In this essay

In this essay, it will debate how patient acceptance can be attained by supporting individuals with a long-term ailment. A long-lasting ailment that has no treatment currently; however, can be managed by medications (Department of Health, 2012) can be classified as a long-term condition. In this essay, the skill of taking of patients with numerous long-term ailments, within the public will be mainly discussed. It will stress on patients with two long term conditions, type 2 diabetes and chronic obstructive pulmonary Disease (COPD). The Nursing and Midwifery Council (NMC, 2015) Code of Professional Conduct Guidance has been indorsed in this essay and hence, all identities have been changed to maintain secrecy and protect confidentiality.
Fred is aged 71, who has Chronic Obstructive Pulmonary Disease (COPD) inferior to panic disorder. He lives at home by himself because his significant passed on due to cancer two years ago. Fred is a great smoker and because of that, he faces continuous shortness of breath (S.O.B.) and a terrible cough. He shows that his significant other was an excessive helper for his care and because of that, he feels the reason for him being in this life is not useful; Fred discloses to have started smoking more to help manage with his sadness. He also noted to have face many challenges when it comes to self-management of his symptoms after his beloved passed on.
According to Barlow et al (2002), he explains self-care as a person’s capability to involve with healthy ways of living; distinguishing and applying the right ways to care for their their own symptoms. Ludman et al. (2013) describes it as, self-care permits patients to acquire the required self-assurance in their capability to care for themselves in difficulties and stressful times. Equally, the British Medical Association (2015) plans the dangers of self-caring by stating, it hampers patients from going to their doctors, therefore ensuing in overdue diagnosis. In Fred’s case, regardless of knowing that smoking more will extra worsen his symptoms, Fred still made an aware choice to smoke, this can be acknowledged as having a bad attitude to deal with his condition. Making norms about patient without the proper evaluation can result in inaccurate information about patient’s condition (Yoost, 2015), Bad behaviors mainly stem from defeat which Fred voiced during the discussion which made the nurse to believe he had a bad behavior. In COPD patients, having a bad attitude or lifestyle can have a vast influence on patient’s quality of life; leading to a minimal level of activities being done daily and poor physical, social, and emotional running (Sandelowsky et al. 2016). Also, development in the illness is healthier when a patient has a good attitude regarding their ailment (Kilickaya & Karakas ,2016). Correspondingly, Benzo et al (2016) state that, good behaviors can enhance mental and physical well-being of patients and help with their capability to manage with COPD.
Nurse practitioners must identify the destructive coping strategy of Fred and help him to implement helpful coping strategies. Thorpe, (2014) trusts that, nurses must lay out accurate and attainable goals for patients as it simplifies to recover their self-motivation. To gain enthusiasm, patients must appreciate what they can do for themselves and dynamically involve in caring for their own ailment (Department of Health, 2011). This includes negotiation, because some patients happens to adopt a submissive method to self-caring, which means that not taking part in their own health care management (Coates et al., 2015). Nicol (2015) also explains that, boosting patient’s contribution and inspiring patients to have equal power by giving out all the knowledge and skills instead of patients being the submissive receiver of the care. Patients who take part in their own self-care gives them the chance to have a sense of control and duty and it also changes how they tag themselves (Vahdat et al., 2014). To empower Fred, the nurses must use different communication methods to understand the nature of Fred’s belief of disease and better assist his needs and wants. Lubkin & Larsen (2013) explains that, patient will need information and guidance to help them rebuild their lives, which pave way for them to have a sense of control and therefore lead to the increase of empowerment.
However, Barley & Lawson (2016) dispute that patients who are only educated on how to manage a long-term ailment is not enough to support them but instead, a nurse should be able to build a good relationship before to have better care.
As written above, Fred’s smoking practice led to cumulative shortness of breath and was finding it difficult to obtain information from him. Therefore, the nurse must use suitable communication methods for example closed questions and clarifying questions. For patients who find it difficult to catch their breath, closed questions are preferably recommended because it only needs a minimal effort (McIntyre, 2005). However, MacLeod (2014) stresses on control to this approach by stating that it does not permit all patients to provide answers in depth and so sometimes can take time in response. In relation to Fred, the nurse can also establish a therapeutic relationship to help practice patient-centered care. A therapeutic relationship is grounded on respect and trust, which permits patients to feel secured as their feelings are being listen to. In respect to Fred’s ailment, therapeutic relationship will help him to be genuine about his emotions and talk about matters which are significant to him. However, professional judgement must always be in place by the nurses to command the suitable restrictions of a therapeutic relationship (Griffith, 2013).
Using these various communication approaches, Fred mentioned that he desires to stop smoking however is frightened as it is his only way to handle his sadness. To ease his needs, the nurse can recommend him to smoking-cessation services as a substitute coping approach (Vuong et al., 2016). By doing this, Fred would be able to carry on with his activities of daily living (ADL) which many COPD patients fight with.
McDonald (2014) clarifies that a vital part of feeling empowered is to have control of their lives and treatment. Additionally, physiotherapy referral can be well-thought-out to support Fred in gaining his physical ability.
Some life style influences have an important influence on the way some patients with long term situations control their own care; and therefore, wants patients to adjust their life styles to meet the difficulties of their long term ailment. (citation). As clarified by Jeffries at al. (2015), analysis of their disease can cause patients to attempt changes in their way of life. However, Rise et al. (2013) reason that many patients practice difficulties in making the essential lifestyle changes because of low self-efficacy.
