Chronic Obstructive Pulmonary Disease Essay

CRITICALLY DISCUSS HOW YOU WOULD
SUPPORT SELF- MANAGEMENT OF YOUR
CLIENT/PATIENT LIVING WITH THIS CHRONIC
ILLNESS COPD IN THE COMMUNITY

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY..................................................................................................................................3
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Chronic Obstructive Pulmonary disease is a lung disease which blocks airflow and causes
difficulty in breathing. The illness is characterized by increasing breathlessness because of
increased inflammation and mucus. The essay will outline main causes and pathophysiology of
COPD in order to make patient aware about the chronic condition. Further, the essay will outline
role of nurse in supporting self-management of patient living with COPD in remote community.
The critical analysis will be focused on impact of diseases on carers, family and patient living
with the diseases.
MAIN BODY
Role of nurse in Self- management of 74-year-old man Martin suffering from severed COPD
who living alone in remote community. The patient seek help from daughter who lives in same
community but not with him and he quit smoking few years back when he got hospitalised
complaining from breathlessness, fatigue, severe dyspnea and anxiety. The common symptom of
chronic illness comprises chronic cough, wheezing and shortness of breath. However, patient
experience dry cough and cough with phlegm, respiratory infections, inability to exercise,
pressure on chest, weight loss and loss of muscle.
Main causes and brief pathophysiology
The most common cause of Chronic Obstructive Pulmonary disease according to Smith,
2017, is long term exposure to lung irritants which damage airways and lungs. Further, breathing
second hand smoke like air from people smoking in surroundings, chemical, fumes, dust. Air
pollution are another factor which causes COPD. Also, some people who suffer from Asthma are
also at the risk of developing COPD because asthma is a chronic lung disease which leads to
inflammation and narrowing of airway.
Chronic Obstructive Pulmonary disease develops due to lung damage which comprise
two conditions that is bronchitis and emphysema or combination of both. As per the views of
Davy, 2015, emphysema damage air sacs in lungs and bronchitis leads to excessive mucus
production and swelling in breathing tubes. As per the views of Dye, 2018, Chronic obstructive
pulmonary disease (COPD) is rapidly becoming a global public health crisis with smoking being
recognized as its most important causative factor. COPD is a disease which affects different parts
of lungs and leads to breathing problem. When the person inhale smoke air moves down to
trachea via two tubes which are known as bronchi. The smaller tubes of bronchi are known as
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bronchioles at the end of which little air sacs are present which are known as alveoli. In the end
of alveoli there are tiny blood vessels which are known as capillaries. Therefore, the main cause
of COPD in case of Martin is tobacco smoking because it injures air sacs and airway.
Role of health care worker looking after patient chronicle patient in the COPD
Role of nurse in encouraging self-management is essential to facilitated positive health
outcomes. As per the view of Hughes, 2004, role of community nurse is to assessment level of
independence. When managing care for service user at their place, role of nurse is focused on
promoting patient independence and self-management. For example, in case of Martin role of
community nurse will assist patient with activities of daily living. Support to patient in daily
living activities comprise problem solving, decision making, resource use and effective
partnerships. For instance, role of nurse is to assist patient with diet and fluid intake, social
interaction, physical exercises, etc. Assistance to Martin in daily living activities by
community care nurse will include maintenance of sufficient intake of food, air and wate.
Further, nurse will ensure balance between rest and activity, solitude and social interaction. In
contrast, Chang, 2015, stated that when assisting patient suffering from COPD at home role of
community nurse is to provide emotional support to service user for which individual role is to
focus on fear, depression, stress and anxiety of patient. Thus, it can be said that assisting patient
in daily living activities empower service user which boost individual behaviour.
