Critical Exploration Therapeutic Approaches Practice Assignment Sample

Introduction Of  Critical Exploration Therapeutic Approaches Practice Assignment

Therapeutic approaches focus on providing holistic care to patient, it further incorporates evidence-based models and emphasise on empathy while delivering care to service users. The complexity of health within healthcare setting extending beyond mere presence of the chronic illness, this encompasses multilayered interactions taking place between the social, psychological and biological factors (Cole and Florez, 2020). Nurses are playing major role in navigating such complexities by developing therapeutic approaches that encourages holistic care to patients. Nurses utilises therapeutic communication relationship and building techniques for facilitating awareness in patient. This further helps in ensuring emotional support to patient and accordingly mutual understanding has been developed and significant support assured to service users. Thus, there is no doubt in stating that therapeutic approach is essential significantly in such cases where patient like Mrs J suffers from varied chronic illness. The present essay will be based on analysing the case of Mrs J, who is suffering from different health complexities such as Diabetes, COPD and mental health issues.

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Critical evaluation of the complexities involved in her healthcare management would be done. Prior focus will be assured on specific nursing intervention associates with wound care management that aims to avoid hospitalisation for Mrs J and this further supports her in managing diabetes effectively at home. The epidemiological and sociological influence of diabetes and the ways in which nurses facilitates shared-decision making and self-management strategies will be described. Hence, the goal of essay is to critically assessing the therapeutic relationship that has been inherent in nursing practice along with the biopsychosocial impacts of the determined interventions. The essay will undertake a critical evaluation of the given case and significant evidences will be involved for making information authentic. In-depth evaluation of intervention related to identified condition will be done and holistic care will be assured to Mrs J.

First section

Mrs J is a 68-year-old woman who is living alone, she has a history of Type 2 diabetes [T2D], osteoarthritis and COPD. Further, patient is struggling with depression and anxiety; this is significantly depicting about the physical and mental complexities that have been experienced by Mrs J. The prevalence of T2D reaching epidemic levels while increasing the ramifications for healthcare system by impacting older people just like Mrs J. Epidemiologically, diabetes aligns with varied complications such as neuropathy, stroke, cardiovascular disease, diabetes foot ulcers and so on chronic complications (Babel and Dandekar, 2021). Diabetic individuals require to maintain appropriate routine that composed of rich diet and physical activities. Lack of management in this context led to develop significant complications and same has been evident in Mrs J’s case. Ineffective glycaemic control led to diabetic foot ulcer; it is a type of open wound which is commonly occurs at the bottom of foot. Approximately 15% of the patient who are diabetic struggles with Diabetic Foot Ulcer. If wound management has not been done then, infection becomes severe and patient needs to admit in the hospital (Ali et al, 2022). As per World Health Organisation 2023 report, diabetes considered as leading cause of mortality and morbidity in patient that further imposing financial and resource strain on community and healthcare system (World Health Organisation, 2023). Diabetes is a long-term condition which requires consistent management and lack of focus in this context led to varied complications and same aspect witnessed in the case of Mrs J.

From the sociological perception it can be said that Mrs J’s current situation exacerbating her current condition. She is economically unstable and this is limiting her ability to access the healthcare facilities, healthy foods and important resources that are required for managing diabetes (Tatulashvili et al, 2020). The Social determinants of health [SDH] expounded as non-medical domains that impacts health outcomes of people, in Mrs J’s case, education, access to healthcare and economic stability proves to be crucial components restricting her ability to receive care. Thus, the social determinants of health have been underscoring interconnectedness of her chronic complexity with her living conditions, family support, emotional and psychological state. However, her adult children providing intermittent support to Mrs J which is not sufficient for managing her condition. Social isolation of Mrs J impacting her over-all health and this is specifying about the comprehensive nursing intervention that led to address psychosocial and medical dimensions of the health. The sociological domains are majorly influencing over-all health status of patient, Mrs J does not have any kind of emotional support from her family members that is making her condition worse (Naranjo et al, 2020). Furthermore, management of chronic illness requires consistent monitoring and set routine that improves Quality of life [QoL]. However, in case of Mrs J she has been suffering from complexities of physical and mental well-being which led to diabetic foot ulcer. She has no one who can look upon her and manage glycaemic index. Furthermore, she is not aware how it can be done; thus, lack of education is another significant component contributing in declining health status of Mrs J.

