Chronic Illness: Control and Prevention of Tuberculosis - Essay Example

Chronic Illness Tuberculosis is a chronic illness that tends to have far-reaching impacts on the patient’s personal and social life. These effects are influenced by various factors that are evident in the discussion. In addition, the best nursing practices for handling tuberculosis patients are evident. Chronic Illness Part A Yancee (2001 p.11) describes tuberculosis as “a bacterial infection that usually attacks the lungs but can lodge almost everywhere in the body of its victim”. Places where tuberculosis can lodge in the body apart from the lungs include the spine, the kidney, and the brain (Wouk, 2014). There exist two main tuberculosis types namely active TB and latent TB. Latent TB is a evident when the infected person carries the bacteria but shows no sickness or clinical manifestation whereas active TB is the type of tuberculosis whereby the infected person shows clinical symptoms or is sick and can spread the infectious bacteria to other people. Tuberculosis is an air bone disease. A sick person’s cough contains tiny droplets that carry along the bacteria and when inhaled might cause infection to a healthy person. Tuberculosis affects a person’s life both at a personal level and at the community level. At personal level, tuberculosis has an impact on the lifestyle in terms of ability to lead an active life and the financial strain caused both by the resultant incapability and the cost of healthcare. Since tuberculosis finds its way to the lungs, it destroys lung function and makes it hard for the patient to breathe. Consequently, it slows down a person’s active life. Tuberculosis affects the psychological well being of a person. The stigma that one is subjected to when suffering from tuberculosis has far reaching consequences. The patient has to deal with the isolation by the community and desertion. Part B David is a 21-year-old university student taking a course in theatre performance. His passion in playing rugby sets him apart from other regular students. A year ago, he was diagnosed with tuberculosis after a long series of misdiagnosis. He faced numerous challenges because he was not able to play rugby for a while because the disease could not allow him to lead an active life due to the difficulties in breathing. David also faced stigma because people feared that tuberculosis, as an airborne disease would infect them. Given the fact that tuberculosis is associated with HIV/AIDS, many people assumed his HIV status was positive. This stigma and isolation also affected his family because people thought they could be carriers of the pathogens and did not freely interact with them. Part C David’s medical condition affected him negatively. Firstly, there was the concept of stigmatization. According to the Mental Health Commission of the Government of Western Australia (2014), stigma is often associated disgrace that discriminates against a person. In the event that a person is labeled by their sickness, they are part of a stereotyped group. The perception leads to prejudice and discrimination. The victim therefore moves from a normal social status to a discredited one. In David’s case, the society had a discriminative perception about him. The thinking of the society that David is not a friend or companion, together with statements of prejudice against him and his family all amount to stigma. Another aspect that played a part in David’s situation was social isolation due to the fear of being infected by the disease (Ormerod, 2000). He lost several friends and many would not want any physical contact or close distance association with him. His family suffered the same problem as people perceived them as possible disease vectors. David was a social person who was now condemned to a life of social isolation trying to learn how to live a more solitary life. Psychological impacts from this type of treatment have far-reaching consequences. Social challenges and perceived isolation are connected with reduced levels of physical and psychological health. Adaptation aspect is also portrayed in David’s scenario. Based on the changes in his physical, social and psychological status, he had to find a way to make to survive. The TB medication is based on a timely dose and medication, meaning that the danger of skipping a single dose is high (Macq, Torfoss and Getahun, 2007). David had to adapt to this new lifestyle for six months during the period of medication. There were also major changes in the social setting causes by the resultant stigma and social isolation. The stigma had a significant effect on his self-esteem and personal value because many people were not willing to trust, rely on his capabilities and skills (Ormerod, 2000). Consequently, he had to adapt and find a way to maintain his self-value and self-esteem. Isolation by his friends made David adapt to a solitary life. Part D Tuberculosis can be addressed at all healthcare