that she could never understand what the professionals wanted to do with her and why she was having medications and taking the help of different therapies. She was not being able to understand why her joints started aching and whether it would even help her to live peacefully. From these discussions, it becomes clear that she never had developed enough health literacy about her disorder. She has never taught the ways of self care and this always kept her anxious and nervous about her situation. This was indeed one of the most important approaches that the professionals had never paid importance in her care. All these had made her very tensed and nervous. Depression and anxiety of this kind often have negative outcomes on the health of the patient and affect the mental and emotional stability of the patient. Therefore, for this reason, the approach to her treatment was never considered to be correct.
The patient was seen to suffer from different types of symptoms that affected her quality of life. She complained pain, stiffness as well as limitation in full movement of the joints. She stated that the stiffness seems to be worst in the morning and situations gradually ease out in the afternoon. Swelling as well as inflammation of the affected join made her, suffer from poor quality life (Singh, 2015). All these prevent her from undertaking activities of daily life herself and she has to depend on the other persons of the family to help her in such activities. She complained that her osteoarthritis had even affected her hip portion for which she even fails in putting up her socks and shoes as well as in getting in and out of the care. Often her pain becomes so high at times that she starts crying until it comes under control again by taking medications. Hence, the excess pain suffered by her had created a barrier in her activities of daily life like bathing, dressing, walking, moving and performing any household activities. This disorder had also affected her mobility and gad made her feel that she has become a disabled person. This is said so as she had been seen to have stopped going out of her houses and meeting people in the society and in her community. Previously she was active in community activities and worked with educational centers of the community. However, her disorder had made her very difficult to walk independently and she fears of falling anytime as he believes that she no longer can gain the confidence to walk alone on roads. This had made her feel socially excluded from the community and loss of such freedom of such an active life had made her morose and depressed (Visvalingam, Dhillon & Gunasekaran, 2017). She feels alone and hopeless about her situation as she no more sees her to enjoy the beauty of nature by going outside the house. This is one of the barriers indentified of the patient where her mobility had been severely affected that had created a barrier for her to lead an independent life. This had also made her socially excluded that had affected her mentally and emotionally.
The patient was seen to lead a very poor life. She stated that her daughter in law was the main caregiver who used to help her in daily activities of life. Moreover, she also stated that that her daughter in law often finds it difficult to manage all the activities as she cannot manage handling the weight of the body. She also stated that such actions often gave her very difficult time and she used to suffer from backache (Ackerman et al., 2015). Moreover, another of the support she had was of her General physician whom she visits when her pain goes out of control. The professionals prescribed her new medication and she comes back and starts the new medication. This has been going on for years and her conditions have become worse day by day. Therefore, it was seen that she was feeling hopeless about the treatment of the general physician but she never tried to change her GP. She did not want to live anymore and therefore all these seemed worthless for him. A physiotherapist also used to come who used to help the patient but the physiotherapist never communicated with the GP of any other health professionals and never tried to know the new needs and requirements of the patient (Chapman et al., 2017). Therefore, the support that she was receiving on an individual level from her daughter-in-law and from the general practitioner and physiotherapist from the social and healthcare structures were the only supports that she had at that moment.
In this scenario, it is extremely important for the healthcare team to develop a proper planning and involve every expert in order to meet the specific needs of the patient. Different experts have different important roles that would help the patient to develop better quality life. One of the most important actions of the physiotherapist is to follow the modern modes of therapy and communicate with the patient in order to identify the specific issues she is facing in her joints (Kisch et al., 2018). Accordingly, he needs to plan the actions and thereby apply the interventions accordingly. He should communicate with the occupational therapist and the expert should indentify the issues that she is facing in life due to the disorder. He would be able to help the patient develop capabilities of daily activities of life and thereby set goals and help the patient to meet the goals. He would be helping the patient to overcome the fear that she has developed and hence help in gaining confidence (Hurley et al., 2015). A social worker also needs to be accommodated who would help her and her daughter in law in managing her activities of daily life, provide proper educations to her in a timely manner, encourage her to tale short walks and come out of the house as much as possible. As she feels socially excluded, therefore, it is very much important for the social worker to engage her in the community (Entwhistle et al., 2018). These could be done by helping the patient to get involved in community activities like yoga, meditation classes as well as exercise sessions. She could be arranged with referrals to interact with other patients with the same disorder and come to develop ideas about the how others are coping with the symptoms and thereby enable her to gather courage to overcome the fear.
