Physiology as the Most Fundamental Cause for Injuries - Report Example

?Patient Narrative More often than not, nurses encounter situations where they are presented with patients experiencing medical problems, as well as psychological symptoms. It is quite beneficial for nurses to understand grief and reaction processes. This cuts across issues such as behavioral, physical and psychological. The World Health Organization (2000) defines health as being a state of complete physical, social and mental well-being and not just the absence of disease. This definition by WHO appears to be more realistic and holistic towards the lifestyle of an individual in taking into account both the psychological and social aspects of an individual’s life. The Department of Health, (DoH, 2007, pg 41), on the other hand, defines health as being a subjective state of being contended, comfortable, healthy, happy, and satisfied with quality of one’s life. The two definitions seem more holistic to an individual while appearing to support the biopsychosocial model (Spury, L, 2008). The biomedical model was developed in the late 19th century. The model states that individuals are not responsible for their illness and that the body and the mind work independently from each other. The model, therefore, proposes that illnesses are brought about by the physical entities, such as biochemical imbalances, viruses, injuries and bacteria. However, Physiology is seen as the most fundamental cause for injuries, and illness. It becomes apparent, therefore, that a biomedical viewpoint then appears to ignore cultural background of the patient, the influence of patient’s mental states, as well as the social relationships of the patient (Stever, G, 2011). The bio psychological model can be used in exploring the perception of a patient, concerning her ill health and perception. A Patient narrative highlights and offers in-depth understanding of an ailing person’s life besides malady’s history (Herman, D, 2011). Principally, this encompasses varied aspects, which comprise one’s life besides medical challenges faced by the patient where if not attended to effectively might worsen one’s condition. This entails socio-economic, environmental, psychological and holistic aspects, which are essential in attaining the full recuperation of an individual (Spury, L, 2008). Besides, they enable the medical personnel especially the nurses to develop a close relationship with the patient. Since, it makes the patient feel cared for apart from developing trust amid the medical practitioners and the ailing people owing to the practitioners’ exercise of compassion while executing their duties, interacting, listening and advising them accordingly hence, accelerate their recovery (Larsson, P, 2012, p. 17). The health care provider should be skilled at ensuring the patient’s comfort (Alder, B, 1999). This can be done through listening, monitoring and managing the flow of the interactions. During this interview, it became ostensible that the establishment of a rapport is essential in evoking comprehension of the patient’s perspective. The aim of this narrative is to critically evaluate the biomedical and biopsychosocial perspectives, as well as influences on the health and on the well being of a patient, a 32 year old female who is suffering from chronic back pains and type 2 diabetes. In accordance with the Nursing and Midwifery council (2008) ethics, confidentiality of the patient has been maintained, and the patient will be referred to as “Sally”. This narrative introduces Sally as a patient suffering from obesity. Oakley established that female respondents in a research are happy to open up about life and health issues to female interviewers who could share in the same experiences. Sally has opted to consumption of junk food and intense smoking due to a failed relationship. According to Erickson, a man goes through a series of development phases in which he runs into a conflict between a desirable outcome, which he needs, and an undesirable outcome which he does not need. According to the information she provided, she expected that the relationship would take a step further but instead, the worst happened, and it was over. Sally was exposed to isolation. She could not respond positively since she had been exposed to negativity. Over the last few years, obesity has been on the increase across the world. According to the World Health Organization, obesity has been rampant amongst those of low socio-economic status. There have been various explanations and solutions on the relationship between obesity and the status of people. Material deprivation is one of the principal factors contributing to health inequalities. Such inequalities emphasize on the need for education and poverty measures to address them. The choice of lifestyle of individuals plays a significant role in obesity. This determines the diet of an individual. World Health Organization has placed emphasis on campaigns designed to urge individuals to take responsibility for their well being. Various authorities in the world