Application Of Theories And Frameworks In Providing Ethical And Effective Health Care For Aboriginal Patients – A Case Study

NUR1201 The Patient Experience

Application of Person-Centered and Family-Centered Care Theories

It is the fundamental right of aboriginal individuals to receive equal and quality treatment without any discrimination like other communities do. With this thesis statement, this assignment will discuss the case study of Raelene Ward, who is a 40 year old aboriginal woman who experienced being a patient in a healthcare facility due to her pregnancy and gestational diabetes (Kerr & Hayward, 2013). While receiving care in the healthcare facility she faced several effective and ineffective nursing interventions that affected her health care experience. In this assignment, several theories will be applied in case of Raelene Ward’s care such as family centered and person centered care as well as for the health care professionals, the code of ethics and its importance will be discussed. Besides this, application of Erikson’s 8 stage framework will also be used for the care process of Raelene ward (Holmes et al., 2013). Moreover, with the discussion of theories and framework, the communication process, effective and ineffective care process and partnering in care strategy with strategies to maintainof patient experience will be discussed in this assignment.

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It has been witnessed with the support of several researches that application of family centered or patient centered care is the process using which patient experience about care process is easily enhanced. In this case of Raelene Ward the person centered care and family centered care will be applied and the nursing professionals will be asked to comply with the ethical code of conduct (Inzucchi et al., 2015). While communicating with Raelene, it was observed that after the diagnosis of gestational diabetes, the health care professionals did not provided a detailed information about her health condition and directly applied insulin instead of diet or nutritional modification or oral medication to control the diabetes (Barry &Edgman-Levitan, 2012). This indicated towards the ethical violation of code of conduct as the health professionals should always take care of patient’s autonomy. Therefore, the care process should involve person centered care as a detailed information about the ailment and effective intervention will help the patient to support the health care professionals in the application of health interventions (Kerr& Hayward, 2013). On the other hand, Erikson’s 8 stage frame work will also be applied in the case scenario which helps the care professionals to identified 8 different negative and positive and negative aspect of care scenario that could affect the patient experience (Holmes et al., 2013). This will be applied in the case scenario, so that the loopholes present in the care process of Raelene ward could be removed and the care process could comply with the chosen theories and framework.

On closely evaluating the case scenario it can be revealed that two evident care providing frameworks can be detected which includes effective and ineffective care. According to Kitson et al. (2013) effective care and ineffective care have been classified under the subtypes of providence of positive and negative care. Providence of effective care broadly relies upon the providence of a patient centred holistic care (Douglas et al., 2014). In order to dispense effective care, it is mandatory to incorporate effective training so that care providers are able to stringently evaluate patient needs and accordingly provide care. Further, it can be said that ineffective care broadly relies upon the inefficiency of the healthcare professionals to meet the needs of the patient and apply appropriate interventions (Gulanick&Myers,2016). According to the information dispensed by the case study, it can be stated that the subject Raelene Ward was affected with gestational diabetes. The case study further states that Raelene Ward was an aboriginal woman who had been admitted to the hospital to seek medical guidance. However, her experience mentions clearly that she faced both effective and ineffective care during her treatment.

Application of Erikson’s 8-Stage Framework

Evidence of ineffective care is detected from the manner in which the client was treated. The case study states that Raelene was a nursing professional herself and the manner in which she was treated was extremely biased. There was no proper intimidation dispensed to her about her treatment procedure and she claims to not have been informed in any way about her illness condition. The care procedure did not involve a holistic approach. No efforts were undertaken to introduce dietary changes or include a fitness routine in order to monitor the blood pressure and glucose level. Instead, the client states that she had been administered insulin injections directly. Hence, it can be concluded, that an ineffective treatment care was provided to the patient.

However, an instance of effective care can also be witnessed on closely evaluating the case study. The care providers engaged in the treatment of the client maintained a track of the blood sugar level of the patient and administered insulin in order to control and regulate the glucose level. Scientific evidences reveal that administration of glucose can effectively control elevated level of glucose in the blood and has been found to be extremely effective in controlling gestational diabetes. The case study further mentions that the client was visited by a nutrition expert on a regular basis every week. Hence, it can be deduced that the dietary expert kept a track on the diet intake of the patient and effectively planned a diet chart. These elements reflect the providence of a holistic medical care. However, it is important to make the client understand the procedure of the treatment in an effective manner and educate the client about the disease condition which was not done at any step. The professional background of the client might have played a major role behind the disparity of the treatment. Hence, it can be said that the care provided was not effective (Papastavrou et al.,2014).

