Managing Chronic Obstructive Pulmonary Disease - Assignment Example

Name Tutor Institution Chronic Obstructive Pulmonary Disease among the Aborigines of Australia Background to the Aboriginal Community of Australia The population sub-group chosen for the action plan in the Aborigines of Australia. Aborigines are the indigenous people of Australia. In the whole of Australia there are about 400,000 aboriginal people (Bartlett 2002). This amounts to only 2 percent of the population of Australia. Aborigines fall into between 500 and 600 different groups. However, they have some common links. Since the 1980s, Australian aborigines have been reported to suffer from chronic non-communicable diseases such as chronic lung disease and cardiovascular disease. Chronic Pulmonary Obstructive Disease has been reported in these populations as well. These diseases mostly affect the aboriginal people occupying remote areas and there level have often been described as epidemics (Andrews & ‎Curtis, 1998). Globally, minority populations have been observed to have these diseases. Aborigines suffer from these conditions because of abrupt change in epidemiology and health services. In the last 45 years, there has been a sharp decrease in in childhood and infant mortality and this implies that many more aborigines live to see their adulthood. Life expectancy has also improved because of the mitigation of treatable and preventable conditions including malnutrition and infections (Collins & Madden 2005). However, the Aborigine population is still plagued by many pervasive disadvantages including poor diet, poverty, drug, alcohol and substance abuse, unemployment and lack of opportunities for training, poor education, poo diet, increasing rates of tobacco smoking, poor housing and lack of exercise. Awareness and proper management of chronic diseases among Aboriginal populations in rural and remote areas has been undergoing a transformation since the 1990s. However, less remote areas lack enough evidence for this because it is not easy to determine the status of aborigine sin these areas (Andrews & ‎Curtis, 1998). Priority areas and their justification Priority areas for the action plan are the rural and remote areas in Australia and the informal settlement areas of many urban areas in Australia. These are the areas where larger Aboriginal populations can be found. Most of the Aborigines are economically impoverished and therefore, they stay in remote places and informal settlements in towns and cities (Collins & Madden 2005). In these areas, there is a high prevalence of diseases such as chronic obstruction pulmonary disease. The reason for this is that there are high levels of poverty which lead to poor malnutrition and smoking, which are major causes of COPD. It is also not easy to find good healthcare facilities in remote areas hence the high rates of diseases (Andrews & ‎Curtis, 1998). Poverty stricken residences and remote areas also have suitable environments for the development of the disease. These may include air pollution, tobacco smoking and use of other substances. Generally, the areas inhabited by indigenous communities in Australia are worse compared to those inhabited by non indigenous communities. All these areas should be considered in the development of the action plan (Collins & Madden 2005). Objectives i) To reduce high rates of smoking in potential patients Smoking is the biggest cause of and contributor to COPD. Reducing the levels of smoking in would be patients can help in the control of COPD. The action plan has the reduction of high smoking levels in potential patients as one of its objectives because this is can be very effective in preventing those who are well from getting COPD (Beyer & ‎Brigden, 2003). ii) To help reduce cases of unmanageable levels of COPD Another objective in the action plan is to help in the reduction of unmanageable levels of the disease. When the disease gets to a level that is unmanageable there is a high possibility that many people can lose their lives (Bousquet, ‎Khaltaev & ‎World Health Organization, 2007). iii) To reduce the number of smokers Reduction of the number of smokers would directly reduce the existing cases of COPD because as stated earlier, smoking is the biggest cause of COPD. Cutting down the number of smokers would therefore help a lot in the management of COPD (MacNee, ZuWallack & ‎Keenan, 2009). iv) To help as many people as possible to avoid getting the disease Prevention of people from getting the disease is the main reason for the creation of the action plan. Other reasons include managing the disease and rehabilitation. This objective is aimed at eliminating the disease by preventing many more people form catching it (Kendall 2010). v) To prevent losses of life from COPD This objective is aimed at preventing people from dying as a result of COPD. The action plan helps to prevent the spread of the disease and to manage it and in the process, the lives of many more people are saved (Quinn, 2005). vi) To reduce the number of people getting COPD COPD can be properly managed if the number of people with the disease is reduced considerably through proper measures. Measures such as awareness creation and education about smoking and health are necessary in order to reduce the cases of COPD especially in people who did not have the condition before (Bousquet, et al. (2007). Action Plan Objectives Strategies Action Deliverable By Who When To reduce high rates of smoking in potential patients Primary prevention of smoking commencement and progress Enhancement of access to smoking cessation programs in the community Develop an inventory for models for service delivery, current and future practices and implementation activities, management intervention in all aboriginal communities, Repository of prevention of smoking and management programs, care pathways in Australia’s Aboriginal