A person chosen for the administration of the questionnaire is JF, who is a distant family member. JF has a stage 3B chronic kidney disease, which is categorized by the severely reduced kidney function and an increased risk of renal failure in the future. The following paper contains a summary of JF’s responses to the questionnaire, the analysis of the responses, and the likely implications of the received information on the planning of care for the group.
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Summary of Responses
JF is a 53-year-old female. She identifies as belonging to the economically disadvantaged socially vulnerable group and points to the lack of insurance coverage as an aggravating factor. It should also be noted that while the person in question cannot be currently identified as belonging to the elderly group, the inclusion into this group is imminent and should be considered during the planning stage. She also did not mention her ethnicity (Hispanic) as a vulnerability factor. JF was diagnosed with CKD at the age of 48 when the condition was already in the late third stage. The diagnosis process was relatively streamlined, with the conclusions made after a physical examination and the arrival of the blood and urine test results.
The patient reported no bias exhibited by the healthcare professionals during the diagnosis or treatment process. Since the day when JF was diagnosed with the condition, she experienced occasional fatigue, sleep problems due to the muscle discomfort, occasional nausea, and attention difficulties (mostly observed during reading). However, JF cannot reliably conclude whether any of the said effects worsened or stayed at the pre-diagnosis rate. The respondent reported no health disparities aside from the difficulties caused by socioeconomic status.
The medications taken by the patient include angiotensin II receptor blockers for the management of high blood pressure and erythropoietin for the management of anemia as a part of the dialysis treatment. Both medications effectively relieve the symptoms and the stabilization of the conditions. The medications are relatively widespread and freely available in JF’s city. The medical evaluation with lipids and serum creatinine was a part of the diagnosing process. JF has high blood pressure and controls it with pharmaceutical means.
The symptoms with the most impact on the quality of life include declining physical functioning (fatigue, weakness, nausea, and lack of concentration) followed by the need for dialysis and the high blood pressure, respectively. The dialysis process requires a graft and bags of dialysate, both of which are relatively inexpensive in terms of equipment and are relatively easily obtainable. However, the contents of the bag are expensive enough to be challenging for JF’s socioeconomic status. The respondent reported receiving additional training necessary to perform peritoneal dialysis on her own. The psychological needs include coping with the untreatable condition, the ability to face the diagnosis, and the planning skills.
On average, the responses are indicative of the typical challenges associated with CKD. However, several specificities are to be pointed out. For instance, JF has not included either ethnicity or age into the list of social vulnerabilities. While the latter can be discarded as irrelevant, the former can be interpreted as an improvement in health care delivery on a local level. Certain ethnicities, including Hispanics, often report biased attitudes of healthcare professionals and are otherwise subject to the increased risk when it comes to coping with chronic conditions (Greer & Boulware, 2015). The socioeconomic factor is the next most significant barrier to the management of kidney failure, which coincides with JF’s responses.
The high cost of the dialysis procedure combined with the low income of the respondent is the main issue in the treatment process (Honeycutt et al., 2013). In physiological terms, the disease is effectively managed through medications and lifestyle changes. The respondent reports no difficulties in dialysis self-administration and only a minor effect of treatment on the quality of life. Therefore, the treatment aspect of the condition can be characterized as acceptable and does not require additional attention. From a psychological perspective, several issues can be identified.
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First, since the respondent identified the need to face the diagnosis and cope with the condition as major psychological challenges, it is obvious that she has accepted the diagnosis in relation to the standard definitions of the disease. However, it is also evident that she has not achieved sufficient acceptance level in any of the identified coping skills since still considers both of them a priority in terms of psychological needs (Clarke, Yates, Smith, & Chilcot, 2016).
In addition, JF has not reported any attempts on the part of healthcare professionals that would provide the methods or coping strategies relevant to the psychological domain. The responses do not contain explicit information on the support from the family members or the difficulties associated with its absence. Therefore, the family does not play a particularly prominent positive or negative role in the reviewed case. It would also be reasonable to conclude that the family does not experience a particularly strong impact on disease management on their overall quality of life.
Effect on Care Planning
Several implications can be drawn for the plan development for patients with chronic kidney disease. First, the responses indicate a lack of adverse effects of physical treatment on the quality of life of the patient. Importantly, the responses also point to the presence of effective educational interventions intended to promote self-management and sustainability among the impacted population. The positive effect seems to be uninhibited by the highly vulnerable low-income status of the patient and is therefore crucial in improving the overall quality of the delivered care. Specifically, the most significant change in behavior (the dialysate bag manipulations) presents a little challenge when accompanied by appropriate education.
Thus, such an element should receive increased attention in the planning phase. Second, the lack of psychological assistance on the part of the healthcare professionals predictably leads to a lack of familiarity with relevant coping strategies among the patients. Since the latter is one of the most significant predictors of the positive outcome in populations with chronic conditions, it is important to allocate additional resources and update the available educational interventions in order to facilitate the necessary level of preparedness among the impacted population.
Finally, a notable positive effect of the unbiased healthcare professionals eliminates several aggravating factors and improves access to care and overall patient satisfaction (Robles-Osorio & Sabath, 2016). While the latter is probably characteristic of the local healthcare providers, it would be reasonable to appropriate this line of behavior to the care plan on both the local and the state level through policies and staff guidelines.
The results derived from the analysis of the person’s responses are generally consistent with the known barriers to coping with CKD. In addition, the gaps in care delivery are correlated with the difficulties reported by the patient. Therefore, addressing the identified gaps at the planning phase would allow for early prevention of the majority of psychological difficulties and the respective improvements in patients’ quality of life.
Clarke, A. L., Yates, T., Smith, A. C., & Chilcot, J. (2016). Patient’s perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes: A narrative review. Clinical Kidney Journal, 9(3), 494-502.
Greer, R., & Boulware, L. E. (2015). Reducing CKD risks among vulnerable populations in primary care. Advances in Chronic Kidney Disease, 22(1), 74-80.
Honeycutt, A. A., Segel, J. E., Zhuo, X., Hoerger, T. J., Imai, K., & Williams, D. (2013). Medical costs of CKD in the Medicare population. Journal of the American Society of Nephrology, 24(9), 1478-1483.
Robles-Osorio, M. L., & Sabath, E. (2016). Social disparities, risk factors and chronic kidney disease. Nefrología, 36(5), 577-579.