Chronic Care in Nursing: Arthritis Care Planning in Sydney, Australia

This report delves into the complexities of chronic care in nursing, specifically focusing on arthritis management within the Australian healthcare system, with a particular emphasis on the Sydney local district. The report begins with an executive summary that outlines the impact of chronic conditions, such as arthritis, on patients' physical, mental, emotional, spiritual, and psychological health. It then provides an overview of arthritis, its clinical manifestations, and existing care strategies and policies in Australia, with a focus on the Osteoarthritis Chronic Care Program (OACCP). The second part of the report presents a case study of a 55-year-old indigenous woman named Jean, who is suffering from osteoarthritis. The case study includes an analysis of Jean's medical condition, lifestyle, and cultural considerations. The report then details the optimal care planning and delivery strategies, including nonsteroidal pain management, physiotherapy, weight management, and cultural safety measures. It highlights relevant services such as the Liverpool Hospital rheumatology department and the Westmead Hospital obesity clinic, while also emphasizing the importance of cultural liaison officers and the Aboriginal cultural safety framework. The report concludes by underscoring the significance of a culturally safe and compassionate care environment to promote health literacy and improved patient outcomes. This report provides valuable insights into arthritis management, care planning, and the importance of culturally sensitive approaches in nursing care.

Running head: CHRONIC CARE IN NURSING
Chronic care in nursing
Name of the student:
Name of the university:
Author note:

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Table of Contents
Executive summary:........................................................................................................................2
Case study analysis and care planning:...........................................................................................4
Case description:..........................................................................................................................4
Case analysis:...............................................................................................................................5
Care strategies and services:........................................................................................................6
References:......................................................................................................................................9

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Executive summary:
Chronic conditions are associated with a wide range of different complications and
lifestyle restrictions which can have a significant impact on the living condition of a patient, on a
more elaborative note, it has to be mentioned that for the elderly population more specifically the
impact of the chronicity is even higher. It has to be mentioned in this context, the chronic
illnesses in most cases are associated with extreme pain and various different lifestyle restriction.
The burden of such pain and restriction on the living conditions can have a significant impact on
the psychological health and emotional or spiritual wellbeing of the patient as well (Briggs et al.
2014). The overall impact on the physical, mental emotional spiritual and psychological health of
the patient of a chronic illness has the power to alter the response mechanism, behavioral patters,
and even the will to live anymore in the patient. This assignment will focus on arthritis as the
chronic condition and will attempt to outline different guidelines and practice standards effective
in the Australian demographics for optimal care planning and delivery, with emphasis n the
Sydney local district.
Arthritis can be defined as the joint disorder that comes coupled with inflammation in the
more than one joints in the body. The key clinical manifestation associated with this disease are
the acute joint pain which is also known as arthralgia, acute inflammation facilitating joint
stiffness, associated bone decay associated with prolonged osteoarthritis and lastly, chronic
mobility restrictions associated with the bone decay, inflamed joints and acute or chronic pain
(Chung et al. 2013).
There are various different policies and care strategies in place for managing arthritis in
the Australian demographics. It has to be mentioned in this context that close to 6.9 million

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people in Australian demographics are currently suffering from some form of arthritis and close
to 30% of that figure is represented by Sydney itself, the capital city. On a more elaborative note,
the percentage of Australians suffering from osteoarthritis, the focus on the assignment, is close
to two million (Ranzijn 2010). Hence, there are different care planning practice standards and
policies in place for optimal care delivery and health promotion for the different individuals
suffering form this chronic condition. First and foremost, there are different disability centered
policies helping the arthritic patients with a lot of treatment and pain management options for the
arthritis patients. On a more elaborative note, the Osteoarthritis chronic care program (OACCP)
from the Sydney Local Health district can be mentioned in this context. It is a detailed care
planning and delivery program, designed for the care of the patient dealing with osteoarthritis
providing treatments and occupational rehabilitation programs for the benefit of the patient and
helping them to lead a life as comfortably as possible with the burden of this chronic condition
(Banaszkiewicz 2014). Along with that, it has to be mentioned that this program targeting
individuals with hip and knee osteoarthritis which provides evidence-based treatment options to
reduce pain, improve function and quality of life, and ultimately enable the client to self-manage
their injured joints and related health problems more effectively. The care planning and
implementation procedure, on the other hand, will be based on the kind of arthritic that the
patient is going through, the severity of arthritis, the co-occurring disorders burdening the
patient, and along with that the health status of the patient as well.

