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TNA4002 Person and family centred approaches to health care assignment sample

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TNA4002 Person and family centred approaches to health care assignment

Introduction

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Nursing has diversified and evolved in its scope in treating the patients suffering from different illnesses and disorders. This report focuses on the approaches of care given to the patient. The patient-centred care and family-centred care are elaboratively discussed along with its' differences. The strengths and weaknesses of Family oriented care approach is evaluated in the context of mental health nursing (Yevchak, et al., 2017). This report also envelops the explanation of terms, behaviours, values, and beliefs. All these terms are studied to determine the role of a health care worker in serving the patient. This report is vital to assess the relationship between the internal attributes of a healthcare worker in the profession of nursing. In the second section of the report, descriptive research has been used to assist the discussion of evidence-based care and reflection model used (Sagong, and Lee, 2016).

The name of the patient has been concealed to respect the privacy of the patient. The care given to the patient is briefly discussed and the principles of holism, autonomy, choice, and empowerment are determined from the care episode. These attributes are discussed concerning delivering quality PCC and FCC (Adams, 2016). The communication style and its effectiveness are also studied in context with evidence-based care. Multi-disciplinary teams and application of inter-professional collaboration in providing service to patient along with PCC and FCC are presented in the report (Zaccagnini, and Pechacek, 2019). Patient's recovery and performance of the treatment plan are also embedded in the report. The vitality of the report can be determined by the widespread of using an integrated system of providing care to the patients suffering from mental illness like depression, bipolar disorder, anxiety disorder, and Schizophrenia (Yevchak, et al., 2017). Recent works of literature of scholars and theorists have been used to prepare this coherent report.

Segment 1

patient-centred Care

The decision-making system of the health care unit, in patient-centred care, is based on the individual's needs and desired outcome. Patients assist the health care providers in planning and choosing the type of treatment and take participation not only from a clinical point of view but also from a wider emotional and behavioural perspective (Hochman, 2017). The elements constituting the patient-centred Care are goals of the patient for the treatment, the decision is assisted by mutual consent of the healthcare provider team and the patient, well-being of the patient, both physically and mentally, and background and diversity of the patient are given due respect. Communication and team cohesiveness is an integral part of this approach of providing care by the healthcare team (Sagong, and Lee, 2016). This is an optimistic and effective approach and the results are better as the patient takes part himself and this shows the willingness of the patient to get treated and achieve health goals with collaborative efforts (McKay, Ariss, and Rudnick, 2020).

family-centred Care

Family-centred care was designed to assist patients with special care treatment and it included children suffering from disorders and illnesses. It uses a relation-centred approach to take vital treatment decisions (Mathews, 2020). The decisions are taken to best suit the condition of the patient and it includes analyzing the stage of the condition of the patient and the surrounding and comfort zone of the patient by involving their relatives in the decision-making process (Smart, et al., 2019). The main element is the involvement of care partners from the family. Usually, for children, their parents and adult siblings constitute to the team. The major merit of this approach is the participation of a rational person who will help the team to make the best decision by assessing the condition and requirement of the patient. Communication is a vital aspect of this approach (Mathews, 2020).

Difference between PCC and FCC

This section discusses the difference between the above two mentioned approaches to assess the best approach to suit the chosen field of nursing. These two approaches have been used collaboratively but these are distinct in a below-discussed way. PCC or patient-centred care involves the patient himself/herself whereas, in family-centred Care, the assistant of the healthcare team is someone from the family of the patient (Sagong, and Lee, 2016). FCC is suitable when the patient is unable to make rational decisions and is not mature enough to participate in their own's healthcare concerns, for example, children. On the other hand, PCC is suitable when the person is mature to take his own decisions and is willing to cure his illness. There are many factors which determine the need for a specific approach. If the person is living alone and is the eldest member of the family like a single mother, PCC is suitable (Sagong, and Lee, 2016). On the other hand, mental disorders like learning disability need the FCC to treat the patient. The patient is the only person who knows the whole condition as he lives with it. The next best alternative is any relative or family member who is close to the patient (Skundberg-Kletthagen, et al., 2020). If the family members are not close to the patient and do not maintain cordial relation with the patient or the patient is not comfortable enough with the family members, it is better to let go the FCC approach. The benefits derived from each of the approaches are, however, similar but vary in degree. PCC is the most effective approach to make the treatment speedier and fruitful (Hochman, 2017). While FCC can make the treatment consume more time but ensures safe and quality recovery of the patient

