NSG 4055 Illness and Disease Management across Life Span Project Part 3
NSG 4055 Illness and Disease Management across Life Span Project Part 3
The client for this project is K.H, a 35-year-old male with schizoaffective disorder. He exhibits psychotic symptoms, including delusions and hallucinations, which alternate with depressive symptoms. After administering a questionnaire, I established that the client has a major depressive disorder based on the presence of four depressive symptoms occurring more than half the days and one symptom occurring nearly every day. The depressive symptoms have adversely impacted his occupational and social functioning. This paper seeks to discuss interventions of the professional caregiver, implementing Healthy People 2030 objectives to improve wellness and the impact of the environment on patient’s health.
Support Needs of the Participant
The assessment results revealed various support needs that H.K requires to accelerate his recovery process. High priority needs include coping skills, positive reinforcement, and treatment adherence. Medium-priority needs include self-esteem, financial, and sleep issues. Low-priority needs include nutrition, physical exercise, and acceptance to treatment.
Appropriate Interventions of the Professional Caregiver
Interventions for the professional caregiver, such as the PMHNP, should include encouraging the client to adhere to his treatment plan. The PMHNP should help the client develop creative reminders to remind him to take his medications and keep clinic appointments. The PMHNP should also give positive reinforcement by reminding him of his positive qualities and his significance to his family and friends (Gariepy et al., 2017). Giving positive reinforcement can help the client stop judging himself harshly and finding fault with everything he does. Besides, the professional caregiver can assist the client in creating a low-stress environment, which will lower the severity of depressive symptoms (Gariepy et al., 2017). For instance, the PMHNP can guide the client in creating a schedule for meals, physical activity, medication, and sleep, to lower the stress caused by chaotic timelines. The PMHNP should also help the client locate and join support groups that offer counseling and resources for depression.
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How to Implement Objectives of Healthy People 2030 to Increase Wellness
One of the Healthy People 2030 goals is to enhance mental health through prevention and ensuring access to appropriate, quality mental health services. Objectives related to schizoaffective disorder include: Reduce the suicide rate; Reduce the proportion of persons who experience major depressive episodes; Increase the number of adults with mental health disorders who receive treatment; Increase depression screening (ODPHP, 2020). The objectives can be implemented through individual, family, institutional, community, and policy interventions to improve mental health and various social outcomes across social-ecological levels (Castillo et al., 2019). At the individual level, outreach activities can be implemented to increase access to mental health services and evidence-based treatment for individuals. Community health workers should also increase the acceptability of mental health services.
At the family level, health providers can provide psychoeducation for families to improve mental health literacy, reduce stigma, and increase help-seeking in mental health. Providers should offer psychoeducation and skills training to minimize risky behaviors such as drug abuse and domestic violence associated with mental health consequences (Castillo et al., 2019). There should also be case management for families at risk of mental disorders. At the institutional level, organizational leaders should embed mental health services within the workplace. Besides, they should modify institutional policies and processes to better serve persons with mental disorders (Castillo et al., 2019). Leaders should also modify policies to foster access to mental health services and prioritize social and emotional wellbeing. Community outreach programs should be implemented at the community level to improve individuals’ knowledge, attitude, and collective efficiency in mental health (Castillo et al., 2019). At the policy level, policy-makers should provide technical and financial support for community-based organizations that focus on mental health to collaborate with the healthcare sector.
Nursing’s Role as an Advocate for Participant Acceptance of Diagnosis and Treatment
Nurses interact with patients the most compared to other healthcare providers and are thus ideally positioned to be patients’ advocates. Nurses have a role of helping mental health clients to translate medical terms, navigate the multifaceted medical system, and make ethical decisions (Gerber, 2018). To promote clients’ acceptance of diagnosis, nurses have a role of explaining to the client about their diagnosis, including causes, risk factors, treatment interventions, and prognosis (Gerber, 2018). Explaining to the client helps reduce the anxiety associated with the diagnosis and increases the likelihood of accepting the diagnosis.
