Integrated Nursing care of the adult patient

This report discusses the determinants of health, health care provisions in the UK, and how it affects the patient. It includes a case study of Gladys, a 78-year-old female suffering from lymphoedema and leg ulcer. The report recommends effective care services to improve her health. Subject: Nursing Art and Science. Course Code: NA. College/University: Not mentioned.

Nursing Art and Science

INTRODUCTION
As per the world Health Organization, the determinants of Health are generally the
factors which can influence the health of a person and can include the economic and social
environment, the physical environment as well as an individual's own characteristics and
behaviours as well (Fortuna et. al., (2022)). In this, the context of an individual's lives that can
identify the health, and so imputing the people for having the reduced Health or generally
accepting them for a good Health is unfortunate. In this report, it will cover a case study of
Gladys who is 78-years-old female and lives in Newham, London. She is suffering from
lymphoedema and has a leg ulcer that is dressed weekly by the tissue viability nurse at the leg
ulcer clinic. There is a discussion about the health and care provisions within the United
Kingdom as well as who it can influence the patient such as Gladys's Health. In addition to this,
there is also a discussion in the following report about local policy and the best care practices
with the broader socio-economic and political influences in context with case study.
MAIN BODY
Identification of one determinant of health.
The determinants of Health are generally the range of essential factors which can
influences the Health status of a person or a population as well. At all the stages of life, Health is
mainly identified by the specific complex interactions among the social as well as economic
components, the physical environment as well as the behaviour of a person. As per the given
case scenario, the identified health determinant in Glady's case was the Health Care services.
There are various factors which can combine together to affect the Health of a person and its
communities as well. As due to the COVID situation, Glady is not able to move from her place
and due to this, she is not able to receive her regular care treatment fro her illness to become
well. Whether a person is healthy or not, is mainly identified by the effective circumstances and
their environment as well. To a huge extent, the components like where a person can live, the
state of a environment, family relationships and many more all are specifically considerable
influences of the Health, whereas the considered elements like having access as well as use of
the Health care services frequently have make reduce of an influence as well. In context with
case study of Gladys, she is living alone in her bungalow in Newham, London. Gladys is 78-
years-old women, having one daughter who generally lives 50 miles away from her. She is

suffering from lymphoedema and has a leg ulcer that is dressed weekly by TV such as tissue
viability nurse at the leg ulcer clinic. In this, due to the restrictions in COVID times, she is not
able to receive the care treatment which she used to and has been missing her daily appointments
with healthcare professionals. It is identified by her daughter that she has also been suffering
from gradual loss of memory and is suspected with diagnosis of dementia. In her case, the main
determinant of health is generally the socio-environmental factors. As the socio-environmental
elements of Health are generally the full set of both the physical as well as the social conditions
in which a person or such as Gladys (as per case scenario) can live, consisting the socio-
economic, demographic, the cultural as well as environmental components along with the health
care system. In case of Gladys, due to the COVID restrictions she is unable to receive her routine
medical care aid and also, she is not able to meet her friends and daughter as well, which can
make her feel more depressed and isolated. Due to the socio-environmental element it can also
not able to communicate with her daughter and her neighbours as well. At the same time, she is
also suffering from memory loss and is suspected with the diagnosis of dementia. The conditions
of her can make her worse with time if she will not able to receive an effective care treatment.
Due her distance among daughter and herself, but her daughter can support her to do her
shopping online as well (Blasimme, (2021)). It is known that during the COVID times, the old
age group of people are generally more prone towards having specific illnesses and the condition
of Glady at that time was not so good such that she is not able to receive an appropriate care
treatment. With time, as per her age she also started forgetting the things which she used to do in
her daily routine. This alteration has impacted over her life more adversly.
U.S. Death data, concludes that the socio-environmental factors such as low social
support, income, education, employment etc. are responsible for health related issues (Braveman
& Gottlieb, (2014)). Socio-environmental determinants turns around the ways an individual can
lives, works, plays and learn and relation of such determinants to an individual’s health. The
elements such as discernment, confinement, circumstances within a workplace, involvement in
social places, involvement with neighbourhood and social life etc. are included in that. That is
similar in the scenario of Gladys. Improving status of socio-environmental factors around her can
help in improving her health status. She needs social involvement with people as living alone is
deteriorating her health conditions more. She needs social support from people around her, her

daughter can help her with her likings, and spend time with her online. That will give her social
support and will improve her health conditions.
Present context of health and well-being care provision within the United Kingdom and how this
might influence on the patient.
The government of the United Kingdom has generally sponsored the world-wide Health
care organization known as the National Health Service. In NHS it can involve a series of the
publicly funded Health care system across the United Kingdom. It generally consist the National
Health service England, National Health service Wales, NHS Scotland and the Health and social
care in the Northern Ireland. All the public across UK are mainly entitled towards the Health
care under such system, but have the option to buy a private Health care insurance. The plans of
the National Health Service can promise additional power as well as the information for the
vulnerable patients, more number of healthcare organizations and beds, additional healthcare
professionals, specifically reduced waiting hours for referrals, enhanced Health care for the old
age group patients and many more. According to study of seven industrialized countries, the
Health care system of the United Kingdom is generally one of the most effective across the
nation (Scott et. al., 2021). In this, the quality of Health care is generally one of the main key
concentration of the National Health service. Indeed, one of the stated purposes is to enhance the
quality as well as the safety standards of the Health and social care services. As per the case
scenario of Gladys, there are various issues that act as barrier in receiving care to become well.
As she is not able to going out for her regular healthcare check-ups and she feels so isolated as
well as vulnerable, involving a fear of going out because of the elevated incidences of the
COVID. In this, the quality of problems are mainly addressed in multiple methods. In addition to
this, there are multiple regulatory bodies in place that can monitor as well as access the effective
quality of Health care services specifically given by both the private and public healthcare
providers (The UK Health Care System, (2020)). As Gladys is used to work as a NHS cleaner
and she was a part of NHS care worker and she can receive effective care services from NHS but
all due to COVID restrictions, she is unable to get all such care treatments. In context with
regulatory bodies and policies, it can involve daily as well as a periodic assessment of every
healthcare providers, the enquiry of Gladys's issues which have been drawn towards the attention
of the regulatory bodies as well as a careful consideration to effectively recommend the best
methods of the care practices. The three possible bodies that are mainly responsible for the

regulation of Health care insurance within England such as The Directive for Social Care
Examination, The Healthcare Commission and The Mental Health Act Commission. These all
were effectively merged into the Care Quality Commission in the year 2008. as per the case
scenario, it is recommended for the old lady named Gladys that she must receive an effective
care services with help of healthcare professionals or care nurses at her home so that she can able
to improve her Health and can able to perform the daily living activities more appropriately.
Providing care services to her can help her to cope with her possible dementia symptoms as well
as help her in regular activities so that she can feel confident and comfortable as well. Aiding her
in her daily activities can significantly her to reduce her anxiety and21).
CONCLUSION
From the above conclusion, it is concluded that United Kingdom can give an effective
public Health care to every resident and about 58 million public. The coverage of Health care is
generally free at a point of need as well as is paid for by the general taxation. The National
Health Service can provide an effective care provision to all the people so that they can improve
the health more efficiently and free at a point of care needs. In addition to this, there is also
discussed a case scenario of Gladys who is having lymphoedema and generally receiving regular
care treatment by the leg ulcer care clinic. She requires an effective care to improve her Health
from the care professionals as well as needs an extra attention towards her health (Perez &
Coutinho, (2021)).

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The UK Health Care System, (2020) [Online] Available through:
<http://assets.ce.columbia.edu/pdf/actu/actu-uk.pdf>