Reflective Essay: Adolescent Health and Disability in Nursing

This reflective essay examines two key topics in adolescent health: substance abuse and disability, drawing from the student's experience in a healthcare setting. The first section focuses on the health risks associated with substance abuse, including unintentional injuries, mental health issues, and interpersonal violence, while also highlighting the role of nurses in providing pharmacological and psychosocial support. The second section shifts the focus to functional disability, specifically muscular dystrophy, discussing the major health characteristics, risks, barriers to care, and the critical role of nurses in addressing the physical and psychological needs of patients. The essay emphasizes the importance of addressing the social determinants of health, providing culturally competent care, and offering both pharmacological and non-pharmacological interventions for these vulnerable populations. The author reflects on the challenges faced in providing care and the importance of addressing the specific needs of adolescents with substance abuse disorders and those with muscular dystrophy. This paper highlights the importance of nurses in providing holistic care for these two populations.

Running head: REFLECTIVE ESSAY
REFLECTIVE ESSAY
Name of the Student
Name of the university
Author’s note

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REFLECTIVE ESSAY
REFLECTIVE ESSAY 1
INTRODUCTION
In this essay, I would focus on the topic of adolescent health. About 1.2 billion of total
people of the world’s population are adolescent people, who are aged between 10-19. Although
most are healthy, there a substantial number of premature death, injury and illness has been
found among the adolescents (Winters et al., 2018). Illnesses, will not only hinder their growth
but would also restrict the development of their full potential. There has been a sense of urgency
that action is now required to make a real difference to address the health issue of adolescents.
There had been global goals and targets that are directed towards young people. It is necessary to
promote healthy behaviours during the adolescence, and taking steps for protecting young people
from the health risks for preventing the health problems during adulthood and the future health
of the country and the capability to develop and thrive.
I have been caring for an adolescent patient, who was admitted into the mental health ward.
The patient was a 16 years old boy who has harmed himself since all his access to drugs has been
cut off.
RELEVANT HEALTH RISKS FOR THE POPULATION
I have brainstormed through several government websites and the data of the World
Health Organisation and have identified some of the main health issues related to substance
abuse. Unintentional injuries such as road accidents, drowning have been noted high amount
among the adolescents who are subjected to substance abuse. I have read that substance abuse
can also cause prolonged psychotic reactions that affect the quality of life of the patient.

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Again, depression due to substance abuse has been noted as one of the leading cause of disability
and the death among the adolescents, Humiliation, poverty, and suicide is the second leading
cause of death among the adolescents. Good mental health can be provided to the children and
adolescents by the provision of psychological support and community settings. Programs for
strengthening the ties between families and adolescents are also important. In case problems
arise, they need to be detected and managed by caring and competent health care workers
(Seiffge-Krenke, 2019). Interpersonal violence is another important reason for death.
Adolescents are more vulnerable to binge drinking and addiction. Substance abuse and alcohol
consumption can be identified as one of the important precursors of the interpersonal violence,
emotional, physical and sexual violence perpetrated by their husband or partner. This has also
been found as one of the reasons for the high prevalence of AIDS among adolescents, who are
addicted to substances (Seiffge-Krenke, 2019). An estimation of about 2.1 million adolescents
are living with HIV in the year 2016, the greatest percentage been in the African region. There
are certain determinants behind the poor health condition of adolescents. Some of the
determinants of health of the adolescents are low socio-economic status and lack of health
literacy (Viner et al, 2012). Lack of health literacy and peer pressure might influence the
adolescents to take up reckless decisions like drinking, substance abuse and getting indulged in
unprotected sex and rash driving (Viner et al, 2012). Environmental factors and ambiance in
which the child has been born and brought up. The developmental effects that can be seen among
the adolescents which enable their transitioning in peers, family and the educational domains.
The strongest determinants that have been identified are structural factors lie national wealth,
access to education and inequality in income.