To enable the client to accept treatment, the nurse should explain the available treatment options to the client. The nurse should advocate for the client to be involved in developing the treatment plan, which encourages them to comply with treatment (Gerber, 2018). Besides, the nurse has a role of advocating that the patient’s financial ability be considered when selecting the treatment to avoid financial strain and ensure that the client can afford the medication. The nurse should educate the client on the medications’ mechanism of action, the potential side effects, and the time the drug should take to demonstrate response (Gerber, 2018). Furthermore, the nurse should advocate for modification of the treatment plan if the client reports adverse side effects from the medication. Modifying the treatment plan to reduce adverse effects greatly encourages the client to accept and comply with treatment.
The Impact of the Environment on Patient’s Health
There is a strong link between mental health and the environment. The mental health of psychiatric clients has been associated with design elements that impact their ability to regulate social interaction. Physical environmental factors impacting mental health include those that can affect an individual’s biology or neurochemistry, thus increasing their likelihood of developing a mental disorder (Moore et al., 2018). They include smoking, sleep deprivation, substance abuse, exposure to toxins during childhood, pollution, extreme weather conditions, and hazardous work conditions. Social-environmental factors also impact a patient’s mental health wellbeing and response to treatment. The factors include socioeconomic, ethnic, racial, and relational conditions that affect an individual’s ability to cope with stress (Moore et al., 2018). They include poverty, social stigma, history of abuse, early loss of a parent, family discord during childhood, lack of meaningful work or hobbies, lack of spirituality or religious affiliation, toxic relationships, and lack of self-care.
Social Determinants That Impact Care
Social determinants of health (SDOH) refer to non-medical factors that impact health outcomes. They comprise intangible factors such as socioeconomic, political, and cultural constructs (Catalyst, 2017). They also include environmental-based conditions, including safe environmental conditions, accessible healthcare and education systems, well-designed neighborhoods, and availability of healthy food. The SDOH impacts a person’s access to healthcare, including mental health services that determine their mental health. Individuals residing in areas with limited healthcare facilities have limited access to mental health preventive, screening, and treatment services, which impact their mental health outcomes (Catalyst, 2017). Furthermore, low literacy levels affect a person’s employment opportunities, contributing to low-income financial constraints. Low income affects a person’s access to healthcare and healthy food and results in hardship (Catalyst, 2017). Hardship contributes to stress, resulting in unhealthy coping mechanisms such as substance abuse, affecting mental health.
H.K’s priority needs include coping skills, positive reinforcement, treatment adherence, sleep issues, and self-esteem. The PMHNP can implement interventions such as encouraging treatment adherence, developing reminders, giving positive reinforcement, and recommending the client to support groups. The nurse has an advocacy role of guiding the client to make informed decisions about their health and treatment interventions. The nurse should explain the diagnosis and treatment plan to the client and involve them in developing the plan to promote acceptance of the diagnosis and treatment. Patients accept treatment more readily when they are well-informed of its action, benefits, and potential side effects than when they do not understand the prescribed medication. Both physical and social environmental factors can positively or negatively influence an individual’s mental wellbeing and recovery. They affect an individual’s biology or neurochemistry factors and the ability to cope with stress. The objective of Healthy People 2030 can be implemented through individual, family, institutional, community, and policy interventions to improve mental health and social outcomes.
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Catalyst, N. E. J. M. (2017). Social determinants of health (SDOH). NEJM Catalyst, 3(6).
Gariepy, G., Honkaniemi, H., & Quesnel-Vallee, A. (2017). Social support and protection from depression: a systematic review of current findings in Western countries. The British Journal of Psychiatry, 209(4), 284-293. https://doi.org/10.1192/bjp.bp.115.169094
Gerber, L. (2018). Understanding the nurse’s role as a patient advocate. Nursing2020, 48(4), 55-58. https://doi.org/10.1097/01.NURSE.0000531007.02224.65
Moore, T. H. M., Kesten, J. M., López-López, J. A., Ijaz, S., McAleenan, A., Richards, A., … & Audrey, S. (2018). The effects of changes to the built environment on the mental health and wellbeing of adults: a systematic review. Health & place, 53, 237-257. https://doi.org/10.1016/j.healthplace.2018.07.012
ODPHP. (2020). Mental health and mental disorders | Healthy people 2030. https://www.healthypeople.gov/2030/topics-objectives/topic/mental-health-and-mental-disorders