Case Study Analysis (Leah Purcell) 2022

Running head: NURSING ASSIGNMENT
CASE STUDY ANALYSIS (LEAH PURCELL)
Name of the student
Name of the university
Author note

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Introduction
As per Mittelstadt (2017), narrative has always been associated with healthcare as an
important and crucial part of healthcare. Patients and their stories of recovery, struggle with
healthcare complication and emerge as a survivor has always inspired another patients,
healthcare professionals and the relatives of patients (Hamad et al., 2016). With development
of new medications and policies healthcare facts and findings, and evidence based practice
are given more priorities due to its scientific base, however, the importance of health
narratives cannot be neglected (Gonzalez de Armas, Archibald & Scott, 2017).
In this paper, with the help of Leah Purcell’s interview with Anh Do, the Archibald
Prize-winning artist, her health narrative and three of the social determinants of health that
shapes the health experience of people would be discussed.
Health narrative
As mentioned earlier in this paper, health narrative is the amalgamation of aspects that
shapes the health experience of a certain individual. Hamad et al. (2016) mentions in their
paper that health experience should also be inclusive of social determinants of health as these
are the aspects that includes age, sex, ethnicity, their locations and their education and
economic status. These aspects affects the health and healthcare narrative of people and their
community drastically and hence, when the patients develop their health narratives, these
aspects puts effects on their perspectives. As per Gonzalez de Armas, Archibald and Scott
(2017), health narrative is the aspect that helps people to develop abilities so that recognize
the aspects, absorb them for their wellbeing, and then interpret them to understand their
struggle from illness. As per Mittelstadt (2017), it is important to understand the health
narrative of people and specifically a particular community as it reflects their social
determinants of health and consequently their emerging needs, due to which they suffer from

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critical health complications. Further, on empathic and emotional level, storytelling or health
narrative are aspects which helps the healthcare professional or any other person that is going
through their story, to understand their fear their pain and agony effectively (Mittelstadt,
2017). Hence, through the proper analysis of the health narrative if any individual, it is easier
to understand the positive or negative aspects and their health experience which could affect
their healthcare goals achievement. Besides this, application of health narratives of patients
could help the healthcare facilities and professionals to understand the aspects that requires
change or modification so that rapid and positive health outcome could be achieved (Hamad
et al., 2016).
Another research conducted by psychologists de Armas, Archibald and Scott (2017)
mentioned that there are aspects which could affect the health achievement of the patients and
understand the aspects that could be used to stimulate change. Despite the fact that, in this
age of evidences and scientific facts, healthcare professionals neglect the patients narratives,
Mittelstadt (2017) mentions that through this discussion of patient narrative, it is effective to
make the care process accessible and authentic because patients or care service users are the
primary stakeholders of care process and their narrative should be given top priority so that
patients could avail the effectiveness of it.
What are Social Determinants of Health (SDOH)?
As per the World Health Organisation (2016), social determinants of health or SDOH
are aspects in which one individual born, lives and dies and aspects which shapes the present
and future of that individual. These aspects are the individual’s age, sex, economic abilities,
education, his geographic location and other aspects which makes the individual vulnerable
to his society and community. Recent healthcare researchers are conducting researches to
understand the aspects which affects an individual’s health condition or health experiences
and identified that genetic conditions, the inequalities present in their society, and their life

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experiences shapes their health outcomes. These researches has identified the social
determinants as the primary aspects that shapes the health outcome of the patients and helps
to maintain equality for healthcare opportunities for everyone in the society (Penman-Aguilar
et al., 2016).
Another researcher identified the importance of social determinants of health to for
the growth and development of the aspects which could help the healthcare professionals to
include the aspects required or needed by the individual or that particular community
(Marmot, 2015). Understanding any community’s social determinants of health, helps the
healthcare professionals, the physicians, the policymakers, and the authorities to understand
the needs and requirements of the communities that are not fulfilled and requires their
effective action to be addressed (Penman-Aguilar et al., 2016). Further, discussion and
communication about the social determinants of health related needs of communities has
been seen to help the policymakers to develop policies and guidelines so that their
fundamental needs and rights could be addressed (World Health Organisation, 2016). Hence,
through the discussion of social determinants of health and the needs and requirements of the
communities, the health professionals would be able to identify the aspects that affects the
community’s achievement and availability of healthcare means. Further, discussion and
analysis would also help to understand the aspects or determinants, lack of which could affect
the both the physical and mental health of the individuals (Penman-Aguilar et al., 2016).
Therefore, with discussion about the health narrative, it is important that healthcare
professionals and facilities start focusing upon the social determinates of health related
discussion so that holistic care could be implemented.
Case study analysis
In this case study of Leah Purcell, which is an interview she gave on the show of
the Archibald Prize-winning artist Anh Do, she discusses about her childhood, her struggle of

