Living with a chronic illness can have a huge impact on the patient and the family of the patient. Quality of life of an individual also refers to the quality of life of the ones closest to them, and in this scenario, the added strain, restriction, financial and emotional impact are significant factors that show the effect of living with a chronic illness. Hospitalization in this case and the effect it has on the patient as well as the family can be a harrowing experience depending ton the quality of the care that is being provided.
As per the Australian Nursing and Midwifery Board standards of practice for a Registered Nurse when caring for individuals and their families where the patient has acute to chronic conditions, there are certain set guidelines that they must follow. Actively fostering a culture of safety and reassurance that utilises knowledge, resources to provide the best person-centred care is of primary importance. Following the guidelines and operating within the ethical framework. Registered nurses are accountable for their behaviour, decisions they make and the care they provide to their patients. They have to respond in a timely manner to the health and well being of self and others in elation to capability for practice. The use of resources skill sets and aware ness in influencing better health outcomes is of key importance. Nurses are also responsible for all the communication and delegation of duties that take place.
In this scenario, Chaz is a six-year-old boy who has asthma. After an acute exacerbation of his disease he has been admitted to the hospital. Chaz is in year one of primary school. Chaz’s family consists of his parents, a younger sister and his grandmother. His grandmother is the one who takes care of him while both his parents work at MNC’s. Following this episode, their entire family is worried about Chaz and understanding the full scope of this impact of hospitalization on the patient and the family involves many layers. The separation anxiety for a six year old can be extremely debilitating as they have to confront these feelings of uncertainty and lack if control without the guidance of their primary care givers. Children do not have the understanding to completely comprehend about what’s happening to them and their bodies and this can cause feelings of confusion and dismay. Further alienation from friends and school can affect their moods and temperament too. The stress from unfamiliar surroundings of a hospital can be particularly worrisome for a young child and can make them more sensitive/irritable than usual (Keet et al 2018).
Depending on the seriousness of the situation the effect of an asthma attack must have left Chaz confused and dismayed. His grandmother being the only person to take him to the emergency room must have been extremely worried and scared to not have any absolute control over the condition of her grandson. The severity of the medical procedure is also bound to affect Chaz where he might be come withdrawn or act out. The chances of wetting the bed, sucking thumbs or creating old familiar patterns of comfort are high. the effects on the family include high levels of stress, helpless and apprehension that renders them helpless and guilty in an unfamiliar situation like this. The aim of the parents and family is to alleviate the pain , but to not have the absolute control to do so can be distressing. The financial and mental stress of trying to maintain hospital expenses and treatment can also be an added strain. The family needs to have psychosocial awareness to understand the models of care while providing adequate support to the young child who still cannot make any of his own decisions. Management of chronic pain can be conducted with the help of adequate care but it requires qualified professionals and quality care. The rehabilitation of the young patient and their family can be streamlined with adequate knowledge(Suparto et al 2020)
Person centred care is a collaborative process that is built on mutual trust and understanding. The key element is thorough communication where the patient is treated with due respect where they have right to information about the knowledge of their health , and they have the complete ownership, rights and preferences while being empowered. Person centred care especially recognises the role of family and community in helping an individual. Ensuring patient specific treatment where effectiveness of the data regarding asthma can be utilized can be an instrumental step in this process. Medical management and quality care provided by the clinical workers can be effective and reflective of comprehensive asthma care (Wells et al 2017).
Through the clinical reasoning cycle the nurses can pick on the cues and use their problem solving, decision making and clinical reasoning skills to process the information and give an adequate medical response. Understanding the patient problem in this scenario, and planning/ implementing intervention to hep the family in providing care should be the first priority. In order to improve the adaptive coping mechanism of the child family support system should be prioritized upon. To reduce the stress of hospitalization nurse should encourage the children to interact and communicate while constantly nourishing them support and care to help them through the difficult phase (Hasinuddin, et al 2019).
When dealing with young children with chronic illness, it is necessary for the adult around them to provide a more optimistic and informed perspective so that the young children do not get overwhelmed by the stress of hospitalization and its unfamiliarity.
Suparto, T. A., Somantri, B., Andriani, S., Puspita, A. P. W., Rohaedi, S., Amalia, L., ... & Sari, A. T. (2020, February). Parents’ Roles in Overcoming the Impact of Hospitalization on Preschool Children. In 4th International Conference on Sport Science, Health, and Physical Education (ICSSHPE 2019) (pp. 140-143). Atlantis Press.
Keet, C. A., Keller, J. P., & Peng, R. D. (2018). Long-term coarse particulate matter exposure is associated with asthma among children in Medicaid. American journal of respiratory and critical care medicine, 197(6), 737-746.
Dunfee, M. N. (2017). Connecting patient centered care for chronic conditions to school-based clinics through telehealth: the Asthma Free Schools program (Doctoral dissertation, University of Cincinnati).
Wells, S., O'Neill, M., Rogers, J., Blaine, K., Hoffman, A., McBride, S., ... & Berry, J. G. (2017). Nursing-led home visits post-hospitalization for children with medical complexity. Journal of Pediatric Nursing, 34, 10-16.
Hasinuddin, M., Noviana, U., & Fitriah, F. (2019). Family Support System as an Effort to Optimize Coping Mechanism of Preschool Children During Hospitalization. Jurnal Ners, 14(2), 199-204.
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