Partnerships in Health and Illness Essay

The case study involves the diagnosis of colorectal cancer in a 62-year-old male, John. The patient has been receiving adjuvant chemotherapy for the condition, and he needs to be discharged for continued self-management. John’s active treatment has shown considerable progress and his discharge, therefore, requires adequate patient education addressing critical areas of self-management for the improvement of the quality of life. The essay, therefore, underscores the detailed discharge plan drawn by the nurse who is the cancer care coordinator, highlighting the follow-up regimen, the expected signs and symptoms of the recurrence of the condition, and the education and self-management strategies. Partnerships in Health and Illness Essay. It is the role of the nurse to ensure that survivorship issues related to colorectal cancer are clearly described to the patient and the close family member while considering effective communication principles and the theoretical health behavior models that John can adopt.

Discharge plan

There is increased risk of patients getting metachronous colorectal cancers after undergoing active treatment of the disease (Ayanian et al., 2010). In the case of John, he needs to properly conduct self-management with the help of his wife so that effective clinical outraces are achieved. Statistics indicate that nearly one in every three patients who have been actively treated for colorectal cancer die due to disease recurrence (de Jong et al., 2009). The follow-up regimen for John would dictate that there should be surveillance for early recurrence of the disease so that it can be managed while still at the curable stage. The regimen would further require the performance of colonoscopy to detect polyps and cancers that are recurring. However, studies have demonstrated that colonoscopy is not very useful as it cannot locate intraluminal recurrences and cancers that are metachronous. Instead, it is advised that the procedure should be conducted during diagnosis and surgery of the primary tumor. Partnerships in Health and Illness Essay.

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Secondly, John should be tested for the levels of carcinoembryonic antigen (CEA) in the blood plasma (Beaver et al., 2010). The levels of this marker indicate the recurrence of colorectal cancer or possible cancer metastasis. A high level indicates improvement. It is therefore imperative for John, with assistance from his wife, to ensure that frequent quantification of CEA is done as it is the marker of choice that can be used selectively in monitoring cancers. The liver should also be scanned through computed tomography technology (CT scan) as it can significantly help in identifying early metastases of the liver. Studies have illustrated that there is reduced incidences of mortality when liver scanning is done especially if the follow-up protocols are aimed at detecting extramural disease.Partnerships in Health and Illness Essay.

Additionally, ultrasound scanning of the liver can be done for John, especially if he sensitive to radiation. This helps in avoiding CT scan but still able to obtain results on the liver condition. Chest X-ray should also be performed to help detect any lung metastasis that could occur after active chemotherapy of colorectal cancer (Bodenheimer, 2008). While doing the follow-up, the nurse should consider the individual preference of the patient since some may find it uncomfortable and become anxious.

Upon the recurrence of colorectal cancer, John may experience the same symptoms that he presented with when he had the primary colorectal cancer before the active chemotherapy. These include abdominal pain, constipation, loss of weight and diarrhea. Some of the symptoms can be systematic, resulting in changes in various body systems, for example, fatigue. Other symptoms may present as swellings in the lymph nodes, altered bowel movement frequency, hematochezia, bloating and sensation of satiety.Partnerships in Health and Illness Essay.

Education and self-management plan

Self-management describes the ability of a patient to handle the symptoms and manage the consequences that come with chronic conditions. These aspects involve the treatment, lifestyle changes and those involving physical and social dimensions (Jefford, et al., 2008). It is crucial for John and his wife to be educated on the survival strategies that are beneficial to them as John transits form completion of primary treatment of colorectal cancer to survivorship. The plan would be laid out to the patient and the wife in an accommodating manner that allows the incorporation of their ideas and contribution into the self-management plan (Cotrim, & Pereira, 2008). This ensures that quality of life is improved since both will participate willingly. Education would, therefore, include advising John to be making regular visits to the oncologist, be aware of the recurrence of cancer and its manifestation, being able to manage the effects of cancer and its treatment methods that occur late and the ability to re-establish the daily routines of life. The patient is further educated on ways of combating the residual psychological distress that usually occurs so that the negative impact on relationships and quality of life is reduced (Rowland, & Bellizzi, 2014).

Cancer survivors tend to face several challenges across physical, mental, psychological and spiritual aspects of their lives. In the case study, John is susceptible to physical symptoms manifesting due to cancer even after active treatment. These may include sleep disturbances, fatigue, nausea and vomiting, neuropathy, cachexia, impaired sexual functioning and lymphedema among others (Molassiotis et al., 2009). The quality of life will be affected by these symptoms depending on the type of active treatment that was administered. Also, John’s is elderly, predisposing him to the severity of these symptoms. The healthcare providers should, therefore, work collaboratively to ensure that the follow-up and self-management practices are effectively done to promote good health among cancer survivors (Denlinger, & Barsevick, 2009). Partnerships in Health and Illness Essay.The mental aspects of the life of these people are dependent on the physical health. Evidence suggests that those having chronic conditions like cancer tend to have poor mental health (Brennan et al., 2014). Research further shows that cancer survivors are more likely to have psychological problems that are disabling when compared to healthy adults (Brennan et al., 2014).

Another survivorship issue that John would have to face is the social and spiritual life challenges. Cancer limits an individual in the aspects of social life. The treatment procedures also result in further limitation of undertaking social activities and roles by the patient. The long-term consequence is poor physical and psychological health. Scientists have indicated through research that people who exhibit better social ties and integration display improved resistance to illnesses, reducing mortality rates, increasing cancer survival and lowering cancer recurrence risk (Aghili et al., 2010). Additionally, an individual’s spirituality is essential in helping the person to deal with life stressors like cancer. Healthcare professionals and oncologists have agreed and recognized spirituality to be of immense significance in good health and well-being. It has been established that when a person is in good spiritual health and faith, they can cope better with treatment procedures and disease outcomes. Existential needs of the patient help them overcome the fears and give meaning to life. Having cancer could make the patient abandon or intensify their faith and religious standing.

