Medical Essay: Impact Of Hospitalisation On APatientWith Chronic Anxiety

Question

Task: Background.

Research indicates that the acute hospitalisation for management of exacerbations of chronic disease can have various effects on the psychological, emotional and physical wellbeing of the patient and their family. It is important as a nurse to understand these influences that can be experienced by the patient and their family and implement appropriate coping strategies to support patient and their family cope during this stressful period.

Rationale:
The purpose of this written medical essay is to assess your knowledge of the impact of hospitalisation for patients and their families experiencing acute or chronic illnesses.

Tasks and Instructions:
• Write an academic essay where you critically examine the impact of hospitalisation on a patient and/or their family, who is experiencing an acute exacerbation of their chronic illness.
• Ensure that you access the right assignment as determined by your cohort (Cohort A or Cohort B)
• Select only one scenario provided in your allocated cohort group
• The impact for both the patient and family have been provided for you. In your discussion: Choose 1 impact on your patient and 1 impact on the family
1. Provide a detailed and comprehensive explanation on how hospitalisation can impact the patient and the family
2. Suggest a coping strategy or strategies (could be 1 or 2) for each effect that could support a more positive experience. The number of provided strategies is not a focus but rather, a well justified and developed arguments validated by current academic sources to support your discussion is expected.

SCENARIO 1
Impact of hospitalisation on a teenager and their family
Liam is a 16-year-old male diagnosed with chronic anxiety. He has agreed to a period of hospitalisation to adjust his medications and counselling as his symptoms have recently exacerbated. Liam lives with his mother and stepfather and stepbrother Chris who is 8 years old. He regularly attends counselling at his secondary school and has a solid support network developed amongst his friends. He no longer sees his biological father.

Impacts on a patient (LIAM)
Changes in eating, sleeping and activity, Worried what others think, Separation from peers, Powerlessness, Conflict and power struggles, Stress, Inability to function

Impacts on family
Hopelessness, Guilt, anxiety, Stress to family relationships, Difficulty understanding the treatment and outcomes

SCENARIO 2
Impact of hospitalisation on a young adult and their family.

Jenny is 34-year female who has Multiple Sclerosis. She has been admitted into hospital as she is currently experiencing a relapse in her symptoms and requires administration of high dose parenteral steroids. Jenny lives with her partner Grace and their 2 daughters, 13-year-old Mia and 9-year-old Claire. Jenny normally works at home part time during school hours. Grace holds a position as a paramedic with Ambulance Victoria working shift work. Jenny is the primary carer for their children and undertakes the shopping and meal preparation for the family.

Impacts on patient (JENNY)
Scared of the unknown, Guilt for not managing her disease, Worry about the family, Financial impact, Long term prognosis and outcomes., Anger
Impacts on family
Changes in family roles and responsibility, Financial pressures, anxiety in children, fear of losing their mother. Long term impact of the disease on family, Compromised family coping

Answer

Background of Medical Essay
Exacerbation of chronic anxiety creates persistent worry and fear with excessive and intense effects on daily life. Repeated episodes of anxiety require hospitalisation that comes with critical impacts on the patient and family simultaneously. However, it is essential for the organisational management and the care-service providing individuals to identify the coping strategy with the unexpected situations for both family and patients. The essay focuses on identifying the impact of hospitalisation on Liam, a sixteen years old boy with chronic anxiety with the need for special care due to exacerbation of the disease.

Impact of hospitalisation on the patient
Primarily, patients face issues such as inability to function, stress, powerlessness, and separation from peers when it comes to staying in hospital to recover from acute diseases. However, this essay focuses on evaluating the impact of hospitalisation regarding changes in eating, sleeping, and activity in the case of Liam to provide him required support from the end of service providing individuals.

Restrictions of mobility and diet in the case of Liam can create issues regarding coping with the situations (Cobham et al. 2020). At the same time, it is also crucial for the caregivers to take care of changing habits of eating and sleeping activities due to homesickness. Most importantly, Liam is facing issues regarding anxiety, and it is quite tough for him to stay away from his friends and family along with his daily life.

Coping strategy
Talking openly
It is crucial for the caregivers to consider the physical and mental conditions of Liam when it comes to providing him support and care. Caregivers require providing sufficient opportunity to the patient to accept his condition along with understanding his perspective regarding any situation. In this case, caregivers require providing counselling to Liam regarding the importance of having food and sleep on time to stay fit (Ullmann et al. 2019). Along with that, friends of Liam can help him in overcoming the stress and issues in daily activities and food habits by helping him to stay happy. Along with that, providing scope to share the words of his heart can help him to go beyond the issues regarding nervousness and anxiousness.

Communication
Open communication and cooperation in the procedure of counselling Liam can help in earning trust of this teenager that can help him to feel better. In the process of medication, it becomes easier for the caregivers to provide required medicines and therapy to the patients by earning their trust through honest communication that can lead to a fruitful approach of managing the disease (Toledano-Toledano and de la Rubia, 2018). Hospitalisation often comes with serious issues such as not having sufficient interests to have proper food in the hospital. However, the caregiver can help Liam to manage his diet and sleep related activities by knowing his preference of food as per the physical condition.