support the campaign. The campaign aims at promoting the healthy eating and doing exercises. Though this campaign seems to be effective, poverty is one of the main stumbling blocks. Low income families cannot afford a healthy meal and instead turn to the cheap high cholesterol products. Healthy eating can help reduce the chances of obesity and reduce the prevalence of chronic diseases such as coronary heart disease, stroke and diabetes. In reference to Herman (2011) definition of disease, obesity can be regarded as a body disorder. Herman (2011) denotes that diseases are organic matters that have no relationship with the mind and soul and that it is a separate entity which affects the normal functioning of the body. From the history extracted from Sally, she is a 32 year old lady weighing 109 kilograms and 1.63 meters tall. This makes her immensely obese. She suffers from type two diabetes and chronic back pain. According to Draznin, and Rizza (1997), the danger of type two diabetes increases with the degree and duration of obesity (p.73). Sally lives with her 3 children in her two bedroomed flat. Sally said that she waited the local authorities to move her to a larger and better place. Since she does not have time to cook, her diet consists of junk food and fizzy drinks. Sally accounts that she cannot walk for long distances because of reduced mobility and tiredness. According to Blackburn, and Kanders (1994, p. 24), obesity increases and individual’s fatigue and decreases the chances to walk for long distances. Based on cognitive therapy approach, human behavior and emotions are triggered by their internal state of dialogue. In this regard, human beings can learn how to challenge their ways of thinking to correct cognitive distortions. Based on behavioral economics approach, human beings hold perceptions in things that are vividly described, as opposed to those that lack vivid descriptions. Sally unveiled that she preferred to stay at home and watch TV other than going out. Though she admitted to the hospital for chest pain, tachycardia and shortness of breath, Sally does not perceive herself as sick. In reference to Blackburn and Kanders (1994), the health risks associated with obesity can be reduced by doing exercises. Exercises help in reducing the fat build up and clogging in the blood vessels (p. 123). Though she agrees that she should try to lose weight, she asserts that food is her only comfort. Sally also confessed suffering from depression and opting to smoking as the only stress reliever after her partner left her for someone else. After admission at the hospital for chest pain, tachycardia and shortness of breath, she has been under medication. She accounts that her intense smoking caused the chest pains. Since she is not able to do any physical exercises, the doctors issued her with clot-bursting drugs and blood thinners drugs to dissolve blog clots that may block blood from reaching the blood muscles. She was also issued with Nitroglycerin. According to Fletcher et al. (1999), nitroglycerin is an artery relaxer that relaxes and eases heart arteries to allow blood to flow easily via the narrowed artery spaces (p. 134). They widen the blood vessels. Though the drugs have tried to help her, she asserts that she needs to be helped both medically and psychologically. The incidence about her partner profoundly affected her psychologically, and she changed her feelings, behaviors. Alder (1999) asserts that distress is a medical disorder that needs to be treated like any other disease (p. 73). He proposes that this can only be treated through getting to know the reasons for the distress and helping the patient overcome it (p. 74). In the middle of taking the history from Sally, her first born child, Erick, comes in and sits next to her. It is by that time that I come to realize that Sally is not able to do much. Erick had come to enquire whether she needed anything. Recently sally nearly slipped when she was heading to the kitchen to get a glass of water, Erick accounts. Erick has to be around his mother to ensure that everything is within her reach before going to school. A small distance can make her tire enough, Fletcher et al. (1999, p. 123) accounts. Sally said that as she was walking towards the kitchen, her legs could not bear the heavy weight of her body, and her heart beat increased abruptly. Eckel (2003) asserts that reduced blood circulation to all the body muscles reduces the supply of oxygen to the muscles and may cause fatigue and failure of muscles to perform a task (p. 23). In reference to World Health Organization (2000), an individual suffering from obesity health complications requires close and continuous medical checks and examinations (p. 24). Sally accounts that she has been receiving daily medical attention from the hospital nurses. She confirms that since she cannot stand for a long period, she always has to rely on the nurses to help her in cleaning herself. The biomedical model of health does not locate the body in its social environment. It does not acknowledge salient links between