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Integrated Concepts of Disease Management

Abstract

Disease management plays a central role in the improvement of nursing outcomes in healthcare systems. The integrated approach of disease management is effective in the management of chronic diseases among patients. The course has contributed significantly to the achievement of my professional and personal goals because it provided insights, which are integral to disease management. Reflection on each professional and personal goal effectively explains how the course has enabled me to achieve my goals in disease management. The conceptual approach to disease management improved my understanding of disease processes. The application of evidence-based literature enhanced my ability to formulate relevant exemplars. The course has made me understand the essence of diverse approaches to teaching, such as learner-centered approach, constructivist approach, collaborative approach, and integrated approach. Analysis of professional and personal goals shows that they apply to interprofessional collaboration and patient education. Overall, the course has improved my understanding of integrated disease management and made me a better nurse educator.

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Introduction

Disease management is an integral part of nursing because it entails empowering patients and populations to aid in the management of diseases that affect them. Integrated and coordinated healthcare interventions enable nurses to empower patients and populations to manage diseases effectively and consequently reduce morbidity and mortality rates. Lukewich, Edge, VanDenKerkhof, and Tranmer (2014) assert that nurses play a central role in disease management because they implement healthcare interventions in primary care. Given that nurses mediate the relationships between patients and healthcare specialists, they provide appropriate healthcare services, which suit the needs of patients in the health care system. In this view, the coursework of integrated concepts of disease management has enhanced my understanding of disease management. Essentially, the coursework has made me achieve my professional and personal goals. Therefore, the reflective essay explains how coursework has enabled the achievement of goals, boosted understanding of disease processes, assisted in the formulation of exemplars, advanced teaching approach, and expanded literature review.

Course Goals

Professional goals

The coursework has assisted me to achieve my professional goals, which I formulated in the course of the first week. The first professional goal is to investigate how culture, motivation, and adherence theories affect disease management processes. From the course, I have learned that culture has a marked influence on disease management processes because it constitutes beliefs, attitudes, norms, values, and principles that societies, communities, and individuals apply in the management of diseases. Given that disease management entails coordinated and integrated healthcare interventions, culture affects the delivery and administration of nursing care. According to Brown and Bussell (2011), culture affects motivation and adherence among patients because beliefs, attitudes, norms, values, and principles override healthcare interventions. Therefore, cultural factors act as barriers that hinder disease management among diverse societies, communities, and individuals.

Regarding the aspect of disease management, I have noted that motivation and adherence theories elucidate how culture influences disease management. Sirur, Richardson, Wishart, and Hanna (2009) state that the protection motivation theory, the theory of planned behavior change, the theory of reasoned action, the health belief model, and the social cognitive theory are theories that elucidate adherence among patients. The protection motivation theory holds that adherence is dependent on the threats that patients experience and their abilities to cope with them in their cultural environment. The theory of planned behavior stipulates that attitudes towards healthcare intervention, subjective norms, and perceived behavioral control influence intentions and reasoned actions of patients, and consequently, determine adherence. The theory of reasoned action elucidates that attitudes and perceptions influence the intentions of patients to adhere to certain regimens, which are subject to norms. The health belief model holds that perceptions of vulnerability, severity, and barriers determine efficacy expectations and stimulants to action concerning adherence. The social cognitive theory holds that sociocultural factors mediate self-efficacy and outcome expectations, which are significant variables of adherence. Therefore, these theories provide insights about disease management, and thus, they have enabled me to conceptualize how culture, motivation, and adherence collectively influence disease management.

The second professional goal is to utilize conceptual learning principles to formulate exemplars integrating pharmacology, health assessment, and pathophysiology processes. The course has enhanced my conceptualization of learning principles because I have known how to formulate exemplars. An exemplar is a case study, which describes an outstanding nursing practice that applies to the improvement of nursing care. Through exemplars, nurses express their actions, intentions, decisions, thoughts, and feelings in relation to a clinical situation such as disease management. Fundamentally, exemplars have enabled me to illustrate disease management processes that are central to nursing. Since pharmacology, pathophysiology, and health assessment are complex processes in disease management, exemplars reduce their complexity. The integration of pharmacology, pathophysiology and health assessment provides a multi-disciplinary approach to disease management. Nurses should understand the pharmacokinetic and pharmacodynamics mechanisms of drugs so that they can administer drugs safely and effectively. Moreover, nurses need to understand the pathophysiology of diseases so that they can assess patients, administer drugs, and monitor their progress. Kemppainen, Tossavainen, and Turunen (2012) state that multi-disciplinary approaches to nursing care effectively promote healthcare among patients. In this case, I have managed to formulate exemplars that integrate pharmacology, health assessment, and pathophysiology process, and thus, acquired the capacity to improve the quality of nursing care.

