Interview
Introduction
The burden of chronic illness and disability (CID) is quickly rising around the world. The prevalence of chronic illness is a physical or mental health problem that has persisted for a long time and causes various dysfunctions that need continuous monitoring or clinical intervention. In the United States, chronic conditions are rampant and costly to federal and state governments. Statistics reveal that about 45 percent or 133 million of all citizens in the U.S. have at least one chronic disease and the figure is expected to increase in the future (Raghupathi & Raghupathi, 2018). Chronic ailments often result in long-term hospital admission, permanent disability, decreased quality of life, and even death (Wei et al., 2016). Additionally, persistent illnesses have affected the labor force systems by being the main cause of absenteeism, early retirement, turnover, reduced performance, and the like (Asay et al., 2016). In the United States, persistent ailments and related disabilities consume about 75% of the overall healthcare budget or an approximated $5300 per citizen each year (Raghupathi & Raghupathi, 2018). With regard to healthcare insurance, the treatment of chronic ailments covers a greater proportion of expenditure. For instance, Medicare is 96 cents per dollar while Medicaid is 83 cents per dollar (Raghupathi & Raghupathi, 2018). However, it is not only the government that encounters the burden posed by CID, but also individual patients and their families, friends, colleagues, and caregivers. Therefore, the comprehension, control, and prevention of chronic illnesses are essential objectives if the entire society offers better, quality clinical care to public members and enhance their general quality of life. Therefore, the primary aim of this study is to explore the impact of CID on health consumers. This report is based on phone interview findings with a family member with a chronic disease.
Impact of Chronic Illness on Health Consumer’s Life
The interview session was with a female family member suffering from diabetes and arthritis. The interviewee said that, apart from the specific symptoms associated with diabetes and arthritis, she experienced some invisible signs, such as pain, mood disorder, and fatigue. Physical changes from the conditions affected the patient’s appearance, which converted her positive self-image into a negative one. The interviewee claimed she did not feel good about herself, and that she often isolates herself and withdraws from friends and other social activities. According to Westfall et al. (2019), mood disorders, especially depression and anxiety are common complaints in individuals with chronic illnesses, such as diabetes, but they are completely treatable. The interview session found that the risk of depression increases directly when the diabetic complication aggravates.
Moreover, the interviewee confirmed that chronic conditions influence a patient’s ability to work effectively. The respondent claimed that she encountered morning stiffness, reduced distance of motion, and other physical restrictions. As a result, she has been forced to change her work activities and environment. Arthritis, which one of the chronic conditions the interviewee’s family member suffers from, is associated with swelling and tenderness of joints (Mayo Clinic, 2020). The major symptoms are severe joint pains and stiffness. In turn, the sickness affects motions and an individual’s daily activities. The inability to work effectively can result in financial problems at an individual and family level.
The interview further found that the patient felt loss of control, anxiety, and uncertainty about the future as life continues to change due to the chronic conditions. Moreover, the family started to experience role reversals as relatives who were once stay-at-home began to go back to work due to the patient’s inability to work. In other words, chronic illness force other family members to search for employment to provide for the patient that is unable to report work. In addition, stress due to the illnesses built and shaped the patient’s feelings about life. Long-term stress can result in frustration, distress, bleakness, hopelessness, and, in some cases, depression. The individual with a chronic ailment is not the only one affected, but family members are equally impacted by persistent chronic health issues of a loved one.
The interviewee noted that all her family members, young and old, were limited in their daily operations due to her chronic illness. For individuals with persistent illnesses, family is always on the first line of their healthcare and social support (Golics et al., 2013). Arguably, Golics et al. (2013) claim chronic illnesses have significant effects on the quality of life of family members. Regardless of the sicknesses a person is suffering from, it is family, first and foremost, that cares for their sick relative. In this context, the respondent confessed her chronic condition affected the lives of all people in the family. Household roles and routines change progressively. In some cases, clinicians that care for a sick relative become part of the family. In this case, the respondent claimed that her family members have spent considerably on medication, hospitalization, and caregiving.
The interview session revealed various ways though which chronic illnesses influence family life. First, the interviewee claimed that daily routines and activities change due to her limitations, as well as the requirement of treatment and social support may need other relatives are often more available. Second, the family was forced to exchange caregiving roles as it helps all members to feel that they are participating in their loved one’s welfare. At the same time, the sharing of caregiving responsibilities protects one member from potential fatigue. Third, the interviewee admitted that some family members experienced strong emotions, such as distress, guilt, sorrow, fear, anxiety, and depression. In most incidents, these are normal responses to stress and it is important to talk about these emotions with family members. Fourth, the sick relative may want to identify ways to be as autonomous as possible due to the limitations associated with arthritis and diabetes. Lastly, regardless of the demands of persistent diseases, family members are always required to work extra hard to ensure that the patient leads a normal life. In turn, this can help the ill member integrate into the system of family life and reduce her sense of guilt about the demand the sickness places on the entire family.
