Defining Relevant Terms: Well-Being, Social Determinants of Health, and Culture
1.Read the Case scenario Define relevant terms including ‘well-being’, ‘social determinants of health’ and ‘culture’.
2.Using the “Gibbs Reflective Cycle”, examine and reflect on a recent placement, where you were involved (directly or indirectly) in a collaborative team interaction with a patient(s). Include in your reflection what the event was, what occurred, what you learnt from this interaction and what you will take into your practice in relation to both working in a team and being an active participant in a team.
‘Well-Being’ can be understood as a state or condition of being happy, prosperous and healthy. A high level in the well being is an indicator of a positive condition experienced by a group or an individual. Well-being involves several inter related factors such as mental, physical and social well being, extending the definition of health beyond the traditionally understood explanation. Furthermore, wellbeing is also associated with factors such as self perceived health, health behaviour, longevity, social connections, mental and physical health, productivity and factors in the social and physical environment. Wellbeing can be differentiated into physical well-being, social well-being, economic well being, emotional well being, psychological well being, development and activity, life satisfaction, engaging activities and work and domain specific satisfaction (Sen, 2017; Steptoe et al., 2015; Michalos, 2017).
‘Social Determinants of Health’ are factors in the environment in which individuals are born, live, work, learn, play, age and worship which influences their health, quality of life, daily activities as well as health risks and health outcomes. It involves various conditions, such as physical, social and economic present in different types of environments (such as schools, homes, workplace or communities) (Stevenson, 2018). The 5 key areas of the social determinants includes: economic stability, education, social and community context, health and healthcare context, neighbourhood and built environment. The social determinants significantly influence the health and wellbeing of the individuals and thus are an important concept to understand how environmental factors are related to the wellbeing of people (Ferrer, 2018).
‘Culture’ can be understood as a set of social behaviours and norms that are seen within the human society. Culture can involve a range of information or learning transmitted in human societies within the domains of art, ritual, cultural practices, music, dance, traditions and technologies. This information is passed from one generation to the next, in the form of cultural inheritance or learning. Culture also can be understood as the attitudes, expectations, goals, values, morals and customs held by individuals of a collective group or a society. Such knowledge helps individuals or groups to differentiate between things that are acceptable or unacceptable (Napier et al., 2014).
The Impact of Social Determinants of Health on the Well-Being of the Patient
Impact of social determinants of health on the well being of the patient:
According to the World Health Organization, the Social Determinants of health that affects our health includes factors such as: address of residence, education, family, race and ethnicity, marital status, health insurance status, childhood care, income status, housing status, discrimination, physical environment, research inclusion and healthcare technologies (who.int, 2018).
Andermann (2016) pointed out that the social determinants of health are related to health outcomes and in the determination of the health and well being of individuals and groups. They pointed out that groups within the population that are less empowered or having a lower socioeconomic statuses generally are seen to work and live in more degraded conditions and have higher exposure to various risk factors for diseases as well as higher chances of psychological effects from chronic exposure to stressors, owing to which their health conditions are worse and life expectancies shorter (Rubin, 2016). The social determinants largely comprises of those factors affecting their health, which the individuals are not in control of. For example, the socio economic disadvantages and the higher prevalence of convenience stores in the neighborhood have been related to tobacco consumption, while increase in the number of fast food stores, reduction in the supply of fresh and healthy food products and lack of recreational facilities in the neighborhood can lead to nutritional deficits and sedentary lifestyle, which in turn can increase the risks of many diseases (Keshavarz Moahmmadi, 2017).
During childhood and early development, the environment can significantly influence the physical and mental health of the individual as well as the life expectancy. Children exposed to chronic abuses or domestic violence or those coming from families with a history of mental illness, or having members with criminal conviction have higher risks of committing suicide, or becoming alcoholics or drug addicts. Moreover, children exposed to these stresses can additionally cause onset of mental health issues among the exposed children (Burke et al., 2017; Hanson et al., 2015).
Culture can also influence the health and wellbeing, since it involves the collective behavior of a group and community where an individual is born or brought up and thus learns from. For example, in deprived communities, where problems like domestic violence, homelessness, unemployment and addiction are prevalent and a part of the culture, the children becomes more prone towards such problems as well (Steel et al., 2018).
National and International Influences of Culture on Health and Well-Being
In the given case scenario, the patient is an 80 year old lady, who stays alone in her own house, which is a 10 minute drive from her son and his family. She used to be active in the community, regularly visiting her place of worship. She also visits the medical center regularly for routine checkups and her medications are packed and delivered to her fortnightly. However, she started having pain in her hips and knees since the most recent visit last week, which is significantly affecting her movement and is facing difficulties even to go to the toilet. Due to this she started using incontinence pads. She was offered community support, which she declined, stating she does not need such support yet. Here it can be seen that staying along is significantly taking an effect on her well being, and her inability to move have also reduced ther ability to socialize as she used to. Such factors (not being able to socialize, chronic pain and not taking social support) can adversely affect her physical and mental health.
National and International influences of culture on health and wellbeing:
Culture can involve several aspects such as ethnicity, language, religion or beliefs, gender, socioeconomic status, age, sexual orientation, geographic origin, group history, education, upbringing and life experiences. It is a dynamic and constantly evolving system that is learnt and passed from a generation to another, and shared with likeminded individuals. It can be identified symbolically and integrated into the day to day life of people.
Culture can influence the health and wellbeing of individuals in several ways:
- It affects how the patients and healthcare providers understand health and illness.