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The application of chosen theories and framework are important, as it will help to enhance the patient experience about the care and make the care process compliance to the social, ethical and culturally compliance (Kuo et al., 2012). Further, it will also help to reinforce the effective care process for Raelene and being an important stakeholder of the care process her importance and participation will be improved. As per the patient centered care process, she will be informed with all the important information and then informed consent will be obtained so that ethical compliance could be achieved (Carman et al., 2013). This will make the care process effective and improve the patient experience. On the other hand, as per the family centered care, members of her aboriginal community that helped her in her crisis situation will be included in the care process so that they could be informed about any critical care related decision (Tinetti, Fried& Boyd, 2012). Moreover, after all these theories, application of Erikson’s 8-step model will be applied in the care process and due to this, the patient will be able to understand the importance of self-management as well as the implication of physical and mental changes (Deci& Ryan, 2012). Further, with the application of this, help the health care professionals to make the care process as per the preference of patient. They will be able to apply their creative problem solving skills to reinforce the ethical code of conduct and the ethical aspect of the care process sin the care process to maintain the autonomy of the patient (Vahdat et al., 2014). This will help o make the care process creative, effective and sharp, as the health care professionals will be able to use their critical thinking to improve the patient condition (Burke, Evans&Jarvik, 2014). Hence, this is the way the care process should include the applied theories and framework in the care process of Raelene Ward.

Effective and Ineffective Care

Conclusion

Health has been categorized as a basic element to support life. It must be noted that individuals get adequate access to health care facilities. A major discrepancy in terms of providing health care facility to individuals have been observed in Australia where a gap has been noticed in terms of providence of care to aboriginal and non-aboriginal people. It can be said in this context, that there is a need to revise the health care facilities. The case study reveals the providence of ineffective care to the client based on professional and cultural disparity. Hence, it can be suggested that adhering to the Erikson’s eight stage model can effectively help in improvising the manner in which treatment is dispensed to enhance the health status of individuals across the world.

References

Barry, M. J., &Edgman-Levitan, S. (2012). Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781.DOI: 10.1056/NEJMp1109283

Burke, W., Evans, B. J., &Jarvik, G. P. (2014, March). Return of results: ethical and legal distinctions between research and clinical care. In American Journal of Medical Genetics Part C: Seminars in Medical Genetics (Vol. 166, No. 1, pp. 105-111). DOI: https://doi.org/10.1002/ajmg.c.31393

Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Adams, K., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Affairs, 32(2), 223-231. DOI:
https://doi.org/10.1377/hlthaff.2012.1133

Deci, E. L., & Ryan, R. M. (2012). Self-determination theory in health care and its relations to motivational interviewing: a few comments. International Journal of Behavioral Nutrition and Physical Activity, 9(1), 24. DOI: https://doi.org/10.1186/1479-5868-9-24

Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M., Lauderdale, J., …& Purnell, L. (2014). Guidelines for implementing culturally competent nursing care. Journal of Transcultural Nursing, 25(2), 109-121.

Gulanick, M., & Myers, J. L. (2016). Nursing Care Plans-E-Book: Nursing Diagnosis and Intervention. Elsevier Health Sciences,pp 32-40

Holmes, G. M., Morrison, M., Pathman, D. E., &Fraher, E. (2013). The contribution of “plasticity” to modeling how a community’s need for health care services can be met by different configurations of physicians. Academic Medicine, 88(12), 1877-1882.doi: 10.1097/ACM.0000000000000026

Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., …& Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes care, 38(1), 140-149. DOI: https://doi.org/10.2337/dc14-2441

Kerr, E. A., & Hayward, R. A. (2013). Patient-centered performance management: enhancing value for patients and health care systems. Jama, 310(2), 137-138. DOI: doi:10.1001/jama.2013.6828

Kitson, A., Marshall, A., Bassett, K., &Zeitz, K. (2013). What are the core elements of patientcentred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of advanced nursing, 69(1), 4-15.

Kuo, D. Z., Houtrow, A. J., Arango, P., Kuhlthau, K. A., Simmons, J. M., & Neff, J. M. (2012). Family-centered care: current applications and future directions in pediatric health care. Maternal and child health journal, 16(2), 297-305.DOI:https://doi.org/10.1007/s10995-011-0751-7

Papastavrou, E., Andreou, P., &Efstathiou, G. (2014). Rationing of nursing care and nurse–patient outcomes: a systematic review of quantitative studies. The International journal of health planning and management, 29(1), 3-25.

Tinetti, M. E., Fried, T. R., & Boyd, C. M. (2012). Designing health care for the most common chronic condition—multimorbidity. Jama, 307(23), 2493-2494. doi:10.1001/jama.2012.5265

Vahdat, S., Hamzehgardeshi, L., Hessam, S., &Hamzehgardeshi, Z. (2014). Patient involvement in health care decision making: a review. Iranian Red Crescent Medical Journal, 16(1).doi:  10.5812/ircmj.12454

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