Healthcare professionals possess certain competencies that guide them to address various health problems (Anheyer, Lauche, Schumann, Dobos, & Cramer, 2017). Patients suffering from co-occurring conditions find it hard to receive timely, quality, and safe medical support.
This complexity explains why caregivers, physicians, and nurse practitioners (NPs) should develop evidence-based models to meet the needs of such patients (Aadil, Cosme, & Chernaik, 2017). Individuals suffering from psychiatric illnesses might develop other complications or physical illnesses.
The situation worsens when the affected patient is a child. This discussion focuses on two conditions that tend to co-occur in both adolescents and children. These illnesses include attention deficit hyperactivity disorder (ADHD) and colitis.
Patient Case Scenario
Maurice is an 8-year-old boy. He is currently in his second grade. Sometimes he is inattentive in class and at home. He shows some signs of hyperactivity. He bounces from one task to another.
His concentration level has been observed to be below average despite the fact that his teachers provide a quiet environment to promote the learning process. Affected children lose their toys and items frequently in comparison with their classmates (Carmona, 2017). Sometimes the child talks excessively, squirms, and fidgets. He has recorded poor outcomes in school. He gets into trouble with classmates and neighbors.
Within the past week, Maurice’s energy has reduced significantly. He has exhibited symptoms such as cramping, diarrhea, and endless abdominal pains. His body temperature has increased sharply. He has displayed signs such as fatigue, eye inflammation, chills, and canker sores.
The patient has been receiving neurofeedback sessions over the past eight months. The use of efficient sessions produces significant improvement in class (Topczewski, 2014). His grades have progressed during the period. However, his hyperactivity still remains high. Some drugs such as Ritalin have been administered to deal with his condition.
Maurice’s physician indicated that he was suffering from colitis. This is a condition characterized by “the inflammation of the colon” (Teixeira, Hosne, & Sobrado, 2015, p. 231). Antibiotics were administered to treat the condition. A supportive plan is used to minimize the impacts of the illness. Pain relievers have also been administered. The child has been encouraged and guided to take water frequently.
Case Formulation
Presenting Problem
The patient shows signs of attention deficit hyperactivity disorder (ADHD) and colitis. The presented treatment regime includes the use of therapy sessions, pain relievers, hydration, and antibiotics.
Patient Description
The patient’s gender is male. He is aged 8 years and speaks English. He appears dehydrated and withdrawn. Although his health status has improved within the past week, he is in need of advanced care and medical support.
Brief Life History
The patient is from a nuclear family. He has two sisters aged 2 and 5 years. The other members of the family are healthy and show positive cognitive abilities. The patient has ADHD. The illness has disoriented his learning goals and objectives. He has been taking medications to deal with the condition. No cases of drug abuse in the family. The social, educational, and health facilities present in the community have supported his needs.
Psychiatric History
The patient was diagnosed with ADHD a year ago. He has been receiving appropriative psychological support and therapy within the past eight months. The patient has been responding positively to such interventions. His therapists acknowledge that he has recorded positive results.
Treatment Plan
Current treatment process seeks to deal with colitis and manage the psychological condition. Medicines and therapies form part of the care delivery model (Teixeira et al., 2015). Different players such as parents, family members, teachers, therapists, and psychologists are involved to deliver high-quality care.
Clinical Case Formulation
The presented scenario indicates that the patient has co-occurring illnesses. The difficulties experienced in learning and behavior arise from attention deficit hyperactivity disorder (Carmona, 2017). The condition explains why the patient has portrayed signs such as insensitivity, focus on numerous roles, and mishandling of personal items.
The presence of another disease explains why he is unable to continue with his therapy sessions. The positive cultural practices embraced in the neighborhood have supported the patient’s healing process. The inclusion of skilled therapists has led to positive health outcomes.
Current Clinical Concerns
This clinical situation calls for an integrated strategy or deliver quality care to the patient. However, these two illnesses pose a major challenge that can affect the health delivery process. Certain medicines such as Ritalin and antibiotics can result in drug-to-drug interactions.
