S. B. is a 27-year-old man suffering from PTSD for the past two years. The symptoms began when his wife went missing. They include insomnia, nightmares, and depressive moods; previously S. B. had hallucinations and displayed aggressive behaviors. The man has an underage son and experiences frequent stress from the hardship of having to raise him alone and the difficulties with the emotional relationship between them. S. B. takes Paxil, tries to live a healthy life, and sees a counselor to help him get through the psychological issues. S. B. is a believer and takes his son to church with him. It can be concluded that S. B. is presently demonstrating a positive trend towards improvement. His goals include continuing leading a healthy lifestyle, stabilizing the emotional state, and ceasing to take the medication.
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Within the proposed approach to treating S. B., it is necessary to identify patterns, challenges, or needs in terms of four parameters of his health: physical, mental, emotional, and spiritual. The physical need is to defeat insomnia. Refusal from medication can also be regarded as a partially physical challenge, although it requires some progress in terms of other aspects of health, too. The rationale behind this is that insomnia and the inability to perform daily tasks without the antidepressant are recognized by S. B. as major consequences of his disease that seriously disturb him and prevent him from leading a normal life. The mental challenge is coping with the depressive moods as well as anxiety as one of the possible outcomes of PTSD. This is important as part of the physical challenge to stop taking the medication. Another rationale is that PTSD is a mental disorder, and the treatment of it should be primarily aimed at improving the mental state of a patient.
However, care provided to S. B. should not be limited to physical and mental assistance measures only. A comprehensive overview of his case through in-depth interviewing (as opposed to a mere description of symptoms) demonstrates that emotional and spiritual aspects bear equal significance to treatment. S. B. recognizes his failures to improve the relationship with his son as a consequence of the mental disorder. Therefore, there is an emotional need to stabilize the state of S. B. so that he could rebuild emotional connections with his son as well as friends. Finally, spirituality is an important factor in S. B.’s case. The man does not simply identify as a believer; he engages in spiritual practices that constitute a meaningful part of his life. Taking his son with him to church is also part of achieving the health goal in terms of emotionality: to attain the emotional connection with the child. Spiritual practices were observed to positively affect the condition of S. B. They can be regarded as signals of the adaptive coping pattern (Cooper & Gosnell, 2014), which is more beneficial for S. B.’s recovery than the coping patterns he used to adopt, such as denial and avoidance.
The proposed approach to S. B.’s treatment is based on the principles of the holistic nursing care, which bears a number of distinct characteristics that make it different from the traditional nursing. Holistic care is based on expanding traditional care, but it also can be argued that holistic approaches are qualitatively different from the traditional ones. The expansion is expressed in more comprehensive consideration of the patient’s state (Papathanasiou, Sklavou, & Kourkouta, 2013). First, instead of merely identifying a problem and finding solutions to it, holistic nursing suggests examining the patient’s background and past experiences that may not seem to be linked directly to the treated disease. Second, there is a need to accumulate objective data instead of limiting care considerations to subjective information. Third, holistic methods emphasize the importance of applying scientific knowledge to patient cases instead of fully relying on established practices and procedures. Finally, the emotional relationship between a care provider and a patient is a crucial element of holistic care, while in traditional care it may be regarded as an optional feature of treatment.
As the fifth point of comparison, it can be noted that there is a principal qualitative difference between holistic and traditional care expressed in the nature of the caring process. In traditional nursing, the process is linear: there is a problem, possible solutions, treatment, evaluation, and resolution, i.e. the process has a beginning and an end. The holistic process is circular, which means that its elements may occur simultaneously, work together, be highly interconnected, be repeated, and start over (Dossey & Keegan, 2012). This way of addressing nursing objectives is, therefore, more profound, comprehensive, and efficient. It reduces the risks of missing important elements of a patient’s state, thus ensuring that the treatment not only addresses a particular health issue but generally contributes to the health and well-being of the patient.
The analysis of S. B.’s case identified the adaptive coping pattern, the needs to defeat insomnia and stabilize the emotional state, and the challenges of coping with the depressive moods and refusing from antidepressants. The analysis was largely based on the holistic approach to nursing, which will help ensure better treatment for S. B.
Cooper, K., & Gosnell, K. (2014). Foundations and adult health nursing. New York, NY: Elsevier.
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Dossey, B. M., & Keegan, L. (2012). Holistic nursing. Burlington, MA: Jones & Bartlett Publishers.
Papathanasiou, I., Sklavou, M., & Kourkouta, L. (2013). Holistic nursing care: Theories and perspectives. American Journal of Nursing Science, 2(1), 1-5.