Second section

The nursing intervention which has been selected in the case of Mrs. J aligns with management of Diabetic foot ulcer [Wound management]. Managing ulcer proves to be crucial component in diabetic care. The primary goal of wound management associates with achieving functional closure and preventing the chances infection as it speeds up the healing process. The intervention composed of different steps such as conducting regular wound assessment, implementing wound care strategies, monitoring of blood glucose level and educating patient regarding diabetes self-management (Wang et al, 2023). The community nurse is accountable for collaborating with other healthcare professionals such as dietitians and podiatrist and combinedly everyone assures comprehensive care to patient that is concerned with evidence-based guidelines (Kim et al, 2021). However, throughout the procedure it is essential to undertake monitoring of patient at each stage lack of monitoring can result in making infection severe and there might be possibility that Mrs. J needs to remove foot or toes via amputated [Surgical procedure]. Evidence has shown that it is important to use structured wound care protocols that reduces the chances of infection and further speed up recovery process in the diabetic foot ulcer management. Nurse-led intervention in wound care management result in significant improvement and often reduces the possibilities for admitting in hospital (Niculescu and Grumezescu, 2022). Thus, the role of community nurse associates with wound care management, educating patient and coordinating with other healthcare professionals. In this manner, significant support can be assured to Mrs. J and she will be able to manage his condition in effective manner.

Educating patient is an important domain in wound cate and it contributes in improving the health outcomes (Wang et al, 2023).  Lack of awareness can make situation worse and this can further lead to infection that make it difficult for Mrs. J to manage her condition. Clinicians equips service user with essential information and resources that helps in managing wound. Appropriate understanding led to develop important insights in patient so they can effectively manage wound (Arif et al, 2021). However, in case of Mrs. J there is risk as she is an old woman and there might be possibility that she might forget important things described by community nurse. Therefore, significant focus requires to be implied in this area and consistent discussion with Mrs. J must be done and a time table should be made for her that consist of written strategies that are important in wound management. Educating Mrs. J helps in Glycemic control which is an integral part in preventing future complications. This is concerned with guiding about self-management strategies to patient so appropriate actions can be undertaken for managing diabetes. As per the current scenario it is important to empower patient as this helps in taking significant decision related to wound management (Zhang et al, 2020). It is important to empower Mrs. J by discussing about her condition and she must be guided regarding the food and other aspects that are important for wound management. Furthermore, she should be made aware regarding the consequences of infection, this led to motivate Mrs. J for adopting healthy lifestyle and this results in speeding healing process.

Third Section

Nurses plays significant role in shared-decision making process specifically in managing patient like Mrs. J Nurse-patient communication is an important approach that supports nurses to effectively participate in shared-decision making process. The consistent interaction with patient has been made and a therapeutic relationship is built. Via active listening and communication nurse can effectively understand the concerns, complexities and preferences of Mrs. J. These insights can be used while implementing self-management strategies (Driever et al, 2020). Thus, this process led to encourage patient for collaborating in care plan rather only following guidance and directives. As a result, it led to foster the sense of agency and empowerment. Nurse can enhance the shared decision-making process by considering the evidence base decision-making criteria. In this manner, quality decision can be taken for Mrs. J that led to prevent wound and further reduces the chance of infection. Community nurse perceives their preferred role within shared decision making that potentially enhance patient outcomes (Doyle, 2020). On a contrary note, it has been identified that, in case patient does not willing to interact with nurse then it acts as a potential barrier in the involvement of nurse in shared decision procedure (Bashkin et al, 2023). For instance- If Mrs. J does not speak about her issues and barriers then, it is not possible to assist in self-management strategies. Therefore, prior focus must be implied on developing therapeutic relationship with Mrs. J, in this manner emotional bond with the patient can be developed and intervention can be implied in significant manner.

The role of nurse aligns with educating Mrs. J about her condition and available treatment options which involves lifestyle modification and glucose management techniques. It has been considered as the critical aspect of a nurse role. Furthermore, incorporation of motivational interviewing technique helps in increasing the confidence of Mrs. J and it further motivates her to enhance her confidence level (Pursio et al, 2021). Moreover, the community nurse will act as a liaison between healthcare professionals and Mrs. J for ensuring that person-centered and culturally competent care has been implemented for patient. Hence, by involving in shared decision-making self-awareness can be developed in Mrs. J and this also enhances the health outcomes of patient. Mrs. J will be able to take control over her heath status (Penconek et al, 2021). Nurse facilitates the patient engagement in shared decision making, hence, engagement of Mrs. J can be increased and this further foster resilience capabilities in her that enable patient to cop up with health complexities. Thus, it can be said that nurse plays foremost role in shared decision-making process and this supports in delivering of intervention in effective manner along with encouraging patient to undertake self-management strategies. Thus, there is no doubt in stating that nurses are accountable for building an effectual connection with patient so that mutual understanding can be developed (Chaboyer et al, 2021). This further helps in enhancing over-all health outcomes of patient, it also facilitates the engagement level of patient and enable them to take decision by their own. However, in case of Mrs. J nurse need to gain her trust as this support in implementing intervention effectively.

