Final Care Coordination Plan: Social Support and Subjective Burden

This care coordination plan was created for John, a 62-year-old man who has stage tree non-small cell lung cancer with a history of COPD. The plan is intended to guarantee that John’s lung cancer is treated in a timely and effective manner while also controlling his COPD and other comorbid health issues. The plan also targets to provide John and his close relatives with support and resources throughout his cancer treatment journey, to improve John’s life quality and general wellness. It also seeks to coordinate care through numerous healthcare professionals and setups, integrating hospital, outpatient, and residential care.

Patient-Centered Health Interventions and Timelines

Many patient-centered treatment approaches will be adopted as a component of the final coordinating plan to improve John’s life quality of life and regulate his cancer and COPD. One of the most crucial therapies for John is smoking cessation. Tobacco use is a primary element of danger for both COPD and lung cancer, thus quitting can assist with both. The timeline will involve a four-to-ten-week nicotine replacement therapy-assisted progressive reduction in smoking.

Furthermore, because of their illness and treatment, people with lung cancer and COPD frequently endure weight loss and malnutrition. Within two weeks after his diagnosis, John will be directed to a certified dietitian who will create a specific dietary plan for him that will be fully implemented. Physical fitness can also assist improve pulmonary function, reduce COPD symptoms, and enhance the quality of life in lung cancer patients. During the first 30 days of his treatment, a physical therapist will help John to build an activity regimen that is specific to his needs and skills. Breathing exercises, aerobics, and stretches may all be part of the approach. Additionally, providing psychosocial support is critical because a diagnosis of cancer can be emotionally taxing for patients and their loved ones. Within the initial two weeks, John will be linked with a care worker who will offer emotional support and services.

Three Health-Care Issues

Firstly, depression is a frequent health issue among lung cancer and COPD patients. Patients may feel burdened, apprehensive, or despairing as a result of their illness and the difficulties that come with it. Depression can make it difficult for a patient to manage their condition, adhere to their treatment regimen, and preserve their life quality. Healthcare practitioners should test patients for depression regularly and treat individuals as needed. Psychotherapy, prescription, or consultation with an expert in mental health may be used.

Secondly, individuals with lung disease and COPD frequently require substantial assistance from their caretakers. Caregivers may feel stressed, worried, or sad as a result of their involvement in providing care for a loved one (del-Pino-Casado, 2018). Healthcare professionals should value caregiver assistance and provide services to assist caregivers in dealing with the difficulties of caring for an individual with lung cancer or COPD with help through counseling, support groups. Finally, patients with severe lung cancer and COPD may necessitate end-of-life care, which is emotionally tough for families as well as patients. the world’s most dangerous disease. Hospice care, palliative care, and other end-of-life services may be included.

Intervention for Each Healthcare Issue

Counseling, prescription, or recommendation to a specialist in mental health may be used to treat depression in individuals with lung cancer and COPD. There is a type of talk rehabilitation known as Cognitive-behavioral therapy (CBT) useful in treating depression (Kazantzis, 2018). Antidepressant medicines may also be administered to treat depression symptoms. For caregiver assistance in lung cancer patients and COPD, interventions such as therapy, support networks, or respite care can help them deal with the emotional burden. Ultimately, end-of-life care interventions for lung cancer patients and COPD may have palliative care, hospice, or other later-part services. Palliative care concentrates on symptom management and quality of life for people with critical illnesses.

Identify Three Community Resources for Each Health Intervention

Individual and collective therapy is available at local mental health centers for depression. The National Alliance on Mental Illness (NAMI) also offers depression support groups for patients and their families (Phillips, 2020). The National Suicide Prevention Hotline can also provide rapid assistance to people in a mental health crisis. Adult day-care centers also provide caregiver respite and interaction chances for patients. Through an online community, the Caregiver Action Network offers tools and support to caregivers of all types. For later part care, terminal and palliative care professionals offer care facilities, symptom treatment, and practical help for patients and their loved ones. There is also the Dialogue Project, which provides individuals with tools and resources to help them plan for the later part of care.

Consider Ethical Decisions in Designing Patient-Centered Health Interventions

Creating patient-centered health therapies necessitates several ethical issues that are addressed. Respecting patient autonomy because patients must make their health and healthcare decisions (Johnson et al., 2019). It is of the essence to include patients in the formulation of health initiatives and to keep them properly aware of their options. Treatment plans should also strive to improve patients’ well-being; the intervention’s benefits should outweigh any possible drawbacks or dangers (Levine et al., 2021). It is also paramount to guarantee that patient information is kept private and that patient names are not revealed without their permission.

Practical Effects of Specific Decisions

Honoring patient autonomy can lead to higher patient satisfaction and retention with the treatment, as well as better health outcomes because patients are more involved in their treatment. Beneficence promotes better health outcomes, higher patient satisfaction, and lower healthcare expenditures due to fewer adverse outcomes. Preserving patient anonymity improves patient satisfaction and prevents undesirable repercussions such as identity fraud or discrimination.

