Prioritizing Support
The use of patient interview materials is a vital strategy for an effective therapy that takes into account the patient’s history and interests. Patient T. from this interview has been shown to suffer from hypertension and has chronic gastritis as her primary diagnosis. T. is an older woman at age 72, so many of her daily activities are much more complex than those of younger patients with the same diagnoses. However, as stated in the analysis, the patient is healthy for her age and actively copes with her illnesses thanks to the support of her daughter and grandson. This section discusses the main types of support the woman needs, in decreasing order of priority.
T.’s primary need for support is the need for regular visits to the doctor and taking medications. By now, among the patient’s primary complaints are the presence of chronic gastritis, which can develop into peptic ulcers and frequent intense headaches, which are caused by high blood pressure. Ignoring these problems can lead to more profound consequences, which include internal bleeding, heart attacks, and strokes up to and including death (CC, 2020). Therefore, the need for medication and clinical support is the essential need for T. currently. Meanwhile, the patient needs daily support, which is realized in reminders to take medications, help with household chores, and monitor physical activity and hygiene. T. is a reasonably capable woman, but old age can affect the quality of her memory and mental performance. Support through her daughter and grandchild is a necessary need for the patient so that she can delegate some of her responsibilities to them and expect to have her interests and needs protected. As already shown in the interview, the critical conditions were saved by the ambulance call, which were explicitly initiated by the daughter against the patient’s wishes. This means that family members help take care of the woman’s health, so this support is essential.
An essential need of an older woman is financial support. Purchasing medications and visiting a clinical provider requires money, and insurance plans for the elderly do not always cover the full range of health care delivered. Consequently, the elderly patient must have financial support in order to feel personally safe and able to see doctors. This can include either personal savings, retirement benefits or support from relatives. It is clear that a lack of financial support will lead to severe problems with medications and may also be detrimental to the psychological well-being of the elderly patient.
The fourth highest priority need for support is the need for training. There is no guarantee that family members will always be with the older woman, which means she must be trained to be capable enough to take care of her health. This applies not only to learning how to take her own medications and physical activity but also to regular visits to the attending physician or nurse practitioner. In addition, a woman should be able to perform everyday household chores, whether it be cooking, hygiene, or wet cleaning, in case she has to live alone. If this need cannot be met due to T.’s incapacity, then she or her family members should take care of hiring a caregiver or elderly social worker in advance in case family members are not available. Investing in this support meets the need for self-care in one’s life.
Examples of Interventions
Based on the collected interview responses and the analysis performed, it becomes possible to identify several examples of interventions by the nurse practitioner to support patient T. First, there is the need for education, which the nurse can implement during sessions. If the nurse is visiting the patient at home, the training can be implemented there; in the case of hospital sessions, the training needs to take place in the clinic setting. In either case, the nurse’s intervention consists of imparting expertise in managing household chores, taking medications, and physical activity. This knowledge is intended to improve patient T.’s quality of life and ability to care for herself when needed.
In addition, the nurse’s appointments themselves are examples of professional intervention. As mentioned earlier, such sessions can be implemented either at home or in a clinical setting. However, it is not so much the place where they are conducted that is important, but rather the regularity of such appointments. The nurse practitioner should carefully analyze the patient’s health, take into account data from daily blood pressure measurements, and suggest changes based on clinical tests. For example, if a patient reports intense headaches, it is the nurse’s job to explore probable causes of this condition and find solutions.
The professional nurse also ensures communication with the patient’s family members in case of emergencies or the need for quick consultations. Moreover, if the elderly patient T. is unable to use a smartphone, communication with family members is the only channel of communication. The nurse responds to questions from family members, advises on therapy-related issues, and reminds them of the need for another doctor’s appointment. The value of this intervention is determined by the importance of effective communication between the nurse and the patient: ignoring this communication leads to a decline in the quality of therapy and the development of undesirable effects.
The importance of the nurse as an object of emotional support for the patient should not be ignored either. T. lives with her daughter and grandchild, so she can be expected to receive daily communication and interaction with relatives. The emotional component of working with the nurse inspires the patient and motivates her to self-care for her health (Oosterhuis & Aan de Stegge, 2021). In addition, the nurse helps to resolve any uncertainties and problems that may become a cause of stress, which negatively affects the overall well-being of the therapy. Thus, in the context of clinical intervention, emotional support is essential for the patient.
Healthy People 2030
One of the global programs to improve the health care agenda is Healthy People 2030. This program aims to improve public health by eliminating disparities in access to medicine, creating social and cultural motivation for treatment, and promoting healthy lifestyles (U.S. Department of Health and Human Services, 2020). Among the differential goals of this program should be the goal of promoting self-management of patients with chronic illness in ways that improve their quality of life. In the case of Patient T, the goal means taking a set of measures, including training and support for ongoing communication, that would promote greater independence from others and increased capacity for her own health. Similar measures have been targeted at older patients — Healthy People 2030 offers programs to reduce the proportion of older patients who suffer from chronic conditions. Strategies for this improvement include making medicine more accessible to an older population, which includes patient T. and encouraging more frequent clinical appointments to monitor their health more closely, on a routine basis.
The Role of the Nurse
The professional nurse must function as an advocate for the patient’s interests so that the measures taken will improve the woman’s health. Patient T. must be assured that her interests and needs are brought to the nurse’s attention, as this understanding allows the quality of therapy to improve. Meanwhile, the nurse must convey to patient T. all the specifics of her diagnosis since she is the only competent source of clinical information for the woman. Once the patient is fully aware of the importance of her disease, understands the possible prognosis, and recognizes the seriousness of neglecting therapy, it has a decisive impact on improving therapy for chronic gastritis and hypertension.
Influence of the Environment
Meanwhile, the overall quality of therapy depends not only on the motivation and experience of the patient and nurse but also on external determinants. Such factors include, for example, the environmental safety of the environment as an indicator of the cleanliness of the air and water, which influences the quality of life of patient T. In addition, the absence of unhealthy habits and physical activity are determinants that contribute to health promotion (WHO, 2021). It is worth emphasizing social determinants, which include the availability of clinical services and medications, the absence of social inequality and discriminatory practices, as well as the state social protection of the interests of the population. The combination of these factors allows the patient to be more confident and feel socially secure in the society in which she lives.
References
CC. (2020). Why you shouldn’t ignore dizziness problems. Cleveland Clinic.
Oosterhuis, H., & Aan de Stegge, C. (2021). Between Emotional involvement and professional detachment: The challenges of nursing in Dutch mental institutions (1880–1980). Social History of Medicine, 34(4), 1277-1396.
U.S. Department of Health and Human Services. (2020). Chronic Pain. ODPHP.
WHO. (2021). Social determinants of health. World Health Organization.