Chronic Illness

Questions: Considering your own clinical practice context discuss the following scenario. Mr David Uluru is a traditional 65 year old Aboriginal and Torres Strait Islander man who lives in a remote community in central Australia. As a result of a CVA, he is wheelchair bound and has a history of T2 DM and HTN as well. He is admitted to your unit for management of his chronic foot ulcer and review of his diabetic retinopathy and HTN. He arrives in your unit from his community after many hours of travel. 1. barriers and issues might he face in the management of his chronic disease/illness in his remote community and how would you ascertain this? 2. Discuss the range of issues that may put Mr Uluru at risk of social isolation while in your unit? 3. What interventions could you implement and what community resources may be of help in minimising the risk of social isolation during his admission? Answers: 1. Mr. David Uluru is suffering from various health complications, as mentioned in this case study. He has undergone a cardiovascular accident and is wheelchair bound. He has a history of type II diabetes mellitus and hypertension. He has developed chronic foot ulcer and diabetic retinopathy. So, from these conditions it can be said that Mr. David Uluru might face different issues and barriers in the management of his chronic illness. The first and foremost reason for this is he belongs to an Aboriginal and Torres Strait Islander community and stays in a remote area in central Australia. So, cultural barrier to his care is an utmost important point (Martin and Kipling, 2006). Next, for his treatment he arrives at the care unit after many hours of travel. So, it can be said that treatment access to this remote community is very much difficult. He might find it difficult to access the care he needs. Short times and irregular consultation gives rise to poor health literacy. There is a l ack of highly structured treatment programs for the aboriginal people. A pure biomedical approach to health treatment and promotion fails to recognize and illustrate respect for the holistic aboriginal understandings of public wellbeing and health. 2. The first and foremost risk of isolation for Mr. David Uluru might be his cultural background. Being a Torres Strait Islander person communication problem is very much common. He may find it difficult to properly communicate and convey his health issues and requirements to the health care staffs (Markwick et al., 2015). Next, he has developed a foot ulcer due to diabetes (Chapman, Smith and Martin, 2014). The other people might have this belief in mind that being originated from an aboriginal culture, he might have less knowledge and interest about personal hygiene and care and thus he might has formed this foot ulcer (Worrall-Carter, Edward and Page, 2012). For many other people this might be assumed as contagious. Another issue might be that, Mr. Uluru is wheelchair bound due to his CVA (Keleher and Parker, 2013). So, other non-aboriginal people might show disrespect to him or might feel unwilling to assist him in the care unit. 3. To minimize his risk of social isolation during his admission the healthcare provider should appoint a community nursing aide who can assist him during his admission to overcome his communication difficulty. A nurse interpreter can help him in collecting his health history during the initial process of admission. This will help on his further health analysis. Mr. Uluru is wheelchair bound so a nurse aide should be appointed who can help him in is mobility during and after his admission. He should be briefly taught about his health condition, so that he can increase his awareness and can learn how to avoid getting affected with further crucial health illnesses (Archibald and Fraser, 2013). To access treatment he needs to travel for hours, so the care facility can arrange for his easy transport or can arrange for a stay in a nearby residential care home, which is particularly arranged for the aboriginal and Torres Strait Islander community people. References Archibald, M. and Fraser, K. (2013). The Potential for Nurse Practitioners in Health Care Reform.Journal of Professional Nursing, 29(5), pp.270-275. Chapman, R., Smith, T. and Martin, C. (2014). Qualitative exploration of the perceived barriers and enablers to Aboriginal and Torres Strait Islander people accessing healthcare through one Victorian Emergency Department.Contemporary Nurse, 48(1), pp.48-58. Keleher, H. and Parker, R. (2013). Health promotion by primary care nurses in Australian general practice.Collegian, 20(4), pp.215-221. Markwick, A., Ansari, Z., Sullivan, M. and McNeil, J. (2015). Social determinants and psychological distress among Aboriginal and Torres Strait islander adults in the Australian state of Victoria: A cross-sectional population based study.Social Science Medicine, 128, pp.178-187. Martin, D. and Kipling, A. (2006). Factors shaping Aboriginal nursing students experiences.Nurse Education Today, 26(8), pp.688-696. Worrall-Carter, L., Edward, K. and Page, K. (2012). Women and cardiovascular disease: At a social disadvantage?.Collegian, 19(1), pp.33-37.