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COMMON BARRIERS TO HEALTH EXPERIENCED BY THE POPULATION
GROUP
One of the potential barriers to health are concerns regarding confidentiality, which
restricts the adolescent from visiting a doctor, with regards to sexual and reproductive health
(Fuentes, Ingerick, Jones & Lindberg, 2018). The patient whom I was caring for was very
disheveled in thoughts and was not ready to admit that he needed treatment. Hence, it was
difficult on my part to apply any treatment to the patient. As a nurse , it becomes quite difficult
to convince patients with psychotic disorders and encourage them to take medications. Some of
the other common barriers are the high cost of care, no insurance coverage, lack of availability of
services, lack of care that is culturally competent (Pinedo, Zemore & Rogers, 2018). These
barriers to access health care cause unmet health care needs, delays in the receiving appropriate
care and inability to receive preventive services, avoidable hospital admissions, and financial
burden.
ROLE OF NURSES IN CARING FOR THE SPECIFIC POPULATION GROUP
Nurses are directly involved in the care provided to patients with substance abuse
disorder. Adolescent individuals who suffer from substance abuse disorder require
pharmacological therapy as well as non-pharmacological therapies like psychotherapies or
cognitive behavioral therapy (Winters et al., 2016). Rates of medication adherence are quite low
in clients suffering from such disorders. This can increase the risk of relapse and contribute to a
low quality of life. As mentioned earlier, my patient was suffering from a substance abuse
disorder. Hence, my primary aim was to ensure that the patient had entirely stopped using
substances. Being a nurse, it was my duty to explain to him about the way to cope up with the
disruptive thoughts (Townsend & Morgan, 2017). Distraction from triggering environment and

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helping the patients to develop connectedness to normal life is another duty of a nurses. I also
tried to engage the patient to some constructive activities to distract his away (Townsend &
Morgan, 2017). One of the biggest role of the nurse is to provide psychological support to the
patient, during the withdrawal symptom. Apart from this, being a nurse it was also my duty to
look after the nutritional status, hydration status and the pharmacological needs of the patient.
CONCLUSION
It is evidenced from experience that substance abuse is a common disorder that the
adolescents suffer from. There are several determinants behind the prevalence of substance abuse
like peer pressure, depression and lack of health literacy. Hence, being a nurse, it will be my
responsibility to provide psychosocial care to the concerned patient. Standardized care would
involve both pharmacological as well as non-pharmacological interventions.

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TOPIC 2 – DISABILITY
INTRODUCTION
Disability can be defined as a condition that is judged to be significantly impaired
concerning the usual standards of a group or an individual. The term is usually referred to as the
functioning of an individual including physical impairment, cognitive impairment, intellectual
impairment and cognitive impairment (Stark, 2015). It can also be conceptualized as a
multidimensional experience for the concerned person. In this paper, we will be reflecting on a
particular kind of disability like functional disability. The essay would further focus on the
specific health characteristics of the target population, the relevant heath risk factors, and the
environmental factors. Social determinants and the health behaviours. Finally, this paper will
discuss about the role of the nurse caring for this specific individual.
SPECIFIC POPULATION GROUP
While my placement in the health care setting, I was assigned to care for a boy using
functional disability, who used a wheelchair while moving from one place to the other. The
physical disability in the patient was mainly caused due to muscular dystrophy. The patient had
progressive weakness due to a considerable loss in the muscle mass. Muscular dystrophy is a rare
muscle disorder but it is one of the frequent genetic condition that is found 1 in 3500 male births
throughout the world (Stark, 2015). It is normally characterized by weakness or wasting of the
muscles of the pelvic region. The shoulder muscles are also involved. With the progress of the
disease, the muscular weakness and the atrophy reaches the effects parts of the forearm and the
trunk and finally involves the additional muscles of the body.