The prevalence of CID has detrimental effects on the lives and well-being of health consumers around the world. Chronic ailments and disability have been destructive social, physical, mental, and economic effects on individuals, their families, friends, and even their caregivers. Most people with chronic conditions and disabilities have lost autonomy and depend on other people for survival. Within a family setting, CID can result in psychological distress throughout all relatives and may negatively affect the household’s capability to support the pertinent. Socially, chronic conditions impede an individual’s relationship with family, friends, colleagues, and caregivers. Over the years, the major CIDs affecting numerous people around the world, including cancer, diabetes, arthritis, vision and hearing impairment, dementia, chronic pain, depression, schizophrenia, and post-traumatic stress disorder (PTSD) (Harris & Wallace, 2012). Governments and families across the world have invested significant resources in containing these conditions, which are the primary causes of morbidity and mortality. Despite measures implemented to combat chronic diseases and disabilities, they continue to be a major concern to human health and well-being.
RLT Model
The Roper, Logan, and Tierney (RLT) model is an essential framework that focuses on the client as an individual in living the entire life period and shifting from dependence to autonomy based on the environment, age, and situation. Therefore, the interviewee needs to borrow the ideas underlying RLT, which include progression throughout a lifespan, dependence/independence range, and activities of living (Kara 2007).
The RLT model highlights that assessment, which is widely regarded as the initial phase of the nursing process, has to be conducted frequently. In this regard, the RLT model on activities of living is preferred for the interviewee’s case. The model evaluates the patient’s needs comprehensively and can identify the impact of arthritis and diabetes on the activities of her daily living. RLT model can help healthcare providers develop a care plan that is customized to her needs.
Clinical Reasoning Cycle
The clinical reasoning cycle (CRC) is an eight-phase model used in nursing practice that takes healthcare providers through systematic steps, which often entails logical considerations. The cycle facilitates effective thinking in patients’ management plan. As a result. It enables nurses to go through a series of systematic stages, eventually resulting in ultimate decisions that consider the best intervention for a patient in a certain condition (Hoffman et al., 2011). In the first stage, healthcare professionals (HCPs) received the necessary information and medical information of the patient. In this case, diabetes and arthritis history of the patient. The second phase entails gathering information on the medical history of the patient, such as medication, treatment plan, symptoms, and diagnosis results. The third stage, which is the core of CRC is processing the gathered information. Then, the fourth step entails identifying the patient’s problem or the reason behind the persistent illness. In the fifth phase, HCPs identify treatment goals for diabetes. The sixth phase entails taking action to meet the patient’s treatment goals. The seventh phase involves evaluation and getting cues to determine the effectiveness of nursing interventions. Lastly, the reflection phase offers the best opportunity to review the practice.
The major nursing problems for treating diabetes limited knowledge and risk of infection. In most cases, patients are unaware of insulin injection, dietary modifications, available information, and interpretation of diagnosis results. Therefore, before discharge, patients should demonstrate knowledge of insulin injection, better nutrition, symptoms, and the like. The second problem is the risk of infection. During hospitalization, diabetic patients are always at the risk of being infected by harmful microorganisms. Thus, nurses should identify effective interventions to prevent or minimize infections. HCPs should demonstrate methods and lifestyle changes to avert development of infections. All in all, persistent diseases have negatively impacted the health and well-being of numerous people around the world. Chronic conditions have been the primary contributors to high health costs.
References
Asay, G. R. B., Roy, K., Lang, J. E., Payne, R. L., & Howard, D. H. (2016). Peer reviewed: Absenteeism and employer costs associated with chronic diseases and health risk factors in the US workforce. Preventing Chronic Disease, 13, 1-11.
Golics, C. J., Basra, M. K. A., Salek, M. S., & Finlay, A. Y. (2013). The impact of patients’ chronic disease on family quality of life: An experience from 26 specialties. International Journal of General Medicine, 6, 787-798. doi: 10.2147/IJGM.S45156
Harris, J. R., & Wallace, R. B. (2012). The Institute of Medicine’s new report on living well with chronic illness. Preventing Chronic Disease, 9, 1-3. doi: 10.5888/pcd9.120126
Hoffman, K., Dempsey, J., Levett-Jones, T., Noble, D., Hickey, N., Jeong, S., … & Norton, C. (2011). The design and implementation of an Interactive Computerised Decision Support Framework (ICDSF) as a strategy to improve nursing students’ clinical reasoning skills. Nurse Education Today, 31(6), 587-594.
Kara, M. (2007). Using the Roper, Logan and Tierney Model in care of people with COPD. Journal of Clinical Nursing, 16(7b), 223–233. doi:10.1111/j.1365-2702.2006.01561.x
Mayo Clinic (2020). Arthritis. Retrieved from https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772
Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the United States: A visual analytics approach to public health. International Journal of Environmental Research and Public Health, 15(3), 1-24
Wei, M. Y., Kawachi, I., Okereke, O. I., & Mukamal, K. J. (2016). Diverse cumulative impact of chronic diseases on physical health-related quality of life: Implications for a measure of multimorbidity. American Journal of Epidemiology, 184(5), 357-365.
Westfall, J. M., Frances, V., Brown-Levey, S., Ambrozic, L., Zittleman, L., & Nease, D. E. (2019). Check your sugar, check your mood managing diabetes and depression. J Diabetes Rep, 1, 1-6.