Chronic Illness Prevention in Children in Australia - Essay Example

?Chronic Illness Prevention in Children in Australia September 14, Chronic Illness Prevention in Children in Australia Purpose The purpose of the study, which follows, is to convey information on the understanding of the role of the registered nurse in child and adolescent health in Australia. This purpose of this report is to inform both carers and professionals working and caring for children and families on the progress and issues related to improving and promoting the health and optimum development of Australian children. Introduction This work in writing examines chronic illness in children in Australia and will outline the contributing factors for chronic illness and explore the effect that chronic illness has on the family. Due to the enormity of the issue of chronic illness, this report will focus on children between the ages of 5 and 19 years of age. This report will conclude by identifying recommendations that nurses can implement in their role as primary health practitioners. Definitions Chronic Disease: A chronic disease is characterized by having a duration “that has lasted or is expected to last at least six months. Has a pattern for recurrence, or deterioration. Has a poor prognosis and produce consequences, or sequaelae that impact the individual’s quality of life.” (Child and Youth Health Intergovernmental Partnership, 2004) Diabetes (diabetes mellitus): This is a chronic condition in which “the body makes too little of the hormone insulin or cannot use it properly. This raises the blood level of the body’s major energy source, the sugar glucose, and causes other widespread disturbance of the body’s energy processes.” (Child and Youth Health Intergovernmental Partnership, 2004) Type 1 diabetes: This is a chronic condition, which generally arises in childhood or youth and is known as ‘juvenile onset’ diabetes “marked by a complete lack of insulin and needing insulin replacement for survival.” (Child and Youth Health Intergovernmental Partnership, 2004) Type 2 diabetes: The most common form of diabetes, “occurring mostly in people aged 40 years and over and marked by reduced or less effective insulin.” (Child and Youth Health Intergovernmental Partnership, 2004) Cancer: This includes a “range of diseases where some of the body’s cells begin to multiply out of control, can invade, and damage the area around them, and can also spread to other parts of the body to cause further damage.” (Child and Youth Health Intergovernmental Partnership, 2004) Cystic fibrosis – This is a “life threatening genetic disorder that primarily affects the respiratory system (lungs), the digestive system (pancreas and sometimes liver) and the reproductive system. The mucus glands of people with cystic fibrosis secrete very thick sticky mucus.” (Child and Youth Health Intergovernmental Partnership, 2004) Cerebral palsy: This includes a “range of disabilities associated with movement and posture. ‘ Cerebral’ refers to the brain and ‘palsy’ means weakness or lack of muscle control. The disorder is caused by a permanent, nonprogressive brain defect or lesion present at birth.” (Child and Youth Health Intergovernmental Partnership, 2004) Epilepsy: This disease involves a “disturbance of brain function marked by recurrent fits and loss of consciousness.” (Child and Youth Health Intergovernmental Partnership, 2004) Background Asthma is reported to be the most common of all chronic diseases among children in Australia and is cited as well as being the most common of all reasons that children in Australia are hospitalized. Type 1 and Type 2 diabetes is reported to be on the rise among children in Australia. (Australian Institute of Health and Welfare, 2005, p.2) Other chronic diseases affecting children in Australia include those of Cancer, Cystic Fibrosis, Cerebral Palsy and Epilepsy. Discussion There have been a great many possible risk factors linked to the development of chronic disease in childhood however, it is reported that of these risk factors that only a “very few have been identified as modifiable risk factors.” (Child and Youth Health Intergovernmental Partnership, 2004) There is a stated need to “focus on improving treatment and management practices for chronic illnesses” stated to be important since failure to adequately manage chronic disease can “seriously affect the social, psychological and physical development of children” with the outcome stated as “limited education and participation opportunities as well as the potential for conditions to worsen.” (Child and Youth Health Intergovernmental Partnership, 2004) Furthermore, it has been demonstrated in the research on this subject that chronic disease adversely affects the finances and psychological status of families of children with chronic diseases. According to the Women and Children’s Health Network – Parenting and Child Health, coping with chronic childhood illness “can be very difficult...in addition to the child’s physical health and medical needs” the need exists to “manage the feelings that come with all the changes and health issues.” (Women and Children’s Health Network, 2011) Included among the impacts of chronic childhood illness are such as: (1) symptoms of discomfort and pain; (2) frightening, uncomfortable and painful treatment; (3) parental distress; (4) a high demands on time, energy and resources, which include both financial and personal resources. (Women and Children’s Health Network, 2011) In addition to these strains is the strain the child experiences in attempting to talk with others about their illness as well as the limitations that chronic illness places on the child’s activities. The work of Martin and Nisa (1996) entitled “Meeting the Needs of Children and Families in Chronic Illness and Disease” reports that chronic illnesses “affect the lives of children through the limitations they impose on schooling, recreation and vocational choice. The resources to support their adjustments to these activities are often lacking in our society that is orientated particularly to the well and able.” (Martin and Nisa, 1996, p.1) Chronic illness is reported as presenting “different challenges at different life stages.” (Martin and Nisa, 1996, p.1) Another problem is that due to the many domains of the child’s life that is affected by chronic illness “many children require complex treatments from multiple health care providers. This places their care at risk of fragmentation, duplication and overlap.” (Martin and Nisa, 1996, p.1) This makes continuity of care a vital feature of healthcare provision. The work of Fairley and Quayle (2000) entitled “Emotional Issues Affecting Children with Chronic