Special Health Needs Management - Case Study Example

? Special Health Needs Management Evidently, researchers have constantly argued about the management of an adult or child with special needs can be largely be interpreted with communication difficulties as well as mental health. According to Bethell (2002), individuals that are considered to have special needs are those with disabilities, those with serious mental illness, elderly and minority groups within our societies. Other individuals who can be categorized is a pregnant woman who will be considered within this study, individuals with special dietary need as well as an individual who have been displaced during natural calamities (Bethell 2002). This paper focuses on understanding management of a child or an adult with special health needs, this will be achieved by analyzing history taken from patient, finding on examination and findings, outline the various patients’ health needs as well as various action taken to overcome matter related to this effect including communication with other agencies and team members. The designed case study will incorporate critical discussion of relevant ethical, legal and professional issues. According to Andre and Velasquez (2010) adults and children with special health needs are a diverse group. They tend to experience health conditions ranging from body pains, hypertension and other physical disorders. Katy (2002) maintains that, among pregnant women level of special need may vary from abdominal pains which are considered normal during pregnancy to lower abdominal pains which are very risky especially in late pregnancy. Clearly, the intensity and type of services required to treat this ranges from prescribed medicine and regulated exercise (Oredugba and Akindayomi, 2008). Adding to this diversity in cases related to special needs, it is important to connect special health need individual management with relevant ethical, legal and professional issues so as to create a practical example of what take place in that given situation (Katy, 2002). Lower abdominal pain is widely generated from an organ within any organ situated within the stomach area. For instance, these pains can highly originate from colon, liver, small intestines, pancreases, gall bladder and spleen which can produce painful sensations which may vary largely in intensity which can be felt in the lower stomach especially in pregnant women (Christopher and Volpe, 2007). Researchers indicate that whether the pain is restricted to a specific area or those which are localized; it is quite general that it can be a sign of a certain underlying root cause (Herzer, Goebel and Cortina, 2010). The paper encompasses a lady who is suffering from lower abdominal pain and who is thirty weeks pregnant with her first child. This lady was identified by her midwife to have abdominal pains which complicated her pregnancy. The midwives attributed that this problem could be as a result of misuse of substance as well as experiencing mental related problems (Shapland, 2006). Although having abdominal pains during pregnancy is a normal experience having lower abdominal pains can be risky and one that requires a lot of attention especially to women having special needs (Christopher and Volpe, 2007). June and Alexandra (2006) maintain that preventing of lower abdominal pain for a lady with special need requires a proper attention. It is important for this lady to be given food whose dietary will assists in treating irritable bowel in connection to managing stress. Christopher and Volpe (2007) maintain that, here are various ways that lower abdominal pains can be diagnosed and be treated in this woman. There are chances that lower abdominal pains during labor in this woman can either result to miscarriage or the miscarriage can be prevented through giving tentative care if the woman health is not put in question (June and Alexandra 2006). Firstly, it is important for health practitioners to carefully observe the pain area, it duration and intensity as well as other issues that may arise from the lower pain such as bloating. It is necessary for the medical practitioners to conduct through physical examination to this lady so that to diagnose the root cause of the pains. According to U.S. Department of Health and Human Services (1996), physical examination can be through x-ray, laboratory tests as well as getting involved in endoscopy checkups so as to ensure that the cause of these problems is rectified. It is quite evident that with proper diagnosis, the lady’s doctor can be able to treat the pain to secure both the health of the mother and her baby (Christopher and Volpe 2007). According to doctors, treatment of lower abdominal pain depends mainly on the root cause of the pain. Medication such as antacids, acid blockers, inhibitor, antibiotics, proton pump and antispasmodics can be prescribed for relief of pain. Further, pain in the abdomen area can also be due to simple reasons or serious illnesses (U.S. Department of Health and Human Services 1996.). If symptoms and signs related to abdominal pains are detected earlier, the lady abdominal pain can be avoided and prevented from reaching a critical stage. Clearly, if serious illness resulting from abdominal pains are detected it is obvious that the lady condition can be remedied so as to ensure that the pains are alleviated completely and to safeguard her pregnancy (World Health Organization, 2003). World Health Organization (2003) maintains that, based on communication, it is very important for all members within the team both the lady, her guardian and her medical practitioner to communicate so as to ensure that the lady condition is well managed. One thing that is helpful in special needs management is communication. According to Christopher and Volpe (2007), it is very important to make the lady remain calm whereby both the doctor and guardian should make the lady realize that having lower abdominal pains