The course has also assisted in achieving my third professional goal, which is to integrate principles of fluid and electrolyte regulation, thermoregulation, glucose regulation, elimination, gas exchange regulation, clotting disorders, autoimmune responses, sepsis, and infection in concept-based exemplars. According to Giddens (2013), a concept-based curriculum improves nursing practice because it enables nurses to develop a concept, formulate an exemplar, incorporate content knowledge, and apply concepts to nursing practice. In this view, the course provides a concept-based curriculum involved in the management of diseases. Given that electrolytes, temperature, blood glucose, elimination, and gas exchange regulation are parameters that assess the healthcare conditions of patients, I have understood that their application in disease management is essential. Moreover, constant monitoring of clotting disorders, sepsis, autoimmune responses, and infections are necessary for disease management because they are critical factors that determine the health conditions of patients. Lukewich et al. (2014) argue that nurses integrate numerous principles in assessing and monitoring the progress of patients under their care. Thus, the course has enabled me to formulate concept-based exemplars that are applicable to disease management.

Personal Goals

The course has assisted me in achieving my personal goals. The first personal goal is to create and evaluate curricula in both academic nursing education and professional staff development fields. Assessment of nursing curricula indicates that there is a marked gap between academic nursing education and professional staff development fields. The curriculum of academic nursing education focuses on theoretical practice and thus making nurses not have the capacity to handle disease management. Furthermore, the nursing practice is unaware of the evidence-based practices that are emerging in the field of nursing. Ajani and Moez (2011) confirm that there is a significant gap between theory and practice in nursing, which affects the delivery of nursing care. Thus, my creation and evaluation of nursing curricula require consideration of theoretical and empirical knowledge in the management of diseases. In essence, the course has enabled me to maintain the balance between theoretical and empirical knowledge so that nurses can update their knowledge in the wake of new findings.

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The course also assisted me to achieve my second personal goal, which is to apply leadership principles in response to the increasing complexity of instructional needs at all levels in the health care system. Assessment of the nursing profession indicates that students require complex instructions because the demand for nursing care is increasing, the emergence of new diseases, and the application of new technologies. Regarding the increasing demand for nursing care, nurses require extra knowledge to manage an increasing number of patients in the health care systems while maintaining or improving the quality of nursing care. Given that nurses experience dilemmas, they require leadership skills so that they can apply ethical principles of beneficence, maleficence, justice, and autonomy in nursing. Moreover, the emergence of new diseases complicates the nursing practice, and hence, nurses require additional leadership knowledge and skills for disease management. The application of new technologies in nursing compels nurses to adopt and utilize technology in nursing care. Hutchinson and Jackson (2013) advocate for transformational leadership in nursing because it keeps in tandem dynamics of nursing care. Hence, the course has assisted me to understand the essence of transformational leadership in nursing.

The third personal goal is to analyze and evaluate nursing philosophy, concepts, and methods of quantitative and qualitative research in making evidence-based decisions in nursing. In the achievement of my third personal goal, the course has enabled me to understand the importance of evidence-based decisions in nursing. Essentially, the evidence-based decisions improve the quality of nursing services because they promote the safety and effectiveness of healthcare interventions. Nursing philosophy and concepts emanate from empirical studies, which have occurred for centuries and provide firsthand information. Qualitative and quantitative studies offer diverse findings, which form the basis for evidence-based decisions in nursing. Giddens (2013) argues that evidence-based decisions are appropriate owing to the increasing complexity of nursing care. In this case, the course has made me appreciate the application of quantitative and qualitative research methods in deriving evidence-based nursing practices.