communities. Repository will need to be updated annually. Government and healthcare providers Within the first 20 years To help reduce cases of unmanageable levels of COPD Detecting the disease early in groups at risk Increasing access to spirometry To promote the gathering and analysis of useful data about COPD patients in order to increase COPD management, improve COPD risk factors assessment, reduce costs and improve on efficiency. Definition of the procedures for implementation of technologies and tools for monitoring, assessment, decision making, screening, support for the sick, protocols and standardized approaches. Healthcare providers in collaboration with government and relevant institutions Within 10 years To reduce the number of smokers Improvement of the rates of stopping smoking Education and awareness on the dangers of smoking and counseling with smokers. Increase information dissemination and effect change of attitude about COPD and its prevention. Development of methods and procedures for measuring and gauging the success of anti-smoking campaigns. Healthcare providers Within 20 years To help as many people as possible to avoid getting the disease Preventing exacerbations Washing hands, taking medicine and avoiding contact with people infected with flu and colds Tools, models and programs for self management The patients suffering from COPD Within 20 years To prevent losses of life from COPD Managing stable disease Provide access to services Raise awareness on the importance of proper care for those with COPD complications. Repository of resources on stake holders and professionals, their role in the implementation of COPD strategies, needs of patients and demand for support, funding and other streams for resources. Government and stakeholders in the health sector Within 30 years of the beginning of the program To reduce the number of people getting COPD Avoiding exposure to risk factors Reducing exposure to cigarette smoke, chemicals and dusts at work and pollutants both indoor and outdoor. Planned activities for disease prevention and other developments Patients and those at risk of getting the disease Within 30 years of the onset of the program Strategies Tobacco smoking has been found to be the biggest cause of chronic obstructive pulmonary disease. Therefore, the prevention and management of tobacco smoking is important in the prevention and management of chronic obstructive pulmonary disease (South Australia Department of Health, 2009). The strategies for the prevention and management of chronic obstructive pulmonary disease include preventing the commencement of smoking, detecting the disease early in groups that are at risk such as smokers, enhancing the rates of stopping smoking, preventing exacerbations and managing the stable disease. Another strategy is to avoid, reduce or eliminate exposure to risk factors. The main way of dealing with chronic obstructive pulmonary disease is to control the use of tobacco. Cigarette smoking is a major factor contributing to the development of COPD. Passive exposure to cigarette smoke is also a risk factor (The Australian National Preventive Health Agency, 2013). Preventing the commencement of smoking The prevention of smoking among aborigines should take the form of education and awareness creation about the dangers of smoking. In order to prevent people from starting to smoke, there should be developed a co-ordinated plan that addresses smoking, especially among the aborigines who are the target population. Among these communities, particular concern should be given to people with mental health problems, pregnant women and those with low socio-economic status (Nolte & McKee, 2008). Action This strategy is achievable through the enhancement of access to smoking cessation programs in the community and health awareness campaigns in the population. People should be encouraged to seek medical advice early enough whenever they notice any respiratory complications. Early detection of disease To manage and prevent COPD, the strategy of early detection is very effective. When the disease is detected early, it becomes possible to intervene and reduce the potential burden of COPD. It is important for people who are exposed to tobacco and have any respiratory symptom to get a spirometry to help in detecting COPD in its early stages (Kendall et al 2010). Early detection ensures that the disease can be properly managed so that the patient does not have to lose his or her life. Action The appropriate action for implementing this strategy is to increase access to spirometry which is important for diagnosing COPD by way of identification and provision of spirometry providers. Increasing the rates of stopping smoking Cessation from smoking is the only most effective and affordable way of cutting down exposure to the risk factors that cause COPD. Every smoker whether suffering from COPD or at risk of getting the disease, should be given the best smoking intervention (Krueger, Williams & Kaminsky, 2007). Action Appropriate actions to achieve this strategy include education and awareness on the dangers of smoking and counseling with smokers. A short counseling session of 3 minutes can result in rates of stopping smoking of between 5 and 10 percent. Both national and state governments should come up with comprehensive programs and policies for controlling the use of tobacco (Institute of Medicine, 2000). These programs should have clear, repeated and consistent messages that discourage smoking being delivered via any feasible channel. These channels include schools, television, radio, health care providers, print media and community activities. Government officials should develop legislation that can create smoke free schools, working environments and public facilities. The public and public health workers should encourage and support this (Krueger & Kaminsky, 2007). Preventing