HSNS363 Ben Case Study Assessment Anwers

Aspects of Ben medical history

Ben developed post-traumatic stress disorder (PTSD) as a result of the serious trauma he experienced during his ten years of service in the Australian Defence Force (ADF). Traumatic event exposure causes PTSD, a complicated mental health illness that necessitates specialised psychological care and continuing support (National Institute of Mental Health, 2023). In addition to PTSD, Ben is now dealing with worsening depression. Depression is a severe mental illness that can have an effect on a person's emotional health, day-to-day functioning, and general quality of life. Ben needs regular psychotherapy sessions and occasionally medication to treat his feelings of depression (WHO, 2023). A training accident that resulted in a L4-L5 spinal fusion has left Ben with a chronic lower back pain issue. The complexity and difficulty of managing chronic pain make it difficult for Ben to participate in employment and other activities (National Institute of Arthritis and Musculoskeletal and Skin Disease, 2023). Ben's treatment plan calls for a number of different medications, including Sertraline for depression, Ibuprofen for pain management, and harsher painkillers like Panadeine Forte and Oxycodone when necessary (NHS, 2022). Careful control of the medication combination is necessary to prevent potential interactions and negative effects.

Ben's desire to perform manual labour and his past employment as an infantry soldier in the ADF have complicated his medical condition. His persistent back pain prevents him from performing certain tasks, and his PTSD and depression may make it more difficult for him to handle some job conditions. Ben has experienced social isolation as a result of returning to the family farm, where the closest neighbours are located 5 km away, and as a result of losing his job in the nearby mine. Social isolation can make mental health problems worse and make it difficult for healthcare professionals to offer support and solutions (Brandt et al., 2022).Since losing his work, Ben has started drinking more as a stress-reduction technique and to distract himself from his difficulties. Alcohol abuse complicates the management of his mental health and can be detrimental to his general wellbeing (Mental Health Foundation, 2022). Ben and his father, Doug, have a strained relationship, and Doug's advice to "toughen up and get on with it" might not be helpful in treating Ben's mental health needs. Family relationships can have a big impact on someone's mental health journey, therefore healthcare practitioners need to handle them delicately (Thomas et al., 2017). To protect Ben's wellbeing and enhance his overall health outcomes, a multidisciplinary healthcare team must manage and address these interconnected challenges in a thorough and coordinated manner.

Situational complexity of Ben

Ben's complex situation involves a number of environmental and personal issues, which makes nursing management difficult. These elements add to the difficulties medical professionals can have when caring for and supporting Ben. Ben currently resides on the family farm, which is located 25 kilometres from the closest town and 5 km from the closest neighbours. The conduct of routine in-person appointments and follow-ups can be challenging for healthcare professionals, especially nurses, due to this geographic isolation. It can be difficult to efficiently coordinate care due to the distance, which could cause delays in getting healthcare services. Additionally, Ben's mental health may be impacted by his lack of social connections and little opportunities for social contact (Razu et al., 2021).

 Ben's loss of employment at the nearby mine owing to downsizing has left him in a precarious financial position. Financial hardship may make it difficult for him to obtain healthcare services, including prescription drugs and therapies that the Department of Veterans Affairs (DVA) may not fully cover. Financial strain can also increase his total burden, which could affect his commitment to therapy and worsen his depression (Ryu & Fan, 2023).

The family and Ben's healthcare team may be unable to work together effectively to manage Ben's health because of the lack of open communication and unwillingness to share problems.Ben's increased alcohol drinking as a coping strategy puts his general health at risk and may make managing his mental health more difficult. Alcohol consumption can affect decision-making and interfere with the efficacy of therapy, making it difficult for nurses and other healthcare professionals to properly administer interventions (Wu, K., & Baker,2019).

Ben needs specialised care from a variety of healthcare providers due to his complex physical and mental health issues. Ben may encounter difficulties getting timely and effective care due to the scarcity of specialised providers in his remote community. Doug's lack of knowledge about the advantages of psychological therapy and his attitude make it difficult for him to accept and seek out mental health care.Nurses and the healthcare team must use a patient-centred therapy order to navigate these situational complexity. Person centred therapy is a form of psychotherapy which will help Ben to get motivated and encouraged to achieve positive functioning (Yao, L., & Kabir, 2023).

