HLTENN012 Chronic Diseases Research Paper Based Assessment

Visit the National Strategic Framework for Chronic Conditions:

1. Identify the four (4) main categories of the Determinants of Health.

2. List four (4) positive and four (4) negative health determinants. Please provide a rationale for why you believe they are positive or negative.
You may find the World Health Organisation website helpful: http://www.who.int/hia/evidence/doh/en/

Use of Hospital Services

• Hospitals provide a range of services for people suffering from chronic diseases.
• In some cases, frequent but short visits to hospitals are required for treatment and monitoring of the disease beyond what is available from GPs.
• For others, an extended stay in hospital may be needed to provide relief from pain, palliative care, or for a surgical procedure and subsequent recovery.
• Two (2) measures are used here to gauge the impact of chronic diseases on hospital services:
  • Number of hospital admissions
  • Average length of stay in hospital
• In 2015-2016 there were 9.8 million hospital admissions in Australia many admitted had one or more chronic conditions.
• In addition to illness, pain and disability, chronic diseases are also a significant economic burden, both on those who suffer from them and for the wider community.
• An estimate of this economic burden is available from the AIWA Disease expenditure database, where information on expenditure in various parts of the health system is compiled and then allocated to specific diseases.
• According to this estimate, total health expenditure in Australia in 2015-2016 was $181.6 billion compared to $60.9 Billion in 2001.

Every year demand is rising. Currently 36% of all patient admissions suffer from chronic illness. 70% of all illness and injury across Australia is attributable to chronic disease and this is likely to hit 80% by the end of this decade. Heart disease, diabetes, high blood pressure and lung disease are all on the rise.

The significant impact and cost of chronic disease to the community has become a focus of governments. As we face the challenges of an ageing population, which then results in an increase in the incidence of chronic disease, the focus on keeping communities healthy has become stronger.

3. Visit the Department of Health and Aging website:
http://www.health.gov.au/

List six (6) community programs aimed at reducing the risk of developing a chronic disease.

4. Read the following National Chronic Disease Strategy and answer the questions that follow:
http://www.health.gov.au/internet/main/publishing.nsf/Content/chronic-disease

a. Define ‘Chronic Disease’.

b. Can chronic diseases be prevented? Explain your answer.

Chronic Disease Management

The world Health Organisation (WHO) defines Health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (Koutikidis, 2016).

Disease may be defined as a disturbance of structure and/or function of any aspect of a person. Illness can be defined as an abnormal event in which aspects of a person’s social, physical, emotional or intellectual condition are impaired.

Traditionally health was defined in terms of the presence or absence of disease. Medicine was traditionally aimed at treating the illness or disease and restoring a state of health and well-being.
There are many ways of classifying illness; the most common way is as ACUTE or CHRONIC.

5. Provide a definition for the following:

a. Acute Disease/illness

b. Exacerbation or Acute on Chronic episode

In the late 19th century the focus of medicine and health care was on the “how of the disease”, the pathogenesis, how it caused the changes. The 20th century the focus was on finding cures. Currently the focus for health care is on preventing illness and promoting health and wellness for individuals, families and communities (Kozier & Erb, 2016).

Nursing has shifted from being illness focused to being a profession that is health orientated.
As we face the challenges of an ageing population, our focus on keeping communities healthy has become stronger.
As nurses, like all health care professionals, we are involved in caring for chronically ill individuals of all ages in all types of settings – homes, aged care facilities, hospitals, clinics and other institutions. Care needs to focus on promoting the highest level of independence, sense of control and wellness.
This is a good time to reflect on nursing theories and models.
Theory enables understanding of the WHAT, HOW AND WHY of the practice of nursing. It facilitates questions about the relevance and application of nursing practice and research.
Nurses use two major theoretical frameworks in promoting the health of individuals, needs theory and developmental stage theories. In needs theories human needs are ranked on a scale according to how essential they are for survival; the most renowned needs theorist would be Abraham Maslow.

6. Identify by drawing a diagram that represents the five (5) levels of needs according to Maslow’s theory.

The Developmental Stage theory categorise a person’s behaviour or tasks into approximate age ranges or in terms that describe the features of an age group.
Over the last few years Australian governments have developed the National Chronic Disease Strategy (NCDS) to provide national policy directions for improving chronic disease prevention and care across Australia for the next five to ten years.
Although more common in older age groups, chronic disease can occur across all age groups. Type 1 diabetes and childhood asthma are classic examples of chronic diseases that begin early in life.
Illness brings about changes in a person’s life as an individual, and as a member of families and communities. The changes that occur will vary depending on the age of the individual, their role in the family and community, the type of illness, severity and duration of the illness, their financial situation, lifestyle and attitude of the person.

Changes that may occur within the family structure include:

• Changes in roles and responsibility
• Financial problems
• Increased stress and anxiety
• Loss of independence
• Change in social custom and routine
• Social isolation
• Task reassignment

How a client copes and manages their chronic illness/disease depends on many variables. The appearance and severity of symptoms will also be relative to the support and nursing care/interventions required as well as the attitude of the client toward the interventions.
Although the causes and signs will differ with chronic diseases the symptoms and problems experienced by the individual will be similar.