Conceptual Approach

A conceptual approach assisted in disease management because it enhanced my understanding of disease processes. A conceptual approach is an integrated approach to disease management in nursing. As nursing is science and art, the conceptual approach allows simulation of nursing activities with a view to promoting understanding of disease management. Nursing theorists have come up with diverse theories and models, that conceptualize nursing care, and thus, enable nurses to apply them in their routine nursing practices. According to Giddens (2013), the conceptual approach simplifies complex nursing activities and enables nurses to understand critical aspects of disease management. In this case, with the help of nursing theories that are relevant to nursing care and disease management, I have acquired the capacity to develop a conceptual approach, which can improve nursing outcomes. Learning from the course, I have known that the conceptual approach simulates different strategies for nurses to choose and apply in diseases management.

Given that diseases have complex effects, understanding their processes is central to effective nursing care. The disease process is intricate because it comprises physiological, biochemical, immunological, psychological, and physical processes that interact and lead to certain healthcare outcomes. Understanding these processes enhances nursing outcomes because nurses can apply appropriate healthcare interventions and assess specific outcomes. Wilson, Brooks, Procter, and Kendall (2012) argue that nurses contribute significantly to the management of chronic diseases because they understand the mechanisms of these diseases. During the course, I learned about disease processes such as pathophysiology, which are central to pharmacology, health assessment, and nursing care. Essentially, understating of the disease process forms the basis of healthcare interventions and promotes the prognosis of diseases. The overall understanding of the disease process promotes nursing care because nurses would employ effective healthcare interventions. Therefore, the course has enhanced my capacity to develop the conceptual approach to a certain disease and promoted my understanding of the disease process in nursing care.

Use of Evidence-based Literature

The use of evidence-based literature assisted me in the formulation of exemplars related to disease management. Given that it is difficult to experience complex nursing scenarios, which are applicable to exemplars, the literature review provides robust evidence. The existence of massive evidence in databases supports the use of evidence-based literature in the formulation of exemplars. The databases provide peer-reviewed articles, which hold information that is not only valid but also reliable in the formulation of exemplars. Thus, the use of evidence-based literature considerably assisted me in the formulation of exemplars that are applicable to disease management.

Teaching Approach

In teaching pharmacology, pathophysiology, and health assessment, I would employ three teaching approaches, namely, learner-centered approach, constructivist approach, collaborative approach, and integrated approach. The learner-centered approach is appropriate because learners have residual knowledge and skills, which form the basis of their gradual learning process. The constructivist approach is appropriate in teaching the aforementioned topics because they require conceptualization of nursing practices. Brandon (2010) states that constructivism promotes active learning among students because it stimulates the construction of concepts and ideas. Essentially, the approach requires students to construct knowledge based on their experiences and theoretical knowledge, and thus, enabling them to derive evidence-based meanings. The collaborative approach is central to learning because it allows students to participate in the learning process. In this approach, I would employ discussions, teamwork, and partnerships in teaching the topic of disease management. The integrated approach applies the interdisciplinary and multidisciplinary approach to specific nursing fields. Given that pharmacology, pathophysiology, and health assessment are diverse fields of nursing, the integrated approach would enable me to assimilate different fields in highlighting disease management.

The Use of One Textbook

The use of only one textbook did hinder my approach to written assignments. Since disease management is a complex field in nurses, the use of only one textbook does not offer sufficient information for the assignment. The required textbook only focuses on concepts that are applicable to nursing practice, yet the assignment requires diverse aspects of disease management. In this view, I need many books and articles to facilitate the writing of the assignment.

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Discussions Pertaining Exemplars

The discussions pertaining to exemplars with my peers enhanced my level of comfort with collaborative work. Exemplars promote the collaborative approach to learning because they stimulate learners to discuss, participate, and collaborate during the learning process. As exemplars provide significant lessons to nurses, their discussions in collaborative work are more comfortable than the discussions of firsthand experiences. Exemplars shift nursing issues to a third party, while firsthand experiences do not. In this view, discussion of exemplars does not affect discussing parties, but discussion of firsthand experiences affects discussing parties. Therefore, exemplars promoted my collaborative work with peers because they enhanced the level of comfort in the discussion.

