This ethics case study assessment will focus on a married man of Swedish origin born in a small town of Scania. He moved from his birth town at the age of 13 years because his parents divorced, and he later moved to a university town. He was not happy at his birth town because he had problems with making new friends at school and he was constantly humiliated. He moved to a new village for a positive change in his life after his parents divorced. He has moved other five times because of financial problems and divorced with his first wife. The client has changed jobs at different times because of personal problems, which have led to his instability. The client has attained university level education. He works and lives with his second wife and children.
The client is a white man born in Sweden in a small town of Scania. He seems to prefer residing in small villages because that is where he moves. In the literature, he does not mention hereditary history of their family and his psychological dis-order cannot be defined as a genetic problem. The client has a psychological disorder characterized by anxiety, depression and insomnia elevated by over consumption of alcohol. He has suicidal ideation, but he has not attempted to end his life. The client has been hospitalized in a psychiatry institution. The client has a sense of an individual responsibility over his health because he attended a psychology facility. The client endured only one history of self-medication when he took tranquilizers because of anxiety, insomnia, and depression caused by problems at his place of work. The client gets angry and frustrated easily which causes him to over-indulge in alcohol consumption. The client is a family man, he believes in the social structure of having a family. He has been in two different marriages. In the first marriage, he had a child, but it ended in divorce. Currently, the man stays with his second wife and two children. The client is a fully aware of his responsibilities as the head of the house. In both marriages, the client moves to a bigger house whenever he expected a child. He provides for his family despite him running to financial problems. The client is quite fertile because he gets a child in each marriage. The literature does not mention his interaction with the extended family after he moved to university. The client has a problem with communication skills, which is shown by his low self-esteem and isolation from the world. This happens when his girlfriend at university leaves him. The client got a good job after completing his university studies. Initially, he had ambitions that were hampered by personal problems. His decision to change workplace shows he has freedom of choices. The literature does not mention his religious practices, nutrition practices, and death rituals. The client’s timeline can be summarized as;
The client belongs to the depressive disorder subculture group of psychology disorders. Depressive disorder is a psychological disorder caused by specific stressful events in life and occasional chemical changes in the brain. The prevalence is not determined by education, ethnicity, occupation, and family status. Suicidal ideation is common among patients. Patients also suffer from insomnia, anxiety, panic attacks and tend to abuse drugs. There is a high chance of second episodes after the first episode (Fatemi, 2008) and two-thirds of those affected by this disorder recover fully. The patients have self-medicating practices after the first episode and not all patients feel obligated to seek medical help. Patients who seek rehabilitative care benefit from it and give a positive feedback. Depressive disorder comes with a sudden change in dietary preferences resulting to loss in appetite, weight gain or weight loss. Spirituality of a person is extremely important during recovery. Rehabilitative care of patients with suicidal idealities involves helping them understand the meaning of life that helps them get over committing suicide and individual strength motivates them to overcome the stressful events, which triggered the depressive disorder (Purell & Paulanke, 1998). Family dynamics play a crucial role in a depressive disorder patient because most of the stressful events emerge from family related issues. The family background of a patient determines whether he suffered predisposing life events, and whether he later experienced more stressful events in his/her life. Education and occupation are not part of underlying causes of depressive disorders, but the working conditions are a great determinant.
According to Kleinman (1978), for a caretaker to establish from the client the reasons behind him seeking healthcare at that particular time, the caretaker should know what concerns the client about the illness. If the client knows what kind of problem, he is suffering from, the illness onset, cause, and effects; this is an added advantage as it aids the caretaker to establish the problem much faster. Literature states that depressive disorder is caused by stressful events and how individuals react to them (Quam & Abramson, 1991). The client reported that his first attack was caused by stress when he was in the university after his girlfriend left him. He never sought healthcare for this attack. The second attack was caused by stress with dealing with his colleagues at work and divorce. This is when he sought health-care. The facility can provide effective and appropriate care to this sub-culture through communication. Patients have to spend more time with the nurses to build trust, which is important in building a therapeutic relationship (Langley & Klopper, 2005).
Several psychiatric facilities can offer appropriate care to psychological patients. Facilities meant for people with depressive dis-order specifically currently do not exist. In choosing the appropriate care, a patient must find a facility that provides a suitable rehabilitation. The best facility for this sub-culture should have crisis stabilization center for managing the suicidal patients and a general care center to provide care as a patient recovers.
Sub-culture assessment is vital in understanding the needs of the group and establishing a sustainable plan of treatment for the group. The nurses should use communication as a tool for treatment because it builds a relationship with the client and it helps in understanding the client’s life situation.
References
Burnard P. (1996) Teaching the analysis of textual data: an experiential approach. Nurse Education Today 16, 278–281.
Fatemi, S. H., & Clayton, P. J. (2008). The medical basis of psychiatry (3rd Ed.). Totowa, NJ: Humana Press.
Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness, and care: Clinical lessons from
anthropologic and cross-cultural research. Annals of Internal Medicine, 88(2), 251-258.
Langley G.C. & Klopper H. (2005) Trust as a foundation for the therapeutic intervention for patients with borderline personality disorder. Journal of Psychiatric and Mental Health Nursing 12, 23–32.
Purnell, L., & Paulanka, B. (1998). Transcultural health care: A culturally competent approach. Philadelphia: F. A. Davis.
Quam J.K. & Abramson N.S. (1991) The use of time lines and life lines in work with chronically mentally ill people. Health & Social Work 16, 27–34.