does not necessarily mean that she is going to have a miscarriage (World Health Organization 2003). Communication will ensure that the lady does not panic. Through proper management, the lady is able to realize that abdominal pains happen to all women have similar conditions but with proper care there is no need for panic. It is important that communication is maintained between all the team members involved since this will ensure that the lady is able to have both emotional and physical recovery such that he is able to try conceiving again without any kind of fear. In addition, it is important that the lady keeps constant communication which should be open to health care providers, family and friends during the period of low back abdominal pains (Carolyn and Jeffrey 2004). Gibson and Blandford (2003) maintains that, communication in a special need situation such like our case, it should also entail the health practitioner often analyses the lady condition until her conceiving time. This should further be accompanied by making sure that the lady is encouraged to keep undertaking proper exercise that will not hurt the baby but will be effective in minimizing the pain and reduce chances of having a miscarriage. On the other communication can be enhanced by way of assembling other women with the same special need so that they can encourage one another (Margret and Jenifer 2008). By so doing, the lady is able to achieve not only physical help but also emotional assistance thus preventing her from acquiring stressful thoughts that can result to miscarriage. This communication ensures that women are able to be involved in meetings and discussions regarding their pregnancy states (MedlinePlus, 2011). According to Margret and Jenifer (2008), communication among team members will ensure that the lady is able to realize that pregnancy should be a joyful period for her. It is quite evidence that proper communication will enable the lady experiencing lower abdominal pains to take extra caution especially in cases when these pains are severe. When patients present themselves in the hospital the first thing a doctor does is to conduct an interview to the patient to give directions on the diagnosis to be done (Hopcroft and Forte, 2009). Among these, is taking of the patient’s history which is a good and an important step to be undertaken in treating the patient. Given that it is a patient being treated and not the condition, it is always important to take a good history, this is because the better one understands the patient, the better the chances of getting good compliance from the patient and the better the plan of treatment will be (MCH Library, 2011). The interview may be looked at the perspective of comprising two parts i.e. setting of the interview and the interview process itself. The setting should be such that the patient feels relaxed. Is normal though for some patients to feel anxious of the whole process hence the need to use a proper approach, the questioning should not appear like an interrogation as this will lead to the patient not responding (Boonstra, 2009). The tone should be checked and controlled not to appear as being judgmental as this will make the patient disregard the advice and instructions being given to them and can go further to looking for another doctor with whom they feel more comfortable with. Secrest (2009) reveals that it is important to take note of the personal history of the patient, that is age, height, occupation etc. the next step is to CC of the patient (chief complaint) and then enquire the duration taken while suffering from the complaint. It is also important to take note of possible medication that the patient might have taken to alleviate the pain (Lindsey, 2011). The next thing to do is ask the patient about the onset of the problem for example did the pain start slowly or it just erupted suddenly? To understand the extent of the pain, the patient may be asked to rate what the pain is like on a scale of 1-10 and also to ask if the pain radiates to any other part of the body and if it disrupts daily activities (Netdoctor, 2011). In this patient’s case, she was complaining of lower abdominal pain. More like menstrual cramps and without diarrhea which occurs like four times an hour, after further questioning she also admits to suffer from a dull backache that in a way radiates to around the abdomen (Baby Centre, 2010). The patient also ascertains to be 30 weeks pregnant. One possibility as to why this pain exists is that the patient may have stretched or pulled a ligament or the patient could be having much more serious problems like having an ectopic pregnancy or maybe she could suffer from a fibroid that has broken down. To be certain about the cause of the pain, several tests have to be taken. These include blood tests like Blood film, Serum beta-hCG which aids in the diagnosis of ectopic pregnancy, Biochemistry that is hepatitis serology, glucose, renal and liver function. Others include urine tests (Urine microscopy and culture) and ultrasound (Patient.co.uk, 2011). After the several tests, it was found that the patient was suffering from labour pains. Other than just diagnosis and treatment of patients, there are other professional and ethical issues that have to be dealt with. The disciplines of law and medical ethics do overlap each other in most cases. But it is agreeable that both do address among other factors the access to medical care, informed consent on any undertaking, advance directives and confidentiality of health care information. In several cases, health care providers have shown great influence in legal standards due to their input in the creation of professional ethics and standards. Good ethics has always been said to be where the law ends. When treating such a patient as this one who is experiencing early labour pains, it is important that the patient is well informed of the diagnosis, available options of treatment the dangers