Understanding the Roots of a Patients Illness - Essay Example

?Introduction Patient experience and satisfaction plays an important role in the treatment process, recovery and treatment related discipline of the patient. It is only if the patient has faith in the nurses that they follow the medicine related routine religiously. Hence, it is highly important for nurses to develop a bond of trust with their patients, and gain their confidence. This can be achieved by practicing ‘person-centred care’. This paper aims at discussing the importance of hearing patient’s voice and person-centred care in understanding the roots of patient’s illness and in treatment of a patient. Due to space imitation, the paper will focus only on the challenges that were experienced during the case study discussed, and not on the treatment. Different studies have revealed that person-centred care not only gives psychological satisfaction to patients, but also helps the nurses to gain psychological satisfaction in their job, as person-centred care not only makes easy their ‘job’, but also provides certain sense of spiritual meaning and depth to the process of caring. The Case Study The case study included in this paper is of a teenage female client who was recommended by her school for counseling and therapy. The physical examination of the client had revealed that the client was severely overweight and was suffering from obesity related problems. Her academic performance had gone down drastically in last six months, and she was becoming emotionally and psychologically distant from her peers and teachers. However, the decision to send her for counseling was taken when her parents approached the school regarding her performance and expressed worries over her behaviour problems. The method used to understand the client was personal interview. Six sessions of interview were conducted with the client. It was found that she was suffering from low self-esteem and insecurity. It was also found that the client had developed the problem of obesity since last 3 years. The interview revealed the root cause of client’s problem of obesity, and that was her emotional insecurity. Challenges From the personal interview sessions of the client, it was revealed that she had developed obesity due to emotional and psychological distress. The client’s eating pattern was related to the emotional insecurity and unfulfilled needs. Hence, it was very necessary to adopt a person-centred approach to gain her confidence and faith. Person-centred approach is one of the most effective approaches in care. According to Ford and McCormack (2000), “in order to provide person-centred care, practitioners must acquire knowledge about the person which allows them to provide care and services that are compatible with individual’s values and which are, as such, highly valued” (Clarke, Hanson and Ross 2003, p.697). However, understanding the values of a person is not an easy task. There were many challenges that were experienced during the journey of the treatment process. Interestingly, the challenges started right from the beginning of the treatment as the first challenge was faced when I had to understand the core values of my client. Building mutual trust Communication between nurse and patient is an important aspect of a successful treatment. However, communication is possible only when the patient trusts the nurse and believes that the details of his personal life will remain confidential. Hence, in order to encourage my client to open up emotionally, it was necessary for me to gain her trust. It was important to assure her that I was not going to judge her in any way, but understood her point of view completely. It has been observed that due to differing interpretation of illness and related conditions, the mutual trust between the nurse and the patient, which is necessary for good communication, cannot be developed (Sartain, Clarke and Heyman 2000, p. 913). Mutual trust can be enhanced by accessing and resolving the difference in patient’s and service provider’s interpretation of the medical condition and related issues (Sartain, Clarke and Heyman 2000, p. 913). Hence, forming a platform on which the client feels comfortable to open up herself, and puts her trust in me, was one of the main challenges of the case. Understanding the core values Human values play a major role in developing the behaviour and personality of a person. Values define the core aspects of a person. Hence, understanding values of a client is very important for a nurse as they can provide an insight into the root cause of client’s medical condition. Values can be understood only when a person opens up completely in front of you without any inhibitions or hesitancy, as they lie at the core of the being. Hence, to understand the core values of my client, it was necessary to gain her trust and listen to her ‘inner voice’ when she was responding to my probing during the sessions. According to the policies of NHS, to bring about positive change in the health services, approaching the patient as an individual through person-centred care is essential (Clarke, Hanson and Ross 2003, p.697). It has been found that quality of treatment and planning can be improved immensely