exacerbations To prevent exacerbations in COPD people should learn how to wash their hands often. This helps to prevent infection. It is also helpful to avoid having close contact with people having colds and flu (Hanania & Sharafkhaneh, 2010). The sick should take their medicines such as steroids, inhaled beta-agonists and long-acting anticholinergics because they help lower the risk of exacerbating COPD. It is also advisable that those with COPD should take antibiotics or other drugs whenever they have sinus problems or other infections. The sick should use spirometry for knowing if the lungs are working well or not. The spirometry measures the amount of air that can be blown out in a second. The devices show if the functioning of the lungs is getting better or worse. Spirometry helps those who do not understand early exacerbation signs (Hanania & Sharafkhaneh, 2010). Managing the disease Managing COPD in its stable condition has moved from relying on pharmacological treatment to various interventions such as educating the patients, patient management of exacerbations by themselves and pulmonary rehabilitation. The disease is also managed through the adherence to a plan with a doctor, performing pulmonary function tests, treating with drugs, and nutrition intervention (Global Initiative for Chronic Obstructive Lung Disease, 2013) Action Management of the disease is possible by increasing access to the necessary services provided by primary, secondary and tertiary providers which focuses on self management, COPD action plans and exercise training. For this to be achieved, it is necessary to expand community based ambulatory services for COPD and create integrated protocols and referral pathways (Bousquet, ‎Khaltaev & ‎World Health Organization, 2007. The government and health providers should try to manage acute exacerbations of COPD by creating access to clinical assessment facilities for everyone with COPD, especially those with acute symptoms in the community. Patients should get support and care in the last stages of their lives. The government in collaboration with stakeholders should create a service delivery model for palliation and end of life for people with COPD (Division of Social and Behavioral Medicine Stephen J. Kunitz M.D. Professor, Community & Preventive Medicine University of Rochester Medical Center, 2006). This can help to make sure that care is given either in the home or the community and that people are encouraged to use advance health. There should be interventions in cigarette smoking, self management training for chronic diseases, palliative care and application to chronic conditions and pulmonary rehabilitation. The national and state governments should support the development of information and communication technology because these make it possible to have multi-disciplinary care planning. They also help to make sure that every patient with COPD can access their health records and control their health information (Collins & Madden, 2005). Avoiding exposure to risk factors It is advisable that people should avoid all exposure to risk factors. Cigarette smoking for long periods is the most common risk factor for COPD. The risk increases depending on the number of years and packs that an individual smokes. Those who smoke pipe, cigar and marijuana and those people with huge exposure to smoke can get COPD (Collins & Madden, 2005). The chances of getting COPD also increase when asthmatic individuals smoke. People should also avoid occupational exposure to chemicals and dust. Exposing oneself to chemical fumes, dust and vapor at work may cause lung inflammation and irritation. In order to manage COPD people should totally reduce personal exposure to cigarette smoke, chemicals and dusts at work, pollutants both indoor and outdoor (Frith, Cafarella & Duffy, 2008). Evaluating Action Plan Effectiveness To evaluate the effectiveness of action plans there should be measurement tools that provide the relevant specific information. This helps to move smoothly through the strategies to the objectives (Civicus, 2013). The process of evaluating the action plan follows the below steps. 1. Defining the purpose and scope of the process of evaluation The purpose of the evaluation process is to determine the value of the action plan and find ways of improving it. The purpose helps the planner in focusing and delineating subsequent steps of the evaluation process. It is important to design both a summative and formative evaluation. 2. Specification of Evaluation Questions Evaluation questions should be crafted in a very complete and clear manner. Evaluation questions can be of different forms. The best way is to craft the questions on a smaller scale. Clear and comprehensive questions will lead to clear and understandable answers which then provide a reasonable judgment on the suitability of the action plan for managing and preventing COPD (Civicus, 2013). 3. Specification of the Evaluation Designs An evaluation can be designed in many ways. Some designs for evaluation can be very complex while others can be easily implemented. Choosing the suitable evaluation design is a task that should be taken seriously because the evaluation design helps to show the effectiveness of the action plan. A good and workable design provides the best results. On the other hand, if the design chosen is the wrong one, it might give untrue results about the effectiveness of the action plan. 4. Creation of the Data Collection Action Plan The evaluation questions tell which data sources will be used. When the questions have been specified, the next thing is determining where the information needed to answer these questions will come from. The data collection plan gives a description of data sources and the techniques to be used in the collection of this data. Some data may be available and the only thing needed is to collect and analyze