Multi-morbidity impact on diagnosis and treatment for complex patients

For complex patients like Ben, multi-morbidity—the coexistence of two or more chronic medical illnesses in one person—poses serious obstacles to providing appropriate care (Skou et al., 2022).The following are some ways that this intricacy may affect the diagnosis and treatment procedures:

1- Impact on Overall Health: A patient's multi-morbidity may worsen their condition overall. A vicious cycle of health decline can result when one illness is present and exacerbates another. Ben's chronic lower back discomfort, for instance, might make it difficult for him to exercise, which would damage his mood and exacerbate his depression. To improve his general wellbeing, it is crucial to address the interconnection of his diseases (Cassell et al., 2018).

2- Impact on psychosocial health: Stress, worry, and social isolation can result from having to deal with the burden of treating numerous ailments, especially for those who have chronic pain and mental health issues. The patient's general health and treatment outcomes may become more complicated as a result of the emotional impact (Brown et al., 2021).

3- Effective communication: The communication between the patient and healthcare professionals is essential for managing multimorbidity. Patients like Ben may struggle to express their symptoms and concerns in detail, which could result in underreporting or misinterpretation of their health state. To encourage patients to divulge all pertinent information, healthcare providers must foster a welcoming and honest environment (Pati et al., 2021).

4- Diagnostic Difficulty: Multiple morbidities might complicate and complicate the diagnostic process. It can be challenging to determine the underlying reason of a patient's complaints because the symptoms of various illnesses can sometimes coexist or manifest in unusual ways. Healthcare professionals need to carefully examine and distinguish between symptoms due to PTSD, depression, chronic back pain, and other potential comorbidities in complex patients with multiple diseases like Ben (Suls et al., 2019).

5- Treatment Burden: Managing several medical illnesses frequently necessitates a variety of drugs, treatments, and lifestyle changes. The burden of treatment increases with the number of ailments a patient has. When patients take many drugs, this might result in polypharmacy, raising the danger of drug interactions and complicating medication adherence. The mix of Ben's medications for PTSD, depression, and chronic pain complicates his treatment plan, and it is critical to ensure effective administration and monitoring (Ryu, S., & Fan, 2023).

Management elements of nursing care plan for Ben

There are several components in Ben's nursing care management plan that could potentially conflict with one another, which could make it difficult to implement a comprehensive and successful healthcare strategy. Ben's management objective is to be able to carry out manual work or farm-related activities without difficulty. He also has persistent lower back pain from a training mishap, though (Husky et al., 2018). Physically taxing activities may make his back pain worse and make it more difficult for him to accomplish them painlessly. He must carefully weigh his desire to work with his hands against his need to manage his back discomfort, which may mean looking into less physically demanding job alternatives (Carneiro et al., 2021). Ben's depression has gotten worse recently, necessitating more help than his regular monthly visits with the visiting psychiatrist. The strategy recommends consulting a nearby psychologist in the time between appointments. Different mental health specialists may, however, make differing treatment recommendations or prescribe differing drugs. To prevent contradicting advice or treatments, it is essential that the visiting psychiatrist and local psychologist effectively communicate and coordinate (Hoeft et al., 2018).

Ben has been drinking more after losing his job because he uses it as a stress reliever and to block out his troubles. Alcohol consumption, however, can exacerbate PTSD and depression symptoms and interfere with how well treatment works (National Institute of Mental Health, 2023). Focusing on different coping methods and helping Ben cut back on alcohol use through counselling and behavioural treatments are necessary to resolve this problem. Ben doesn't have the same close-knit group of pals he did in town, and he lives in isolation on the family farm. In order to treat his depression, the treatment plan attempts to improve his participation in enjoyable activities, particularly social ones. However, the difficulty in participating in social activities brought on by isolation may make it difficult to achieve this goal( Kelly et al., 2017).The nursing care management plan must include a multidisciplinary approach with excellent communication among all healthcare professionals involved in Ben's care to meet these conflicting treatment components. Regular care team meetings can promote cooperation and guarantee that the various treatment modalities are consistent and do not conflict. The strategy should also be adaptable and unique to Ben's demands, taking into consideration his preferences and constraints (Taberna et al., 2020).

