The Patients Journey: Home to Home - Case Study Example

The Patients Journey/Home to Home According to the World Health Organization, overweight individuals and those whom we consider to suffer from ‘obesity’ are those who have abnormal or excessive fat percentages in their body which become detrimental to an individuals health. Obesity is one of the major reasons for the development of various kinds of chronic diseases. These include diabetes, heart conditions, hypersensitivity (which is very common and goes unnoticed), as well as cancer. Obesity was first attributed mostly to Western countries or areas of higher economic prosperity but recently it can be seen that it is becoming a rapidly growing danger in countries of lesser socio-economic status as well. This is causing a major sense of distraught amongst professionals who are still not yet able to battle the onset of infectious diseases and malnutrition in these countries. These paradoxical problems damper efforts to bring about change and hamper the initiatives to be taken in solving health care problems. There are again, a number of reasons which are responsible for this odd ended health problem anomaly. The fact that under-nutrition and obesity can be found in the same scenarios, within the same country and same society, is an indication of internal health problems, and needs to be addressed by exploring the reasons. These are linked to inadequate pre-natal, infant, and young children care of nutrition. The foods which individuals at these ages are subjected to are usually found to be high in fats and poor in nutrient value. This coupled with lack of physical exercise leads to occurrences of overweight problems. “Indeed, the prevalence of obesity is so high that one might consider it statistically ‘normal’ if it weren’t for the serious implications of health, as well as for social and psychological functioning.” (Barlow & Durand, 2008, pg.28) The problem is clearly severe and reaching epidemic proportions. It needs to be curved, and carried out till the end of the recovery process, not just stop at the point of treatment since the effects of obesity reach dimensions further than just the physical aspects of an individual’s health. This case study deals with an obese patient who is 18 years of age. The patient suffers from hypertension which is minimal as compared to the situation of the obesity. The status of obesity in his case is important for healthcare individuals in order to help facilitate recovery of such individuals. It is also necessary to understand where the problems that the patient faces originate from. Though a number of factors go into the health impediments of obese individuals, asides from their actual obesity, these same factors as well as added pressures affect routes to recovery. Qualified, up to date, and ethical professionals must realize the implications of not being able to help the patient recover. There are always chances of relapse and can be avoided most of the time with correct awareness and when the appropriate measures are taken. After all, obesity is not an end in itself. It can give rise to other more dangerous illnesses as well as psychological disorders. Obesity is a disease which hits home on a number of different levels, especially when it comes to teenagers. Many teens don’t give much considerance to their physical health but do indeed allocate much value on their physical appearances. Since physicality holds a good deal of weightage, not being able to comply with popular standards of ‘good-looking’ result in a negative outlook from their peers and fellow age-group members. Unfortunately this situation does not occur only in peer relations but adults can be as cruel and unsympathetic at times, especially when the obesity arises from a more organic or hereditary deviance. Needless to say, a significant number of obese teens, especially girls, are diagnosed with depression, anorexia, and bulimia due to unhealthy obsessions with weight and physical size. There is much research and statistics that support the fact that obesity has great negative psychological impacts on individuals. The range of effects varies from depression and low self esteem to cases as extreme as suicidal tendencies. Recent surveys report that obese individuals go so far as rating their quality of life as poorly as the results given by individuals suffering cancer and being treated with painful procedures such as chemotherapy. But a number of behavioural problems are arising which not only affect the suffering individual but also others around them which directly influences the society as a cohesive social structure. The most common of these is social isolation and poor socialization skills. This gives rise to introverted, verbally inadequate, and inferiority-complex suffering individuals who have difficulty functioning in the vast array of roles that society has to offer and requires of them to fill. We know that individuals who can not cope up with the pressures of modern life usually do not make much headway when it comes to socio-economic progress. This causes stress and a lack of sense of belonging. A common stereotype is that individuals believe that they are not ready to face the world and are ‘misfits’. At least, this is the case with my patient. The individual feels anxiety at the thought of re-immersing in society and is hesitant to begin building relationships and new communicative relationships. This can be indeed due to stigmatization. As one study, rightly points out, “Adolescents are extremely reliant on peers for social support, identity and self-esteem. Bullying, teasing, withdrawal of friendships, social marginalization are some of the ways that overweight children are treated. Although no direct link is drawn between these behaviours and psychological disorders, these studies suggest that the disparate treatment of obese children by their peers has psychological ramifications” (Janssen, 2004, p. 118) Thus individuals of this age group already are very conscious of themselves and are in a constant contrastive flux with their peers. So though progress may be achieved and slowly being worked upon, the patient’s previous apprehensions about social interactions need to be dealt with. This can all be done, and furthermore, needs to be done, simultaneously with treatment and once treatment has ended with increased fervour to overcome stereotypes of the patients own mental body image. The goal then has to be to ease the patient into a healthy social lifestyle. Concordance is usually confused with compliance. But compliance covers the aspect of going along with the health care suggestions and advices of the physician/doctor/nurse, etc. Concordance takes this a notch further and talks of the patient being an active part of their own health treatments. In