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Case study analysis and care planning:
The second part of this assignment is associated with a case study and based on the case
study the optimal care planning and delivery of the planned care activities to help relieve the
burden on the patent as much as possible and along with that being able to incorporate as much
comfort as possible in the living condition of the patient. This second part will also incorporate
important information from the different policy directed care programs that are applicable to the
scenario based with respect to the care needed by the care professionals.
Case description:
The case study chosen for the assignment emphasizes on a patient named Jean who is 55-
year-old indigenous women living in the southern region of Sydney Southwest local health
district. The patient in the case study had previously been diagnosed with the chronic condition
osteoarthritis and she has recently been experiencing acute exacerbation of the symptoms.
Further information about a patient reveals that she doesn't like attending the hospital and issues
that she had presented to the give professional for not liking the Healthcare facilities is that she
feels that everyone in the Healthcare facility are in a rush and no fun performs active listening to
the issues and grievances that the patient feels. Furthermore, the patient is also concerned with
the lack of privacy and cultural safety when the clinical staff discusses her conditions. Lastly, she
has also communicated that she worries if the care staff will be able to articulate appropriate care
plan that will impress each and every health need that she is accepting and support her health on
a long-term basis after the discharge.
The case study has revealed a few key information cues recording the medical condition
of the patient and the emotional health of the patient. The patient has revealed that she had been

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taking her regular medications however she has confirmed it with the Healthcare professionals
that sometimes she forgets to take her medication and it happens more frequently and her
conditions are issues are well managed and she is feeling better. As per the personal information
shared by the patient, it can be mentioned Jean to describe her marriage to be 36 years long and
really happy with her children and grandchildren. Along with that, the patient has also mentioned
that she is an active chain smoker and she smokes 10 cigarettes a day which she understands is
not good for health, however, finds very difficult to quit as her husband is also an active smoker.
Furthermore, the patient is also reported that she has gained some weight over the years however
she was embarrassed by her last clinic visit when the nurse had suggested how to follow a weight
management plan. The patient has mentioned that she tightly habits usually contain take away
food for fresher also eat little fruits and vegetables and has no active habit of alcohol. Also, the
patient is also reported that she drinks 6 cans of soft drink a day which is very harmful to the
patient.
Case analysis:
Analyzing the case study that has been selected for the assignment it can be mentioned
that the patient is executing a varied range of different health adversities or issues. First and
foremost it has been mentioned that the chronic condition that the patient has been suffering with
is osteoarthritis which can have a significant impact on the health and well-being of the patient
and also Lifestyle conditions and even psychological health. Along with that, the patient has
mentioned that she had been suffering from exacerbation of her arthritis which can be increased
join inflammation, chronic pain, and associated bone decay or osteoporosis. Hence the patient
will require a detailed and extensive arthritis management care plan that focuses on pain
management physiotherapy and bone decay reduction treatments (Smolen et al. 2010).

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However, it has to be mentioned that the patient has also been experiencing a few
associated health disorders the first of it should be mentioned as her weight management. As the
patient has expressed that she had been gaining weight since past few years and a community
care nurse that has already seen her has previously suggested weight management planning for
the patient as well. Focusing on the dietary habits of the patient it has to be mentioned that she
has takeaway fried food every single day and is also an active smoker which can add a
significant burden to her already Rising bodyweight. Along with that, it can be stated that the
patient is also suffering from excitation of osteoarthritis which limits and mobility. Once more or
less sedentary Lifestyle that the patient leads can also be a significant burden on the obesity risk
factor that the patient is under. Hence the optimal care delivery should also focus on proper
weight management of the patient with respect to the mobility restrictions and pain issues that
the patient has under the influence of osteoarthritis (Peters et al. 2010).
Lastly, it has to be mentioned that the patient has expressed a few cultural safety and
communication issues that she has faced previously while receiving care. As mentioned by her
she has experienced negligence and lack of culturally safety practices before in the Healthcare
facility which has turned her into visiting a hospital. Being an aboriginal by origin she has also
felt embarrassed many times when the health care staff has previously recommended had to go
for weight management. Hence take a strategy for her should also focus on cultural safety and
cultural competence communication under the aboriginal health and safety framework
(Westwood and Westwood, 2010).

