Supplementary Assessment by midnight on 9 December 2019.
Assessment description: You are to write an essay, including an introduction and conclusion, using the sections below as a guide with a word count of 1,250 words (+/- 10%). The reference list is not included, however in-text citations are included in the word count. The aim of this assessment, is to consider the following questions and discuss and analyse the following key concepts:
Andrew is a 69 year old gentleman of Italian heritage, who has come into hospital for a below knee amputation due to complications from his Type 2 Diabetes (18 years post diagnosis). He is retired and lives with his wife of 40 years and his daughter, son in law and their three young children in a three bedroom house in the outer suburbs of Sydney. He has failing eyesight and has not had a job for the past 15 years due to his health problems. He is currently taking the medication to help manage his blood sugar (Metformin), however his blood sugars continue to be very high. Andrew does not like taking his medication as he finds it expensive and does not believe it helps him maintain his blood sugars within a healthy range. He believes there is nothing he can do to manage his blood sugar levels and that the amputation was a natural progression of the disease state. He infrequently takes his blood sugars, and does not see the point in attending frequent doctor appointments again due to the cost.
Andrew’s son in law is the only one who brings an income into his household, and this must support Andrew, Andrew’s wife, his daughter and their children. With limited resources, it is important that Andrew keeps his medical bills as low as possible. The family does enjoy spending time together and enjoy celebrating and connecting over meals. His son-in-law usually joins Andrew in an evening after the family meal to drink wine and smoke cigars. Both men find this an important time to connect and relax after a long day. Andrew socialises very infrequently with anyone else outside of his family, as his failing health and eyesight prevents him from being able to drive anymore.
Assessment Description- the aim of this assessment is to utilise the provided case study to answer Section A and Section B.
Introduction: (125 words)
Section A: (500 words)
Section B: (500 words)
Conclusion: (125 words)
The particular essay is developed with an aim to provide effective and accurate care support to the patients that helps in improving their health conditions. The essay is segregated into two major sections. First section of the essay identified seven dimensions of person centred care and how those dimensions can be applied to ensure patient centred care. The second section of the essay conducts a comparative study between biological model and social model of care. Further the effectiveness of social model of care in providing psychological support is justified. To carry out the study, given case study is considered and all the models and theories are explained in regards to the patient given in the case study.
Seven dimensions of patient centred care are access to care, patient engagement in care, patient values and preferences, information systems, integrated and comprehensive team care, emotional support, involvement of family and friends. With the utilization of the seven different dimensions, holistic therapeutic care can be provided to Andrew. Patient centred care has been defined by Vincent, et al., (2016) as providing care that is respectful, where patient’s preferences are highlighted, responsive, and designed as per the needs and values of the care users and ensure that care users values are the guiding forces of therapeutic decisions. Considering the health status of Andrew, different needs and physical conditions are needed to e consider to provide patient centred holistic care.
Patient satisfaction is key goal of every organization and this can be achieved by following the seven dimensions of patient centred care:
Access to care: Since Andrew has been suffering from different consequences due to Type 2 diabetes complication such as failing eyesight and below knee amputation. He has visited hospital for below knee amputation, his failing eye sight and limited financial sources are the key issues that he is experiencing where he has been find accessing health care very expensive that again may have detrimental impact if discontinued. Hence the care user must have proper access to care so that Andrew can manage his health conditions with right transport availability, easy to access to specialists, availability appointments, easy access to clinics and proper instructions regarding the cause of referrals.
Patient engagement: Patient engagement has very important role in patient centred care as patient can share their health needs and their expectations from the therapeutic system. Based on the heath needs, effective care plan can be developed where patient involvement is compulsory. Patient engagement is effective in encouraging them in obtaining better health outcomes that involved their skills, ability, knowledge and desire to manage their own care through effective communication in developing positive attitude (Fox & Reeves, 2019).
Information systems: Health is improved with the involvement of evidence based research, studies, clinical findings and support system and these information and data are collected with the application of information systems (Fallowfield & Selby, 2018). Therefore, accurate information system should be in place that supports evidence based holistic care to Andrew.
Integrated and comprehensive team care:Patient centred care is always an integrated and team based comprehensive care that involves different care professionals who look into different aspects of care such as medication, emotional support, and communication (Delaney, 2018). Hence excellent coordination among the team is required so that effective patient centred care can be delivered.
