Asthma and its impact on levels of functioning
Smith is a 39 years old athlete with the medical history of asthma admitted to OPD department with breathlessness. He has been working up with symptoms of this health disorder nearly two months and has had two unscheduled asthma visits for mild flares. The patient has low oxygen saturation, PaO2 is 60mmHg, PaCO2 is 50 mmHg, BP is 150/85 mmHg and Pulse rate id 129 beats/minute. The ICF model can be used to identify the impairments, activity limitation and participation restrictions. Asthma is the disorder which causes health issues like inflammation, obstruction of the airways and remodeling. It is a serious health problem that is caused by contraction or narrowing of the airways. The patient is an athlete and used to run on a daily basis but, the treatment process of this health issues may restrict the running and cycling activities as they might increase the chances of asthma attacks (HÄKKINEN, Arkela-Kautiainen, Sokka, Hannonen, & Kautiainen, 2009). The asthma attacks might also be caused by heavy weight lifting, smoking, air pollution and the condition where the patient is living. The patient may also be restricted to participate in sports events, social functioning schools. The quality of life due to this disease has been impacted (Van Gent, van Essen-Zandvliet, Klijn, Brackel, Kimpen, & van Der Ent, 2008)
Managing asthma in the emergency department is the difficult task to do. It is a serious health condition, therefore effective management is necessary. Registered nurses can play an important role in systematically reviewing and evaluating how well the patient’s condition has been improved. Nurses are the one who is trained to take care of the sick or injured people and have all the knowledge about how to provide information related to the disease to the diseased person (Lemmens, Nieboer, & Huijsman, 2009). In this case, nurses may assess, examine and take care of the vital of the patient.
The patient with this health condition needs to understand the disorder as it is the lifelong disorder and required an effective self-management. The disorder is generally caused by excessive exercising, allergen, and pollutants, therefore the patient needs to gain knowledge about what to do to avoid these factors and how to modify the normal management routine. The main goal of asthma management is to prevent the acute episodes that may be caused by the causing factor. If the condition may worsen due to excessive exercise, the person will be required to understand will about how to manage the health issues with the help of a nurse. Nurses are the best professionals fit in this condition to teach the patient (Krieger, Takaro, Song, Beaudet, & Edwards, 2009).
In this case study, the ICF components that should be targeted is activities limitations. Asthma may restrict the person to do regular exercises like running and cycling. As the patient is an athlete, he needs to stop or limit the running time so that the asthma events can be avoided. Running is the strenuous activity that may trigger asthma than other exercises. By improving the knowledge related to the disease the asthma attacks can be prevented or reduced. The patient should know their limits and stat running slowly or running at limited speed (Carson, Chandratilleke, Picot, Brinn, Esterman, & Smith, 2013).
ICF components in asthma
The risk involved related to the intervention provided to the patient includes social isolation and stress or depression. As the patient is an athlete, it is difficult for him to set limitation to their running habits in result he may develop these issues. Some of the studies indicated that the patient with asthma more likely to be social isolate and develop negative thoughts like “why this happened to me only”, This may lead to stress and depression. Strategies that can be helpful to prevent these risks include making therapeutic communication and encouraging the patient. Therapeutic alliance can help the patient to develop a feeling such as somebody care for him and be with him throughout his journey of improving life quality in asthma. Encouraging the patient might improve his self-confidence to do exercise as advised (Di Marco, Santus, & Centanni, 2011).
The other health professional in the inter-professional team assigned for Mr. Smith is pulmonologist. A pulmonologist is the expert doctor that specializes particularly in lung issues and respiratory disorders like the disease of the respiratory system including upper airways, lungs, the thoracic chest wall, and thoracic cavity. This may also include the other parts of the body that affects the ling functioning. A pulmonologist is classified under internal medicine subspecialty. They are the one who is able to perform a complete pulmonary (lung) function testing. The patients should see a pulmonologist they are unable to achieve a good asthma control with the help of the primary care doctors. People should meet to a pulmonologist if they experience a life threating asthma attacks, hospitalized and controlled after 3 to 6 months, respiratory symptoms besides asthma. In addition to a deceased person’s physical examination and interviews the pulmonary expert mat also person different complex tests to diagnosed the patient condition. The flexible scopes can be used by them to look at and biopsy the air passage. The individual in the case study have issues like breathlessness and other respirations that are caused due to airways obstruction. A pulmonologist may help him to manage this particular airways problem (Bass, P. (2018).
The components of ICF can that can be targeted by the pulmonologist include inflammation and airway obstructions. They are specialized in internal medication to treat the health issues. A pulmonologist may prescribe some medicine to manage asthma such as beta 2 antagonists, corticosteroids, nedocromil sodium, anticholinergic medications, and methylxanthines. He or she can also apply immunological treatment. Epinephrine can also be prescribed to treat airway swelling caused by allergens (Dale et al., 2017).
