Therapeutic Nursing, Improving Patient Care through Self-Awareness and Reflection - Essay Example

?Home to Home A patient’s journey in a primary health care system begins with the smooth contact of the patient with health care. This is then characterised by successive interplay between various components of the health care system. The journey also entails the provision of care in the community setting. The success of the patient’s journey is ensured through the cooperation of the health care providers that work cohesively in the delivery of effective health care. This involves the production of national programmes and plans that enhance the disease management and care within different levels of the primary health care. The patient’s journey describes how a person experiences a disease from the initial realisation of the symptoms through the stages of presentation, diagnosis, treatment and adherence to the medication leading to cure, remission or death. Coronary heart disease results from the build-up in the arteries that blocks the blood flow and increases the risk for heart attack and stroke. Its main cause is the development of the heart complications that prevent it from receiving sufficient oxygen as well as nutrient rich blood. The most devastating symptom of the coronary heart disease is the development of abrupt cardiac arrest. Others include chest pain, short breath upon exertion, palpitations and dissiness. Some of the treatment measures administered to the patients suffering from coronary heart disease include aspirin, Beta-blockers and nitro-glycerine. Some of the preventive measures include adoption of a healthy lifestyle during childhood as well as reducing the risk factors. Critically analyse the sociological and psychological drivers that impact upon the patient’s journey through any health care setting. Sociological and psychological drivers share common interests in the management of the coronary heart disease. Such factors are related to psychosocial issues such as the cause of the condition, help-seeking behaviours and their adherence to the treatments, change in lifestyles, the health improvement strategies, quality of life and mental illness. However, each discipline is unique in its perspectives and concepts as well as the focus and explanations. This inflicts a distinct impact on the patient’s journey. Psychological Drivers Most patients are unaware of the psychological drivers that affect their health care journey. This procures the health care providers with an uphill task of undertaking primary research on these patients to ascertain these factors. One of the prominent factors affecting the psychological drive is the occurrence of stress (Ogden, 2009). High levels of stress delays the recovery rate of the patients suffering from the coronary heart disease. Patients under stress cannot strictly follow the treatment or the preventive guidelines. Patients suffering from coronary heart failure may also experience trans-generational and cumulative trauma. Most of them are normally resigned to the fact that they will acquire the disease genetically, making them ignore the keenness measures required for undertaking effective medication (Helman, 2007; Ayers, 2007). Most of the patients may also experience discrimination or racism that may lead to stigma. This slows down the recovery rates, with most of them succumbing to the ailments in severe cases. Sociological Drivers The prominent sociological factor that negatively affects the patient’s journey for those suffering from coronary heart disease in a primary health care setting is the rise in the social media listening programmes (Gray, Degeling and Colebath, 2008; Barrett, Sellman and Thomas, 2005). The social media platform has provided patients with an electronic avenue for sharing the health information through utilisation of the speed of the Internet. Patients are able to become the members of the online family that connects them to the fellow patients and share information related to their conditions. The health care institutions can also tap on the information extracted from the online conversations to enhance healing. The patient information is also helpful in the identification of the trends in the patient’s view towards health care experiences. Giddens (2010) terms the family and kinship system as another sociological factor that affects the patient’s journey. The modes of treatment are determined through discussions between the patient, the cardiologist and the family members. The decision made through consultations of the family members and the health care professionals is dependent on various factors that focus on ensuring that the patients undertake the most efficient journey while fighting for the health of their conditions. Every choice of treatment that is chosen has consequences that vary depending on the patient’s health condition. Another sociological driver is ethnicity. Studies have affirmed that Caucasians have a shorter healing journey compared to the members of the other races. Their compliance with the proposed medical procedures is higher compared to the members of the other races (Barrett, Sellman and Thomas, 2005). Races have also been associated with the evolvement of the minority and majority populations. The minority populations may lack the sufficient funds required for accessing the required treatment for management of their health status due to their economical disadvantage. Other sociological factors that have limited impacts on the treatment journey include community cohesion, access to quality housing, employment, support services, living conditions and social inclusion. Critically appraise factors that contribute to the individual’s concordance / non-concordance with proposed health regimes. The degree to which a patient adheres to the medical regimes is a prominent concern in all the medical specialties involved in caring for the welfare of the patients suffering from the coronary heart disease. Factors that contribute to the individual’s concordance/non-concordance with proposed health regimes are either linked to the patient or clinician (Naidoo and Wills, 2008; Naidoo and Wills, 2009). Some of the factors related to the patient include their concerns about the side effects of medication, few perceived benefits, the stigma associated with the adherence to the health regimes and the concerns about the cost, availability and dependency. The clinician factors include poor relationships between doctors and patients, inadequate follow-up on the impact of the health care regimes among the users and poor communication. Patient Factors The patient’s journey is variably determined either by the inherent factors or those associated with the behaviour. Such a factor is the intentional non-adherence to the proposed medication for heart diseases (Kleinbaum, Sullivan