Healthcare Influences Physical Care Need

Introduction

The quality delivery of patient care is important as it contributes to create positive experience for the patient recovery and enhance the physical as well as mental health of the people suffering from serious illness like cancer (Livet et al., 2018). In this presentation, the care support and needs of Mrs A is to be discussed who is a 31-year old female suffering from right breast cancer. For this purpose, the holistic care needs, factors influencing the care needs, leadership style in care, management of issues in care and multi-agency care are to be discussed and reflected.

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Case Study

According to the NMC Code of Practice, no personal information of the patient is to be revealed and their confidentiality along with privacy is to be maintained in all condition (NMC, 2018). Thus, the pseudonym A is used to indicate the patient to maintain her privacy and confidentiality. Mr A is a 31-year-old married individual with 2 children aged 10 and 11 years respectively. She has breast cancer in the right breast and has fungating wound which requires daily dressing. She needs end of life care and administration of oramorph and lorazepam is done each time before changing the dressing for the wound.

Holistic Care Needs

The five areas of holistic care are physical, emotional, social, spiritual and mental care (Waite, 2019). In case of Mrs A, her physical care need is effective dressing of the fungating wound with reduction of any associated pain due to presence of wound and worsening of breast cancer. This is because extreme pain interferes with the daily activities of the patient by making them unable to execute actions and develop disturbed moods (Morris et al., 2018). The presence of worsened stage of cancer makes patients feel emotionally numb along with develop anxiety leading to create sleep problems. This is because the complication of health condition along with pain and suffering as well as fear of death leads the individual unable to manage stable emotional condition (Leysen et al., 2019). In case of Mrs A, her worsening condition of breast cancer along with her incapability to care for the small children have raised mental care need of resolving anxiety and depression with the health condition.

The patients suffering from any form cancer of experiences issues with maintaining effective social life. This is because of their deteriorated physical health and energy to manage and engage in social actions (Møller et al., 2020). In case of Mrs A, her social care need is supporting her to visit her family and children. This is because in the current COVID-19 situation it is found that both are children are affected by the disease and allowing her socially to meet the children would create adverse health consequence for the children as well as the mother since COVID-19 is highly contagious. Mrs A does not represent any spiritual need of care as per the health assessment. However, Mrs A expresses care need of supporting upbringing of her children in her absence due to death from breast cancer that has relapsed intricately.

Social, Political and Economic factors influencing care needs

The family size and structure are influencing the social and physical care needs of Mrs A. This is because larger families with children makes the patient who are the child’s parents to worry regarding the management of supporting developmental needs of the children. It leads the parents who are patients to try to socially interact with the children as it helps in coping with stress and anxiety regarding care for the children (Karampour et al., 2018). The social factor of access to healthcare influences physical care need of Mrs A. This is because effective access to healthcare influences the patient to ask and avail for required physical support needed to enhance their health (Chen et al, 2017). Thus, the physical need of increased care for breast cancer treatment is influence by the social availability of cancer care in the UK for Mrs A.

Leadership Style (S and W)

In caring for Mrs A, the leadership style used is autocratic leadership. The autocratic leaders mainly act by willing to take control over all decisions and allow little contribution of ideas from the group members in executing work. The autocratic leaders make choices based on their own judgement and ideas and rarely uses advice from others in leading any task (Bridges et al., 2017). In Mrs A’s case, it was seen that she was negotiating with the nurses regarding the way dressing of her fungating wound is to be executed. However, the tissue viability nurse (TVN) was acting as autocratic leader to try and take control of all the aspect of Mrs A’s life without accessing any idea from her as she was unable to control the way dressing of her wound is to be done by the other nurses. It indicates that TVN prioritises their care decision over the patient’s ideas even though the patient show negotiating attitude. Thus, the weakness of autocratic leadership is that it causes the development of work or care culture based on the ideas of the leader while neglecting the ideas from patients and others which makes the patients experience dissatisfaction with care (Gillies et al., 2021). The strength of autocratic leadership is that it allows quick decision-making and assist in creating clear command chain in leading execution and completion of any task (Wigley et al., 2020).

Way concerns are managed

In caring for Mrs A, the concern to be raised is hindered care delivery to her due to lower quality care support. The NMC Code of Conduct mentions that nurses are to identify the care needs of the patients and provide care in the best interest of the patient (NMC, 2018). They are to listen actively to the patients and team members in identifying care concerns and report them to appropriate authorities (NMC, 2018). Thus, the concern of care quality to be raised in case of Mrs A is to be managed by the nurses by following the Code of Duty mentioned by the NMC. Another concern to be raised in safety issue for Mrs A due to lack of effective risk identification and management. The NMC Code of Conduct mentions that nurses are to identify and keep record of any risk for the patients, develop strategies to manage the risk as well as act in delegating task and duties to others based on their competence (NMC, 2018). Thus, to care for Mrs A, the nurses are to follow the Code of Duty in ensuring safety of Mrs A and to manage her concern regarding health.