Involving Liam in Decision-making process
Liam lives with mother, step-brother, and step-father, and he does not meet with his biological father. However, this aspect might affect his condition regarding chronic-anxiety. In such a circumstance, this issue can be resolved in the time of hospitalisation by identifying the most critical reason for such a disease. For example, involvement of Liam in the decision-making process regarding his interests to stay in touch with his biological father can help in improving his mood. Along with that, it is also essential for the entire team of caregivers to counsel Liam to take his favourite things such as books or video games with him.

Impact of hospitalisation on the family
Most critical impact of hospitalisation on the family of a teenager is difficulty in understanding the treatment and outcomes. In this case, the family might face issues regarding finding out the importance of hospitalisation in the case of Liam to treat him more efficiently. For example, Liam’s mother might go through stress regarding the entire procedure of treatment. However, these issues can also be resolved through the most acceptable strategies regarding coping with the situation.

Coping strategy
Communication
Caregivers can provide information in minute detail regarding the entire procedure and list of medications that will be used to treat Liam. Along with that, the parents need to know about the reason for this hospitalisation. For example, in this case, Liam has faced an exacerbation related to his anxiety (Renna et al. 2018). In such a condition, it is essential for the family members to talk to the caregivers regarding the consequences of such an issue in the case of Liam. Along with that, nursing professionals have the opportunity to communicate with the parents of Liam to help him in coping with his situation to become healthier in future.

Medication related information
Knowing the side-effects and usefulness of the medicines will be used for treating Liam can help the parents to stay calm regarding helping their children to stay fit. It is not possible for Liam to cope with the unexpected situation of fighting the anxiety related issues without having proper support from the family members. Therefore, the caregivers can help the family members to know about the entire procedure of managing the issues and communicating with Lima more efficiently.

Conclusion
Support from family, friends, and caregivers make feel better to any patient of anxiety. In this case, Liam is a sixteen-year-old patient with chronic anxiety. This disease comes with negative impacts on the body and mind. However, after facing a critical condition it is better for Liam to become hospitalised. Moreover, hospitalisation comes with issues such as negative impact on both the patient and family. In this case, changes in eating habits and sleeping can affect the entire procedure of improvement of Liam.

However, positive interference of the caregivers in communicating honestly and openly can help the boy along with motivating him to talk to his friends. Presence of friends every afternoon can help the boy to stay more fit and active while having food. Support from the family and friends positively can only help this boy to stay happy and get rid of anxiety. It is no different in the case of his family as the entire family can cope with the stress regarding the medication process through communication with the caregivers.

References
Cobham, V. E., Hickling, A., Kimball, H., Thomas, H. J., Scott, J. G., & Middeldorp, C. M. (2020). Systematic review: anxiety in children and adolescents with chronic medical conditions. Journal of the American Academy of Child & Adolescent Psychiatry, 59(5), 595-618. https://www.sciencedirect.com/science/article/abs/pii/S0890856719321100
Dunbar-Jacob, J., & Mortimer-Stephens, M. K. (2001). Treatment adherence in chronic disease. Journal of Clinical Epidemiology, 54(12, Supplement 1), S57-S60. https://doi.org/https://doi.org/10.1016/S0895-4356(01)00457-7
Renna, M. E., O'Toole, M. S., Spaeth, P. E., Lekander, M., & Mennin, D. S. (2018). The association between anxiety, traumatic stress, and obsessive–compulsive disorders and chronic inflammation: A systematic review and meta?analysis. Medical essayDepression and anxiety, 35(11), 1081-1094. https://www.researchgate.net/profile/Megan-Renna/publication/327495787_The_association_between_anxiety_traumatic_stress_and_obsessive-compulsive_disorders_and_chronic_inflammation_A_systematic_review_and_meta-analysis/links/5b91e6aaa6fdccfd541f8887/The-association-between-anxiety-traumatic-stress-and-obsessive-compulsive-disorders-and-chronic-inflammation-A-systematic-review-and-meta-analysis.pdf
Toledano-Toledano, F., & de la Rubia, J. M. (2018). Factors associated with anxiety in family caregivers of children with chronic diseases. BioPsychoSocial medicine, 12(1), 1-10. https://bpsmedicine.biomedcentral.com/articles/10.1186/s13030-018-0139-7 Ullmann, E., Perry, S. W., Licinio, J., Wong, M. L., Dremencov, E., Zavjalov, E. L., ... & Tseilikman, V. (2019). From allostatic load to allostatic state—an endogenous sympathetic strategy to deal with chronic anxiety and stress?. Frontiers in behavioral neuroscience, 13, 47. https://www.frontiersin.org/articles/10.3389/fnbeh.2019.00047/full