health and material circumstances of sally. The model proposes that illnesses are brought about by the physical entities, such as biochemical imbalances, viruses, injuries and bacteria. The state of depression of Sally signifies a state of bereavement cycle, which is essential according to Loss – Kubler-Ross in dealing with life’s drawbacks (Dixie, D, 2009, p. 65). However, this lacks the proper management, which will shun its adverse effects on her health and social life. Since she has not even accepted the reality, and sought any assistance that will make her attain inner peace. Depression (Sally’s condition) coupled with poor housing may also affect her children adversely; both physically and psychologically, since she will not be able to interact with them as necessitated (Dixie, D, 2009). This because Sally she is nursing depression by preferring isolation strategy where it is possible that she will not encourage them to interact and play with their friends, hence affecting their social life. Besides, according Erving Goffman’s theory evaluation, Sally experiences stigmatization and she adopts isolation as a copying strategy to conceal what she is undergoing through denial (Lopes, G, 2006, p. 387). Sally’s children they are more probable to be obese owing to the eating habits, which their mother normally prefers in her house. This is because she does not cook and complains of an excessive burden of looking after her children singlehandedly. It is also possible her children will emulate the habit of smoking from her, since she is unable to hide owing to the excessive intervals that she smokes. Sally, though, ailing and experiencing depression, adequately fits in a sick role criteria/theory and she is compliant in active management of her condition, but unwilling to adopt health living habits. This is evident in the manner she prefers junky foods and even fails to cook in her residence, though; she is unable to afford the required food. Sally’s response to her break up with her lover and adoption of social isolation as a coping mechanism might have descended from her socialization and upbringing. For illustration, the break up with her lover she views it as an intense loss yielding to a prolonged grieving, which plunges her to depression (Larsson, P, 2012). Sally owing to the intense feeling of anxiety and sadness she seems to stagnate both at the depression and denial stages of bereavement instead of proceeding to the acceptance phase (Bowlby’s bereavement cycle). Inequalities in health that relates to age and social class discounts the patient’s opinions and experiences with the personal account of sally and her condition are not seen as being relevant. In ensuring, the treatment is effective, Sally, should receive treatment that caters for emotions, behavior and feeling illness. Conversely, biomedical model disregards the keenness to address the aspect of inequality evident in the medical sector where its lines of segregation encompass gender, age and social classes (Alder, B, 1999). To be effective, it should implement and ensure anti - discriminatory practice among the health personnel. This will enable an individual receive medical attention not only on the grounds of any social classification but also as required (Larsson, p, 2012). Through ignoring this aspect, normally contributes do more harm to the patient than it should to relieve them of their chronic pain. This is especially if they cannot access the required services as necessitated owing to the discrimination especially among the increasing elderly generation. Additionally, biomedicine due to more inclination on preferring the superiority of medical expertise does not accommodate the patient’s experience and opinions regarding what have prompted to have a particular condition (Nebel Pederson, S, & Emmers-Sommer, T, 2012). For instance, Sally’s condition, where she complains of socio-economic challenges besides other aspects, hence unable to observe health living. NHS attempts to become cost effective and more efficient while encouraging behaviors that are known to be promoting health Sally’s smoking is a risk behavior. Nurses owing to the patients that they normally encounter while executing their duties suffering from differing predicaments, they ought to be conversant with bereavement process or cycle (Sperry, p, 2008). This is especially in dealing with psychologically ailing people where they will effectively comprehend and even notice various responses. This vital it will aid them in notifying these individuals especially via their social and psychological conduct. The most evident behavior commonly with psychologically ailing individuals is the denial characteristic. Here, they normally devise coping mechanisms to conceal their trauma, which they have encountered such that it is hard for their peers to notice. Primarily, this is evident when one is trying to adjust to the loss or trauma encountered (Stever, G, 2011). Sally’s coping mechanism is the social isolation, where she prefers being in the house coupled with over excessive TV