Chronic Diseases of Aborigines of Australia - Essay Example

? Running Head: Peritonitis Case Study. Peritonitis Case Study                 Introduction The Aborigines are an indigenous Australian group. An estimated 24% of the Aboriginal population lives in remote areas and is considerably marginalized by the Australian mainstream population. The Aborigine population has higher levels of poverty, which characterizes the remote areas that they inhabit. According to Reading (2010), the burden of chronic diseases is extremely high relative to the mainstream population in Australia. The disparities arise from economic marginalization, which leads to poverty and poor health. The table below shows disparities between the two populations: The implication of these disparities is that the population has a significant shortage of healthcare services. As such, the Aboriginal society has a number of serious health problems such as obesity, substance abuse, renal diseases, high infant mortality, pulmonary diseases and cardiovascular conditions. In spite of the developments in mainstream Australia, the Aboriginal people are still strongly bound to their traditional societal structures. Their society still holds strong family values and highly values family bonds and ties. The Aborigines still hold strong beliefs in their traditions and spiritual life. As such, the provision of healthcare to such a group should take into consideration various factors including their economically disadvantaged position in society and their strong cultural background (Margereson, 2009). This paper critically evaluates the health condition of Peggy Moloney-an elderly Aboriginal lady from New South Wales aged 62. Though primarily admitted for peritonitis, the evaluation will take a critical review of her medical history and experience as well as these elements to her current health, which plagued by multiple conditions. Therefore, cultural, economic, social, psychological and biological elements will be factored in during the evaluation. The mind map on Peggy’s condition starts by reviewing her medical status in relation to her biological and physiological conditions. The major elements of consideration include her medical history and general status of biological/physiological health. Mrs. Peggy’s medical history shows that she developed renal failure seven years ago after a bout of nephritis. This occurred after a treatment of streptococcus infection on her left leg. After an antibiotic treatment, the legs infection was treated, but her nephritis persisted, and finally caused the damage of both kidneys. Her history presents the following conditions 1) Renal failure (2); peritoneal dialysis (3); diabetes mellitus (4); peripheral neuropathy on both feet (5); intermittent claudication; and a cataract on the left eye. Currently, she presents the following symptoms: fever, a general unwell feeling, clouding of central vision, loss of peripheral vision, shortness of breath, swollen lower legs and ankles as well as cellulitis around her catheter insertion site. In Mrs. Moloney’s case the most probable risk to her immediate admission condition-peritonitis-is peritoneal dialysis. This can be inferred from the occurrence of cellulitis on the area around her catheter (Treves, 2008). However, considering her multiple conditions, old age can be cited as a possible biological contributing factor. Notably, old age is characterized by a general decrease in immunity, muscle mass and strength. The decline in immunity on skin cells in the affected area may be a contributing factor to the infection cited on the dialysis catheter point (Lye, MacLennan & Hall 1993). However, primarily the infection may be a result of handling dialysis insertions. The decline in immunity as a result of aging was shown by the multiple conditions that included nephritis and a streptococcal infection on her leg. The persistence of nephritis coupled with weak immune finally led to renal failure, which could have been a result of general decline in immunity. Notably, Mrs.Peggy also has diabetes mellitus-an exceedingly high level of glucose, which is at 18mmol/L. This is an indicator of lack of sufficient insulin (Galbraith, Manias & Bullock, 2007). This implies that Peggy may not be managing her diabetes well through diet or insulin. The fact that she cannot physically exercise due to her multiple conditions also contributes to the inability to regulate her insulin. The condition seems to be worsening due to the noted presence of other conditions caused by progressive diabetes. These conditions include peripheral neuropathy and cataracts, which have appeared on both eyes already. Peggy’s progressive diabetes causes a serious threat of multiple complications including poor healing, poor blood circulation, cardiovascular problems and neuropathies (Fama & Fox, 1996). Mrs. Peggy should be advised on changing her diet accordingly because it is the best diabetes control considering that she cannot physically exercise. The physical problem of Mrs. Peggy