NUR3005: Developing a Care Plan for Aboriginal Patient

This report provides a detailed nursing care plan developed for an Aboriginal patient, Paul, who is managing chronic conditions and transitioning from acute to primary care. The care plan addresses issues identified through a concept map, including post-cataract surgery care, Hepatitis C management, and depression. Person-centred interventions, such as patient education and social support, are prioritized to empower Paul and improve his overall well-being. The rationale for each intervention is supported by current literature and evidence-based practice, emphasizing cultural sensitivity and collaboration with Aboriginal health workers to overcome barriers to treatment and promote positive health outcomes. The plan aims to improve Paul's physical health, mental health, and satisfaction with healthcare services.

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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Concept map related to Paul’s life:

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Care plan for Paul:
Issues/problems Person-centred
Goal
Interventions/
Actions
Who is
responsible
Evaluation
Criteria and
date
Cataract surgery,
pain in the eyes
and symptoms
related to Hepatitis
C (physical needs)
To empower
Paul to
understand the
cause of Cataract
surgery and
teach strategies
related to self-
care of eyes after
cataract surgery
and identify
symptoms of
Hepatis C
1.Delivery of
clear discharge
instructions and
personalized
patient education
related to reason
for cataract and
methods to
protect the eye
during the healing
process.
2. Instructions
need to be
provided in both
verbal and written
format in the
native language
Health service
staffs
Evaluation can
be done based
on Paul’s
interest and
knowledge in
clearly
articulating
improvement in
his symptoms
and actively
seeking
information to
self-manage
issues related to
care of the
cataract.

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of the patient
(Umfress and
Brantley Jr, 2016)
3. To provide
psycho-education
to overcome
barriers to
treatment like
depression,
hallucination and
psychosis caused
by diagnosis of
Hepatitis and
empower client to
take control of
their health
(Hong et al.,
2011)
Depression and
social isolation
because of
discrimination and
To provide
effective health
and social care
support to client
1.To implement
individualized
interventions like
coordinated care
Health service
and
community
Good mental
health outcome,
positive physical
state and overall

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poor satisfaction
with health
services
(Psychosocial
issue)
by addressing
discrimination
and providing
holistic and
culturally
appropriate care
arrangement,
social support and
holistic client-
centred care plan
(Brener et al.,
2015)
2.Include more
Aboriginal health
workers to
overcome
language gap and
promote client
engagement and
satisfaction with
care (Brener et
al., 2015). This
strategy would
also resolve the
issue of racial
discrimination
faced by Paul
when visiting
health care
support staff satisfaction with
the service will
indicate success
of the care plan

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services as
Aboriginal staffs
can easily related
with social and
culture issues
affecting health
of the client.
Rational for the care plan:
As Mr. Paul has recently undergone cataract surgery and he has been experiencing pain
in the eyes, the intervention of patient-education has been prioritized first so that Paul’s eye can
heal and recover soon. Good recovery will promote psychosocial well-being of client and
increase interest in self-management of other chronic conditions like Type 2 diabetes and
participation in other meaningful activities too. As part of patient-centred care, personalized
patient education has been chosen as it has the potential to improve outcome for older people and
those with high racial risk factors. Rosdahl et al. (2014) gave the evidence that educating patients
about diagnosis and plan of care in the field of ophthalmology is essential to promote patient
engagement and prevent adverse events like irreversible blindness. The study proved that
providing patient education according to preferred learning practices can increase patient’s
interest in cataracts. Newman-Casey et al. (2015) argues that counselling can improve patient’s
knowledge related to cataract surgery and decisional aspect particularly for those patients who
are illiterate or have limited access to care. Older patient mostly prefer one-on-one interaction

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and as Mr. Paul is above 50, such interaction will also benefit him as he can also get information
related to age related problems that influence his recovery and healing process.
Hepatis C has also been included as a physical issues for Paul because the analysis of
Paul’s video transcript revealed that Paul had poor conceptions related to knowledge about
Hepatitis C and he was not sure whether certain symptoms experience by him were related to
Hepatitis C or not. As he expressed interest in getting some resources related to Hepatitis C, the
intervention of psycho-education has the potential to mitigate both barriers to treatment as well
as treat depression and anxiety occurring due to poor management of the condition (Hong et al.,
2011). Evidence by Surjadi et al. (2011) has revealed the effectiveness of education for
vulnerable population particularly injection drug users. As such population have limited
knowledge about Hepatitis C, standardized patient education plays a role in reducing disparity in
HCV prevalence and outcomes. As Paul is an aboriginal, he may also be vulnerable to poor
outcome because of poor knowledge. Another advantage of education is that health care
maintenance increase when people have good knowledge about HCV. Yang et al. (2017) argues
that patient knowledge improves acceptance to antiviral therapy for Hepatitis C. This was proved
by conducting research to evaluate the impact of HCV education on patient’s knowledge of HCV
and acceptance of therapy in rural China. Knowledge about HCV significantly reduced risk of
transmission and enable patients to make better decisions about their treatment. Hence, Paul will
also be able to take best treatment decision when have good knowledge about the condition.
Another problem or issue identified for Paul was diagnosis of depression. Both ageing
related factors and social factors is the reason for diagnosis of depression. Age related factors
include feeling of social isolation and poor self-esteem because of loss of independence and
inability to engage in pleasing life activities like driving and social engagement. Evidence by