Strengths and Weaknesses of the FCC in context with a patient suffering from mental illness

Strength of the FCC approach

  1. Family members live with the patient and have better knowledge about the patient's condition and the surrounding he has been brought up in (Skundberg-Kletthagen, et al., 2020).
  2. Family members or relatives inculcate natural benevolent nature and put the patient's priority and needs before their own's. this is true in the case of a child's care who is suffering from a mental disorder like depression or bipolar (Smart, et al., 2019).
  3. This approach uses the ability of the skilled staff to work with the knowledge gained by the way of including family members to decide the best alternative to suit the treatment (Mathews, 2020).

Weaknesses of the FCC approach

  1. Attachment of family members with the patient makes it difficult to choose strict methods to treat a patient suffering from a mental disorder.
  2. Including family members who have different perspectives can make decision-making ineffective as the discussions and arguments might consume time.
  3. Including family members in the decision making process becomes complex if the family member disagrees with the MDT members frequently and interrupt the treatment (Skundberg-Kletthagen, et al., 2020).

Despite the above-mentioned weaknesses and strengths, to treat patients with mental disorders and illness, the family-centred approach is suitable because they are the only one who can make a rational decision for the patient (Smart, et al., 2019).

Behaviours, Values and Beliefs

Behaviour refers to the sum of manners, response and actions of an individual. These responses, actions or manners can be coveted, acquired, voluntary, involuntary and conscious and unconscious. Behaviour is majorly dependent on how a person perceives a situation, object and circumstance (Adams, 2016).

Values are the normative ethics and sum of principles and beliefs that affect a person's behaviour in life. Values are an inseparable trait of a quality human being. Preferences and decisions of a person are based on his values. Values determine the sense of a rational human being in perceiving what is right and what is wrong (Blais, et al., 2016).

Belief is an internal feeling of a human being of accepting the existence of a thing or a cause without having proof. Existence of God is a matter of belief. Benevolence and payment of one's deeds in future is a matter of belief. Beliefs are the base of the formation of values (Murphy, et al., 2018).

Traits of a Healthcare Worker and its impact

A healthcare worker, like a nurse, is required to have a positive attitude, selfless service approach and an appropriate and amicable behaviour towards the patient and his family members. A healthcare worker needs to inculcate kindness, courage and confidence to treat the patient in an ethical manner (Smart, et al., 2019). A healthcare person must give priority to the needs of the patient and always take decisions that best suit the treatment. Loyalty, dignity and respect for the privacy of the patient and his family members are also recommended to a healthcare worker. All these traits will make the practitioner suitable for nursing and do justice with the profession (Adams, 2016).

The impact of inculcating these traits includes the effectiveness of the treatment and job satisfaction that the practitioner will receive. The practitioner will be contented with the positive response of the patient (Davies). Recovery of the patient dealing from severe mental illness will make the practitioner and members of MDT achieve goals and satisfaction from within. The greater implicit values and ethical code of conduct will widen the scope of the profession for the practitioner (Raine, et al., 2014).

Segment 2

Reflection model

The model that I have chosen for this report is Atkins and Murphy model of reflection. In this model, the first step is being aware of the situation and the case and I have provided my perception through a brief description of the case (Mantzourani, et al., 2019). The next step is to describe the events and factors that are empirical to study. The third step is to analyze the feelings I discovered in case I was assigned. I reflected upon my behaviour and my code of conduct to make the best use of my abilities (Zaccagnini, and Pechacek, 2019). Then the fourth step of the process which is to evaluate the relevance of my disposition and decisions and how it helped me to deal with the situation. In last, I have identified the areas I need to work on and learning new things and enhancing my knowledge (Ahmed, 2018).

Case study

The privacy of the patient is maintained by following the pseudonym approach of informing the case details. Patient P is a 25 years old married woman and living with her husband in Ohio. Due to childhood trauma, the patient is suffering from chronic depression. The pandemic worsened the situation as she lost her job as an accountant. The patient's husband informed that the patient was behaving erratic and stayed in her room for more than a day without talking or doing any activity. The patient has tried to self-harm that shows signs of extreme anxiety and negativity. The patient was rushed to the hospital when she fell from the stairs and her husband confirmed she remains lost most of the time. 