with the help of patient’s story and discussion of their journey (Gullick and Shimadry 2008, p. 34). Hence, knowing the core values of client was a strong challenge in the journey of the case. During the sessions, I learnt that one of the most important things that my client valued was acceptance from her parents and particularly, from her father. Communicating the real problem Communicating the real cause, that is the emotional insecurity and negative self image, to my client was a strong challenge in the treatment process. During the session, it was found that my client spent most of her free time alone inside her house. Instead of playing with her friends, she spent her time in watching TV or in playing video games. On probing, she revealed that she feared being ridiculed about her weight and preferred being alone. Researches have found that development of obesity in childhood is directly linked with the amount of time spent in watching television (Miller, Rosenbloom and Silversteing 2004, p. 4211). Moreover, the eating pattern of my client was quite unhealthy. It was found that she binges on potato chips and chocolates when she is anxious and nervous. Hence, communicating the vicious cycle of obesity, that is, indulging in unhealthy food to ‘feel good,’ gaining more weight by that and again feeling depressed due to being overweight, was a great challenge in the process. However, the most important thing that came out during the session was the unhealthy eating pattern of the family and pressure on the client due to high expectations from her father. Communication with parents During the sessions, the client revealed that her father has a great influence on her. However, being the only child, he was also very demanding and strict with her. Since her childhood, she was always under pressure to perform well and be a ‘good girl,’ to gain appreciation and acceptance from him. However, with growing age, she found it difficult to cope with the pressure of being the best in everything. She developed anxiety and fear inside her. It was through fast food and chocolates that she tried to find comfort and love. Her father’s love and appreciation was conditional and she found it difficult to fulfill his demands and expectations on continuous basis. This information from the client provided an important insight on the emotional basis of her obesity. It was clear that she tried to fill the emotional emptiness with food. Her habit of binging on snacks and chocolates was developed out of need for love and affection. Hence, communicating the parental pressure as one of the root causes of her obesity was a huge challenge during the process as it is difficult for parents to accept that their child’s problem is due to their own behaviour. Eating behaviour Qualitative research study by Gullick and Shimadry revealed that trustworthy carer and support from family is considered as positive dimensions of experience by patients (2008, p. 33). To provide a person-centred care, it was necessary to listen to patient’s life experiences related to her problem. It has been found that underlying emotional, psychological and physical needs of the patient can be explored if emphasis is given on patient’s narrative through which the patient expresses her experience in context of her life (Wilcock et al. 2003, p.429). During one of the sessions, through the narration of client’s story, it was found that the eating pattern in her family was quite unhealthy. Due to hectic schedules, her parents were in habit of ordering food from outside. Breakfast was usually quick affair and dinner was never on time. Hunger pangs made the client to binge on snacks. Hence, it was important to make the parents realize that they needed to modify their eating behaviour and food choice. Hence, planning a change in their eating behaviour and food choices was a strong challenge. Conclusion Person-centred care is one of the best approaches in health services. When a person feels that he is being treated as an individual and a human ‘being,’ and not just as ‘another patient,’ his heart and mind opens to the carer, and he trusts the treatment being provided. This brings a quantum leap in the health service and the outcome is always positive. Hence, person-centred care not only satisfies the patients, but also the service providers, as it make them feel fulfilled in both, the professional and the spiritual way. References Clarke, A., Hanson, E.J. and Ross, H. 2003. Seeing the person behind the patient: enhancing the care of older people using a biographical approach. Journal of Clinical Nursing, 12, pp. 697-706. Gullick, J. and Shimadry, B. 2008. Using patient and carer stories to improve quality of care. Nursing Times, 104(10), pp. 33-34. Miller, J., Rosenbloom, A. and Silversteing, J., 2004. Childhood Obesity. The Journal of Clinical Endocrinology & Metabolism, 89(9), pp. 4211–4218. Sartain, S.A., Clarke, C.L. and Heyman, R., 2000. Hearing the voices of children with chronic illness. Journal of Advanced Nursing, 32(4), pp. 913-921. Wilcock, P.M. et al., 2003. Using patient stories to inspire quality improvement within the NHS Modernization Agency collaborative programmes. Journal of Clinical Nursing, 12, pp. 422-430. Read More