Patient-Centered Care Essay
Health needs are diverse; thus, healthcare workers apply various strategies to meet each one of them. The population health of a community is dependent on the health of its members. Reduced level of health needs among individual translates to the well being of the population and vise versa. Therefore, nurses employ patient-centered care to meet the specific health needs of individual members in a population to achieve community coverage. Patient-centered care is where the nurse identifies the unique health needs of an individual and apply interventions specific to the needs. This type of care requires the health worker to develop a therapeutic relationship with the client (Hochman, 2017). The relationship allows the nurse to conduct a comprehensive assessment to obtain all information that is required to develop a diagnosis. The diagnosis then determines various interventions applied for the caregiver to achieve goals of addressing the diagnosis. This paper focuses on the evaluation of the outcomes of interventions applied to population health through patient-centered care. The evaluation provides the nurse with feedback on which interventions were effective and those that require modification in the case scenario.Patient-Centered Care Essay
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Case Scenario Description
Keith is a teenager (18 years old) a high school student who has recently been diagnosed with HIV. The patient had not been on treatment since he is afraid that the insurance company will drain all his family finances on learning he has a chronic condition. Keith is also in a gay relationship that his family does not approve so they kicked him out. He is living with Nick’s parents (his boyfriend), they feed him but they won’t allow them to share a bed. He has not been on HIV but has been taking methamphetamines which he was told it ‘slows down the sickness.’ However, he is not comfortable taking the drugs because they make his heart beat faster which scares him. He has insight into the condition and is willing to start treatment but he does not know how to go about it.
Nursing Diagnosis and description
Keith has fear and anxiety related to the separation of the support system and as evidence by expressed concerns regarding his personal life and his support system. Humans are social beings that require a support system in most of their life activities. Keith lacks social support from his immediate family. They are deep-rooted Cristian who believe having gay relations is a sin. Their values had him kicked out of his home after learning that he contracted HIV from a gay relationship. The client sort help from his boyfriend Nick’s family where he was welcomed. However, there is still tension in the setting since the family will not allow the two to share a bed. He is surrounded by uncertainty since he is not sure if Nick’s family knows about both their relationship and health status (Chen et al 2018). He is living in hope that his boyfriend does not break up with him since he will have nowhere to go. Keith also feels he does not want to be a burden to his family in terms of financing his medication.Patient-Centered Care Essay
Interventions and Outcomes
The first intervention in this diagnosis is to explain procedures in layman terms that are easily comprehended with opportunities for questions and answers. The other one is to arrange for a support person to stay with the patient during procedures and consultations to reduce anxiety. The rationale for those two interventions is to have Keith obtain information that will help him overcome his fear. The client is overwhelmed with fear and anxiety since he is not certain of what to do about his condition. Thus, the caregiver should explain the possible options and also allow him to ask questions related to the same. Patient-centered care will allow the caregiver to provide a solution specific to Keith’s problem. The outcome of this intervention is that he verbalizes awareness of findings and healthy coping mechanisms to handle them. He also displays an appropriate range of emotions and decreased anxiety. Demonstrates appropriate problem-solving skills. Therefore, the nurse achieved the intended outcomes of these interventions.
Nursing Diagnosis and Description 2
Keith is having social isolation that’s related to inadequate personal resources, support systems, and physical isolation as evidence by expressed feelings of loneliness imposed by his family. He is also experiencing the feeling of rejection, and the lack of that family support system. The client is physically separated from his family where his parents and siblings since they do not approve of his relationship (Astuti & Kurniati, 2018). He is also physically separated from his boyfriend since his family will not allow the two to share a bed. That form of separation denies him the emotional support that he requires to cope effectively with the new diagnosis. The separation also gives him a feeling of rejection where he cannot effectively interact with his younger sisters. Thus, he lacks an effective support system to express his emotional and health needs. Keith also has financial pressure since he feels he have an inadequate fund to cover his medication. He is still a student thus he doesn’t have a stable source of income. He is afraid that if he uses the family health insurance cover, his family would be heavily impacted financially. The diagnosis has both short term and long-term impact on his general health. He will experience stigma and that may lead to mental disturbance thus failing to comply with drugs.Patient-Centered Care Essay
Interventions and Outcomes