References

Brandt, L., Liu, S., Heim, C., & Heinz, A. (2022). The effects of social isolation, stress and discrimination on mental health. Translational psychiatry , 12 (1), 398. https://doi.org/10.1038%2Fs41398-022-02178-4

Brown, V., Morgan, T., & Fralick, A. (2021). Isolation and mental health: thinking outside the box. General psychiatry , 34 (3), e100461. https://doi.org/10.1136/gpsych-2020-100461

Caneiro, J. P., Bunzli, S., & O'Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Brazilian journal of physical therapy , 25 (1), 17–29. https://doi.org/10.1016/j.bjpt.2020.06.003

Cassell, A., Edwards, D., Harshfield, A., Rhodes, K., Brimicombe, J., Payne, R., & Griffin, S. (2018). The epidemiology of multimorbidity in primary care: a retrospective cohort study. British Journal of General Practice , 68 (669), e245-e251. https://doi.org/10.3399/bjgp18X695465

Hoeft, T. J., Fortney, J. C., Patel, V., & Unützer, J. (2018). Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review. The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association , 34 (1), 48–62. https://doi.org/10.1111/jrh.12229

Husky, M. M., Ferdous Farin, F., Compagnone, P., Fermanian, C., & Kovess-Masfety, V. (2018). Chronic back pain and its association with quality of life in a large French population survey. Health and quality of life outcomes , 16 (1), 1-9. https://doi.org/10.1186/s12955-018-1018-4

Kelly, M. E., Duff, H., Kelly, S., McHugh Power, J. E., Brennan, S., Lawlor, B. A., & Loughrey, D. G. (2017). The impact of social activities, social networks, social support and social relationships on the cognitive functioning of healthy older adults: a systematic review. Systematic reviews , 6 (1), 1-18. https://doi.org/10.1186/s13643-017-0632-2

Mental Health Foundation. (2022). Alcohol and mental health. https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/alcohol-and-mental-health

National Institute of Arthritis and Musculoskeletal and Skin Disease. (2023). Back Pain. https://www.niams.nih.gov/health-topics/back-pain

National Institute of Mental Health. (2023). Depression. https://www.nimh.nih.gov/health/topics/depression.

National Institute of Mental Health. (2023). Post-Traumatic Stress Disorder. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd#:~:text=Post%2D

NHS. (2022). About sertraline. https://www.nhs.uk/medicines/sertraline/about-sertraline/

Pati, S., Sinha, R., & Mahapatra, P. (2021). Health Communication and Inter-professional Care in Context of Multimorbidity Management: Assessment of Health Professional Curricular Focus in India. Frontiers in Communication , 6 , 661930. https://doi.org/10.3389/fcomm.2021.661930

Razu, S. R., Yasmin, T., Arif, T. B., Islam, M. S., Islam, S. M. S., Gesesew, H. A., & Ward, P. (2021). Challenges faced by healthcare professionals during the COVID-19 pandemic: a qualitative inquiry from Bangladesh. Frontiers in public health , 1024. https://doi.org/10.3389/fpubh.2021.647315

Ryu, S., & Fan, L. (2023). The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults. Journal of family and economic issues , 44 (1), 16–33. https://doi.org/10.1007/s10834-022-09820-9

Skou, S. T., Mair, F. S., Fortin, M., Guthrie, B., Nunes, B. P., Miranda, J. J., & Smith, S. M. (2022). Multimorbidity. Nature Reviews Disease Primers , 8 (1), 48. https://doi.org/10.1038/s41572-022-00376-4

Suls, J., Green, P. A., & Boyd, C. M. (2019). Multimorbidity: Implications and directions for health psychology and behavioral medicine. Health psychology : official journal of the Division of Health Psychology, American Psychological Association , 38 (9), 772–782. https://doi.org/10.1037/hea0000762

Taberna, M., Gil Moncayo, F., Jané-Salas, E., Antonio, M., Arribas, L., Vilajosana, E., Peralvez Torres, E., & Mesía, R. (2020). The Multidisciplinary Team (MDT) Approach and Quality of Care. Frontiers in oncology , 10 , 85. https://doi.org/10.3389/fonc.2020.00085

Thomas, P. A., Liu, H., & Umberson, D. (2017). Family relationships and well-being. Innovation in ageing, 1(3). https://doi.org/10.1093/geroni/igx025

World Health Organization .(2023). Depressive disorder (depression). https://www.who.int/news-room/fact-sheets/detail/depression

Wu, K., & Baker, J. (2019). Patient communication in substance abuse disorders. https://www.ncbi.nlm.nih.gov/books/NBK549858/

Yao, L., & Kabir, R. (2023). Person-Centered Therapy (Rogerian Therapy).StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589708/#:~:text=Person%2Dcentered%20therapy%2C%

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