Description of the case
Vivian is an 18-year-old student who was diagnosed with asthma at the age of eight years. Her impairment includes chest tightness, periodic wheezing, coughing, and shortness of breath. Coughing is most prevalent in early in the morning or during the night. Such impairments result in various limitations throughout her life. For instance, she finds it difficult to breathe due to the insistent airflow obstruction, especially at night. In addition, these impairments restrict her from social participation such as school sports and ability to maintain normal activities such as exercise and school attendance. However, despite these limitations, personal factors such as her optimistic and positive attitude has helped her to remain ambitious in her life. In addition, she has developed a persona asthma plan that guides her on how and when to take her medicine and to manage the condition if the symptoms worsen. Such factors have significantly helped her to live with the condition.
Against the positive personal factors, other factors such as the inability to participate in exercise and other physical activities adversely influence Vivian’s level of functioning. Environmental factors such as availability of quick-relief medicines and long-term control have enabled her to improve the ability to participate in social activities and daily activities. Other positive factors include her supportive family especially her mother who has helped her to cope with the condition. However, negative factors relating to the cost of medication, exercise, and daily activities could mean more intervention program to help her improve her health.
Description and justification of the intervention
As a health professional, my role is to facilitate that assessment and monitoring of asthma to help the patient cope with the condition. This role is closely connected to the concepts of control, severity, and responsiveness to treatment. The severity concept is concerned with the measuring of the intrinsic intensity of the asthma process. This concept is measured mostly direct and easily in a patient who does not receive a long-term control therapy. The concept of control involves measuring the degree of asthma manifestation and minimizing them to meet the goals of therapy. On the other hand, the responsiveness involves measuring the effectiveness of therapy on the asthma control. In addition, the health professional is involved in advising and educating their patients on how to monitor asthma control, adjustment therapy, and identify insufficient asthma control. The intervention program related to this role include educating and reinforcing the self-monitoring techniques to help the patient improve her level of functioning.
The self-monitoring education program will be focused on the facilitating the self-management techniques to the Vivian. The monitoring techniques cover both the peak flow and the self-monitoring to help Vivian assess the level of her asthma control and to identify signs of the worsening situation (National Institutes of Health, 2014). According to the National Institutes of Health (2013), the peak flow monitoring is particularly essential for the patients who are constrained in recognizing a history of severe prevalence, or severe or moderate asthma. Jones (2008) argues that the self-education program is important to the control of asthma in various ways. The self-management education helps the patient to reduce exacerbations, lower the cost of medication, improve the quality of life, and reduce the risk of death from asthma (Ryan et al. 2012; CDC, 2007). In addition, the patient with controlled asthma symptoms has "slower progression of airway remodeling from inflammation" (Jones, 2008, p.779). Significantly, the asthma education program is meant to help the patient to improve her confidence that the asthma symptoms can be controlled and will not limit her normal activities.
The self-monitoring education program involves training the patient to take notes when the use of reliever increases or her symptoms worsen. Consequently, the patient can implement her written action plan on asthma or access to the medication as appropriate. According to Toro-Linnehan (2013), the written action plan is essential in enhancing the patient's participation in her own care. In addition, the program should ensure that the patient participates in goal setting together with basics on individualized treatment and diagnosis. By doing so, the program can help Vivian mitigate the impairments that restrict her daily activities and hence targets the impairment aspect of ICF. The program will help to control the impairments and improve the patient confidence to carry out the normal activities.
Identification of another health professional in the team and description of his role
Another health professional required in this intervention is the respiratory therapists. Various studies have indicated that the Respiratory Therapists play a critical role in asthma education in different settings (Jones, 2008). Therefore, one Respiratory Therapist will be included in the inter-personal team to help Vivian improve her level of functioning. Jones (2008) argues that the Respiratory Therapists are valuable members of the asthma education team for the asthma programs. The involvement of the Respiratory Therapist helps the patient reduce the emergency department visits and hospitalization, missed school days, reduce costs of medication and duration of stay. Significantly, the Respiratory Therapist will be involved in multidisciplinary asthma education programs that fit in both the urban and rural areas. Such health professional is essential in reinforcing and demonstrating self-monitoring techniques such as metered-dose-inhaler techniques and help to improve the lung function to the patient. In addition, the Respiratory Therapist is essential in administering asthma treatment protocol to helps the patient improve her quality of care.