levels that include primary, secondary and tertiary levels. According to the Association of Faculties on Medicine of Canada (AFMC) (2014), primary prevention reduces risk that in turn “prevents the onset of disease”. Primary prevention practices involve vaccination and education or advocating for safe and healthy practices. For example, hygienic coughing practices such as use of a handkerchief are crucial. Primary prevention also aims at imparting the knowledge of the disease to the population in order to enhance prevention. The AFMC also defines secondary prevention as “procedures that detect and treat pre-clinical pathological changes and thereby control disease progression” (Association of Faculties on Medicine of Canada, 2014 p.1). At this stage, the most important aspect is screening in order to verify the presence of disease. The earlier the disease detection is conducted, the better the chance of effective treatment and control. Screening is done at laboratories and health centers by a qualified health professional. The focus at the tertiary center is to facilitate rehabilitation and counseling in order to deal with the psychological aspect. The medical personnel can address the health concerns of a patient through health education. Teaching the society on how to handle and address such issues will address such concerns. It is necessary to emphasize the need to accept the patients as part of the society, avoid discrimination and prejudice. The community should learn the need and importance of offering mental support to the patient instead of worsening their situation by isolating them. They should be encouraged to help the patient remain positive and follow their prescriptions to the latter. Despite the fact that the patient is infected, it does not make him or her, a lesser deserving member of the community. This information for families and individuals both infected and affected by TB can be found on the following websites: The Truth about TB organization website and the World Health Organization website. Part D Nurses play a major role at the healthcare facilities in handling patients of not only tuberculosis but also many other diseases. This handling of patients requires maximum levels of care and responsibility to avoid disease transmission across patients and between the patients and the nurses. The most important practice involves infection control that falls under the World Health Organization’s recommended approach for tuberculosis prevention in PLHIV known as the three I’s for HIT/TB. The setting up of a TB infection control committee is vital in achieving these goals. The committee is charged with the responsibilities of meeting frequently, generating and revising a TB control plan. It also reviews the value of the plan within the facility in order to suggest changes and ensure staff training. AIDSMAP also suggest various practices that can prevention transmission. Evidence Based practice also prompts nurses to identify coughing and proposes screen for tuberculosis. It is also necessary to educate the patients on hygienic coughing practices when they are in and out of the facility. Separating patients identified to be coughing from other patients to reduce chances of disease transmission and collecting sputum in well-ventilated areas preferably outdoors is crucial. Provision of a private and secluded area for patients to produce sputum with running water for hand washing thereafter is also crucial. Health workers should receive required information and encouraged to go for TB screening to boost infection control efforts. References Association of Faculties on Medicine of Canada. (2014). Basic Concepts in Prevention, Surveillance and Health Promotion. Retrieved from http://phprimer.afmc.ca/Part1- TheoryThinkingAboutHealth/Chapter4BasicConceptsInPreventionSurveillanceAndHealt hPromotion/Thestagesofprevention AIDSMAP. (2013). HIV and TB and practice for nurses: TB infection control. Retrieved from http://www.aidsmap.com/HIV-and-TB-in-Practice-for-nurses-TB- infection-control/page/2563967/ Macq, J., Torfoss, T. and Getahun, H. (2007). Patient empowerment in tuberculosis control: reflecting on past documented experiences. Tropical Medicine & International Health, 12: 873–885. doi: 10.1111/j.1365-3156.2007.01858.x Mental Health Commission of the Government of Western Australia. (2010). What is stigma?. Retrieved from http://www.mentalhealth.wa.gov.au/mental_illness_and_health/mh_stigma.aspx Ormerod, L. (2000). Control and prevention of tuberculosis in the United Kingdom: Code of Practice 2000. Thorax 55(11):887-901 Truth about TB organization. (2009). Treating TB. Retrieved from www.thetruthabouttb.org/treating-tb The World Health Organization. (2010). Tuberculosis. Retrieved from: www.who.int/bulletin/volumes/89/3/11.../en Wouk, H. (2009). Tuberculosis. New York, NY: Marshall Cavendish Publishers. Yancey, D. (2001). Tuberculosis. New York: Twenty-first Century Books Publishers. Read More