The signs associated with colitis can disorient the nature and effectiveness of the implemented therapy (Aadil et al., 2017). The case also presents a major challenge regarding the combination of different medications and therapies. This is the case because the presence of a physical illness such as colitis can result in inappropriate inferences regarding the development of the patient’s condition.
Treatment Options
This case requires an evidence-based approach to deliver high-quality care. After examining the nature of the manifested health conditions, it is necessary to focus on colitis because it possesses a major challenge to the patient’s wellbeing.
The first treatment option should be to tackle the clinical manifestations of the disease (Teixeira et al., 2015). Non-traditional approaches that can be used include mesalamine and antibiotics. This should be done after screening is done to understand the causal factors of the condition. Mesalamine is a compound used to maintain any form of clinical remission in individuals suffering with this condition. The drug is usually a 5-aminoalyclyic acid.
The drug can be administered using an approach called multi-matrix system (MMX) technology. This refers to the use of oral drugs that are administered every day. If administered efficiently, the patient will record positive health outcomes within a few days. Antibiotics can be combined to deal with different causing organisms (Teixeira et al., 2015).
Pain should be relieved using strong medications and hydration. Teixeira et al. (2015) support the utilization of traditional methods to ease pain and challenges associated with colitis. Inflammation should be managed using curcumin.
This is a compound obtained from turmeric. Alternative methods include the use of withania and Boswellia serrata. These natural methods have been observed to produce positive results in different patients will colitis (Teixeira et al., 2015).
While maintaining the use of these methods to deal with colitis, it can be appropriate to embrace the power of therapy to manage the psychological disease. The best strategy should combine both medications with psychological support.
Ritalin has been observed to produce desirable health outcomes in the patient. The drug reduces the level of activity, thereby making it easier for a given patient to concentrate on various activities. These psycho-stimulants are known to increase noradrenalin and dopamine.
However, such drugs should not be pursued or used without incorporating other alternatives. Topczewski (2014) indicates that such medications result in various side effects such as abuse and/or drug-to-drug interactions.
Alternative medicine has been supported by different scholars since it has the potential to reduce drug dependency and at the same time deliver desirable results. Different scholars argue that the exploitation of psychotherapy can hearten children with ADHD to interact with other people effectively (Anheyer et al., 2017).
The model makes it easier for the targeted individuals to lead better lives and pursue their aims. Different professionals such as psychotherapists and psychologists can present meaningful insights throughout the process (Topczewski, 2014). The child can be guided to engage in different practices, learn to manage various activities, develop better communication skills.
Behavioral therapy has gained much attention within the past three decades in the management of psychological conditions. Aadil et al. (2017) indicate clearly that the model pursues evidence-based methods to reinforce specific behaviors.
The provision of rewards can encourage the child to chase desirable behaviors. Throughout the intervention, it is advisable to involve different players such as parents and teachers. Positive behaviors will become common if adequate rewards are presented. This should be done while at the same time focusing on the rate at which various colitis symptoms are managed.
Evidence-Based Practice
The presented clinical situation can be addressed using an evidence-based practice. The proposed method should entail the combination of three unique strategies to produce desirable results. The care delivery model should be designed in such a way that it seeks to treat colitis and manage ADHD (Herbert & Esparham, 2017). The case is quite complex and should be pursued by competent caregivers and professionals.
The first process should focus on the use of appropriate medications to deal with the physical health condition. As indicated earlier, the combination of assorted drugs such as antibiotics, painkillers, and mesalamine therapy will ensure the disease is managed.
During the process, the patient should be encouraged to consume different foods that have the potential to improve the healing process. This means that the consideration of herbal medicine can result in positive outcomes.
It would be appropriate for the child’s caregivers and parents to avail various drugs and herbs (Teixeira et al., 2015). The patient should be encouraged to exercise frequently and take enough water. This is an evidence-based practice since colitis results in dehydration (Teixeira et al., 2015).