Angela is a 39-year-old woman with obesity who was diagnosed with type 2 diabetes not long ago. Angela does not have any precise diet and has been so dreadful of high level of sugar in the body thus, normally ends up eating more than what she must and not mingling. Angela’s unhealthy way of living and her low level of health literacy towards her ailment subsidized to uncontrolled diabetes. Angela testified to feel low and nervous as she is worried of hypoglycemic occurrences coming. She was also asked to lose weight however, grumbles of tiredness and back pain whenever she tries to do some activities.
Angela’s way of living became very difficult because of her diagnosis which impeded on her ability to cope with her ailment. It was also known that the insufficient health literacy contributed to her uncontrolled diabetes as her surviving approach was to eat a lot and separate herself from the community in fear of hypoglycemic occurrences.
Angela’s situation may want to rise their health literacy to be in control of their ailment.
It is hence domineering to help her through patient empowerment. Luczynski et al. (2016) defines empowerment as a therapeutic technique that permits patients to regain control and take accountability of their own health. The nurse can empower Angela through patient education as Kelo et al. (2013) summaries it to be a key intercession in promoting patient’s health. Type 2 diabetes needs a healthy lifestyle which comprises diet control and patients must have the essential knowledge to self-care (Ingadottir et al., 2015). As stimulated by NICE guideline (2015,) nurse practitioners can recommend Angela to the Dose Adjustment for Normal Eating (DAFNE) program to improve and manage her diet through carbohydrate counting. The nurse can also hype her ability to manage by giving out the vital information and help on her style of living to keep her diabetes under control. For examples, giving out advise on the type of food to be eaten, and the kind of exercises she should carry out and making her know of the problems that can come up from uncontrolled diabetes such as nephropathy and other heart diseases (Chawla et al., 2016).
However, giving patients advise and educating them alone will not be sufficient; thus motivational interview (MI) can be done to accept behavior changes in patients. Relating back to Angela’s case, the nurse can use the said skills to improve Angela’s health behavior. An example is that, the nurse can start with an open-ended question by asking what is most important to her, which will bring a sense of purpose in her life. The nurse can then reveal empathy and praise Angela by escalating her willingness to change through declaration. Declarations helps to shape up confidence in patient’s ability to change opposing behaviors and achieve the correct attitude (Reims, 2016). The nurse can then offer support and advice corresponding to her goal. In Angela’s case, if a level of trust is not built from the nurse, Angela could be deceitful and approving on certain things just to make sure that the nurse is not upset. However, patients are also sometimes more expected to change some of their coping strategies as their ailment gets better with time. For that reason, MI may not be as helpful for Angela as it is time dependent which is to say, patients may lose the inspiration to change their attitude (Lindhe Söderlund, 2010).). Furthermore, Moss et al. (2017) shows that patients who are already inspired may not be profited from the motivational interview.
Furthermore, the nurse can go on to empower Angela by introducing her to support groups where she will be able to meet like-minded people and care from people will make her less fearful about her ailment; helping her to manage it better. Some groups such as peer support groups enable patients to reflect themselves in others simply by paying attention to them and feel a sense of belonging (Joensen, 2016). In a similar study, few partakers showed that variance in gender and diabetes length can come across as a wall to exchange experiences. Thus, it is obvious that peer support groups can only be helpful if patients enthusiastically engage with other partakers. By providing Angela with support groups to progress in her self-care so she can improve her quality of life (Department of health, 2017).
The psychosocial factors which contributes to the ability of patients and their relatives to deal with long lasting ailment. The Department of Health’s mental health strategy, launched in (2011) has broken it down to people with long lasting ailment are very much likely to suffer from mental illness like depression as to compared to those who do not have a long lasting ailment (Department of health and social care 2017). With reference to Chew et al. (2014), psychosocial problems which are not treated and not noticed can cause poor health and also low level of satisfaction of patient’s capability to manage their ailment. Going back to the essay, Angela mentioned she is scared to have occurrences of hypoglycemic and feels very worried, and this makes her isolate herself from other people. When one has negative thoughts, it causes the individual to become depressed and worried. (Trick et al., 2016). Evidence based, Angela has minimal knowledge about the ailment diabetes and her low level of health knowledge has had a very bad influence on her mental wellbeing. Emotional factors such as depression and low mood can prevent a persons capability to manage their long lasting ailment(Maneze et al., 2016). This joined with simple duties like frequent checking blood glucose often, eating the right food, giving insulin and taking medication makes this irresistible to gain (Helgeson & Palladino, 2012). In Angela’s case through mindfulness, the nurse can upsurge her self-awareness by supporting her to recognize and express difficult feelings. Diary keeping and revising daily also inspires self-awareness (Nicol 2015).
In conclusion, it is vibrant that the main role of health professionals is to evaluate patients and support them to fulfil their needs. The essay has tried to discover the physical, social and psychological encounters people living with long term ailments deal with when dealing with their condition. The proof in the paper shows that self-management needs satisfactory amount of knowledge and understanding as well as autonomy to change. This can be attained using various communication strategies. The pivotal role of communication has also been emphasized to guarantee continuity of care.