Fourth section

The biopsychosocial model provides a systematic framework that assess biological, psychological, social factors and their complex relationship in understanding health illness and health care delivery (Aoki et al, 2022). By considering this model, divers influence of diabetic foot ulcer intervention on Mrs. J can be analysed. Considering the biological factor, it can be said that wound management and glycemic control can decrease the risk of infection and enhances the healing process. Further, this reduces the chances of hospitalization, consistent monitoring of blood glucose level led to enhance physical well-being that limits deterioration and complication related to diabetes. In currents stage- non pharmacological intervention has been integrated for patient and therefore, no potential side effects are witnessed (Roberts, 2023). However, pharmacological intervention will be concerned with providing topical medication such as- Neomycin, Gentamycin, and Mupirocin. The potential side effects are concerned with itching and burning sensation which might be for a limited period and there is no cause of concern. it can be said that the intervention led to provide significant results and enhances the health outcomes of patient (Bolton, 2022). Following set routine can reduce the severe complexity aligned with diabetes. Based on the social factors, this can be said that the intervention has the potential to reduce anxiety and depression in Mrs. J. Also, this led to solve the issues related to social isolation. By integrating community resources and taking support from community an effectual network can be developed for patient, this network support in mitigating the distressed feelings of loneliness and accordingly, Mrs. J can receive emotional assurance. In this manner, issues related to depression and anxiety can be solved and self-esteem of Mrs. J can be enhanced. 

On the other hand, if Mrs. J do not receive emotional support from her family members then, there might be possibility that it negatively impacts her healing process. Support from community and nurse proves to be effectual however, it is important to involve patient family in decision making (Miles, 2020). Therefore, it is important to consult with children of Mrs. J and they must be guided about spending quality time with their mother so faster recovery can take place.

In context of psychological factors, it can be said that, Mrs. J will be able to receive education aligns with wound care and diabetes management. This results in enhancing her self-efficacy and further she can be empowered. However, if Mrs. J becomes inconsistent with her routine, then, this led to create negative impact on her health. Therefore, appropriate monitoring throughout the procedure is needed as it contributes in gaining significant outcomes. The community nurse is accountable for looking upon the needs and requirements of Mrs. J and accordingly significant decisions are needed to be taken.

The psychological outcomes are further interconnected with the physical health, when service users feels that they can control their health then, it results in reducing anxiety levels and subsequently, mental health of patient gets enhanced (Mescouto et al, 2022). Hence, it can be said that this intervention is just not limited to physical healing, it actively contributing in mental health as well. This is signifying that a holistic approach to care incorporated for Mrs. J which is addressing complicated interaction exist between chronic disease management and psychological well-being. Thus, it can be said that the selected intervention will lead to ensure significant benefits to Mrs. J.

Conclusion

Conclusively; this can be said that Mrs. J’s case underscoring varied domains that is impacting her health in negative manner. Inappropriate diabetic management led to develop diabetic foot ulcer in patient and there is risk related to infection. It is essential to undertake wound management so the severity of risk can be reduced. The essay has critically reflected on the case of Mrs. J and potential condition has been identified and accordingly intervention suggested. The summary of the case has been provided along with exploring epidemiological and sociological impact of primary diagnosis. Furthermore, information about intervention provided, wound care management proves to be effectual intervention in current case context as it decreases the chances of infection. Moreover, role of nurse in shared decision making has been highlighted while undertaking critical analysis. Education, healthcare access and economic stability are the major social determinants of health which impacted Mrs. J health status. Appropriate community support, patient education and developing self-management strategies are the major components of intervention which led to enhance health outcomes of patient. Lastly, biopsychosocial impacts of the intervention has been explained and it has been identified that selected intervention is effective in current case.

