A Case Study Considering Person Centered Care Approaches

Introduction of A Case Study Considering Person Centered Care Approaches 

Case study

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Kathrine was 63 years old and used to stay with her daughter, Carla in an apartment in London, UK. Suddenly she started losing her appetite, and after some days she was diagnosed with a tumor in her left kidney. She was under the medical care of the Brats Cancer Institute. Firstly she is advised to do some tests. After these tests they understood that the tumor was inside the kidney. But fortunately the PET CT scan report was negative. The medical team decided to simply remove her right kidney as the human body can perfectly work with one kidney. They decided the date of the surgery. After the surgery they found out that Kathrine’s body was working perfectly and the tumor was also. The medical team of Barts Cancer Institute, London told her to stay under regular checkup for at least 5 years. In this time period her daughter Carla was with her. After all the procedures Kathrine was cured completely. But she became mentally weak after the surgery. Her daughter consulted a medical team for her mental wellbeing. The total medical team supported her a lot and helped her with regular counseling and treatment under the doctor. Slowly she became aware that she can survive after the surgery and can lead a normal life. She was in regular checkups every 6 months (Santana et al. 2018). For the first two years she was fine. In the meantime Carla moved to Birmingham. As she was now alone she kept a nurse to look after her. After that again she started suffering from shortness of breath. Also she lost weight without trying. Again they started consultation under a doctor who can guide her with that. Her daughter Carla was very worried about her. Doctors consulted with them and they suggested some tests. After the test she was diagnosed with Lung tumor. As she was in stage four of the cancer she needed treatment (Schutz et al. 2019). Doctors started Radiation Therapy. It was mainly to shrink the tumor so that they can operate and remove it. It was a treatment of 5 to 7 weeks and 5 days in a week.

Her radiation procedure started .In some days due to this treatment procedure her skin started changing and she started feeling weak. She lost her hair, and started feeling nausea all the time. The radiation therapy was curing her but she was suffering from mental problems (Griffith et al. 2020). The medical team helped her very much. They introduced her to the people who were going through the same type of treatments. She heard the stories of some patients who endured the treatment and were cured. Through all these support she started recovering mentally. The radiation procedure was very much painful but her lung tumor became smaller (Uddin et al. 2018). After this 5 to 7 weeks radiation procedure doctors conducted some tests and planned a surgery to remove the tumor. But after some days her condition deteriorated. She became very sick. Doctors decided to take a pause. They consulted with Carla and Mathew and postponed the surgery. In some days she was diagnosed with several tumors in her lungs. Doctors decided not to do any surgery as she was aged and her health condition had not improved after the radiation procedure (Taylor et al. 2018). As she became very weak and was almost unable to move to the hospital, a healthcare team was appointed to her at home. Carla and Mathew were very much involved, and they started visiting her continuously. As Kathrine was able she used to enjoy their company. The treatment of the medical team was also ongoing. Doctors said that she is deteriorating and can collapse any day (Greenen et al. 2018). Kathrine expressed her wish to stay home and wanted to enjoy the company of her small family. Her daughter and son-in-law supported her decision. They moved with Kathrine.

Interventions chosen

Here two interventions are engaged. Collaborative Care Planning and Health coaching or Motivational Interviewing.

Reasons behind choosing this case

When all healthcare staff are collaborating with the patient in a difficult situation and caring for the patient it is called collaborative care.

 Collaboration Care in HealthCare

(Source: https://www.monash/ medicine/education/ccc)

In this case study the patient Katherine is suffering from cancer. And all the doctors of the hospital, the medical team appointed at her home for her care, were collaborating with her to support her. Her daughter and son-in-law also supported Kathrine in her problem to overcome. In every step the doctors had consulted the whole situation with the family members of Kathrine and took the decision. It is a perfect example of Collaborative care planning. When she was unable to move to the hospital the doctors had arranged a medical team at her home to give her care and assistance.

Health Coaching or Motivational Interviewing is another intervention mentioned in the above case study. It is mainly boosting the mental strength of a patient through discussion and counseling.