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MAJOR HEALTH CHARACTERISTICS, ISSUES, AND PROBLEMS FACED
While caring for the boy, I have witnessed that the boy was becoming weaker each day. I
had to assist him while sitting, walking and lifting the objects. The boy also suffered from
shortness of breath at times, due to which, I also had to take care of proper positioning of the
patient, for facilitating the expansion of lungs. Muscular dystrophy is affecting the central
nervous system, gastrointestinal tract, heart, eyes and the exocrine as well as endocrine glands
(Bann et al., 2016). Besides muscular weakness, these children might be susceptible to the
complications involving the organ system. Some of the complications include dilated
cardiomyopathy, abnormalities in the conduction system and can even lead to sudden cardiac
death.
The disease is progressive and most of the teenagers require a wheelchair for moving
from one place to another. I have understood that such an illness can have a serious impact on
the ability of the person to perform daily activities. Individuals suffering from muscular
dystrophy might suffer from insecurity, due to limited mobility. As a result, the person has to
rely on assistive devices like wheelchairs or walker for getting around. Muscular weakness in the
internal organs might lead to some other conditions which can affect daily life.
RELEVANT HEALTH RISKS FOR THE PATIENTS
Muscular dystrophy is caused by almost all ages and sexes. Some of the health risks
might involve shortening of the tendons and the muscles around the joint. The spine can get
curved due to the weakened muscles. Breathing assistance might be required in individuals
suffering from breathing difficulties. In the concerned patient, for whom I was caring about, he

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often used to have breathing trouble at night. According to Bann et al., (2015) patients might
also develop difficulties in swallowing, in case the muscles involved in swallowing are affected.
In severe cases, aspiration pneumonia can occur, for which feeding tube can be the only option.
Findings by Bann et al, (2015) have brought forward a surprising fact while researching about
the risk factors of this clinical illness. A new study has found the more people with Duchenne
muscular dystrophy can live for a long time by identifying and treating with certain risk factors.
Imperial studies have found that patients’ aces extreme difficulties while facing any
genetic disease that is intractable. The patient whom I was caring about had lower self –esteem
and experienced greater shame and anxiety in children. Fujino et al., (2016) have stated that age-
appropriate disclosure of functional disability can increase the understanding of a disease that
might lead to better coping strategies and higher wellbeing in their normal life.
Social determinants are linked with the fact that people belonging the high-income status
can opt for more treatment and get as medical assistance, compared to those belonging to low-
income status. Bann et al., (2016) have mentioned certain factors affecting the life of such
individuals like age, sex, health literacy, sec, education level, employment, health insurance
coverage and many more.
BARRIERS TO HEALTH CARE EXPERIENCE
Certain barriers restrict individuals suffering from muscular dystrophy. One of the
important barrier is the limited mobility. This increases the transportation cost and can be
difficult for those living in remote communities (Lindsay, McAdam & Mahendiran, 2017).
Cultural barriers like the stigmatization restrict the standardized care that they should receive.
While I was engaged in conversation with the parents of the boy, with muscular dystrophy, I

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found his mother regretting about their luck and that this the result of whatever that they had
done in their previous life. I tried to eradicate their superstitions and misconceptions by
explaining about the entire reason. The most important barrier to care is socioeconomic status.
Treatment for diseases like muscular dystrophy might cause an additional burden for
wheelchairs, medicines, assistive devices, ventilators, keeping a full-time home support (Fujino
et al., 2016)
ROLE OF THE NURSE
Being a nurse, I was accountable to look after both the physical and the psychological
aspect of the patient, as he was just a boy of 13 years. According to Birnkrant et al., (2018),
improvement in the quality of life, functional aspect and longevity of life has been achieved by
following a multidisciplinary approach while caring for the patient. Nursing care involves,
assisting the patient in their daily activities of living, reviewing the stages of the disease,
conducting neuropsychological evaluations, providing health literacy to the patients.
CONCLUSION
In conclusion, it can be said that the proper primary care facilities, screening and
diagnosis, neuropsychological evaluations, psychological care, proper pharmacological
interventions, routined mental health screening, and emergency management system can improve
the quality of life of people suffering from such physical disability.

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