watching, which normally shifts her mind from her predicaments or trauma. Additionally, this makes her feel occupied besides her smoking intervals increasing owing to depression. Sally’s remedy is Bio-psychosocial approach. This will effectively address her predicament while considering her situation and other aspects that she is facing like socioeconomic challenges (Bewden, J, 2011, p. 46). Conclusion. The biomedical model is outdated because it is a traditional model that focuses on biological disease approaches and the pathophysiology (Blackburn, G, & Kanders, S, 1994). This model came up in the late nineteenth century. It proposes that the cause of any disease is the physical attributes or entities like bacteria, injuries, virus, and imbalances that are biochemical. This means that biomedical model fails to take account of the psychological and physical factors. Physiology is a significant cause for illness and any injury. However, a view that is biomedical ignores the patient’s mental states, their cultural background, and social relationships. The biomedical model, therefore, only focuses on the biology of a disease (Cheek, C, & Piercy, K, 2008). In this regard, research has shown out that the fall of the biomedical model came from the fact that it predicts that all illness only have a unit cause, ill health comes about because of a state that is psychological, and that after the correction of the disease, the patient’s health becomes healthy automatically. Another reason for this model to be outdated is because it is neither individualized nor personal and fails to give out an approach that is holistic. This means that biomedical model dealt with traditional, routine physical care but failed to give allowance to the patient’s individuality. In this model, doctors had an assumption that diagnosis was an objective process of pain reduction through doing away with the cause of the disease. Nurses need to use the biophysical care approach because it is a model that emphasizes the advantage of getting to know about the human health and disease (Cheek, C, & Piercy, K, 2008). It is a model that considers social factors, biological psychology, and their interaction in the understanding of illness, health, and delivery of health care. The social, psychological, and biological factors do occur continuously in the natural system. The consideration of social and psychological factors needs the use of social sciences that are relevant. Additionally considering biological factors need the use of natural sciences that are relevant. In this regard, social, and natural sciences are the basis of nursing care. In biophysical model, qualities of humanity are highly valued. This means that, scientific methods do apply to a huge psychological, social, and biological phenomenon that relate to the health of humans. Apart from this, this model acknowledges that different scenarios of clinics could be of advantage if understood scientifically in different levels of the continuum natural system. Application of biophysical approach in care practice requires the nurse to identify that a relationship is central to health care provision, and utilize self-awareness as a therapeutic and diagnostic tool. The patient’s history needs to be eliciting in his life circumstances context. A decision concerning psychological, biological, and social domain aspects should be made so as to understand and promote the health of patients. After all these are done, a multidimensional treatment would be provided to the patient. A study made on the biophysical approach reports that social, psychological and biological factors are the necessary health determinants that a nurse needs to consider in care practice (Bruns, D, & Disorbio, J, 2009. An interaction of social, psychological, and biological factors are extremely crucial in health assessment add formulation of treatment recommendations (Bewden, J, 2011). Blood Sugar Battles. Many physicians find it to be difficult to apply biopsychosocial approach into their care practice. Research has shown that a number of physicians view biophysical model as an emotional burden that takes into account the holistic biopsychosocial caring framework for every patient. Other physicians argue out that this model is a patient –centered type thus not realistic because of the limited time that they give patients on a single occasion (Draznin, B, & Rizza, R, 1997). Because of increased demands for clinics, the physicians tend to over-run on appointments ending up making remarkably little use of the biopsychosocial model. Despite this, all nurses need to utilize all the features of this model to the fullest into their care practice. References Alder, B., 1999. Psychology of Health: Applications of Psychology for Health Professionals. Routledge. Blackburn , G. L., & Kanders, BS., 1994. Pathophysiology, Psychology and Treatment. Jones & Bartlett Learning. Bewden, J., 2011. 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World Health Organisation, 2000. Preventing and Managing the Global Epidemic. World Health Organisation. Read More