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being a daughter of an aboriginal mother, her teenage pregnancy and other aspects that helps
to draw an idea about the social determinants of health that she or her family lacked. She was
a daughter of a white man and an aboriginal women due to which her father always neglected
her and her family. She mentioned about the racial discrimination she faced in her school due
to her mixed ethnicity and the way her lack of education and awareness affected her teenage
pregnancy and post natal phase, due to which she was forced to suicidal steps.
Three social determinants of health of Leah Purcell
While discussing the social determinants of health that affected her childhood, her
teenage and in a way her complete upbringing, discussion about her complications associated
with her childhood experiences, her education and literacy and social support and coping
skills should be discussed. As per the World Health Organisation (2016), the aspects that
affected the social determinants of health of Leah Purcell has been identified as these
conditions arise due to her ethnicity, her age, the availability of educational facilities and
economic aspects and the community they live into.
Childhood experiences
As per the interview given by Leah Purcell, she mentioned that she was the youngest
and seventh children of parents in which her mother was an aboriginal women and her father
was a white man. She was born in Murgon, Queensland and her family was the second and a
secret family of her father. This affected the childhood of Mr. Purcell as she was unable to
receive the care and affection that every child receives from their fathers. In the interview she
mentioned that she used to talk to her father in sign language in public and was unable to
communicate with him because of their aboriginal ethnicity. Further, she also observed her
mom struggle through these social norms and become addicted to alcohol. Therefore, these
are the aspects that hampered her mental strength and increased the gap between her

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fundamental rights and the amount she received in her abilities. Therefore, due to this events
in her childhood her narrative about every aspects of her life such as education, economic
aspects, healthcare and others affected (Artiga & Hinton, 2016). As per the World Health
Organisation (2016), early childhood is considered as the most crucial and important phase in
the life of a children as it affects their mental and physical development, their cognitive
abilities and hence, while understanding the aspects due to which she and mental and
physical conditions suffered, these aspects should be considered (Chung et al., 2016). Besides
this, Metzler, Merrick, Klevens, Ports and Ford (2017) also mentioned that whatever a child
experiences in his/her childhood that shapes their thinking throughout their life. Hence, this
aspect was chosen for Leah Purcell and her health narrative development.
Her education and literacy
As per Velardo (2015), education and literacy is one of the most crucial social
determinants of health as it helps to develop a patient’s health literacy and his ability to gain
knowledge about her health complications effectively. Education and literacy are the aspects
that develops decision making abilities of every individual and help them to take effective
and progressive step in their lifetime. Further, it also helps to develop or achieve positive
health outcome for their growth (Palumbo, Annarumma, Adinolfi, Musella & Piscopo, 2016).
This also related with any individual’s life expectancy and their health related choices. In this
case of Leah Purcell, it was seen that being the seven children of the family, she went to her
school with her siblings however, due to her mixed skin colour, she faced racial
discrimination from her early childhood. Her mother received education till fourth grade and
hence, nobody in her family were aware of higher education. This is the reason Leah Purcell
was not aware of higher education and attended college on the recommendation of someone
prominent in her society. Further, her lifestyle choices, her teenage pregnancy related episode
and the after effect of increased stress and depression helps to identify the adverse effects that

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she was trapped into due to her lack of knowledge about the consequences. All these she
suffered from due to her lack of her health literacy and hence, in this condition, childhood
experiences and the consequences could be included as one of the critical aspects of her
social determinants of health that affected her physical and mental health in future (Coffey,
Ralph & Krause, 2018).
Social support and coping skills
There are multiple researches that identifies and establishes social support and coping
skills as the primary and most prominent aspect due to which the healthcare condition of
patients affected. As per Dardas and Ahmad (2015) social support and coping skills are
densely connected with the social support that the affected individual receives in his/her
lifetime as it helps them to develop emotional wellbeing and helps to boost them with coping
skills so that they could fight with the physical mental and emotional stressors that the
environment exerts upon them (Corin, 2017). In case of Leah Purcell, it was observed that
she suffered from racial discrimination, avoidance and negligence due to her aboriginal
identity and lack of educational and economic strength. Hence, this influenced her to develop
her health narrative.
Conclusion
This paper effectively identifies the importance of health narrative and the effect of it
upon the social determinants of health upon which their physical, mental and cognitive
health. In this paper, discussion of these critical aspects were discussed in alignment with the
case study of Leah Purcell and identified the three social determinants of health that shaped
her future health condition and her ability to take decisions. Further with effective researches,
the impact of social determinants upon her health condition was also discussed.

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