The above issues faced by cancer survivors can be addressed through various strategies. The physical problems can be managed by acknowledging and discussing them with the patient so that they become aware. The nurse coordinator can arrange for a dietitian who would help with nutrition support (Eagar et al., 2010). Certain exercises can also help solve the physical problems. Since John is 62 years old, there may be no need of emphasizing on sexual education as opposed to younger cancer survivors. The psychosocial issues can be solved by educating the patient to embrace positive behavior strategies that enable social integration.Partnerships in Health and Illness Essay.

The patient can be taught about particular theoretical models describing health behavior change that can prove invaluable in attaining better social, mental and spiritual life. One of these models is the Social Cognitive Theory (Glanz et al., 2008). This model describes three aspects including behavior, the environment, and a person. It asserts that reciprocal determinism is key to the dynamics of interaction between an individual and the social group. The behavior of a person can be influenced by environmental factors where there is a possibility of suppression or enhancement of s person’s motivation. Another theory is explains planned behavior and reasoned action. Planned behavior emphasizes the person’s attitudes and beliefs. The intention comes from the combination of attitude and behavior.

The health belief model can also be applied while educating the patient on positive behavior. It describes one’s readiness to act on a health behavior depending on individual beliefs like perceived severity, susceptibility, benefits and barriers (Schwarzer, 2008). The patient will learn to embrace positive behavior changes after knowing all these aspects of the disease state. Collaboration among healthcare professionals help in achieving holistic patient care, for example, the nurses, physicians, assistants, psychologists, rehabilitation clinicians, palliative care clinicians and pharmacists are among the members of the cancer care team (Walsh et al., 2011).

In conclusion, the case study has underscored the various ways through which nurses and other healthcare providers can actively participate in patient education and drafting self-management care plans. While doing this, it is imperative that the nurse who is the cancer care coordinator ensures that there are elements of effective communication while engaging both the patient, John, and the wife, so that their opinions are considered while making the discharge and care plans. Follow up is essential for colorectal cancer patients after active treatment due to the risk of recurrence of the condition. The cancer patient may face different survivorship issues which would require certain interventions involving behavior changes as discussed in the above.

References

Aghili, M., Izadi, S., Madani, H., & Mortazavi, H. (2010). Clinical and pathological evaluation of patients with early and late recurrence of colorectal cancer. Asia‐Pacific Journal of Clinical Oncology, 6(1), 35-41.Partnerships in Health and Illness Essay.

Ayanian, J. Z., Zaslavsky, A. M., Arora, N. K., Kahn, K. L., Malin, J. L., Ganz, P. A., … & Urmie, J. M. (2010). Patients’ experiences with care for lung cancer and colorectal cancer: findings from the Cancer Care Outcomes Research and Surveillance Consortium. Journal of Clinical Oncology, 28(27), 4154.

Beaver, K., Latif, S., Williamson, S., Procter, D., Sheridan, J., Heath, J., … & Luker, K. (2010). An exploratory study of the follow‐up care needs of patients treated for colorectal cancer. Journal of clinical nursing, 19(23‐24), 3291-3300.

Bodenheimer, T. (2008). Coordinating care—a perilous journey through the health care system.

Brennan, M. E., Gormally, J. F., Butow, P., Boyle, F. M., & Spillane, A. J. (2014). Survivorship care plans in cancer: a systematic review of care plan outcomes. British journal of cancer, 111(10), 1899.

Cotrim, H., & Pereira, G. (2008). Impact of colorectal cancer on patient and family: implications for care. European Journal of Oncology Nursing, 12(3), 217-226.

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de Jong, M. C., Pulitano, C., Ribero, D., Strub, J., Mentha, G., Schulick, R. D., … & Pawlik, T. M. (2009). Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients. Annals of surgery, 250(3), 440-448.

Denlinger, C. S., & Barsevick, A. M. (2009). The challenges of colorectal cancer survivorship. Journal of the National Comprehensive Cancer Network, 7(8), 883-894.

Eagar, K., Watters, P., Currow, D. C., Aoun, S. M., & Yates, P. (2010). The Australian Palliative Care Outcomes Collaboration (PCOC)–measuring the quality and outcomes of palliative care on a routine basis. Australian Health Review, 34(2), 186-192.

Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.). (2008). Health behavior and health education: theory, research, and practice. John Wiley & Sons.

Jefford, M., Karahalios, E., Pollard, A., Baravelli, C., Carey, M., Franklin, J., … & Schofield, P. (2008). Survivorship issues following treatment completion—results from focus groups with Australian cancer survivors and health professionals. Journal of Cancer Survivorship, 2(1), 20-32. Partnerships in Health and Illness Essay.

Molassiotis, A., Brearley, S., Saunders, M., Craven, O., Wardley, A., Farrell, C., … & Luker, K. (2009). The effectiveness of a home care nursing program in the symptom management of patients with colorectal and breast cancer receiving oral chemotherapy: a randomized, controlled trial. Journal of Clinical Oncology, 27(36), 6191-6198.

Rowland, J. H., & Bellizzi, K. M. (2014). Cancer survivorship issues: life after treatment and implications for an aging population. Journal of Clinical Oncology, 32(24), 2662.

Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied psychology, 57(1), 1-29.

Walsh, J., Young, J. M., Harrison, J. D., Butow, P. N., Solomon, M. J., Masya, L., & White, K. (2011). What is important in cancer care coordination? A qualitative investigation. European journal of cancer care, 20(2), 220-227. Partnerships in Health and Illness Essay.