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Running head: NURSING ASSIGNMENTNursing AssignmentName of student:Name of university:Author note:
1NURSING ASSINGMENTTuberculosis is a public health concernacross the globe, particularly in the UK for last20 years.In England, there were 5137 cases of TB in the year 2017(tbalert.org 2018). Whencompared to the western countries the mortality and morbidity in the UK due to tuberculosis ishigh. As per World Health Organization (WHO) estimate, there were 1.4 million deaths due totuberculosis in 2011 and some areas have shown the increase in the rate of disease by 50%(Pealing Moore and Zenner 2013). Recent research indicates that burden of the disease isincreasing at an alarming rate, entailing key interventions at the earliest (Pealing, Moore andZenner 2013). Healthcare professionals and nurses are making intense efforts to enable optimalquality care delivery, as one third of world populations have latent tuberculosis infection(Houben and Dodd 2016).The essay discusses the impact of tuberculosis, physiology etiology of tuberculosis, andits global epidemiology. The essay analyses psychosocial elements that impact upon the personliving with tuberculosis care that is relevant to nursing practice. The paper first highlights theimpact of tuberculosis on the individual's physical body, life and self-care. Further, emphasis islaid on psychological issues of the person living with tuberculosis. A critical analysis is thendone on how the experience of the patient is enhanced through the concept of shared decisionmaking. The consecutive section of the paper then applies the concept of self-management forenabling the quality of life in long-term conditions. The application of evidence-based practice inlong-term conditions such as tuberculosis constitutes the next part of the paper. A conclusion isadded at the end for summarizing the key points discussed in the paper.Theglobal burden of tuberculosisis increasing at an alarming rate with each passingyear, and healthcare organisations are constantly striving to address the concern.As per theresearch paper of Kyu et al. (2018) in the year 2015, the number of incident cases of tuberculosis
2NURSING ASSINGMENTin the world was 10.2 million (95% uncertainty interval 9.2 million to 11.5 million). Further, thenumber of prevalent cases in 2015 was 10.1 million (9.2 million to 11.1 million), while thenumber of deaths was 1.3 million.As per reports of Tuberculosis in England (2018) theincidence rate of TB in England was 10.5 per 100,000 in 2015 and it 10.2 per 100,000 in 2016.Since 2012, the decline rate in England was 10%.In 2016, there were 5,664 TB cases notified inEngland.In the UK the highest rate of Tuberculosis was observed in London with the rate ofdisease being, 25 per 100,000 of the population. The TB rates were found below 40 per 100,000in all other London boroughs except in Bexley and Barking and Dagenham (Tuberculosis (TB):regional and devolved administration reports 2018). A better understanding of the trends inincidence, prevalence and mortality of tuberculosis is pivotal for permitting the success ofcontrol programs and identifying remaining challenges (Murray et al. 2014). In summary, therising incidence of TB in the UK has increased the health care cost and demands preventivestrategies (Scott et al. 2018).Tuberculosis is an infectious diseasecaused due toMycobacterium tuberculosis(MTB)which is a small, aerobic, non-motile bacillus. Transmission of the bacilli takes place wheninfected individuals a cough, speak, sneeze, spit or sign, expelling the infectious droplets.Individuals who are in close, frequent or prolonged contact with infected people are at higherrisk of suffering from the infection. Latent TB infection is found in patients without clinical orradiographic evidenceof active TB (Salgame et al. 2015). Active TB occurs if the previouslylatent infection reactivates or the primary infection progresses. Transmission occurs toindividuals infected with pulmonary disease. Inhalation of aerosolised droplets containingbacterium results in infection. Transmission depends on the degree of exposure, the susceptibilityof the person, and infectivity of the source. HIV infected individuals and those with recent
3NURSING ASSINGMENTtuberculin skin test (TST) conversion, drug users, are highly susceptible to the active TB. \(Salgame et al. 2015).The infection process initiates when the bacilli reach up to the alveolar air sacs of thelungs and lead to inadequate containment by the immune system. The bacilli are identified asforeign particles and elimination of the same through phagocytosis is the preferred bodyresponse. However, the bacilli can reproduce within the macrophage, and the immune cells arekilled. Tissues die and eventually rupture, accompanied by the weakened immune system. Theprimary infection site is the "ghon focus” (Fogel 2015). Tuberculosis in the lungs might also takeplace through bloodstream infection. Tuberculosis is a granulomatous inflammatory disease.When the bacteria enter the bloodstream from the damaged tissue area, it is rapidly spreadthroughout the body. Such severe form of tuberculosis is common among those who have HIVinfection (Orme 2012). The common symptoms of tuberculosis include chills, fever, loss ofappetite, night sweats, fatigue and weight loss. In case the infection is active, involving the lungs,symptoms suffered are chest pain and prolonged cough that produces sputum. An asymptomaticcondition such as inflammation might be present in certain cases (Baugh et al. 2015).The relationship betweenpsychosocial factorsand patient’s quality of life in case ofchronic conditions such as tuberculosis has been well documented in the literature. The diseaseshave a deep impact on the life of the patients who struggle to combat the challenges emerging inthe social and psychological context. The two most prominent psychosocial elements that arerelated to the life of a patient suffering from tuberculosis are depression and stigma. Thesefactors are associated with adverse health outcomes, and evidence from cross-sectional studiesindicated thatdepression and stigmadecrease the patient’s self-confidence in achievingrecovery (Loveday et al. 2018).