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Psychosocial Health Assignment: Patient’s Care Within Healthcare Setting

Question

Task: You are required to write an academic essay in the form of a critical discussion based on a prescribed topic derived from the unit content

A diagnosis of an acute illness can affect a person’s physical, psychological, spiritual, and social well-being. Unmet psycho-social care needs can be associated with significant morbidity and distress. Distress has been defined as an unpleasant emotional experience of a psychological (cognitive, behavioural, emotional), social and/or spiritual nature that may interfere with the ability to cope effectively with an acute illness, its symptoms, and its treatment.

Answer

Introduction
The following study of psychosocial health assignment is based on the health condition and psychosocial needs of a patient suffering from acute diverticulitis. Acute illnesses influence the health and psychological demeanour of patients within the healthcare setting. It is observed that the emotional, physical, spiritual and social needs of patients with acute illnesses vary with time. It is the responsibility of nursing staff and care providers to identify the root cause of distress for a patient and provide them with additional aid. The study would provide detailed knowledge about the psychosocial treatment and strategies of care providence that healthcare practitioners could implement providing better care to the patient.

The following study gives a critical analysis of the situation and distress Mrs G (name changed for privacy) experienced within a healthcare setting. The 71-year-old female patient was diagnosed with perforated diverticulitis. She had to go through an emergency laparotomy with an end ileostomy. Since the operative procedure on Mrs G was an emergency scenario, she was not well informed about the process and proper consent regarding the after-care and operational procedure was not conducted for Mrs G.

The following study aims to provide a detailed understanding of the psychosocial care behaviours and the enablers to the type of psychosocial care evidenced in case of treating Mrs G within the healthcare setting. The study would identify the difference in treatment that should have been provided to Mrs G within the setting and the after-math of the absence of proper knowledge on the patient is observed in the study.

Psycho-social behaviours
As per the psychosocial behaviour norms that healthcare practitioners need to provide to their care seekers involves three major steps, screening and assessing the problems that the patient experiences within the care setting, providing the patient with relevant information and the tactics of intervening at critical moments through assessment of the patient care. The study would provide relevant information that should be presented to the patient within the care setting. These psychosocial elements of the relationship are easier and effective in discussing them with the patient.

Screening and assessment
As opined by Graffigna & Barello (2018), it is necessary for practitioners and nurses to develop a detailed assessment of the patients’ needs and concerns before framing a care plan for the care seeker. This psychosocial health assignment noted that individuals develop psychological and emotional issues after being diagnosed with an acute health problem and care providers have to arrange for additional psychological treatment or support for the patient in such cases (Kennedy-Malone, Martin-Plank & Duffy, 2018). Depending on the severity of the problem, the care providers have to arrange for aggressive psychosocial treatments. In Mrs G’s initial assessment and screening processes, it has been found that the patient lives by herself yet she is acquainted with a supportive neighbour and few friends.

Her physical environment comprised of her 4-bedded room, which appeared effective for her as she was able to talk to other patients and not feel lonely. The support and communication with other patients proved effective for her, especially during her distressing recovery. It is necessary for care providers to assure their patients with an effective physical environment where they can relax and de-stress. Any acute illness presents certain emotional and psychological stress markers and care providers need to provide effective psychosocial treatment to patients as per their requirements (Kimura et al., 2017).

It can be noted after analysing the context of psychosocial health assignment that in case of Mrs G, she was previously an active woman with healthy community life and after knowing she required ileostomy, she was emotionally and psychologically distressed to the point of seeking death.

Information provision
It is necessary for care providers to develop appropriate communication channels with the patient in order to enable the providence of effective psychosocial treatment through communication. In the case of Mrs G, it was identified that there was lack of communication between the care providers and the patient and Mrs G did not have necessary information regarding the medical procedure that would benefit her. The need for effective communication and provision of information within the care process enables care providers to initiate better planning and treatment processes for the patients (Morgan, 2016).

As opined by Adler, Page & Setting (2008), a core element in providing psychosocial treatment to patients include communication and provision of information. Since Mrs G was not acquainted with the process and after-care of her treatment for diverticulitis, it was difficult for her to accept stoma and associated care post-operative (Burch, 2017). It is illustrated in this psychosocial health assignment that communication enhances the scope of gaining a patient’s trust and engaging in better care providence within the care setting. Mrs G would have benefitted through the process of effective communication and provisioning of information.

Communication plays a major role in building trust between the care provider and the patient and enables the patient to voice their issues efficiently. Mrs G’s care providers would have recognised her discomfort and issues with the stoma care process and the external ileostomy bag was a source of distress to the patient. The presence of an excoriated periosteal skin was also a major issue for the patient as it was painful for her and depressed Mrs G for a while post-operation.

Interventions and referrals
The need for interventions in the providence of effective care in psychosocial therapy for distressed patients is essential as it provides them with the opportunity to gather information and treatment from a variety of individuals with expertise in pain management and psychological treatment regarding extreme distress (Colorectal.surgery.ucsf.edu, 2019). Mrs G required additional support from psychotherapists and related pain management staff but she was able to bond with the stoma care nurses within the healthcare setting only.