One of the most important aspects that the healthcare team member needs to incorporate is the development of the effective communication among each other and work as a team. They need to discuss with each other about the progress of the patient in each phase and accordingly develop interventions and modify the interventions according to the current needs of the patient. Once all the members come together and discuss about the interventions, they would be able to develop a plan and accordingly work in coordination so that the treatment of the arthritis is conducted in a systematic manner (Selten et al., 2016). I believe that one of the most important aspects that were missing in the care of the patient was that she had no knowledge about the disorder and she was not able to understand what she could do in order to feel relieved. This is mainly because of the fact that the professionals who were working with her did not educate her about her disorder and did not explain to her the interventions that would help her to take self-care. Moreover, she was taking medication without knowing what the actions of the medications were and how the medications are helping her. Moreover, the physicians had not performed his duty entirely by not referring her to the important professionals who needed to work together to address each of the needs of the patient. Therefore, I believe that management of chronic illness creates huge emotional and mental pressure on the patient along with physical sufferings. Therefore, only providing physical aid is not enough. The professionals need to develop therapeutic relationship with the patient through effective communication, development of trust and mutual respect and educating about the disorder to the patients. This would ensure best care to the patient.
References:
Ackerman, I., Bucknill, A., Page, R., Broughton, N., Roberts, C., Cavka, B., … & Brand, C. (2015). Preferences for disease-related education and support among young people with hip or knee osteoarthritis. Osteoarthritis and Cartilage, 23, A199-A200.
Ali, S. A., Kokorelias, K. M., MacDermid, J. C., & Kloseck, M. (2018). Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review. Arthritis, 2018.
Chapman, L., Brooks, C., Lawson, J., Russell, C., & Adams, J. (2017). Accessibility of online self-management support websites for people with osteoarthritis: A text content analysis. Chronic illness, 1742395317746471.
Entwistle, V. A., Cribb, A., & Owens, J. (2018). Why health and social care support for people with long-term conditions should be oriented towards enabling them to live well. Health Care Analysis, 26(1), 48-65.
Hurley, D. A., Murphy, L. C., Hayes, D., Hall, A. M., Toomey, E., McDonough, S. M., … & Matthews, J. (2015). Using intervention mapping to develop a theory-driven, group-based complex intervention to support self-management of osteoarthritis and low back pain (SOLAS). Implementation Science, 11(1), 56.
Kisch, R., Bergmann, A., Koller, D., Leidl, R., Mansmann, U., Mueller, M., … & Grill, E. (2018). Patient trajectories and their impact on mobility, social participation and quality of life in patients with vertigo/dizziness/balance disorders and osteoarthritis (MobilE-TRA): study protocol of an observational, practice-based cohort study. BMJ open, 8(4), e022970.
Selten, E. M., Vriezekolk, J. E., van der Laan, W. H., van der Meulen-Dilling, R. G., Nijhof, M. W., Schers, H. J., … & van den Ende, C. H. (2016). AB1087-HPR Non-Pharmacological, Non-Surgical Care in Hip and Knee Osteoarthritis: The View of Healthcare Providers. Annals of the Rheumatic Diseases, 75, 1303.
Singh, I. (2015). Training and professional development for nurses and healthcare support workers: supporting foundation for quality and good practice for care of the acutely III older person. Int Arch Nurs Health Care, 1(007).
Visvalingam, A., Dhillon, J. S., & Gunasekaran, S. S. (2017, July). Review on the role of social support in health information systems. In Research and Innovation in Information Systems (ICRIIS), 2017 International Conference on (pp. 1-6). IEEE
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