The next focus should be on the best approaches to deal with the targeted psychiatric condition. The application of different therapies will definitely deliver positive health outcomes. In order to achieve desirable results, a multidisciplinary team should be established to provide the intended therapy. The first approach should entail the utilization of drug therapy to minimize hyperactivity.
However, caregivers must ensure that such medications are moderated (Herbert & Esparham, 2017). The drugs should then be combined with psychotherapy. This approach will succeed if different models are applied.
For instance, a behavioral approach will be implemented to ensure the patient develops better behaviors. As indicated earlier, the child’s parents and psychotherapists can use different rewards to foster desirable deeds. Therapists should employ their skills to guide the patient, explore his feelings, and discuss his expectations.
The proposed multidisciplinary team will be characterized by different psychologists. These professionals will guide positive actions, feelings, and experiences. Cognitive-behavioral therapists will design the best programs to support the healing process.
The experts should liaise with Maurice’s teachers and parents throughout the process (Aadil et al., 2017). This strategy will ensure the teaching programs are redesigned depending on the nature of patient’s home or school setting.
Specific goals will be outlined by the therapists. These objectives will be used as guidelines for promoting the most appropriate outcomes. The patient’s parents, sisters, and teachers will be guided by the behavioral-therapists to make sure the outlined rewards (or consequences) are maintained throughout the process (Herbert & Esparham, 2017). This tactic will ensure the patient record positive outcomes within the shortest time possible.
Educational specialists should be part of the multidisciplinary team tasked with the provision of the required therapy. The educationists will use appropriate teaching techniques that resonate with the unique needs of the learner.
The educational specialists will identify specific assistive technologies that can be embraced to deliver meaningful results (Carmona, 2017). In addition, the inclusion of alternative methods such as diets will support the evidence-based strategy. Some of the proposed food materials include cucumber, cinnamon, beans, soy, and nuts.
Conclusion
Patients exhibit diverse symptoms and signs depending on the diseases affecting them. The occurrence of two or more diseases can be a major challenge for physicians and caregivers.
A proper case formulation can guide medical practitioners to develop an effective treatment and health promotion model to meet the health needs of the targeted patient (Carmona, 2017). The notion of a multidisciplinary team in this case scenario will ensure diverse therapeutic approaches, drugs, traditional medicines, and interventions are combined to deliver evidence-based support to Maurice who has ADHD and colitis.
References
Aadil, M., Cosme, R. M., & Chernaik, J. (2017). Mindfulness-based cognitive behavioral therapy as an adjunct treatment of attention deficit hyperactivity disorder in young adults: A literature review. Cureus, 9(5), 1-6. doi:10.7759/cureus.1269
Anheyer, D., Lauche, R., Schumann, D., Dobos, G., & Cramer, H. (2017). Herbal medicines in children with attention deficit hyperactivity disorder (ADHD): A systematic review. Complementary Therapies in Medicine, 30, 14-23. doi:10.1016/j.ctim.2016.11.004
Carmona, M. P. (2017). Complementary/alternative medicine in adolescents with attention deficit hyperactivity disorder and mood disorders. Revista Chilena de Pediatria, 88(2), 292-298. doi:10.4067/S0370-41062017000200018
Herbert, A., & Esparham, A. (2017). Mind-body therapy for children with attention-deficit/hyperactivity disorder. Children, 4(31), 1-13. doi:10.3390/children4050031
Teixeira, F., Hosne, R. S., & Sobrado, C. W. (2015). Management of ulcerative colitis: A clinical update. Journal of Coloproctology, 35(4), 230-237. doi:10.1016/j.jcol.2015.08.006
Topczewski, A. (2014). Attention deficit and hyperactivity disorder: A therapeutic option. Einstein, 12(3), 310-313. doi:10.1590/S1679-45082014AO2925