7. Discuss at least four (4) common challenges that you think clients may experience with a chronic illness.

As nurses it is our responsibility to be aware of possible effects that a chronic illness/disease may have on an individual and provide appropriate assessment, planning, implementation and evaluation.
Today people who have a chronic disease/illness will live most of their life at home and within the community setting where most of their ongoing health care management will take place. A united problem-solving approach by a team of health care members whether the person is in an acute or community setting is desirable. So much of our care planning is based around a multidisciplinary team.

8. List at least five (5) people who you think may be part of a multidisciplinary team and describe what their role is.

While the focus of this unit is on chronic health diseases, we must realise that many chronic illness/disease have an acute phase that often precipitates the chronic illness or is an exacerbation that requires urgent or emergency treatment. Following an acute episode and appropriate treatment, the illness or health problem will usually return to normal health for that individual and they will be discharged to the community setting.

“The integration of Disease Management Services into health care systems is the direction being undertaken globally to tackle the burden of chronic disease. Disease management supports the shift in healthcare from an emphasis on managing the acute episode to managing the entire disease course, highlighting both prevention and maintenance of wellbeing for patients with chronic diseases. Disease management promotes better integration and coordination of care across all aspects of the health sector. Several disease management initiatives have demonstrated a reduction in emergency department presentations, hospital admissions, hospital stays and overall costs in patients with a range of chronic diseases.” (Australian Disease Management Association 2008)

Many health care facilities now incorporate a health professional in the role of ensuring the smooth transition from a health care setting to a community setting with the aim of reducing unplanned readmissions, shorter length of stay aiming to reduce the cost and burden in the acute sector. These health care professionals may have different titles with similar aims.

9. a. When does discharge planning for each patient start and why is this a necessary process?

b. List four (4) of the contributing factors that can lead to a smooth discharge process for the patient.

Rehabilitation Strategies and Roles

People with chronic illness often require hospitalisation either following an acute episode or complication of their disease, or their disease requires ongoing treatment, intervention and stabilisation.
When admitting a client with a chronic illness as with any disease/illness it is imperative that we as nurses have knowledge and understanding of the assessment process especially in relation to planning ‘Client centred’ care.

Knowledge and understanding of all the body systems normal structure and function and how each system contributes to the overall wellbeing of a person is also vital.

10. Discuss why you think it is vital to have knowledge and understanding of normal processes and functioning when planning care for your patients? (100 words)

11. Complete the table below in relation to each of the chronic conditions:

Chronic Illness

1. Cancer
2. Chronic asthma
3. Chronic obstructive pulmonary disease
4. Chronic pain including back pain
5. Chronic renal failure
6. Congestive heart failure
7. Diabetes
8. Eczema
9. Incontinence
10. Motor neurone disease
11. Neurological injury
12. Long term unconsciousness
13. Osteoarthritis
14. Permanent and temporary tracheostomies
15. Parkinson's disease
16. Rheumatoid arthritis
17. Stroke
18. Systemic Lupus Erythematosus (SLE) 

12. Choose three (3) of the following topics and explain their role in rehabilitation and how they may be beneficial to a person with a chronic disease condition.

• Hydrotherapy
• Massage
• Pilates
• Flexibility, and proprioception
• Art and music therapy
• Use of prosthetics
• Physiotherapy
• Occupational therapy
• Speech therapy

13. Visit a local website or the Victorian Government website and list the services that are available for community support. Please provide the website link in your answer as a citation. https://www.australia.gov.au/directories/australia/health

14. Palliative Care

After having reviewed the information from the palliative care session you should now be able to complete the following.

a. How does the World Health Organisation (WHO) describe palliative care?

b. Where is palliative care provided?

c. Describe the health care professionals who are in a palliative care team.

d. Provide a list of disease processes that may require palliative care management.

15. Disability

Go to the following website:
http://www.adhc.nsw.gov.au/__data/assets/file/0005/301775/1.-PC-Health-Care-Assessments-and-Dev-of-Health-Care-Plans-Practice-package.pdf

a. Identify four (4) medical diagnosis commonly associated with Developmental and Intellectual Disability. Choose one of the medical diagnosis and explain that condition.

b. Using this document discuss disability and health considerations across the lifespan.

Go to the following website: http://www.adhc.nsw.gov.au/__data/assets/file/0003/301782/Working-with-people-with-chronic-and-complex-health-care-needs-Practice-Package.pdf

c. Using this document define ‘disability’.

Total or partial loss of the person’s bodily or mental functions as well as the of a part of the body the presence in the body of organisms causing disease or illness. the malfunction, malformation or disfigurement of a part of the person’s body results in the person learning differently from another. person without the disorder or malfunction. a disorder, illness or disease that affects a person’s thought. processes, perception of reality, emotions or judgment, or that results in disturbed behaviour and includes a disability that: presently exists previously existed but no longer exists may exist in the future is imputed to a person.

d. Using this document identify how you would care for and assist the person to manage the following elements in the table provided:

Nursing Diagnosis/ Problem

• Dysphagia
• Aspiration pneumonia
• Faecal and Urinary Incontinence
• Mental Illness
• Pain management
• Oral Health

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