The characteristics of nursing professionalism that every nurse should have included being confident to take the decision in client care, humble & honest, fulfill duties, self-confident, honest towards the client, loyalty for their duty, co-operative, good listener, the good observer and impartial. Among all the above characteristics three most important features that can be beneficial in Mr. Smith’s case are good listening, cooperative and keen observer. A nurse should be a good listener; this may help in developing the therapeutic relationship with the client ((Hoeve, Jansen, & Roodbol, 2014). This may help the patient to express their feelings and thoughts related to their health condition. The therapeutic relationship is the key important factor to achieve the health goals that are already set for the patient. managing asthma is not the short-term treatment, it can be lifelong, therefore the nurses should maintain an alliance with the patient to deliver information related to their health issues and so that the person and understand the nurses better. This may be achieved by actively listening to the person. Another characteristic of professionalism is being cooperative. To deal with or manage the asthma issues, a team is employed for the patient (Van Bogaert, Kowalski, Weeks, & Clarke, (2013). A nurse is the important part of this team. They are the key link between the patient and the other team members like physiotherapist; therefore he or she should be cooperative in order to maintain the communication and link between both sides. The physiotherapist is the one who can help the patient to manage and limit the exercises for the patient. A nurse can play and key role to deliver the information to physiotherapist related to the improvement and complications. A nurse should also be keen observer so that he or she can observe the improvements or any complication that may arise during the management of the activities implied to treat asthma and inform the concerned physician if necessary (Hoeve, Jansen, & Roodbol, 2014).
Managing asthma: the role of nurses and pulmonologists
A person-centered approach is a philosophical method to service development and delivery of services that see the services provides in a way that is responsive and respectful to prefer that needs and values of the people and those who are more concerning about their health. The key principles of this approach include valuing people, autonomy, life experiencing, understanding relationship, and environment. Strategies to make sure that the practice is person cantered include focusing on the outcomes and involving the patient in the decision-making process. To provide a successful person-centered approach a nurse should focus on the outcome, not just the services they provide they should be a good listen to assess the patient (Bolster & Manias, 2010). The person-centered outcomes include individuality which indicates that everyone’s difference should be identified and respected, privacy; it means the information and activities should be kept confidential, independence; the diseased person should be empowered to do tasks for themselves and their dignity should be treated in a respectful way. Inclusion is also an outcome that means the person should be encouraged to participate n all kind of community events and equalized among the community members. Involving the patient and their family in the decision-making process of their treatment. This is the right of the patient to be engaged in their choices of treatment and this may develop a positive feeling and believe in the health system (Elwyn et al., 2012).
References
Bass, P. (2018). 8 reasons to see a pulmonologist if you have asthma. Retrieved from: https://www.verywellhealth.com/would-my-care-benefit-from-a-pulmonologist-200635
Bolster, D., & Manias, E. (2010). Person-centered interactions between nurses and patients during medication activities in an acute hospital setting: qualitative observation and interview study. International journal of nursing studies, 47(2), 154-165.
Carson, K. V., Chandratilleke, M. G., Picot, J., Brinn, M. P., Esterman, A. J., & Smith, B. J. (2013). Physical training for asthma. Cochrane Database of Systematic Reviews, (9).
Dale, C., Prieto-Merino, D., Kuper, H., Adamson, J., Bowling, A., Ebrahim, S., & Casas, J. P. (2012). Modeling the association of disability according to the WHO International Classification of Functioning, Disability, and Health (ICF) with mortality in the British Women’s Heart and Health Study. Journal of Epidemiol Community Health, 66(2), 170-5.
Di Marco, F., Santus, P., & Centanni, S. (2011). Anxiety and depression in asthma. Current opinion in pulmonary medicine, 17(1), 39-44.
Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., & Edwards, A. (2012). Shared decision making: a model for clinical practice. Journal of general internal medicine, 27(10), 1361-1367.
HÄKKINEN, A., Arkela-Kautiainen, M., Sokka, T., Hannonen, P., & Kautiainen, H. (2009). Self-report functioning according to the ICF model in elderly patients with rheumatoid arthritis and in population controls using the multidimensional health assessment questionnaire. The Journal of rheumatology, 36(2), 246-253.
Hoeve, Y. T., Jansen, G., & Roodbol, P. (2014). The nursing profession: public image, self?concept and professional identity. A discussion paper. Journal of Advanced Nursing, 70(2), 295-309.
Krieger, J., Takaro, T. K., Song, L., Beaudet, N., & Edwards, K. (2009). A randomized controlled trial of asthma self-management support comparing clinic-based nurses and in-home community health workers: the Seattle–King County Healthy Homes II Project. Archives of pediatrics & adolescent medicine, 163(2), 141-149.
Lemmens, K. M., Nieboer, A. P., & Huijsman, R. (2009). A systematic review of integrated use of disease-management interventions in asthma and COPD. Respiratory medicine, 103(5), 670-691.
Van Bogaert, P., Kowalski, C., Weeks, S. M., & Clarke, S. P. (2013). The relationship between nurse practice environment, nurse work characteristics, burnout and job outcome and quality of nursing care: a cross-sectional survey. International journal of nursing studies, 50(12), 1667-1677.
Van Gent, R., van Essen-Zandvliet, E. E. M., Klijn, P., Brackel, H. J. L., Kimpen, J. L. L., & van Der Ent, C. K. (2008). Participation in daily life of children with asthma. Journal of Asthma, 45(9), 807-813.
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