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Nursing Assignment Questions
The purpose of this assessment is to:
1. Develop skills in using critical reflection to maintain a person-in-environment perspective in the health
setting generally, whilst respectfully working with and potentially drawing upon other models of practice.
2. Develop and maintain a person-in-environment perspective in relation to specific health topics and
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Nursing Assignment Solution
Although models proposed have the potential to change the course of action and management, the power issues existing in such a program limits its applicability. To what extent patient empowering is required is not mentioned, as it can lead to ethical issues. The patient might overpower care plan suggestions from the autonomy point of view. From environment and support perspective the planning and guidelines are not always applicable in all types of settings or environments. Similarly Flinders model proposes the application of cognitive behavioral theory to address, patient chronic illness building self-efficacy (Kennedy, et al., 2013). Similarly Stanford model advocates peer educators to be the torch bearers for building self-efficacy in patients. Thus, all the three models propose different approaches in building self-efficacy in patients (Jordan, Briggs, Brand, & Osborne, 2008). [A1] The limitations of three models are the gap which occurs due to poor organizational policy and gap between theoretical framework and practice. The paucity of research publications showing the effectiveness of Flinders model is another shortcoming of this model as no definitive conclusions can be made.
However, professional practice issue affects the implementation of such care models. For example- role conflicts, the blending of responsibilities and limited time are major issues which force us to take the shortest pathway for chronic disease management (Halcomb, Davidson, Salamonson, Ollerton, & Griffiths, 2008)[A2] . Managing two wards at a time due to a shortage of nurses, pressure from patient family as well as the ward manager leads to excessive stress. The self-efficacy building process is a long one that requires time, secondly patient need to adhere to the program in order to be empowered. While we cannot force any patient or constantly monitor for adherence, the positive outcomes get reduced through this process (Auslander and Freedenthal, 2012).
But a number of steps can be taken to improve a patient condition by working at micro, meso and macro level. For example referring patients to community health support and actively engaging those in community health motivates them to adhere to their management program by choice. Social work, motivational interviews in an integrated manner can address chronic health conditions, as they have the potential to influence client behavior. Rollnick and Miller approach of Motivational interviewing can help empowering clients by facilitating an environment of self-responsibility, designing care plans through a partnership with client replacing expert roles. Lifestyle change strategies must be incorporated after communicating effectively with client and make him realize the importance of different external factors. Similarly, cognitive behavioral therapy such as setting goals for specific behavior change, ask the client to self-monitor rather than nurse monitoring, taking steps to prevent disruption from adherence can significantly improve patient mental and physical health status. The above-mentioned strategies have the potential to improve clients self-managing attitude as evident from Koch's work. According to Koch and Wakefield (2014), patients reported emotional impact, lifestyle changes, physical limitations, low social and family support as barriers to chronic health condition management. The studies taken under this lecture series demonstrates how models and different approaches can rightly empower clients, build a therapeutic relationship in the management of chronic health disease.