it. However, there will be a need to collect some types of data. It may be necessary to have an action plan for data collection which gives specific information on the type and source of the data (Civicus, 2013). At this level, it is also necessary to determine if the data should be collected from the whole population being studied or just a sample of it. Generally, it is better to gather information from the whole population than just a sample of it. A sample that is well selected is better than one that is not well chosen. The quantity of data being collected depends on the resources available for the evaluation of the action plan. The highest quantity of information possible should be the target (Bousquet et al 2007). The more information available, the more the likelihood that the information n received back represents the whole population. A low rate of response can result in biased results and therefore a higher number is preferable. 5. Data Analysis The evaluation process will use the simple frequency accounts system. Most of the evaluation questions have to do with change. Data analysis helps to establish interpretations of the data collected which are then used to determine the success of the action plan. 6. Documenting the Findings The main thing here is developing conclusions based on the collected data. It is required that the results be examined carefully and in an objective manner. What do the results say about the action plan and the evaluation questions? The findings should be well documented in writing. The evaluation cannot be complete until this is done (Civicus, 2013). The action plan evaluation report should talk about a clear and accurate report of what is being evaluated, the aim and purpose of the evaluation, evaluation questions and the criteria for data collection on each question. It should also describe the process of the instruments for data collection for every question, the sources of information for the questions, the rate of response, the methods used in analysis and the conclusions and recommendation (South Australia Department of Health, 2009). 7. Disseminating Findings The scope of the evaluation and the questions used in the evaluation helps to determine the audience for which the evaluation report is being created. The information should be tailored to the needs and wants of the specific audience that will receive the report. Some audiences may need to get a detailed and comprehensive report (Grouse, 2012). 8. Improvement of the feedback to the action plan The final step is the review of the results, the findings and the conclusions. Any indication that changes on the action plan should be made must be considered. If the action plan does not meet the set objectives, then it should be changed. It is important to consider policy implications. Budget implications should also be considered and the cost weighed against the benefits (European Innovation Partnership on Active and healthy Aging, 2013). References Andrews, K., ‎Curtis, M. (1998). Changing Australia: Social, Cultural and Economic Trends. The Federation Press. Bartlett A. (2002). The Aboriginal Peoples of Australia. Lerner. Beyer, J., ‎Brigden, L.W (2003). Tobacco Control Policy: Strategies, Successes and Setbacks. World Bank. Bousquet, J., ‎Khaltaev, N.G & ‎World Health Organization (2007). Global Surveillance, Prevention and Control of Chronic Rewspiratory Diseases. World Health Organisation. Civicus (2013) Monitoring and Evaluation. http://www.civicus.org/new/media/Monitoring%20and%20Evaluation.pdf Collins P. & Madden R. (2005). Chronic Respiratory Diseases in Australia; Their Prevalence, Consequences and Prevention. Australian Institute of Health and Welfare. Division of Social and Behavioral Medicine Stephen J. Kunitz M.D. Professor, Community & Preventive Medicine University of Rochester Medical Center (2006). The Health of Populations: General Theories and Particular Realities. Oxford University Press. European Innovation Partnership on Active and healthy Aging (2013). Action Plan A2 on Specific Action on Innovation in Support of “Personalized Health Management, Starting with a falls Prevention Initiative. http://ec.europa.eu/research/innovation-union/pdf/active-healthy-ageing/a2_action_plan.pdf Frith, P, Cafarella, P & Duffy, J. (2008). Chronic Obstructive Pulmonary Disease (COPD) is a Major Personal and Public Health Burden in Australia. Global Initiative for Chronic Obstructive Lung Disease. (2013).Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. Grouse, L. (2012). COPD patients' rights: Can they be won? Journal of Thoracic Disease, 4(2): pp.206–211. Hanania, N.A, Sharafkhaneh, A. (2010). COPD: A Guide to Diagnosis and Clinical Management. Springer. Institute of Medicine 2000. State Programs can Reduce Tobacco Use. The National Academic Press. Kendall, C et.al (2010).The Nursing Contribution to Chronic Disease Management: A Whole Systems Approach. Krueger, H., ‎Williams, W., ‎Kaminsky, B. (2007). The Health Impact of Smoking and Obesity and what to do about it. University of Toronto Press. MacNee, W., ‎ZuWallack, R.L. & ‎Keenan, J. (2009). Clinical Management of Chronic Obstructive Pulmonary Disease. Professional Communications. Nolte, E & McKee, M. (2008).Caring for People with Chronic Conditions: A Health System Perspective: A Health System Perspective: European Observatory on Health Systems and Policies series. McGraw-Hill International. Quinn, C.E (2005). Chronic Obstructive Pulmonary Disease. Class Publishing Ltd. South Australia Department of Health. (2009). State-wide Service Strategy Division. Action Plan for South Australia: Chronic disease action plan for South Australia / South Australia, Department of Health, Statewide Service Strategy Division, Government of South Australia. The Australian National Preventive Health Agency. (2013). New Preventive Health Partnerships for Medicare Locals. Read More