 Motivational Interviewing in Healthcare

(source:http://jicareblog.org/book-review-motivational-interviewing-for-health-care-professionals)

 Here in the case study when the patient was suffering from mental illness after her surgery and during the Radiation therapy, the patient was introduced to a doctor who helped her to give her the positive aspects about her treatment. And all the family members were in her support .They had supported her in all possible ways to boost her confidence.

In the main body the definition, components, pros and cons of the two interventions and their effects on the case study will be discussed in detail.

Main Body

In the above case study two main interventions are discussed. They are the Health coaching or Motivational Interviewing and Collaborative care measures (Chapron et al. 2019). These two aspects are very important in the case of healthcare.

Collaborative care

Collaborative Care Planning in the healthcare system is something where the doctors, all the well skilled medical staff and the family members of the patient are collaborating with the patient to improve her health condition and to cure that patient (Jiang and Wen 2020).. There are four elements of this Collective Care Planning.

These are:

Planning of the Collaboration

Role understanding

Interprofessional Communication

Collaboration Within and across teams

At first the medical staff plan the full patient care program according to the situation and the medical history of that particular patient. Then each part of the caring system divides their work and understands their job role and how they will help the patient (Sirintrapun et al. 2018).The third important thing is the interprofessional communication between the different teams collaborating to help the patient. Last but not the least is collaboration within and across the team (De simone et al. 2018). Inter team coordination is very much needed to do any work. There are many pros and cons of the Collaborative care system.

Pros:

As this is a combined system of different professionals, this gives an admirable outcome in healthcare and with a collective effort it is easier to eradicate a problem.

Many professionals are involved in a process so there are many views of a problem and there are many creative solutions present for that.

This also increases the understanding of a health emergency and treating it accordingly.

Collective care can also make a skill of balanced decision making.

Cons:

If the work of the teams are not defined properly in a collective care system, this can create a malfunction.

The cost of the collaboration may increase and some patients cannot take the help of this system.

In this case study Kathrine got the advantage of the Collaborative care planning. When she was in the hospital different doctors helped her collectively. When she was unable to move to the hospital for her health condition she got a fully skilled medical team to treat her at home (Wastling et al. 2018). This home care team was in touch with the doctor treating Kathrine. She was benefited by this service. On the other hand it costs a lot to maintain these teams.

Different factors related to collaborative patient care

(Source: https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-016-0456-5/figures/1)

In this above figure it is showing the different factors of the collaborative care system and the parameters dependent on the factors.

Motivational interviewing

It is done to motivate a patient to change his/her behavior through counseling. When a patient is mentally devastated for the treatment ongoing then each and every medical staff is trying to help her. They are introducing the patient to the other patients who are going through the same patch. Health Coaching or Motivational Interviewing has four steps.

Those stapes are Understanding the patient’s view, giving empathy to the patient, Resist the righting reflex, Empower the patient

If it is needed to mentally boost a patient it is needed to understand the medical background of the patient. Why is the patient facing challenges? What is his/her mind thinking about that particular illness the patient is suffering from. Understanding a patient is the main thing here (Remillard-Boilard et al. 2021).Professionals have to be empathetic to the patient. They should avoid advising the patient about good health and good life. It is the best way to give hope that due to this illness the patient’s life is not ending. Still there are chances to live life to their fullest. The professional should not be harsh to the patient. They have to motivate the patient, give him/her positive ideas to live life. The main idea is that a particular disease cannot take the enjoyment away from the life of a person.

Four stages of the motivational interviewing are plan, evoke, focus and engage. First the physician has to plan according to the medical history of the patient, again to recall how the history of one patient is separate from the other patient’s. The next step is to focus on the problems and thoughts related to that particular patient. Last step is to work according to the plan.

 Four stages of Motivational Interviewing

(Source:https://coping.us/motivationalinterviewing/overviewofmi.html)

There are pros and cons of motivational interviewing.