References

• Ali, M. K., Pearson-Stuttard, J., Selvin, E., & Gregg, E. W. (2022). Interpreting global trends in type 2 diabetes complications and mortality. Diabetologia, 65(1), 3-13.
• Aoki, Y., Yaju, Y., Utsumi, T., Sanyaolu, L., Storm, M., Takaesu, Y., ... & Edwards, A. G. (2022). Shared decision‐making interventions for people with mental health conditions. Cochrane Database of Systematic Reviews, (11).
• Arif, M. M., Khan, S. M., Gull, N., Tabish, T. A., Zia, S., Khan, R. U., ... & Butt, M. A. (2021). Polymer-based biomaterials for chronic wound management: Promises and challenges. International Journal of Pharmaceutics, 598, 120270.
• Babel, R. A., & Dandekar, M. P. (2021). A review on cellular and molecular mechanisms linked to the development of diabetes complications. Current Diabetes Reviews, 17(4), 457-473.
• Bashkin, O., Asna, N., Amoyal, M., & Dopelt, K. (2023, August). The role of nurses in the quality of cancer care management: Perceptions of cancer survivors and oncology teams. In Seminars in Oncology Nursing (Vol. 39, No. 4, p. 151423). WB Saunders.
• Bolton, D. (2022). Looking forward to a decade of the biopsychosocial model. BJPsych Bulletin, 46(4), 228-232.
• Chaboyer, W., Harbeck, E., Lee, B. O., & Grealish, L. (2021). Missed nursing care: An overview of reviews. The Kaohsiung journal of medical sciences, 37(2), 82-91.
• Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature reviews nephrology, 16(7), 377-390.
• Doyle, N. (2020). Neurodiversity at work: a biopsychosocial model and the impact on working adults. British medical bulletin, 135(1), 108-125.
• Driever, E. M., Stiggelbout, A. M., & Brand, P. L. (2020). Shared decision making: physicians’ preferred role, usual role and their perception of its key components. Patient education and counseling, 103(1), 77-82.
• Kim, K. J., Choi, J., Bae, J. H., Kim, K. J., Yoo, H. J., Seo, J. A., ... & Kim, N. H. (2021). Time to reach target glycosylated hemoglobin is associated with long-term durable glycemic control and risk of diabetic complications in patients with newly diagnosed type 2 diabetes mellitus: a 6-year observational study. Diabetes & Metabolism Journal, 45(3), 368-378.
• Mescouto, K., Olson, R. E., Hodges, P. W., & Setchell, J. (2022). A critical review of the biopsychosocial model of low back pain care: time for a new approach?. Disability and Rehabilitation, 44(13), 3270-3284.
• Miles, E. (2020). Biopsychosocial model. In Encyclopedia of behavioral medicine (pp. 259-260). Cham: Springer International Publishing.
• Naranjo, C., Ortega-Jiménez, P., Del Reguero, L., Moratalla, G., & Failde, I. (2020). Relationship between diabetic neuropathic pain and comorbidity. Their impact on pain intensity, diabetes complications and quality of life in patients with type-2 diabetes mellitus. Diabetes research and clinical practice, 165, 108236.
• Niculescu, A. G., & Grumezescu, A. M. (2022). An up-to-date review of biomaterials application in wound management. Polymers, 14(3), 421.
• Penconek, T., Tate, K., Bernardes, A., Lee, S., Micaroni, S. P., Balsanelli, A. P., ... & Cummings, G. G. (2021). Determinants of nurse manager job satisfaction: A systematic review. International Journal of Nursing Studies, 118, 103906.
• Pursio, K., Kankkunen, P., Sanner‐Stiehr, E., & Kvist, T. (2021). Professional autonomy in nursing: An integrative review. Journal of nursing management, 29(6), 1565-1577.
• Roberts, A. (2023). The biopsychosocial model: Its use and abuse. Medicine, Health Care and Philosophy, 26(3), 367-384.
• Tatulashvili, S., Fagherazzi, G., Dow, C., Cohen, R., Fosse, S., & Bihan, H. (2020). Socioeconomic inequalities and type 2 diabetes complications: a systematic review. Diabetes & metabolism, 46(2), 89-99.
• Wang, S., Wu, W. Y., Yeo, J. C. C., Soo, X. Y. D., Thitsartarn, W., Liu, S., ... & Loh, X. J. (2023). Responsive hydrogel dressings for intelligent wound management. BMEMat, 1(2), e12021.
• Zhang, A., Liu, Y., Qin, D., Sun, M., Wang, T., & Chen, X. (2020). Research status of self-healing hydrogel for wound management: A review. International Journal of Biological Macromolecules, 164, 2108-2123.

Online

• World Health Organisation, 2023. Online. Available through < https://www.who.int/health-topics/diabetes?gad_source=1&gclid=EAIaIQobChMIosfL47OkiQMVGahmAh1eWh7tEAAYASAAEgLVMvD_BwE#tab=tab_1 >

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