Include Ethical Questions That Generate Uncertainty about the Decisions Made

When it comes to patient autonomy, questions like ‘How much should individuals be participating in the development of health initiatives?’ can arise. While promoting beneficence, questions such as “How do we weigh the potential advantages of a treatment approach against the possible risks and harms?” arise. Moreover, when retaining confidentiality ‘What safeguards can we set up to ensure that patients’ data is kept private and that client identities are not released without their permission?’ is a common query.

Relevant Health Policy Implications for the Coordination and Continuum of Care

Policies that stress continuity and coordination of care can enhance patient outcomes by guaranteeing that patients gain professional care at the appropriate time, thereby lowering the likelihood of adverse occurrences and complications. Furthermore, it minimizes the chance of avoidable hospital readmissions, emergency room visits, and other expensive healthcare measures. Patients who receive continuous, evidence-based treatment that is matched to their unique needs can also improve community health outcomes.

Cite Specific Health Policy Provisions

The Chronic Care Act of 2018 makes provisions designed to improve care coordination and implementation for Medicare recipients with chronic diseases, including the establishment of a new home-based primary care program. Furthermore, the Support for Patients and Communities Act of 2018 has provisions targeted at strengthening treatment coordination and continuity for patients suffering from substance use disorders (Moore, 2019). It has provisions for medication-assisted therapy (MAT) as well as the combination of interpersonal health and personal care.

Describe Priorities That a Care Coordinator Would Establish

The care coordinator must first begin by learning about the patient’s interests and preferences regarding care, as well as their health priorities, social and cultural background, and values. Based on the facts, the case managers can collaborate with the care recipient to create a personalized care plan (Martignon, 2019). They must ensure patient safety by evaluating the patient’s treatment regimen and confirming that the patient has the correct prescription and doses.

Clearly Explain the Need for Changes in the Plan

When patients’ health circumstances (such as blood glucose) fluctuate over time, the coordination strategy may need to be adjusted, and their treatment plan should incorporate these changes. If a new drug or treatment is provided for the patient, the case managers should also discuss the possible adverse reactions and complications with other medications. They can collaborate with the patient’s doctors to verify that the therapy is correct and efficient.

Literature on Evaluation

Engaging learners using tactics such as problem-based training and simulation activities is one of the main best practices for productive learning sessions. Another recommended approach for an effective instructional process is to use a diverse range of teaching techniques and resources like lectures and discussion groups. When synchronizing teaching activities with the Healthy People 2030 agenda, it is indespensible to establish relevant goals and outcomes and verify that the learning session’s content and activities are closely related to these objectives.

Align Teaching Sessions to the Health People 2030 Document

Linking instructional programs with the Healthy People 2030 agenda can assist educators in ensuring that their material is relevant and effective in improving public health outcomes. Examining the Healthy People 2030 purposes and identifying those relevant to the teaching session topic will ensure that the content is consistent with the nation’s public health priorities (Santana et al., 2021). Integration of evidence-based techniques and recommendations into the teaching session’s material should be done as well.

Conclusion

Care coordination is fundamental for patients diagnosed with lung cancer, especially those who have underlying health problems like COPD. The major purpose of the coordination strategy ought to be, to provide the most effective care to the patient while reducing the likelihood of complications and negative outcomes. It is also crucial to include the patient and his or her loved ones in the coordination program, ensuring that they comprehend the plan and its reasoning.

References

del-Pino-Casado, R., Frías-Osuna, A., Palomino-Moral, P. A., Ruzafa-Martínez, M., & Ramos-Morcillo, A. J. (2018). Social support and subjective burden in caregivers of adults and older adults: A meta-analysis. PloS one, 13(1), e0189874. Web.

Johnson, S. B., Butow, P. N., Kerridge, I., & Tattersall, M. H. (2018). Patient autonomy and advance care planning: A qualitative study of oncologist and palliative care physicians’ perspectives. Supportive Care in Cancer, 26, 565-574. Web.

Kazantzis, N., Luong, H. K., Usatoff, A. S., Impala, T., Yew, R. Y., & Hofmann, S. G. (2018). The processes of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 42(4), 349-357. Web.

Levine, G. N., Cohen, B. E., Commodore-Mensah, Y., Fleury, J., Huffman, J. C., Khalid, U.& American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis, and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and Council on Lifestyle and Cardiometabolic Health. (2021). Psychological health, well-being, and the mind-heart-body connection: A scientific statement from the American Heart Association. Circulation, 143(10), e763-e783. Web.

Martignon, S., Pitts, N. B., Goffin, G., Mazevet, M., Douglas, G. V., Newton, J. T., & Santamaria, R. M. (2019). CariesCare practice guide: Consensus on evidence into practice. British Dental Journal, 227(5), 353-362. Web.

Moore, D. J. (2019). Nurse practitioners’ pivotal role in ending the opioid epidemic. The Journal for Nurse Practitioners, 15(5), 323-327. Web.

Phillips, K. (2020). Mental illness is not anyone’s fault: A review of NAMI, the national alliance on mental illness. Journal of Consumer Health on the Internet, 24(1), 75-81. Web.

Santana, S., Brach, C., Harris, L., Ochiai, E., Blakey, C., Bevington, F. & Pronk, N. (2021). Practice full report: Updating health literacy for healthy people 2030: Defining its importance for a new decade in public health. Journal of Public Health Management and Practice, 27(6), S258. Web.

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