On the other hand, role of nurse when managing care for Martin will aim at preventing
individual from risk factors like exposure to tobacco smoke, occupation exposure to chemical
fumes, dust and burning fuel (COPD Causes and Risk Factors, 2019). This will be done by
community nurse by sharing knowledge about causes development and risk factors of COPD
with patient as per as her daughter who visit Martin for assistance. Educating patient and family
will comprise sharing of information about respiratory infections and annual flu vaccination
which is necessary to prevent patient and spread of diseases in community. In accordance with
this, community nurse will encourage self-management in patient by introducing attracting
strategy which can reduce exacerbations.
Self- management of patient living with this chronic illness COPD in the community
Pulmonary rehabilitation in remote community is very limited and therefore in case of
Martin home based pulmonary programmes can be helpful for improving exercise tolerance,
quality of life and symptoms. According to Wood-Baker, 2012, self-management is a process by
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which nurse assist families and patients in reducing stress, maintaining patient safety and quality
of care. Self-management of illness by patient can be done by assisting patient with daily
living activities. For managing effective care of Martin at his place community nurse will
promote self-management which will comprise interventions like inhaled steroid combination,
oxygen therapy which will aid in obtaining accurate oxygen saturation levels. For assisting
Martin in daily activities nurse will focus on examining if he is capable of cooking food and if
not then in this case community nurse will promote use of wheel chair in order to make him
capable for seeking food when alone. In routine community nurse will also be responsible for
monitoring respiratory rate nasal flaring and breathing patterns of patient.
On the other hand, educating patient about disease and its causes is the essential
aspect of care and promoting self-management where community nurse will on educating
patient about causes and risk factors of COPD. Like, nurse will guide Martin about the
development of COPD because of smoking by giving example like when a person smokes a
cigarette, nicotine gets into bloodstream and immediately stimulate the brain. Therefore, the
person who smokes regularly, blood level of nicotine decreases and causes restlessness,
increased appetite, irritability, dizziness and crave for smoking. In contrast, nurse will set
priorities and will imply nursing intervention to prevent relapse. Sharing knowledge with patient
about intervention and its process is another self-management practice which supports care and
improvement in health outcome of patient. However, mentoring programmes for remote
communities which are the best approach to self-management for COPD where nurse
communicates with patients and developed patient centred self-management strategy to improve
health outcome. For example, in case of Martin self-management and mentoring can be focused
on involvement in physical activities and smoking cessation. On the other hand, Cruz & et.al.,
2017 stated loss of recreational activities and social isolation is the major impact of COPD on
patient and therefore it is important for the role of nurses is to encourage involvement of patient
in physical activities. In accordance with this, community nurse will make use of shower chair
for the patient if Martin will feel exhausted does not feel like exercising. The chair will be used
by nurse in case of excessive pain in physical movement.
As per the views of Fried & et.al., 2012, smoking cessation is main aspect of self-
management for patient suffering from COPD as it helps in managing further decline in lungs
function. This is behavioural intervention which can be implied in case of Martin to prevent
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relapse. For managing this nurse will make use of patches, nicotine gum, and inhalers. These
intervention helps in smoking cessation by replacing the nicotine-mediated
neuropharmacological effects of smoking. On the other hand, when promoting self-management
of Martin role of nurse will be on keeping patient active like asking patient to walk until he faces
difficulty in breathing. This will be done to improve lung function and involve patient in physical
exercises.
Impact of COPD on patient and family helps in Health Promotion because when
encouraging self-management role of nurse is to educate service users and family about the
patient condition, causes and development of diseases. Creating awareness for COPD in remote
communities is necessary to prevent chronic illness. COPD has become global public health
issue because of lack of knowledge about the causes of illness. In contrast, impact of COPD on
remote family and patient is due to lack of funds. Therefore, managing impact of access of
finance by Australian government can help in promoting health as the community and specify
family will be access health care services which will promote early diagnosis of illness and
causes and will minimize disease occurrence.