and Barker, 2007). Intentional non-adherence is achieved through balancing the individual reasons for and against undertaking medication. Some of the predictors of the intentional non-adherence to the proposed health care practises include insincere claims of less severe diseases, the individual desire to manage their medical states independently, disagreement with the clinicians and disinterest in the medical information provided by the experts. The non-concordance with the proposed medical regimes can also be linked to the specific adverse effects of medications. For example, Scriven (2005) asserts that obesity due to the use of antipsychotics discourages the victims from adhering to the required medical standards. Some of the medical regimes are associated with other side effects such as sexual dysfunction. Olfson, Uttaro and Carson’s (2005) functional study among patients undergoing out-patient treatment affirmed a high rate of sexual dysfunction among patients, a factor that most patients cite as the main reason leading to their non-concordance with medical regimes. Another patient factor affecting the adherence to the proposed medical regimes include their illness beliefs and knowledge of medication. The patient’s level of knowledge of the seriousness of the heart condition and the necessity of treatment enhances concordance. Concordance, satisfaction and understanding depend on the amount and credibility of the information provided to the patients. Studies have proven that patients that understand the significance of the medical prescription are more likely to use them than those that do not understand them (Department of Health, 2006). McPhail (2008) asserts that increased awareness of the treatment enhances the tolerability to the heart disease medication. The age of the patients may also have a crucial impact in the adherence to medications. According to Chilton (2004), the concordance with the health care regimes among the elderly is low compared to the young people. Most of the elderly people are faced with the physical and mental problems that prevent them from adhering to the measures that ensure concordance with the treatment regimes. According to Sines, Saunders and Forbes-Burford (2009), most heart failure cases are associated with the elderly. Therefore, most of them mainly ignore the health measures proposed by the medical personnel because they consider their condition normal. Additionally, aged patients may possess challenges related to hearing, memory and vision. This makes them have difficulties related to the adherence to the health care instructions due to the physical difficulties and cognitive disabilities. Such challenges include difficulties in swallowing of the tablets, reading the instructions in the drug containers and distinguishing the colours of different drugs. The clinician factors involve the relationship between the doctor and patient. Freshwater (2000) and Glennerster (2007) acknowledge the importance of the cordial communication between the patient and the health professional involved in enhancing the concordance with the health regimes. Achievement of efficient communication involves joint therapeutic agreements that involve full participation of the patients (Ham and McIver, 2000). This is a two-way process in which both parties are required to show willingness for being involved in the agreements. Most doctors tend to overestimate the information they provide to the patients while most of the patients consider the information provided to them as complicated due to the difficult terms used. Patients that are unwell or under stress due to the heart problems are unlikely to tolerate and adhere to the instructions provided by the clinicians on the proposed treatment regimes. This is further clarified by Jehan and Nelson (2006), who have shown that collaborative decision making is a predictor of the health outcomes. Analyse the impact of global, national and local initiatives on anyone involved in receiving, delivering or caring for an individual receiving health care. Most health care initiatives offer indirect assistance to patients through enhancing the working conditions of the people catering for their welfare (Pomerleau and McKee, 2008). The involvement of the national, global or local initiatives improves the availability of the equipment necessary for catering for the welfare of the patients. The initiatives are also involved in the provision of the necessary incentives required in the improvement of the working conditions, with more working opportunities being created to diversify and expand the provision of health care. The improvement of the working conditions in health care has promoted the performance and attendance of the people involved in the receiving, delivering and caring for the sick people. The initiatives have also involved provision of direct incentives for the sick people such as reduced cost of medication for patients suffering form the coronary heart disease. This has empowered them to focus on the efficient practises that enable them to improve their conditions. This has simplified the role of the medical practitioners in the improvement of the medical conditions patients suffering from the heart disease. Productivity of the people involved in catering for the welfare of the sick people has also increased, so that these workers are more effective when handling the health issues (Hogg and Holland, 2001). The initiatives have also led to the reduction in the inequalities and the social exclusion that faces the different range of patients. This has contributed to the enhancement in the life status of sick individuals. Some of these initiatives such as work extension programmes have enabled the health providers to work during their old stage if they wish. Conclusion The patient journey is the description of the manner in which a person experiences a disease from the symptoms through diagnosis, treatment and adherence to the medication leading to cure, remission or death. Some of the sociological and psychological drivers affecting the patient’s journey through overcoming the coronary heart disease include adherence to the treatments, family and kinship structures, stress, quality of life and mental illness. Most global, national and local initiatives enhance the effectiveness of the treatment journey through improving the availability of the equipment necessary for catering for the welfare of the patient and offering training to the works to enable them to offer competent services. References Ayers, S. (2007) Cambridge handbook of psychology, health and medicine, Cambridge University Press. Barrett, G., Sellman, D. & Thomas, J. (2005) Inter-professional working in health and social care, Basingstoke, Palgrave Macmillan. Chilton, S. 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