Reflecting on the way multi-agency and collaborative care influence safety and quality

The physical care needs of Mrs A include fungating wound management and pain control. In this context, the health professionals involved in treating cancer patients are seen to work collaboratively with the nurses to support them in understand the way dressing is to be made and oramorph is to be provided in reducing pain and suffering of Mrs A (NICE, 2019). This collaborative care influenced quality of support for Mrs A as it helped the patient access enhanced support from experienced professionals with higher expertise than the nurses (NICE, 2019). The multi-agency care needed for Mrs A is childcare support for her two children. The working with childcare agencies as a part of the multi-agency care influences safety and quality of care for Mrs A and her children. This is because childcare authorities provided supports for enhanced development of the children and their safety in the absence of their cancer affected parents who may be receiving care at the hospital or unable to provide care due to health condition (cancerresearchuk.org, 2021). The NICE guidelines mention that psychologist is to be involved in managing negative emotional and mental health of the patients. In addition, anti-depressants and anti-anxiety medication are to be provided to patients to ensure their normal psychological health (NICE, 2019). In case of Mrs A, the administration of lorazepam for managing her anxiety regarding health and involvement of psychologist helped in influencing quality care as the psychologist acted to implement strategies in stabilising the mood of the patient.

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Conclusion

The above discussion informs that Mrs A is suffering from fungating wound from breast cancer and her current care needs include effective support to reduce anxiety, childcare support in looking after her children, effective care and medication to reduce her pain from wound, enhanced dressing of wounds and others.

The multi-agency and collaborative care for Mrs A influences her safety and quality health and different professionals with wider expertise are involved in holistically resolving al her raised care needed in regard to the disease.

References

  • Bridges, J., May, C., Fuller, A., Griffiths, P., Wigley, W., Gould, L., Barker, H. and Libberton, P., 2017. Optimising impact and sustainability: a qualitative process evaluation of a complex intervention targeted at compassionate care. BMJ Quality & Safety, 26(12), pp.970-977.
  • cancerresearchuk.org 2021, Help with children's costs, Available at: https://www.cancerresearchuk.org/about-cancer/coping/practically/financial-support/what-benefits-can-I-claim/help-children-costs [Accessed on: 18October 2021]
  • Chen, W., Zhang, Q., Renzaho, A.M., Zhou, F., Zhang, H. and Ling, L., 2017. Social health insurance coverage and financial protection among rural-to-urban internal migrants in China: evidence from a nationally representative cross-sectional study. BMJ global health, 2(4), p.e000477.
  • Gillies, J., Morton, V.A.H., Jasim, S., Fox, C., Broggio, P. and Pillay, T., 2021. Effecting a national implementation project through distributed leadership in the West Midlands: rising to the spread challenge. BMJ open quality, 10(2), p.e001227.
  • Karampour, S., Fereidooni-Moghadam, M., Zarea, K. and Cheraghian, B., 2018. The prevalence of death anxiety among patients with breast cancer. BMJ supportive & palliative care, 8(1), pp.61-63.
  • Leysen, L., Adriaenssens, N., Nijs, J., Pas, R., Bilterys, T., Vermeir, S., Lahousse, A. and Beckwée, D., 2019. Chronic pain in breast cancer survivors: nociceptive, neuropathic, or central sensitization pain?. Pain Practice, 19(2), pp.183-195.
  • Møller, T., Andersen, C., Lillelund, C., Bloomquist, K., Christensen, K.B., Ejlertsen, B., Tuxen, M., Oturai, P., Breitenstein, U., Kolind, C. and Travis, P., 2020. Physical deterioration and adaptive recovery in physically inactive breast cancer patients during adjuvant chemotherapy: a randomised controlled trial. Scientific reports, 10(1), pp.1-15.
  • Morris, R.L., Stocks, S.J., Alam, R., Taylor, S., Rolfe, C., Glover, S.W., Whitcombe, J. and Campbell, S.M., 2018. Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership. BMJ open, 8(2), p.e020870.
  • NICE 2019, Morphine, Available at: https://www.nice.org.uk/bnf-uk-only [Accessed on: 18October 2021]
  • NICE 2019, Quality statement 9: Collaborative care, Available at: https://www.nice.org.uk/guidance/qs8/chapter/quality-statement-9-collaborative-care [Accessed on: 18October 2021]
  • NICE 2019, Generalised anxiety disorder and panic disorder in adults: management, Available at: https://www.nice.org.uk/guidance/cg113 [Accessed on: 18October 2021]
  • NMC 2018, The Code, Available at: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf [Accessed on: 18October 2021]
  • Waite, A., 2019. Primary palliative care is not different from holistic care. BMJ, 365.
  • Wigley, S., Dieleman, J.L., Templin, T., Mumford, J.E. and Bollyky, T.J., 2020. Autocratisation and universal health coverage: synthetic control study. bmj, 371. pp.78-90.

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