Interventions applied in this diagnosis include spending quality time talking with the patient during and between care activities. The nurses should also have a supportive open communication line that allows interactive communication from the patient. Treat Keith with dignity and respect for his feelings about love and health. The nurse should also be on the lookout for both verbal and nonverbal communication: withdrawal, statements of denial, anger, a sense of aloneness. During the interaction, the nurse should ask the client if he has thoughts of suicidal ideation. Spending time with the client is an indication that there is somebody who cares about him. The feeling of rejection will be eliminated thus he will be positive about life. Open communication creates a therapeutic rapport between the two parties where the client feels free to open up to the caregiver and even ask questions on areas of the uncertainty of health. Treating the client with respect and dignity gives him a sense of belonging where he feels that someone understands his life decisions (Putri, Malini & Basmanelly, 2019). The nurse can obtain important information about the mental status of the client through verbal and nonverbal communication. Early detection of health risks like suicidal ideation will allow the nurse to develop interventions to prevent the occurrence of the same. After applying the interventions, the client identifies supportive resources and individuals. The client also reports the use of resources like online health blogs for assistance. He also started participating in programs and counseling willingly. The interventions are effective since will no longer feel rejected or stigmatized due to his condition or sexuality. The client will also use available resources to obtain health information about HIV instead of relying on myths (Acree, 2017). Counseling programs will allow Keith to interact with other teenagers in a similar situation which will be part of consolation and reassurance.Patient-Centered Care Essay
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Diagnosis and Description 3
Keith has a knowledge deficit related to his unfamiliarity with information resources and misinterpretation of the information as evidence by patients’ statements of miscomprehension about the treatment and disease transmission. During the interview, the client states that he has been taking methamphetamines which his boyfriend Nick learned from the internet they help slow down the diseases. He does not know that the drug does not have any impact on HIV progress. Keith is also not aware that the drug is highly addictive even though he is already experiencing severe side effects. The drug is a stimulant that can impair his judgment thus increasing the risk of engaging in activities that increase the chance of infecting others. Keith is also scared that his entire family shares a bathroom. He feels that his mother kicked him out since she was afraid that he will transmit HIV to his younger sisters through sharing the bathroom. That indicates a knowledge deficit of modes of transmission of HIV. Inadequate information in such a situation will increase the need for one to isolate and also stigma from other parties (Oginni, Adebajo & Ahonsi, 2017). Such circumstances will only increase anxiety and fear in the client.
Interventions and Outcome
The nurse should review the disease process and transmission with the client. Explaining the disease process and modes of transmission will help the client understand that he is not a threat to his immediate family. Thus, he should not feel the need to isolate himself since he cannot transmit HIV through sharing things like the toilet. The caregiver should also educate the patient that methamphetamines are illegal and can be lethal. Therefore, the use of the drug is not only harming his health but also his social wellbeing. The caregiver should discuss medication management, interactions, purpose, and side effects. The interventions are effective since the client verbalizes comprehension of disease process and transmission. The other outcome in this case initiation of healthy lifestyle modifications and participation in the treatment plan of care. The client also verbalizes the comprehension of medication management and interactions, purpose, and side effects.
Factors that Contribute to Shortfalls of Outcomes
Poor communication skills lead to a misunderstanding of information thus failed outcomes. Knowledge deficits among family the community can also lead to failure of outcomes that require social support. Both the healthcare provider and the client may fail to achieve their goals if there are inadequate resources to deal with the condition. Strategies to control those factors include enhancing communication skills between the patient and the caregiver, sensitizing the community on the essence of providing social support (Jarrar et al., 2018). The care provider should also influence health shareholders to increase the availability of healthcare resources.
Conclusion
Health needs are unique; thus, nurses should provide patient-centered healthcare to meet all the demands. Patient-centered care is achieved by creating a rapport with the client to allow the effective flow of information. This form of care allows the care provider to develop a correct diagnosis and plan for the best interventions. For instance, in the case of Keith, the nurse made three diagnoses and planned interventions based on the intensity of the need identified. Some interventions give positive outcomes where others fail. Factors that cause shortfalls of outcomes include poor communication skills, lack of resources, and unsupportive community. Patient-Centered Care Essay
References
Acree, M. E. (2017). Transition of care for youth with HIV. Pediatric Annals, 46(5), e198-e202.
Astuti, D. A., & Kurniati, N. (2018). Factors Influencing Stigma to Lesbian, Gay, Bisexual, and Transgender (LGBT) Among Teenagers at Ngaran Village, Gamping, Sleman, Indonesia. GHMJ (Global Health Management Journal), 2(2), 19-24.
Chen, W. T., Shiu, C., Yang, J. P., Li, C. S. R., Wang, K., Zhang, L., … & Zhao, H. (2018). Substance use, anxiety, and self-management efficacy in HIV-positive individuals: a mediation analysis. Journal of substance use, 23(4), 408-414.
Hochman, O. (2017). Patient-centered care in healthcare and its implementation in nursing. International Journal of Caring Sciences, 10(1), 596.
Jarrar, M. T., Rahman, H. A., Minai, M. S., AbuMadini, M. S., & Larbi, M. (2018). The function of patient‐centered care in mitigating the effect of nursing shortage on the outcomes of care. The International journal of health planning and management, 33(2), e464-e473.
Oginni, A. B., Adebajo, S. B., & Ahonsi, B. A. (2017). Trends and determinants of comprehensive knowledge of HIV among adolescents and young adults in Nigeria: 2003-2013. African journal of reproductive health, 21(1), 26-34.
Putri, D. K., Malini, H., & Basmanelly, B. (2019). Living with HIV/AIDS: Stigma and Social Discrimination. Jurnal The Messenger, 11(1), 10-17.Patient-Centered Care Essay