Due to the constant need for stoma care for the patient, it was essential that nurses and practitioners perform holistic and supportive treatment to Mrs G. As opined by Cesari et al. (2016), the provision of interventions and referrals are essential in stoma care and for providing effective psychosocial treatment to distressed patients after critical operations. Mrs G would have benefitted if she was referred to specialist psychologists and trauma specialists for the emotional and distressing feeling she experienced post operations.

The need for providing appropriate information to the patient is essential in healthcare practices as it ensures the providence of effective care within the setting (Coloplast.com.au, 2019). The process of developing psychosocial treatment with elderly patients such as Mrs G, the practitioners need to consider her situation and provide treatment plans after examining Mrs G efficiently.

Enablers and impediments to psycho-social care within the psychosocial health assignment
Various elements enable psychosocial care to patients within a specific health and social care setting. However, depending on the situation and type of illness the patient experiences, these elements present impedimental notions for the effective provision of psychosocial care to the patient. The following section will identify the ways psychosocial care for Mrs G were enabled and hindered within the healthcare setting.

Physical environment
The physical environment for Mrs G comprised of 4-bedded stay with other patients. This environment allowed her to communicate with others and live a less restrictive life. The presence of other patients within the vicinity allowed Mrs G to communicate her issues and talk to them as well. As opined by Maruish (2017), the ability of healthcare practitioners to provide their care seekers with effective psychosocial care requires effective environment and additional support from social workers and other supporting staffs.

In the case of Mrs G, it was noted by the practitioner that the physical environment was providing effective psychosocial care through the presence of other patients. However, it was noted that Mrs G was uncomfortable in the 4-bedded stay, as it did not provide her with any privacy. Since her stoma was leaking most of the time, she was uncomfortable and upset with the treatment and felt humiliated with the presence of other patients. Since the patient was upset with the type of treatment and her physical environment, her recovery was slow and painful.

According to the views of Mark-Christensen et al. (2017), the care for diverticulitis for patients require the practitioners to provide detailed information of the type of treatment that they would receive from the care setting. It is necessary for care providers to recognise the need for isolation and privacy for patients as per their requirements.

Nurse-related obstacles
The presence of multiple stoma care nurses was beneficial for Mrs G in reducing the issue of leaking stoma that bothered her. She was able to communicate with the various nurses that cared for her stoma during her stay in the care setting. As observed by Finlay, Sexton & McDonald (2018), the need for specialised nurses is essential for stoma care, especially in diverticulitis-affected patients. The treatment developed for Mrs G involved her getting regular checks for stoma leakage but no separate psychologist was provided to her for the emotional support she needed regarding the development of a painful peristomal skin around her wound.

According to the views generated by You et al. (2019), it is noted that nursing ageing adults, for stoma care requires specialised skills and the nurses need to develop mixed skills. The lack of nurses with mixed skills and specialised care providence ability regarding stoma care proved to hinder for Mrs G in receiving effective care from the care setting. Mrs G regarded that she felt uncomfortable in her care setting due to the constant leaking stoma and the pain associated with the peristomal skin.

A major issue discussed within this Psychosocial health assignment that Mrs G experienced during her stay in the care setting involves the medical emergency regarding another patient required the attention of the nurses more. This reduced the availability of the staffs for patient care such as Mrs G. Stoma care required nurses to provide their patients with diverse and constant care despite any emergency (Ellison, 2018). It is noted that the care setting lacked in skilled staff and was short of staff for managing and providing effective care to patients within the care setting.

Patient-related obstacles
A major issue that affects the effective provisioning of treatment and psychosocial care to patients include the problem that care seekers experience from their own hesitation. The results of such hesitation provide the patient with low communication with nurses and practitioners. As opined by Tremayne & Harrison (2016), caring for adults with stoma require the nurses to be present. Mrs G complained that she does not feel like communicating with the nurses, as they always appear busy with other patients. The issue discussed by Ellison (2018), regarding nursing care and patient-care seeker relations proves that Mrs G needed better relations with the care provider nurses for effective care providence in the health care setting.

The patients’ dilemma in communicating with the nurses reduces the providence of effective care and that hinders the progress that psychosocial treatment plan for stoma care patients. As observed by Feo & Kitson (2016), the ability of the nursing staff to provide the patients with effective care require the management to develop better guidance and specialised skills set among the nurses providing care to the patients.

Cultural or social issues
The cultural and social differences between care seekers and care providers enhance the issues that lead to hindrances of the provision of psychosocial care to patients. As per Thompson (2016), diverticulitis patients require constant care due to the stoma and other associated emotional issues they develop due to acute distress. The presence of multiple nurses with diverse skills in caring for elderly patients enhances the ability of the care authorities to provide care seekers with appropriate care.