Application of principles in the above case

I determined the need of the patient was to communicate her feelings more openly and without being judged. In our lives, we do things that affect us for our lifetime. When I communicated with the patient, I found out that the continuous events of the past few years and the loss of her mother was continuously bugging her (Murphy, et al., 2018). I discovered a need for holism approach to treating the patient. I contemplated on each of the events to meticulously determine the effects on the patient. I considered all the social and mental factors in account to serve the patient (Yevchak, et al., 2017). I made sure, I was kind and listened to her without judging her shortcoming. I did not compromise on my values to justify the events. I maintained autonomy by responding in the right way rather than making the communication diplomatic. I assured the patient with her secrets and feelings and I felt a responsibility to protect her interests and feelings from within (McKay, Ariss, and Rudnick, 2020). I was not faking comfortable dialogues but I was engaging myself to best suit the patient's need. At first, the patient was not willing to open up and I decided to let her take her time and did not bother her because it was her choice to decide on the comfort level. I was trying to make my disposition pleasing and warm to make her comfortable but did not force her to communicate and communicate her feelings. I was continuously communicating with other members of MDT to make sure the plan and treatment were aligning with the goals and I was arranging necessary resources for the patient like medications. I was empowered by leading this case and managing the treatment of the patient with the help of my team (Raine, et al., 2014).

Effectiveness of principles in PCC and FCC

The above case was treated by including family members in the care providing plan. the patient's husband was caring and sensitive towards the need of her wife and helped develop the treatment plan. We tried to explain the treatment to the patient and how the MDT is determined to help her with her condition (Mantzourani, et al., 2019). We conveyed our objective to treat her for her benefit (Raine, et al., 2014). We gradually included her in the plan and decided the appointments with her content. I made sure she felt safe and secure with the medications and the treatment and I elaborated the process and its benefits (Hochman, 2017). I realized that she started gaining confidence and was motivated towards having an optimistic perception. The principles helped me to remain intact while responding favourably to the patient. By following the holistic model, I was able to connect on an informal level with the patient and her husband appreciated my efforts (Skundberg-Kletthagen, et al., 2020). By maintaining autonomy, I was able to justify my efforts to the management team and the patient. I respected the confidentiality of the patient and presented the case in a formal way to the team. I chose to balance the needs in alignment with the treatment to satisfy both ends. The choice of the patient and her husband to decide on the appointments and treatment was also considered while planning the treatment (McKay, Ariss, and Rudnick, 2020). The community healthcare nurses were coordinating well with the plan and the psychologist agreed to the approach as well (Blais, et al., 2016). The service providers were cordially communicating and serving the needs of the treatment. Overall, MDT was harmonious and putting its best efforts to serve the patient. The quality of the FCC model was enhanced by the way of these efforts (Mathews, 2020).

The relevance of the FCC model

I determined the relationship between the husband and the wife was strong and choosing the FCC model would suit the treatment. When we received the patient in the initial stage, it was difficult to communicate with her and determine the needs of the condition. She was not opening herself to the psychologist and was not responding to the medications (Skundberg-Kletthagen, et al., 2020). We thought to include her husband to plan the treatment type. We knew the process will take and we were ready to give our best shot. Her husband was very supportive and had a practical approach, we knew it was hard for him to see her wife in such a condition. I started to make her comfortable before communicating the plan. I started informally and made sure no one is around while she let her guard down. I started motivating her and she started responding to the communication. I was in touch with her husband and reported her performance every day to him. He was engaging and was informing me about the topics I should ignore and the topics I should focus on. This model was a great success and all the members were sincerely coordinating with the plan (Skundberg-Kletthagen, et al., 2020).

I determined that a lot of time was wasted initially while planning the treatment. Communication among the team members was not as effective as it should be. I was fully dedicated to the patient's need that I was not considering others opinions (Ahmed, 2018). I think I am quite rigid and do what suits the condition without involving other participants. However, each member of the MDT was amiable and did not discuss much but I found that they perceived that I would argue and will exert pressure. I need to work on my disposition and I need to respect others opinion too. I should listen more before taking any decision (Skundberg-Kletthagen et al., 2020).