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Singh and Misra (2009) also supports this by stating that older people experience depression and
social isolation because of physical and social role changes in life due to ageing. Lack of contact
with close families and gradual reduction in connections with the cultural origin also increase
diagnosis of depression in elderly people (Theodore, 2017). As Paul came from Aboriginal
background, he faced additional issues in society which increased the likelihood of depression.
These included experiencing stigma and discrimination from health care staffs and other
community members. This is consistent with study by Povey et al. (2016) which explained that
35% of Aboriginal people experience high level of distress because of challenges in accessing
health services and stigma is one of the reasons for poor access to services. Being diagnosed with
multiple disease condition and inability to engage in appropriate therapeutic communication
process with health care staffs also increased the risk of depression for Paul. Hence, in such
circumstances, individualized interventions like social support has been proposed because it
would provide Paul the opportunity to establish reconnection with community life and gain sense
of control over their life. Social support programs can help to engage in cultural activities that is
an indicator of positive cultural identity as well as better mental health outcomes in Aboriginal
people (Dudgeon et al., 2014). Organizational level interventions like cultural competence
training and inclusion of aboriginal workforce can significantly improve the provision of
providing equitable, respectful and culturally responsive care to patients like Paul (Browne et al.,
2016).

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References:
Brener, L., Wilson, H., Jackson, L. C., Johnson, P., Saunders, V., & Treloar, C. (2015). The role
of Aboriginal community attachment in promoting lifestyle changes after hepatitis C
diagnosis. Health Psychology Open, 2(2), 2055102915601581.
http://doi.org/10.1177/2055102915601581
Browne, A. J., Varcoe, C., Lavoie, J., Smye, V., Wong, S. T., Krause, M., … Fridkin, A. (2016).
Enhancing health care equity with Indigenous populations: evidence-based strategies
from an ethnographic study. BMC Health Services Research, 16, 544.
http://doi.org/10.1186/s12913-016-1707-9
Dudgeon, P., Walker, R., Scrine, C., Shepherd, C., Calma, T., & Ring, I. (2014). Effective
strategies to strengthen the mental health and wellbeing of Aboriginal and Torres Strait
Islander people. Issues paper, 12. Retrieved from:
https://www.aihw.gov.au/getmedia/6d50a4d2-d4da-4c53-8aeb-9ec22b856dc5/ctgc-ip12-
4nov2014.pdf.aspx?inline=true
Hong, B. A., North, C. S., Pollio, D. E., Abbacchi, A., Debold, C., Adewuyi, S. A., & Lisker-
Melman, M. (2011). The use of psychoeducation for a patient with hepatitis C and
psychiatric illness in preparation for antiviral therapy: a case report and
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10.1007/s10880-011-9227-6.
Newman-Casey, P. A., Ravilla, S., Haripriya, A., Palanichamy, V., Pillai, M., Balakrishnan, V.,
& Robin, A. L. (2015). The Effect of Counseling on Cataract Patient Knowledge,

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Decisional Conflict, and Satisfaction. Ophthalmic Epidemiology, 22(6), 387–393.
http://doi.org/10.3109/09286586.2015.1066016
Povey, J., Mills, P. P. J. R., Dingwall, K. M., Lowell, A., Singer, J., Rotumah, D., … Nagel, T.
(2016). Acceptability of Mental Health Apps for Aboriginal and Torres Strait Islander
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http://doi.org/10.2196/jmir.5314
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Surjadi, M., Torruellas, C., Ayala, C., Yee, H. F., & Khalili, M. (2011). Formal Patient
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http://doi.org/10.1007/s10620-010-1455-3

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Theodore I., (2017). Aging In Grace and the Effects of Social Isolation on the Elderly
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