The Respiratory Therapist will be important in educating and advising the asthma patient on how to avoid the things that can worsen their condition. Various common things worsen the symptoms of asthma, and the patients are required to know these activities to take effective steps for controlling them. Such common things involve air pollution or pollens that may worsen asthma. Therefore, the patient should avoid conducting daily activities such as school sports and exercises in the areas where the levels of such substances in the air are high. In addition, the Respiratory Therapist will help the patient understand common activities that should be avoided. Such activities involve keeping pets that have fur in her bedroom or home. Therefore, the respiratory therapist will be important in controlling ICF aspects such as physical factors and impairments (Jones, 2008).
Specification of professionalism characteristics
The three main characteristics of professionalism that I am expected to exhibit when conducting an education intervention for the asthmatic patient include autonomy, compassion and empathy, and accountability (Ramsaran-Fowdar, 2005). As a healthcare professionalism, I am required to be responsible for my deeds and care when conducting the asthma education intervention. This is because healthcare professionals are considered to have the highest degree of accountability because they are dealing with a human life when they engage in any care. In addition, I should show a characteristic of autonomy meaning that I can engage into independent professional judgment to best serve my patient's needs. Therefore, I should show a high level of competence by making independent decisions that best help my patient improve her level of functioning. In other words, I am required to be free to serve within the wide spectrum of acceptable practice. Significantly, I should show compassion and empathy towards my patient to make her gain confidence in the asthma control and treatment. This trait should be accompanied by a great awareness of my patient's suffering and the robust desire to help them relieve their impairment. An understanding of the person's experience helps to provide care that meets the patient needs.
Description and justification of person-centered strategies
One of the strategies that I will implement to ensure the person-centered practice works effectively is the collaborative care and support planning. This strategy helps that healthcare professionals and people with long-term conditions work together to plan for their care. This strategy involves formulating a process that explores what is important to the patient such as identifying the best treatment, support, and care. The process also involves helping and supporting the patients to set goals and take the action plan to help them improve their level of functioning. Another strategy involves designing an experience-based co-design. The method involves improving the experience of the health care by gathering the experiences of the staff and patients and then integrating them together to facilitate service improvements (Pearce et al., 2012). The strategy helps the team members to reframe their practices, see things from their patient's perspectives, and collaborate with the patients to recognize the often small changes that enhance the patient's experience of care.
References
Centers for Disease Control and Prevention (CDC. (2007). Asthma self-management education among youths and adults--United States, 2003. MMWR. Morbidity and mortality weekly report, 56(35), 912.
Jones, M. A. (2008). Asthma self-management patient education. Respiratory care, 53(6), 778-786.
Pearce, V., Baraitser, P., Smith, G., & Greenhalgh, T. (2010). Experience-based co-design. User Involvement in Health Care, 28.
Ryan, D., Price, D., Musgrave, S. D., Malhotra, S., Lee, A. J., Ayansina, D., & Pinnock, H. (2012). Clinical and cost effectiveness of mobile phone supported self monitoring of asthma: multicentre randomised controlled trial. BMj, 344, e1756.
Ramsaran-Fowdar, R. R. (2005). Identifying health care quality attributes. Journal of Health and Human Services Administration, 428-443.
Toro-Linnehan, Jeanette, (2013). "Evidenced Based Asthma Education Intervention For Adults In A Primary Care Setting Using Self-Management Guidlines" Doctor of Nursing Practice (DNP) Capstone Projects. Paper 27.
National Institutes of Health. (2013, January). Assess and Monitor Asthma Control. Retrieved May 23, 2016, from http://www.nhlbi.nih.gov/health-pro/resources/lung/naci/discover/asthma-control.htm
National Institutes of Health. (2014, August 4). How Is Asthma Treated and Controlled? - NHLBI, NIH. Retrieved May 23, 2016, from http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/treatment