very basic terminology, we can consider it to be a contract or mutual understanding between a patient and a health care professional in which the authority and person with final say and consent is the patient themselves. Usually, the debate runs hot when it comes to cases of obese individuals and whether compliance or concordance is the best case scenario for most desire-able results. In the case that I have studied, the individual showcased compliance but only through concordance. Being a legal adult at 18 years, there was no valid reason to defer the individual from making his own choice. He chose informed consent. Though it is argued that compliance eventually would allow an individual to concord with his/her supervisor, it is not the practiced norm. However, whether concordance leads to compliance is also an important question. The greatest difficulty which is faced in the relationship between patients and health care professionals is the issue of whether the doctor can give up their professional opinion in favour of the patient’s personal one. “Awareness of the psychological factors at work in both organizational and interpersonal relationships can help to conceptualize the benefits of and, importantly, some of the barriers to effective person-centered care or inter-professional collaboration. From a psychodynamic perspective the challenges that arise for practitioners who are working with issues that are highly emotionally charged, and the sometimes destructive strategies that teams can put in place to cope with the feelings and personal pressures that can arise from care work.” Barrett, Sellman, & Thomas, 2005, p.4) This clearly tells us the state that individuals who suffer from obesity and undergo treatment are in. The issue is a highly charged one indeed and requires professionals to be extra sensitive to the problems that these obese individuals face. The patient in this case, was from a middle class family and educated till the age of 16. The concordant negotiations with his healthcare professional did not reach a mutual, respectful understanding immediately. Frustration was evident on the side of the professional who did not initially give in to the idea of letting an individual make such difficult decisions (about gastric bypass surgery in this case). However, the mutual establishment of a rapport between the two was finally established when the patient entered into a more personalized way of sharing information. This is not recommended in the case of physicians for lack of objectivity, but for patients, especially those suffering the stigmatic obesity, it is not only commendable but brave. The major characteristic which defined their relationship here was acceptance and the giving up the notion of a power struggle between the two. Unfortunately, like other issues and problems in the world, obesity too becomes politicized and in its debatable factors becomes overlooked as a disease and illness and becomes more of a debating ground for other issues. According to Marion Nestle, “The politics of obesity demand that we revisit campaign contribution laws and advocate for a government agency—independent of industry—with clear responsibility for matters pertaining to food, nutrition, and health.” (Nestle, 2003) Under the circumstances, what is needed is a revisiting of contribution laws and the campaigning for a representation from the government. This should be done keeping economy and industry separate and treating healthcare with its own fundamentals in mind. The duties that fall onto this sector would have to account for the matters pertaining to nutrition and food watch so as to stop weight related diseases at both ends of the health spectrum. Internationally, speaking, in keeping with the current and constant outcries from all corners of the world to focus on the increasing issue of health and weight, the World Health Organization is best known for taking initiatives. The WHO has developed a seemingly rigid plan and implementation regime to fight with this growing terror in countries all over the world. The man aim is to deal with obesity right from the grass roots level in order to stop it short of reaching epidemic proportions. The most important output of the WHO in this regard has been the 2003 guidelines for weight reduction and control. These guidelines include, a globally adoptive, nutrition guide which is meant to mediate between both obesity and malnutrition, as a solution to both. The main advocating done in this consultative guideline is the lowering of possibly harmful elements such as salt, sugar, and fats. Other measures that can be implemented locally were the restrictions of marketing of food items. These were especially to be looked at when considering the food supply to students of all levels, mostly children and teenagers. The usage of tax and pricing policies to control food is also suggested (Gournay, Wykes, & Gray, 2002). The entire idea of health and health promotion bases itself on the concept of human rights. Everyone is entitled to the right to a healthy and safe life. Their should follow the attainment of a standard health criteria regardless of any distinction, whatever they may be regardless of race, colour, gender, nationality, etc. But a stereotype which is often treated with disrespect is the obese individual. Instead of granting them the best that health care can do, they are considered ‘lazy’ individuals who simply need to lose weight. But this is surely not the case. The initiatives to ensure that obese individuals are given the care, identification, and validation they deserve is vital for them to recover if we want the recovery to be permanent. This is even more so, since obesity requires a change in the lifestyles and a behaviour modification on the part of the patients. It is a vital element of public health responsibility and something which local communities can promote on their own, independent of authorized backing. Locally, this seems to be being implemented but more needs to be done for active headway. References Barlow, D.H. & Durand, V.M. (2005) Essentials of abnormal psychology: Cengage Learning, 2005 Barrett, G., Sellman, D., Thomas, J., (2005) Interprofessional Working in Health and Social Care, Basingstoke, Palgrave Macmillan Janssen I, Craig W, Boyce W et al., Association between overweight and obesity with bullying behaviors in school-aged children. Pediatrics (2004); 113 (5): 1187-1194. Nestle, M. (2003) "The Ironic Politics of Obesity," Science, vol. 299, no. 781, February 7, 2003 Gournay, K., Wykes, T., & Gray, R. (2002) From compliance to concordance: a review of the literature on interventions to enhance compliance with antipsychotic medication. Journal of Psychiatric and Mental Health Nursing 2002,9, 277–284©2002 Blackwell Science Ltd 277 Read More