Illness and Their Families” reports that when children “are unable to share in simple pleasures with their peers and family due to symptoms of chronic illness, there are invariably emotional repercussions which may manifest in a variety of ways both in the child and his or her family.” (p.1) Reported is that children with “visible condition such as eczema or burns, experience a particular type of stigmatisation. They may be teased at school because of the appearance of their skin and feel shunned when no one wants to be their partner in class lines. Life for children with a visible illness can be made miserable on a very overt level.” (Fairley and Quayle, 2001, p.1) However, the condition, which is visible, is reported to “lend some authenticity to their need for special care and attention.” (Fairley and Quayle, 2001) Illnesses such as chronic renal failure “have invisible and visible aspects, thereby combining these potential problems.” (Fairley and Quayle, 2001, p.1) Stated to be generic issues affecting children with chronic illness are such as “the need to stay close to specialist health facilities which affects parents' job prospects, family holidays, and the time that parents have to devote to the child.” (Fairley and Quayle, 2001, p.1) Other issues that are specific to the disease of the child include such as children on dialysis experiencing body image problems since they are reliant on a machine and the fact that these children often view the machine “as an extension of themselves.” (Fairley and Quayle, 2001, p.1) Other conditions including juvenile arthritis are reported as being “marked more by pain.” (Fairley and Quayle, 2001, p.1) Children with asthma are reported to experiencing “frightening episodes of shortness of breath causing them to confront the possibility of death.” (Fairley and Quayle, 2001, p.1) It is reported that treatment “has implications for the child’s emotional well being, particularly when parents play a major role in delivering the treatment.” (Fairley and Quayle, 2001, p.1) Fairley and Quayle report that the child may often “...become pitted against the parents because they are the enforcer of the treatment. Compliance problems sometimes occur in these circumstances because parents may become reluctant to put their child (and themselves) through the ordeal once or twice every day.” (2001, p.1) The child who spends a great deal of time in the hospital is reported as being “pseudo-mature because of their increased contact with adults, compared with their healthy peers. These children are verbal and may appear sophisticated and insightful about issues way beyond their years, such as the pros and cons of complicated treatment regimes they may be having. However, they may not be as confident in their relationships with peers in the school playground.” (Fairley and Quayle, 2001, p.1) Emotional manifestations of the chronically ill child include those associated with: (1) body image; (2) poor self-esteem; (3) sexual identity in adolescents; (4) withdrawal to the safety of the hospital environment by not complying with treatment at home; (5) rebellion by using the illness as a means of taking risks. (Fairley and Quayle, 2001, p.1) Recommendations The professional nurse can assist parents in understanding the need for modification of behavioural management of the child at the varying developmental stages in childhood and adolescence focused on maximizing treatment compliance and minimizing adverse effects on the well-being of the child. As well, the nurse can assist the family through “taking an interest in the child’s broader developmental progress and using their knowledge of activities within the community to suggest enriching experiences for the child.” (Fairley and Quayle, 2001, p.1) The nurse should ensure that their actions complies with relevant legislation and common law as well as fulfilling the duty of care as well as recognizing and responding appropriate to practice that is unsafe or unprofessional in nature. As well, the nurse should ensure that their practice falls within the framework of professional and ethical nursing. The nursing professional is required to integrate policies of the organization with guidelines on professional standards and to practice in a manner that “acknowledges the dignity, culture, values, beliefs and rights of the individual. (ANMC, nd, p.4) The nursing must practice in alignment with legislation on nursing practice and health care while integrating nursing and health care knowledge, skills and attitudes in a manner that results in the provision of safe and effective nursing care. (ANMC, nd, paraphrased) The nursing practice must be inclusive of critical thinking and analysis and be within an evidence-based framework. Finally, the nursing professional is one that participates in continuing professional development and ongoing education in nursing practice. Quality improvement and the use of appropriate strategies should be at focus for the nursing professional in the provision of care. (ANMC, nd, paraphrased) Conclusion Chronic disease in children in Australia is a focus of the nursing professional who is charged with the responsibility of assisting children with a chronic disease and their family in coping with the ramifications of such disease. The nursing professional has the responsibility to assist these children and their families through making proper referrals, through providing care in alignment with the ANMC guidelines and through delivery of care in a professional and ethical manner, and one in which evidence-based care is provided. Bibliography Chronic Childhood Illness – Managing the Emotional Impact. Women and Children’s Health Network – Parenting and Child Health. Retrieved from: http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=304&id=2578 Healthy Children – Strengthening Promotion and Prevention Across Australia. National Public Health Strategic Framework for Children 2005-2008. Children and Youth Health Improvement Partnership. Retrieved from: http://www.nphp.gov.au/workprog/chip/documents/CHIPFramework14Sept05web.pdf Martin, C. and Nisa, M. (1996) Meeting the Needs of Children and Families in Chronic Illness and Disease. The Context of General Practice. National Center for Epidemiology and Population Health. Australian University. Retrieved from: http://www.aifs.gov.au/conferences/aifs5/martin.html National Competency Standards for the Registered Nurse (nd) ANMC. Retrieved from: http://theses.flinders.edu.au/uploads/approved/adt-SFU20100708.110421/public/09Appendix7.pdf Selected Chronic Diseases Among Australia’s Children (2005) Australian Government – Australian Institute of Health and Welfare. Bulletin Issue 29. August 2005. Read More