Pathophysiology

Discuss about the Child and Adolescence Healthcare Complications.

Child and adolescence healthcare are the essential part of the healthcare structure of any society. The physical and psychological models of a patient who is a child or in teen age are different from the adult patients to some extent (Zühlke et al., 2014). This paper is focused on the particular case of a 14 years old aboriginal girl. Health related problem is very common in child and teenager of aboriginal community of Australia due to their poor socio-economical condition that leads to unhealthy and unhygienic lifestyle. Various bacterial diseases and infections are very common in this aboriginal community.

In this paper, the pathophysiology of the given scenario has been critically discussed with appropriate connection with the existing situation. The roles of the nurse have been also incorporated to analyse the required care for the girl named Sue. Various psychological development and attachment theories have been also discussed to identify the psychological needs of a patient of adulation period. The advantages of Family Centred Care and its impacts on the discussed case scenario have been also described. The potential outcomes for implementing Family Centred Care and for its absence have been critically analysed along with the resultant impacts on both child and parent.

In order to analyse the pathophysiology of Sue the case history and the Etiology have to be analysed critically. Sue is a 14-year-old indigenous girl who lives in a remote community in a rural area of Australia. Sue has a medical report of having streptococcal Pharyngitis and Impetigo over the last 2 years. Pharyngitis is a disease caused by various bacterial infections. Pharyngitis is usually caused by group A Streptococcus bacteria or as a partial symptom of other bacterial diseases namely Gonorrhoea and Chlamydia. On the other hand, Impetigo is a type of bacterial skin infection caused by either Staphylococcal or Streptococcus bacteria. Impetigo can spread by the nasal discharge from another infected person. Both of this can be treated with antibiotics (Kumar & Tandon, 2013).

Sue and her siblings are registered for a secondary prophylaxis program to avoid chain spreading of bacteria. She receives Benzathine Penicillin G IM to reduce the risk of ARF/RHD. ARF/RHD is a Rheumatic Heart disease main cause of expanded and untreated bacterial infection. On the other hand, taking antibiotics is a regular and consistent process without having any break or irregular pause. However, she has failed to receive IM antibiotics. In this situation, the bacteria can spread again with adequate defence mechanism. As a result, she has been experiencing sore throat from last 2 to 3 weeks with migratory joint pains. Gradually, Sue was facing acute joint pain in her knees, elbows, ankles and shoulders from last four days. She also had the body temperature of 38 degree Celsius which was considerably high than normal body temperature.  All of these symptoms can be caused either overwhelmed infection by the bacteria or as a symptom of ARF/RHD. This fever is also known as Acute Rheumatic Fever or ARF (Coyne, 2015).

Family-Centred Care

Sue has been suspected of having Acute Rheumatic Fever. After being diagnosed by the clinic medical officer Sue is referred to the hospital for further treatment in cardiology and echocardiogram. ARF/RHD needs essential treatments focused on patients hygiene. Regular high powered antibiotics intake orally or by injection can improve the conditions caused by bacteria (Ralston et al., 2014). On the other hand, an additional cardiac internal infection caused by disfigured antibodies also needs complete bed rest and adequate healthy diet. Ignorance of this condition can be lethal due to its severe impact on cardiac tissues. Hoverer, The closest hospital is situated at 800km away from her house.

Proper nursing and care are very essential for the case of ARF/RHD in terms of maintaining regularity of medication, hygiene, diet and others. Only systematic approach with an appropriate framework for taking care of the patient can improve the overall condition of the patient. Mostly children from the poor socio-economical condition are found to be affected by this disease. Along with providing adequate healthy and hygienic service nurse or are giver proper awareness and education of cleanliness and safety is also important for overall improvement and prevention (Ball, Bindler & Cowen, 2013). In this case Sue is a 14 years old girl who also needs mental support to deal with her weakness and frustration caused by her physical condition. Therefore to understand the way of development proper implementation of developmental theories of psychology Family Centred Care can be equally helpful (Jackson et al., 2013).

In order to identify an acute method of psychological development for this specific case of Sue understanding of various psychological development theories have to be analysed. According to Freud’s Psychosexual Development Theory and it 5 stage model of child development, a 14 years old child needs same sex peers to interact about their thoughts and socio-psychological impacts over the individual (Smith, Swallow & Coyne, 2015). Being a 14 years old girl Sue need to engage in regular conversation with other girls of her age. Additionally as per this theory the conscious and unconscious influences from the same sex peers Sue can gain additional mental support and courage to cope up with her current physical condition. These interactions will develop multiple levels of confidence which also has a huge impact on patient’s recovery progress.