involved in a comforting way that helps the patient. Not always do patients listen to what medical practitioners advice them to do, sometimes patients completely refuse to do as the medical practitioner advices them to hence endangering their lives and the lives of the unborn babies. In such cases, the medical practioner could be judged as being careless and even be jailed if such occurrence gets to court. It is, therefore, important that the medic gets to explain to the patient exactly what is to happen or about to happen in the most comfortable means possible. The knowledge on prenatal care is ever growing and the legal and ethical issues equally get complicated. It is of great debate as to how non-compliant pregnant women should be dealt with. In a recent study, an estimated almost half of maternal-fetal specialists interviewed were of the opinion that pregnant women who refused to heed to medical advice hence endangering the innocent lives of their unborn babies should be put into detention and forced to follow doctors’ orders. This could as well mean that the rights of the pregnant woman have been violated in that her freedom to choose for herself has been violated. However, a growing trend in the United States; judging by the several court cases already heard ad others pending in court, reveal that forced treatment of pregnant women is getting favor from several quarters e.g. in a certain case the judge ordered “mandatory diet restrictions and incarceration for failing to follow medical advice.” Though most women do take doctors’ advice regarding their unborn, others just do not because they feel it is their right to do whatever pleases them. Looking at it from the woman’s side, the threat posed by forced treatment of a pregnant woman is not an easy one. It denies her fundamental right to freedom therefore having to force a woman to undergo a certain procedure during child birth or forcing her to have medication against her will clearly violating this right. This kind of treatment leaves the affected woman feeling more of an object than a human being and could easily trigger stress in certain women. Furthermore, submitting women to forced medical treatment for the sake of their unborn babies is just like selectively imposing an obligation n them that is never imposed on others (Andre and Velasquez, 2010). In several emergency cases in hospitals, many patients who are otherwise competent persons are at times unable to fully participate in their medical care due to being in capacitated to some extent by their conditions. However, both law and ethics allow medical practioners to treat such victims without consent to the extent that the given treatment saves their lives. It is, however, important to get consent from spouses, relatives and/or close friends. In the absence of the mentioned persons, lifesaving treatment can be administered. Women’s health (2011) reveals that even though medical practioners do make certain decisions without the consent of the patient, they are not always right; an example is that of Amber Marlowe of Philadelphia. She is what many would consider a “pro” at delivering big babies; however, doctors insisted she undergoes a caesarean section yet she was sure she was able to undergo a normal child birth. “All my others, I’ve done naturally,” Marlowe told her physicians. “I know I can do it.” She later checked into another hospital where she had a normal way of giving birth which she described as being a “piece of cake.” However, medical ethicists ad legal experts seem to agree that attempts in prosecution of women for decisions they make regarding their pregnancy and child birth or forcing them to undergo certain medical procedures for the benefit of their unborn babies could be on a shaky ground (Childbirth.org., 1998). Art Caplan, chairman of medical ethics at the University of Pennsylvania said that “There are 50 years of case law and bioethical writings that say that competent people can refuse care and that includes pregnant women as well” (Baby Centre, 2010). In a certain influential case in 1990, a federal appeals court in Washington ruled that a judge was not right in granting a hospital the permission to force “a pregnant cancer patient to undergo a Caesarean in an attempt to save the life of her child” (Unfortunately, the baby and mother died only two days after the operation. The director of Medical Ethics at the Boston University School of Medicine, Dr. Michael Grodin is of the opinion that doctors “should seek court intervention when a mother refuses care only if the patient is mentally ill” (Christopher and Volpe, 2007). According to the journal of perinatal education,” The failure of applying evidence and using ethics to balance competing interests has led to practices that exploit childbearing women. In the United States, examples of not using the evidence for decision-making autonomy include practices such as denial of food and drink during labour” (About.com, 2011). In conclusion, several symptoms that a patient suffers from should be properly investigated to ascertain the real problems. Misdiagnosis of illnesses can be very costly to the overall health of the patient. It is always important to understand what the patient needs and what they are complaining of in order to get the treatment. This way many lives will be saved and a lot of pain alleviated. If care is not taken and the patient feels that they have not gotten what they deserve, there is always a likelihood that a court proceeding will follow. Though it s not easy to get the right answers from patients especially when they are in great pain or not of sound minds, it is the medics work to try and get information that is as accurate as possible from the patient. References About.com, (2011), When do complications occur in labor and delivery?Retrieved 20 Nov. 2011 from http://pregnancy.about.com/od/laborcomplications/p/problemlabor.htm. 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