Emotional support: Andrew is found to be unwilling to take medications because of the poor financial conditions of the family and his deteriorating health makes him feel that medications are of no use. In this situation, where Andrew has been lacking trust on his medications as his medications are not effective in improving his failing eye sights and knee amputation. In this situation, he needs to be provided with adequate mental and emotional support in overcoming the distress that he has been facing.
Involvement of family and friends: It is evident from the given case study that Andrew hardly socialises with anyone else outside his family members and the key reason are his deteriorating health conditions and eyesight. Andrew is a family person who loves enjoying time with family members. Feo & Kitson, (2016) have found that family members play very important role in providing emotional support, adding to the experiences and sharing health needs of the patients. Hence family members of Andrew should be involved in the decision making.
Patient values and preferences: As per this dimension, patient should always be engaged in the decision making as every individual has his or her own value and preferences. Hence promoting respect and dignity of patient’s culture and autonomy and values are to be ensured so that human rights are protected and patients receive appropriate support and care from care providers aligned with their cultural and religious uniqueness.
Biomedical model of health care entirely highlights only on the biological aspects and does not consider environmental, psychological and social influences. This is the most widely used model in Western countries which is a medical model of disability (Feo & Kitson, 2016). With biomedical model, care professionals identify the key reasons behind an illness but rejects other reasons such as psychological and sociological as supports of this particular models explore, identify and treat illness different from their mental or any other external factors (Winnington, Holroyd, & Zambas, 2018). On the other hand, social model of health care unlike biomedical model, upholds the social aspects of health. It further analyses how care uses health is influenced by different external factors such as social, and environmental and psychological. Social model of health acknowledges factors such as lifestyle, and economy alongside other factors mentioned previously (Garg, Boynton-Jarrett, & Dworkin, 2016).
In compliance with the social model, Andrew’s psychological health can be improved as different factors such as social, environmental, lifestyle and economic factors are acknowledge by the particular model. The health care professionals identify how patient health is affected by different factors. Some of the key social determinants of Andrew’s health status are the environment in which Andrew has born, grew and has been living, his financial conditions and income.
All these aspects are identified and analysed in identifying and managing psychological issues of patients. Considering the health condition of Andrew, he is found to have mental and psychologic distress because of ineffectiveness of his medications in managing his blood sugar level that again has been leading to various other ill consequences such as failing eye sights and lower knee amputation. Not only his health conditions but the social and environmental condition in which he lives or had lived also has negative impact on his psychological health as he finds medications and appointments are of no use as no changes occur in his blood reports and the processes are very expensive.
Social model of care is effective in improving the psychological health of Andrew as it helps care providers understand different financial issues, social issues and environmental issues that he has been experiencing currently and his previous lifestyle as well (McCormack, Thomas, Lewis, & Rudd, 2017). When care professional have adequate information about different factors such as social class, inequality, financial source and their effects on mental health conditions of Andrew they are more likely to develop and maintain communication with Andrew.
By developing effective and positive communication with Andrew are professionals are likely to help him modify lifestyle and behaviour that again may have positive impact on his health conditions as he has been suffering from Type 2 diabetes. Additionally, communication and identifying the factors that have bene affecting his mental health will further help the care provides design support care plan accordingly that consequently will improve patient satisfaction, improved behaviour change, better adherence to care plans and prescriptions, better psychological and physical health and less tendency toward risky behaviour that might have adverse impact on the care outcomes. Andrew has been found to drink wine and smoke cigars with his son in law and these practice may have negative impact on his health outcomes. These health risk behaviours can be manged more efficiently with the application of social model.
It can be concluded from the essay that patient centred care is attributed by seven key dimensions and those are needed to be acknowledged and followed in health care in gaining improved health care outcomes. With the application of the seven dimensions, it is found that patient centred care encourages value and respect of the patients, involvement of the patient and their family members in decision making, easy access of care, integrated care and emotional support help care providers attaining better health care outcomes as well as plan care respecting the rights and values of patients. Second section of the essay represents comparison between biological and social model of care. Social model is found to have effective role in providing adequate psychological support to care patients as it acknowledges different factors within care those are environmental, social, lifestyle, behaviours, and environmental factors while providing support to the care users.