According to the views generated by Feo & Kitson (2016), the development of person-centred care practices for stoma-care requires nurses and care authorities to develop appropriate training and skill development procedures in developing better care plans for care seekers. Mrs G required effective care from the care practitioners through multi-channel involvement of different healthcare roles in the health care setting available within the organisation.

As opined by Richards & Willman (2017), the provision of psychosocial care for elder adults require the nurses and practitioners to frame effective treatment plans that enable the patient to develop better bond with the nurses and practitioners within the care setting. It is necessary for patients in stoma care to require specialist aid from different practitioners and additional support from psychologists and social workers (Richardson, Percy & Hughes, 2015).

It is thus observed from the various situations that Mrs G experienced in the social care setting that the provision of psychosocial care for her was hindered through various means. The causal factor that hindered her recovery was due to the poor management of pain and stoma care. Since she was not informed appropriately regarding the process of operations that would be performed on her, the presence of leaking stoma and excoriated peristomal skin was bothering her from the beginning.

Conclusion
It is evidenced by the study of psychosocial health assignment that Mrs G required expert support and aid from specialised care providers that the care setting was unable to provide. The need for providing patients with effective care providers ensures the brand image of the health care setting. The ability of the nurses to communicate with the patients ensures the providence of better care and sustainable care practice. It is determined from the study that the need for psychosocial care allows patients with special needs to develop better relations with the staffs and enjoy the treatment meted out to them within the care setting. The success of the care providers in developing their care plans as per the needs and requirements of the patients help the organisation and healthcare sector to gain better results in providing effective care to the patients.

Reference List
Adler, N., Page, A., & Setting, I. (2008). A Model for Delivering Psychosocial Health Services. Psychosocial health assignment. National Academies Press (US). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK4023/

Burch, J. (2017). Care of patients undergoing stoma formation: what the nurse needs to know. Nursing Standard, 31(41).

Cesari, M., Prince, M., Thiyagarajan, J. A., De Carvalho, I. A., Bernabei, R., Chan, P.,&Manas, L. R. (2016). Frailty: an emerging public health priority. Journal of the American Medical Directors Association, 17(3), 188-192.

Colorectal Surgery - Diverticulitis. (2019). Colorectal.surgery.ucsf.edu. Retrieved 23 August 2019, from https://colorectal.surgery.ucsf.edu/conditions--procedures/diverticulitis.aspx

Ellison, D. L. (2018). Acute diverticulitis management. Critical Care Nursing Clinics, 30(1), 67-74.

Feo, R., & Kitson, A. (2016). Promoting patient-centred fundamental care in acute healthcare systems. International Journal of Nursing Studies, 57, 1-11.

Finlay, B., Sexton, H., & McDonald, C. (2018). Care of patients with stomas in general practice. Australian journal of general practice, 47(6), 362.

Graffigna, G., & Barello, S. (2018). Spotlight on the Patient Health Engagement model (PHE model): a psychosocial theory to understand people’s meaningful engagement in their own health care. Patient preference and adherence, 12, 1261.

Kennedy-Malone, L., Martin-Plank, L., & Duffy, E. (2018). Advanced practice nursing in the care of older adults. FA Davis.

Kimura, C. A., Guilhem, D., Kamada, I., Abreu, B. S., Modesto, K. R., & Gonçalves, J. R. (2017). Life quality for oostomized patients: a perspective in the health and nursing care process. Journal of Nursing Education and Practice, 7(4), 22-31.

Mark-Christensen, A., Lindholt, J. S., Diederichsen, A., Steffensen, F. H., Busk, M., Frost, L., &Laurberg, S. (2017). Association between diverticular disease and abdominal aortic aneurysms: pooled analysis of two population based screening cohorts. European Journal of Vascular and Endovascular Surgery, 54(6), 772-777.

Maruish, M. E. (Ed.). (2017). Handbook of psychological assessment in primary care settings. Taylor & Francis.

Morgan, A. (2016). Development of a learning resource manual for nurses on caring for patients post-stoma surgery.

Richards, D. A., & Willman, A. (2017). Psychosocial health assignment Humanitus: returning to the essential principles of clinical nursing care. BMC Nursing, 16.

Richardson, C., Percy, M., & Hughes, J. (2015). Nursing therapeutics: Teaching student nurses care, compassion and empathy. Nurse Education Today, 35(5), e1-e5.

Stoma Care After Surgery - Information & Advice - Coloplast . (2019). Coloplast.com.au. Retrieved 23 August 2019, from https://www.coloplast.com.au/ostomy/people-with-a-stoma/after-stoma-surgery/

Thompson, A. E. (2016). Diverticulosis and diverticulitis. Jama, 316(10), 1124-1124.

Tremayne, P., & Harrison, P. (2016). Gastrointestinal care for older people. Nursing Standard (2014+), 30(45), 53.

You, H., Sweeny, A., Cooper, M. L., Von Papen, M., & Innes, J. (2019). The management of diverticulitis: a review of the guidelines. The Medical Journal of Australia, 211(9), n-a.

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