is compounded by the fact that she has renal failure, and she has to undergo peritoneal dialysis. Peggy’s dialysis catheter insertion point has shown inflammation and discharge. Additionally, she has a fever and pain at the insertion point. These are possible implications of infection because it is the most significant problem in peritoneal dialysis (Treves, 2008). As such, to prevent the site’s infection higher hygienic standards, should be maintained. Hands should be properly cleaned before handling the dialysis connection. Additionally, the site should be cleaned and disinfected regularly to prevent infection (Galbraith, Manias & Bullock, 2007). The care necessary for peritoneal dialysis sites and procedures involved as well as taking medication may be heavily taxing on an elderly patient such as Mrs. Peggy. Therefore, there is a need to train her well on how to self manage as well as include her husband in the program so that he can assist her. The inclusion of her family members in to training on how to care for her during dialysis helps create the strong social bond characteristic of her societal background. The process of inclusion of her family members will also take care of her psychological needs of companionship and a sense or feeling of care form close family. Additionally, if she is spiritual, encouraging her to seek spiritual care from a spiritual leader or to pray could offer psychological relief (Huether & McCance, 2008). Notably, Mrs. Peggy has limited access to proper care because she lives in a remote area that is economically disadvantaged due to marginalization. The Aborigines’ health problems can best be dealt with through community based initiatives such as the Aboriginal Community Controlled Health Organization. The organization has developed ways of handling Aboriginal community issues (Reading, 2010). Such organizations increase access to health in remote situations and make an appropriate incorporation of cultural values and could offer a satisfactory solution in Peggy’s case. Peggy has minimal access to medical review because she cannot regularly access her medical team. However, if such home reviews and visits could be performed by such community facilitating organizations, then her situation would be a lot better. However, if the visits are not sufficient proper education and evaluation could help put a patient on a path of self-sufficiency in terms of care (Reading, 2006). Mrs. Peggy is from a society that is significantly connected to their society’s culture, mannerism, and family through strong emotional ties. Therefore, family and societal bonds are highly essential as part of their identity. The treatment of Peggy in Sydney will keep her away from family and community, thus severing bonds of union. Additionally, the Aborigines view hospitals as bond breakers and where the sick go to die and suffer away from their families and society. The existence of such views implies that she may be psychologically disturbed by this incident (Meslin, Chadwick & Have, 2011). The situation may even be aggravated because the medical system in the nation has had a history of racism against this minority group (Bain, 199). Therefore, there is a need to improve the medical practitioners’ approach when dealing with Mrs. Peggy. This should include being conscious about her cultural background and enhancing proper interpersonal communication. In order to cater for culture-based differences, and increase accessibility to healthcare some measures should be put in place. These may include initiatives to train local Aboriginal specialists or helpers to care for patients such as Peggy. This allows them to remain within their society and families, whilst getting sufficient care. In cases where local members cannot be trained, translators may be used. References Bain, A. (1999),. Citizens without rights: Aborigines and Australian citizenship. American Historical Review Journal, volume 104, issue 3. p. 889-890 Galbraith, A., Manias, E., & Bullock, S. (2007). Fundamentals of pharmacology, 5th edition, Sydney: Pearson.  Fama, T., & Fox, D. P. (1996),. Managed care and chronic illness: challenges and opportunities, Sudbury, MA: Jones & Bartlett Learning Huether, S. E. & McCance, K. L. (2008),. Understanding pathophysiology, 4th edition, St. Louis: Mosby. Lye, W. D.M., MacLennan, J. W., & Hall, P. R. M. (1993),. Medical care of the elderly, 3rd edition, Hoboken, NJ: John Wiley and Sons Margereson, C. (2009). Developing Holistic Care for Long-Term Conditions, London, UK: Taylor & Francis Meslin, M. E. Chadwick, R. and Have, T. H. (2011),. The SAGE Handbook of Health Care Ethics, Thousand Oaks, CA: SAGE Publications Limited Reading, J. (2010). A Challenge for Public Health, Population Health and Social Policy: Centre for Aboriginal Health Research, University of Victoria, British Columbia, Canada. Retrieved on 9th August, 2012 from http://www.cahr.uvic.ca/docs/ChronicDisease%20Final.pdf Treves, F. (2008),. Peritonitis, Charleston, CA: BiblioBazaar Publishers. Read More