Preparation for the Nurse Educator Role

Personal and professional goals related to interprofessional collaboration, patient education, and nursing principles in the preparation of nurses as educators. The personal goal that relates to interprofessional collaboration is the application of leadership principles in promoting instructional needs at all levels in response to the increasing complexity of health care. Transformational leadership enhances interprofessional collaboration because it ensures that nurses keep abreast with advancements in nursing. Two professional goals that relate to interprofessional collaboration are the investigation of how culture, motivation, and adherence theories affect disease management processes and the integration of principles of concept-based exemplars. The first goal relates to interprofessional collaboration because it requires health specialists, nurses, patients, caregivers, and family members to collaborate in promoting adherence among patients. The second goal relates to interprofessional collaboration because the integration of principles of concept-based exemplars enhances understanding of nursing issues.

The first personal goal that relates to patient education is the creation and evaluation of nursing curricula that suit both academic nurse education and professional development. The creation of curricula considers patient education because they are the recipients of healthcare services that originate from nurses. The second personal goal that relates to patient education is the application of philosophy, concepts, and research methods in deriving evidence-based nursing practices. The exposition of patient education requires the application of nursing philosophy, concepts for nursing practices, and appropriate research methodologies. Farahani, Mohammadi, Ahmadi, and Mohammadi (2013) assert that effective nursing care requires the adaptation of nursing practices to diverse cultural backgrounds. In this view, philosophies and theories are applicable to the process of adapting nursing practices to various diseases and diverse patients. The professional goal that relates to patient education is the utilization of conceptual learning principles in the formulation of exemplars with a view of integrating pharmacology, health assessment, and pathophysiology processes. The conceptualization of learning principles is central to the formulation of exemplars, which provide nursing models. The integration of pharmacology, health assessment, and pathophysiology mechanisms prepare nurses to approach nursing from a multidisciplinary perspective.

Conclusion

Disease management is a complex field of nursing, which requires an integrated approach for nurses to deliver safe and effective nursing care. Reflection on the importance of the course shows that it has enhanced my understanding of integrated disease management. The course has effectively enabled me to achieve all my personal and professional goals. The conceptual approach to disease management increased my understanding of disease processes. Moreover, the application of evidence-based literature played an integral role in the formulation of relevant exemplars. The course also made me realize that learner-centered approach, constructivist approach, collaborative approach, and integrated approach are effective approaches to teaching learners.

References

Ajani, K., & Moez, S. (2011). The gap between knowledge and practice in nursing. Social and Behavioral Sciences, 15(1), 3927-3931.

Brandon, F. (2010).Constructivism theory analysis and application to curricula. Nurse Education Perspectives, 31(2), 89-92.

Brown, M., & Bussell, J. (2011). Medication adherence: WHO cares? Mayo Clinic Proceedings, 86(4), 304-314.

Farahani, M., Mohammadi, E., Ahmadi, F., & Mohammadi, N. (2013). Factors influencing patient education: A qualitative research. Iranian Journal of Nursing and Midwifery Research, 18(2), 133-139.

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Giddens, J. F. (2013). Concepts for Nursing Practice. St Louis, MO: Elsevier.

Hutchinson, M., & Jackson, D. (2013). Transformational leadership in nursing: Towards a more critical interpretation. Nursing Inquiry, 20(1), 11-22.

Kemppainen, V., Tossavainen, K., & Turunen, H. (2012). Nurses’ roles in health promotion practice: An integrative review. Health Promotion Intentional, 1(1), 1-13.

Lukewich, J., Edge, S., VanDenKerkhof, E., & Tranmer, J. (2014). Nursing contributions to chronic disease management in primary care. The Journal of Nurse Administration, 44(2):103-110.

Sirur, R., Richardson, J., Wishart, L., & Hanna, S. (2009). The role of theory in increasing adherence to prescribed practice. Physiotherapy Canada, 16(2), 68-77.

Wilson, P., Brooks, F., Procter, S., & Kendall, S. (2012). The nursing contribution to chronic disease management: A case of public expectation? Qualitative findings from a multiple case study design in England and Wales. International Journal of Nursing Studies, 49(1), 2-24.

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