Conclusion

To conclude, it will not be wrong to confirm the need for an appropriate approach in treating the patients suffering from disabilities and illness. Different cases require different approaches. patient-centred care is the best approach where the patient is willing to take treatment and cure his illness. But if the patient is not able to make rational decisions and depend on others, then the family-centred Care approach must be used. Both the approaches are different in some manner and the solutions may vary in degree. The principles that are embedded in a healthcare worker are also elaboratively included in the above report to determine the ethical side of the approaches to be applied in care. Patients are humans and have feelings and might get hurt or feel insecure, and that is why these values and principles are of utmost vitality in the nursing profession. Principles of holism, autonomy, choice and empowerment are vital for the nursing profession as the cases are usually complicated and sensitive. In the above case, the woman is vulnerable and suffering from chronic depression. Continuous motivation and effective communication are necessary to deal with patients suffering from mental disorders. The above discussion elaborates the necessity and scope of nursing through different approaches and inclusion of the multi-disciplinary team to develop an effective plan and serve the needs of a patient. Nursing is a noble serving profession in which the priorities of the practitioner is always inclined towards the needs of the patient. The complexities in handling human behaviour in multi-disciplinary teams and inclusion of family members and patient need a broader perspective and embedded traits in the healthcare worker.

References

Adams, L.Y., 2016. The conundrum of caring in nursing. International Journal of Caring Sciences9(1), p.1.

Ahmed, M.H., 2018. Reflection for medical undergraduate: learning to take the initiative to look back to go forward. J Hosp Manag Heal Policy2(31), pp.1-5.

Blais, K., Hayes, J.S., Kozier, B. and Erb, G.L., 2016. Professional nursing practice: Concepts and perspectives (p. 528). Pearson.

Davies, V., BECOMING A REFLECTIVE PRACTITIONER.

Hochman, O., 2017. Patient-centered care in healthcare and its implementation in nursing. International Journal of Caring Sciences10(1), p.596.

Mantzourani, E., Desselle, S., Le, J., Lonie, J.M. and Lucas, C., 2019. The role of reflective practice in healthcare professions: Next steps for pharmacy education and practice. Research in Social and Administrative Pharmacy15(12), pp.1476-1479.

Mathews, J., 2020. Exploring Family-Centered Care from the Perspectives of Home-Health Physical Therapists.

McKay, K., Ariss, J. and Rudnick, A., 2020. RAISe?ing awareness: Person?centred care in coercive mental health care environmentsA scoping review and framework development. Journal of Psychiatric and Mental Health Nursing.

Murphy, J.W., Franz, B.A. and Schlaerth, C., 2018. The Role of Reflection in Narrative Medicine. Journal of medical education and curricular development5, p.2382120518785301.

Raine, R., Wallace, I., Nic a'Bhaird, C., Xanthopoulou, P., Lanceley, A., Clarke, A., Prentice, A., Ardron, D., Harris, M., Gibbs, J.S.R. and Ferlie, E., 2014. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Health services and delivery research2(37), pp.1-172.

Sagong, H. and Lee, G.E., 2016. Person-centered care and nursing service quality of nurses in long-term care hospitals. Journal of Korean Academy of Community Health Nursing27(4), pp.309-318.

Skundberg-Kletthagen, H., Gonzalez, M.T., Schrder, A. and Moen, .L., 2020. Mental Health Professionals' Experiences with Applying a Family-Centred Care Focus in Their Clinical Work. Issues in Mental Health Nursing, pp.1-9.

Smart, E., Nalder, E., Rigby, P. and King, G., 2019. Generating expectations: what pediatric rehabilitation can learn from mental health literature. Physical & occupational therapy in pediatrics39(2), pp.217-235.

Yevchak, A., Fick, D.M., Kolanowski, A.M., McDowell, J., Monroe, T., LeViere, A. and Mion, L., 2017. Implementing nurse-facilitated person-centered care approaches for patients with delirium superimposed on dementia in the acute care setting. Journal of gerontological nursing43(12), pp.21-28.

Zaccagnini, M. and Pechacek, J.M., 2019. The doctor of nursing practice essentials: A new model for advanced practice nursing. Jones & Bartlett Learning.

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