Apparently, cultural safety is another factor which is impacted by COPD as it is
related with behaviours, beliefs ad practices of people in different communities. Determinants of
culture comprise social inclusion, community, integration, educational level can be managed by
promoting causes and health management strategies in people of remote areas. For example, in
case of Martin nurse can focus on educating daughter as well patient about the intervention and
self-care management for the diseases. This will support improvement in care services and
knowledge of people living in remote areas. Organising mentoring campaigns for entire
community can assist in influencing people to consider action for preventing occurrence of
COPD (Dwarswaard, 2016). Closing the gap initiative by Australian government to reduce
disadvantage among Aboriginal and Torres Strait Islander people. The initiative is to promote
culture safety by focusing on early childhood education, life expectancy, education remote
community, etc. The initiative can be beneficial for improving social interaction among people to
minimize social isolation. Thus, it can be said that such initiatives support knowledge
management among people living in remote community about the diseases and aid in minimizing
racism and culturally different which will promote interaction.
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Also, encouraging self-management against COPD in remote community of Australia is
the best strategy to empower patient and families. This support learning of people about the
risks, causes and early symptoms of diseases. Making people learn about the risk and causes is
step to prevent occurrence and seeking help from health care services.
CONCLUSION
The essay summarized causes and pathophysiology for the to derive role of nurse in looking
after patient suffering from Chronic Obstructive Pulmonary disease. The patient in study was
Oldman who lives alone in remote community of Australia and is suffering from COPD. The
study highlighted three specific self-management strategies which are implied by nurse to
manage appropriate care for patient suffering from COPD. The essay concluded with by
outlining impact of impact of COPD on patient, carer and family with respect to Health
Promotion, empowerment and cultural safety.
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REFERENCES
Books and Journals
Chang, A. B., Bell, S. C., Torzillo, P. J., King, P. T., Maguire, G. P., Byrnes, C. A., ... &
Grimwood, K. (2015). Chronic suppurative lung disease and bronchiectasis in children
and adults in Australia and New Zealand Thoracic Society of Australia and New Zealand
guidelines. Medical Journal of Australia. 202(1). 21-23.
Cruz, J., Marques, A., & Figueiredo, D. (2017). Impacts of COPD on family carers and
supportive interventions: a narrative review. Health & social care in the
community. 25(1). 11-25.
Davy, C., Bleasel, J., Liu, H., Tchan, M., Ponniah, S., & Brown, A. (2015). Effectiveness of
chronic care models: opportunities for improving healthcare practice and health
outcomes: a systematic review. BMC health services research. 15(1). 194.
Dwarswaard, J., Bakker, E. J., van Staa, A., & Boeije, H. R. (2016). Self‐management support
from the perspective of patients with a chronic condition: a thematic synthesis of
qualitative studies. Health Expectations. 19(2). 194-208.
Dye, C., Willoughby, D., Aybar-Damali, B., Grady, C., Oran, R., & Knudson, A. (2018).
Improving chronic disease self-management by older home health patients through
community health coaching. International journal of environmental research and public
health. 15(4). 660.
Fried, T. R., Fragoso, C. A. V., & Rabow, M. W. (2012). Caring for the older person with
chronic obstructive pulmonary disease. JAMA. 308(12). 1254-1263.
Smith, D., Harvey, P., Lawn, S., Harris, M., & Battersby, M. (2017). Measuring chronic
condition self-management in an Australian community: factor structure of the revised
Partners in Health (PIH) scale. Quality of Life Research. 26(1). 149-159.
Wood-Baker, R., Reid, D., Robinson, A., & Walters, E. H. (2012). Clinical trial of community
nurse mentoring to improve self-management in patients with chronic obstructive
pulmonary disease. International journal of chronic obstructive pulmonary disease. 7.
407.
Online
COPD Causes and Risk Factors. (2019). [Online]. Available through:
<https://www.webmd.com/lung/copd/what-causes-copd#1>.
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Hughes, S. A., (2004). Promoting self-management and patient independence. [PDF]. Available
through: <
https://pdfs.semanticscholar.org/4376/19e37016c7fd0c3988a391f097ee42884fa6.pdf >.
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