 Pros:

It boosts the mental strength of a person who is devastated mentally. It helps the patient to think out of the box. To feel good about their own life.

This type of treatment can change many high-risk lifestyle behaviors of a patient.

Motivational interviewing makes people more self-reliant, self-confident and responsible. It is a healthy habit.

Cons:

Motivational interviewing or health coaching can be dangerous for the people who have bipolar disorder and Schizophrenia.

This cannot help the patients who have chronic depression. In this medical case the motivation may be not enough for that patient.

Motivational interviewing does not work for the people who are already motivated enough to make a change in their life.

Same type of motivational words may not work on different people.

One sided communication is never healthy in this process. It needs double sided participation, and the patient needs to be free while telling the professional about their own fears.

In the above case Kathrine was mentally devastated for her illness and surgery. The doctor helped her with the counseling and finally her situation was improved. She learned about the same type of patients who recovered from the situation. In this case she had only experienced the advantage of Motivational interviewing.

Conclusion

In the portion of introduction a case study is given. Two interventions are derived from that study and it is explained how they are connected with the case study. In the main body portion the interventions are explained in detail with their definition, course of action, advantages, disadvantages and relevance with the case study.

The two interventions chosen here, both are separately useful for a patient. Motivational interviewing and Collaborative care planning both are used to treat a patient. Collaborative care is for either physical treatment or mental treatment. But motivational interviewing is only for mental treatment purposes.

References

Journal

, M.J., Manalili, K., Jolley, R.J., Zelinsky, S., Quan, H. and Lu, M., 2018. How to practice person?centred care: A conceptual framework. Health Expectations, 21(2), pp.429-440.

Schutz, D.D., Busetto, L., Dicker, D., Farpour-Lambert, N., Pryke, R., Toplak, H., Widmer, D., Yumuk, V. and Schutz, Y., 2019. European practical and patient-centred guidelines for adult obesity management in primary care. Obesity facts, 12(1), pp.40-66.

Griffith, D.M., Sharma, G., Holliday, C.S., Enyia, O.K., Valliere, M., Semlow, A.R., Stewart, E.C. and Blumenthal, R.S., 2020. Men and COVID-19: a biopsychosocial approach to understanding sex differences in mortality and recommendations for practice and policy interventions. Preventing chronic disease, 17, p.E63.

Uddin, M.A., Stranieri, A., Gondal, I. and Balasubramanian, V., 2018. Continuous patient monitoring with a patient centric agent: A block architecture. IEEE Access, 6, pp.32700-32726.

Taylor, C., Lynn, P. and Bartlett, J., 2018. Fundamentals of nursing: The art and science of person-centered care. Lippincott Williams & Wilkins.

Geenen, R., Overman, C.L., Christensen, R., Åsenlöf, P., Capela, S., Huisinga, K.L., Husebø, M.E.P., Köke, A.J., Paskins, Z., Pitsillidou, I.A. and Savel, C., 2018. EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis. Annals of the rheumatic diseases, 77(6), pp.797-807.

Chapron, C., Marcellin, L., Borghese, B. and Santulli, P., 2019. Rethinking mechanisms, diagnosis and management of endometriosis. Nature Reviews Endocrinology, 15(11), pp.666-682.

Jiang, Y. and Wen, J., 2020. Effects of COVID-19 on hotel marketing and management: a perspective article. International Journal of Contemporary Hospitality Management.

Sirintrapun, S.J. and Lopez, A.M., 2018. Telemedicine in cancer care. American Society of Clinical Oncology Educational Book, 38, pp.540-545.

De Simone, S., Planta, A. and Cicotto, G., 2018. The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction. Applied Nursing Research, 39, pp.130-140.

Wastling, T., Charnley, F. and Moreno, M., 2018. Design for circular behaviour: Considering users in a circular economy. Sustainability, 10(6), p.1743.

 Rémillard-Boilard, S., Buffel, T. and Phillipson, C., 2021. Developing age-friendly cities and communities: Eleven case studies from around the world. International journal of environmental research and public health, 18(1), p.133.