According to Erikson’s Stages of Psychosocial Development Theory, the overall psychological development from both conscious and unconscious aspect, the impact of external factors like parents, society, peers and others have a huge impact on the development of an individual from childhood to adulthood. As per the theory every person needs to go through 7 developmental stages to complete lifecycle. Sue fits in the 5^th stage o development of this psychosocial development theory (Dweck, 2013). In this part of life, a person struggles to find out self-identity by negotiating with social interactions and developing the concept of morality and ethics. Therefore at this stage, Sue has strong bonding with his or her family members and close friends

Psychological Development Theories

As per Bowlby’s Attachment Theory the psychological and personality development has a huge influence on the attachment process from the infant phase. Cognitive, behavioural, social, emotional and other attachments with the surroundings make any individual strongly bounded with surroundings (Gibbs, 2013). Sue has been brought up in her family with the siblings. Therefore the emotional attachment with the family members generates a ‘contact comfort’ which is most essential part of building mental capability to survive. To improve Sue’s physical condition close encounter and support of her parents and siblings are very important.

Family Centred Care also is known as FCC is a partnership based approach to health care, involving patients, families and healthcare providers. In this healthcare practice, the patient is treated along with a consistent presence of the family members. This approach is usually used for treating child where both the child and parents and other family members are counted to collect feedback about the updated condition and improvement of the patient (Crain, 2015). To execute this FCC approach proper accommodation for the patient and his or her family members are required. The effective advantages of FCC in this given situation of Sue are:

• FCC can empower Sue and her families and fosters independence.
• FCC can support her family in caregiving and decision making that will allow the caregivers to keep track the psychological condition of Sue.
• FCC also respects patients’ and families choices and their values, beliefs, and cultural backgrounds that are also built on Sue and her family cooperation.
• FCC allows consistent interaction and attachment between Sue and her family that can influence her conscious and unconscious mind to build up strong physical and mental survival capacity that can lead to quicker improvement.

In this given case scenario Sue comes from an aboriginal origin where she did not get the adequate environment to have a physically healthy life. On the other hand, the hospital is situated at 800km away from her house that can also cause lack of interaction between Sue and her family members.  In this situation, FCC can be very effective that also involves patients and families in planning, delivery and evaluation of healthcare services (Barber & Xia, 2013).

The hospital is situated at 800km away from her house that indicates that the distance between her house and the hospitalisation will hinder the comfortable integration of Sue and her family members. Both Sue and her family members can be affected psychologically by hospitalisation of Sue.

As the result of long-distance hospitalisation Sue can face excessive depression and anxiety being unable to maintain consistent interaction with her family members. It can also reduce the confidence level of the patient that has a huge impact on patient’s physical health as well (Hockenberry, & Wilson, 2014). Apart from that, she belongs from aboriginal community. Therefore detachment from her community and social environment can have a considerable impact on Sue’s mental condition and peacefulness. As per the discussed socio-psychological development theories, absence or inappropriate connection with this external influence and these mental supports can even decorate the physical condition of Sue.   

Inappropriate interaction with the child can have a high impact on Sue’s parent as well. The lack of communication with their child can lead to misconception about the healthcare facilities provided by the hospital. Sue’s parent can also face some psychological tension because of lack of information about the current condition and improvement of their child. All of this situation can hinder the overall process of patient’s care and treatment needed for ARH.

Conclusion

From the above text, it can be observed that proper nursing and care is highly essential for the case of ARF/RHD in terms of maintaining regularity of medication, hygiene, diet and others. On the other hand, in the case Sue, she also needs mental support to deal with her weakness and frustration caused by her physical condition. In order to identify the acute method of psychological development for this specific case of Sue understanding of various psychological development theories must be implemented.

On the other hand, Family Centred Care also known as FCC is a partnership based approach to health care, involving patients, families and healthcare providers. Apart from that, as the result of long-distance hospitalisation Sue can face excessive depression and anxiety being unable to maintain consistent interaction with her family members. Sue’s parent can also face some psychological tension because of lack of information about the current condition and improvement of their child. FCC can be the very helpful approach in this given case scenario.

References

Ball, J. W., Bindler, R. C., & Cowen, K. J. (2013). Child health nursing. Prentice Hall.

Barber, B. K., & Xia, M. (2013). The centrality of control to parenting and its effects.

Coyne, I. (2015). Families and health?care professionals’ perspectives and expectations of family?centred care: hidden expectations and unclear roles. Health expectations, 18(5), 796-808.

Crain, W. (2015). Theories of development: Concepts and applications. Psychology Press.

Dweck, C. S. (2013). Self-theories: Their role in motivation, personality, and development. psychology press.

Gibbs, J. C. (2013). Moral development and reality: Beyond the theories of Kohlberg, Hoffman, and Haidt. Oxford University Press.

Hockenberry, M. J., & Wilson, D. (2014). Wong’s nursing care of infants and children-E-book. Elsevier Health Sciences.

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Kumar, R. K., & Tandon, R. (2013). Rheumatic fever & rheumatic heart disease: The last 50 years. The Indian journal of medical research, 137(4), 643.

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Smith, J., Swallow, V., & Coyne, I. (2015). Involving parents in managing their child’s long-term condition—A concept synthesis of family-centered care and partnership-in-care. Journal of Pediatric Nursing: Nursing Care of Children and Families, 30(1), 143-159.

Zühlke, L., Engel, M. E., Karthikeyan, G., Rangarajan, S., Mackie, P., Cupido, B., … & Francis, V. (2014). Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study). European heart journal, 36(18), 1115-1122.