- It influences how the healthcare providers considers the causes of various diseases
- Determines the types of diseases that are stigmatised in the society and the reasons for the stigma
- The types of healthcare practices and promotions that can be recommended, insured or conducted
- It influences the experience and expression of pain
- It affects from where the patient look for help and how they look for help and when they make their first attempt to seek help
- Affects the interaction of the patient with the healthcare providers
- It affects the extent to which individuals can understand and follow the treatment plan recommended by a healthcare provider from a different cultural background
- It affects how chronic conditions and treatment options are culturally viewed by the patients or healthcare providers
(Napier et al., 2014; Steel et al., 2018)
Culture can also affect the health in other ways such as influencing the acceptance of a diagnosis of disease (including when, how and who should be involved), accepting the diagnoses, health prevention and disease prevention measures, perceptions of death and dying, usage of direct or indirect communication, willingness of individuals to discuss the symptoms or signs of health conditions, affecting the family dynamics (such as the traditional gender roles or responsibilities of family members towards the affected individuals), perceptions of the youth and aging populations, and also the accessibility of the healthcare system (Hajdu & Hajdu, 2016).
In the given scenario, the cultural and religious background of the patient is a significant factor, as it helped the patient to remain connected with the community and society. However the inability to continue with such activities could increase her health risks and thus such risks should be adequately monitored. Moreover, through cultural support, the patient can be encouraged to accept social support services, which woul further support her well being, since she currently stays alone.
Reflecting on a Recent Team Interaction with the Patient
Evidence based best practice which supports sustainable changes to the patient lifestyle that allow her to maintain her independence:
In the given case scenario, involving an elderly female patient (80 year old), living alone in her house and diagnosed with hypertension and angina, a strategy that can support sustainable changes to the lifestyle of the patient and allow her to maintain her independence can include strategy for Healthy and Active Ageing. This strategy involves the following aspects:
- a) Maintaining balanced dietwhich helps to maintain a healthy body and mind (Kiefte-de Jong et al., 2014)
- b) Regular physical activitieswhich helps to build muscle, control movement and gait as well as blood pressure, cholesterol, pain, blood sugar. Exercise also helps to manage problems with bones and joints like osteoporosis and arthritis and reduce the risks of several other diseases such as cardiac problems, stroke and even cancer. Improving the gait also reduces the chance of falling and injuries caused by it (McPhee et al., 2016).
- c) It helps in active participation and social engagementwith others, thereby fostering the patients to be more social (Shankar et al., 2015).
The strategy includes steps using which the diet can be controlled and modified, involving food from different sources such as: fruits and vegetables; food like bread, cereals, whole grains; milk and dairy products; fish; meat; eggs; and reducing the amount of food rich in fats or sugar. Controlling the diet can ensure that the patient follows a healthy food pattern, and reduces the risks of health conditions caused due to unhealthy diet (Beard et al., 2016; Viña et al., 2016; World Health Organization, 2015).
Similarly, strategies to increase physical activity can ensure that the patient is able to move independently, with the least amount of support or intervention with the others. The patient used to frequently visit her place of worship, which was affected due to her chronic hip and knee pain, which is slowly restricting her movement. However since the patient does not want a community based support, it can be recommended that strategies to improve herself independence, independent movement and her diet can significantly improve her ability to continue living independently. For the assessment of the patient’s health, regular nursing visits can be suggested, which can allow healthcare providers to monitor the health of the patient, and to identify any risk factors or indicators of health deterioration which might need prompt intervention (McPhee et al., 2016; World Health Organization, 2015).
2.Reflection on a recent placement where I was involved in a collaborative team interaction with a patient is outlined here below using Gibbs Reflective Cycle (Husebø et al., 2015; Howatson-Jones, 2016)
The incident involves an elderly man (75 years), who recently suffered the demise of his wife (last year) and is currently living alone. He has a daughter studying abroad and a son living in a different state. He was diagnosed with hypertension and diabetes type 2, and currently has been showing signs of confusion and depression, due to which he stopped socializing. He was a regular at the nearest recreational club, along with other elderly people, but since the last 6 months, he stopped going out of his house. I was involved in a multidisciplinary team, trying to assist the patient increase his physical activity, plan his diet and provide psychological counselling. At the end of the session, the patient showed more willingness to engage in physical activities such as walking and gardening, and start socializing again, playing board games and also started having healthier food (Johns, 2017).
Feelings about the event:
I felt that the psychological symptoms like depression and confusion was caused because the patient was finding it difficult to cope up with the loss of his wife and because of this he became more and more isolated and withdrawn. This was made worse as the patient did not have either his son or daughter living nearby to take care of him (Potter, 2015).
Evaluation of the event
Through education and psychological intervention, it was possible for the healthcare team to help the patient understand the behavioural factors that are adversely affecting his health, and how he can change them to improve his well being. Talking to the patient was a vital element that allowed the patient to express his feelings and provide insight on how that was affecting his well being, and thus design interventions to help him more effectively (Johns, 2017).
Analysis of the event
At the end of the sessions, the patient showed interest to improve his own health and well being, taking proactive steps, like increasing his physical activity, improving his diet and socialising more often. This showed that the strategies of educating and counselling the patient were an effective one (Husebø et al., 2015).
Conclusions from the event
It can be concluded that strategies that helps to empower the patient with knowledge and knowhow on how to improve their own well being by themselves can be a significant strategy to ensure the health and wellbeing of the patients (Bastable & Bastable, 2017).
Action plan for future events:
In similar future circumstances, it can be suggested that the patient suffering from bereavement be psychologically supported through counselling, and education also be given on how they can improve their health. Most importantly, it is important to understand that most patients in such scenarios need somebody to talk to, and that becomes a significant responsibility for anyone trying to help them (Howatson-Jones, 2016).
References:
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