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Care strategies and services:
First and foremost, according to the Arthritis treatment policy in southern Australia, she
will need to be put on nonsteroidal pain management treatment along with different
nonpharmacological arthritic management plans. Along with that, the patient will also be
requiring physiotherapy exercises best suitable for her to keep her joints flexible and enhance the
muscle strength. According to the policy protocols the patients with acute Arthritis joint
inflammation that are not responding to corticosteroid or nonsteroidal anti-inflammatory drug
treatment can also receive glucocorticoid injections directly into the inflamed joints
(Sydneyboneandjoint.com.au 2018).
For pain management, nonpharmacological interventions such as heat cold therapy,
mindfulness-based meditation, and physiotherapy, joint protection to prevent strain and stress on
the inflamed joints can also be given to the patient. Considering the care services that the patient
can be benefited from include Liverpool Hospital rheumatology department, which can provide
her occupational therapy, physiotherapy, transition care, and Arthritis care
(Wslhd.health.nsw.gov.au 2018). The South Western Sydney clinical School also offers a few
curated arthritis management plants that can be helpful for the patient.
Another very important aspect that has been identified in the Arthritis care strategy at the
Australian policies include weight management and dietary changes for enhancing the lifestyle
and living quality of the patient. The patient will have to include a few healthy dietary changes
towards more antioxidant and fiber-rich, home cooked foods rather than take out food. The
Westmead Hospital obesity clinic can also be accessed by this patient in the local health district
that she belongs to in order to effective and functional weight management (Singh et al. 2012).

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For the cultural safety management, she can have the assistance of culture liaison officer
and language translator along with cultural safety officer under the policies of aboriginal cultural
safety framework of Australia (Ombudsman 2010). According to the aging support framework of
TAFE, Jean could have had the assistance of cultural safety officers to overlook the care
activities that she receives and whether the care activities are aligned to the cultural norms and
the traditional health and healing concepts of aboriginals (Swsi-tafensw.libguides.com 2018).
The patient will require a culturally safe compassionate care environment which will help her
with enhanced health Promotion and literacy regarding her health issues and along with that the
lifestyle habits that she will have to change such as it into the lifestyle smoking and takeout food.
Lastly under the national disability insurance scheme in case the patient is incapacitated
by the exacerbations of osteoarthritis she can benefit from the national disability insurance
scheme in order to receive long-term high-quality support in order to help the patient with the
disabling impact of arthritis and episodic as well as chronic manifestation and exacerbation of
the disease (Kanakkanatt 2018).
On a concluding note, it has to be mentioned that Arthritis is a chronic condition that can
have a significant detrimental impact on the living condition of the patient requiring multifaceted
and multidimensional care. This assignment has articulated different care services start an
Arthritis patient will need with various different commodities and how the patient can get
support from care Services within the local health district the patient belongs to. Along with that,

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this paper has also outlined the impact of different policy protocols that can provide a useful
Framework for outlining planning and implementing the care required by the patient.
References:
Aph.gov.au. (2018). NATIONAL ABORIGINAL & TORRES STRAIT ISLANDER WOMEN’S
ALLIANCE. [online] Available at: https://www.aph.gov.au [Accessed 27 Apr. 2018].
Banaszkiewicz, P.A., 2014. Traumatic arthritis of the hip after dislocation and acetabular
fractures: treatment by mold arthroplasty: an end-result study using a new method of result
evaluation. In Classic Papers in Orthopaedics (pp. 13-17). Springer, London.
Briggs, A.M., Towler, S.C., Speerin, R. and March, L.M., 2014. Models of care for
musculoskeletal health in Australia: now more than ever to drive evidence into health policy and
practice. Australian Health Review, 38(4), pp.401-405.
Chung, A., Lau, W., Perera, C., Raj, A.D., Khoo, K. and Tymms, K., 2013. Health Related
Quality Of Life (hrqol) Outcomes In Rheumatoid Arthritis Patients On Biological Dmards:
Comparison Between Regional Nsw And Metropolitan Act. Internal Medicine Journal, 43, p.14.
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https://www.sprc.unsw.edu.au/media/SPRCFile/Arthritis_and_Disability_2014.pdf [Accessed 27
Apr. 2018].
Ombudsman, N.S.W., 2010. Improving service delivery to Aboriginal people with a
disability. NSW Ombudsman, Sydney.

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Peters, M.J., Symmons, D.P.M., McCarey, D., Dijkmans, B.A.C., Nicola, P., Kvien, T.K.,
McInnes, I.B., Haentzschel, H., Gonzalez-Gay, M.A., Provan, S. and Semb, A., 2010. EULAR
evidence-based recommendations for cardiovascular risk management in patients with
rheumatoid arthritis and other forms of inflammatory arthritis. Annals of the rheumatic
diseases, 69(2), pp.325-331.
Ranzijn, R., 2010. Active ageing—Another way to oppress marginalized and disadvantaged
elders? Aboriginal elders as a case study. Journal of Health Psychology, 15(5), pp.716-723.
Singh, J.A., Furst, D.E., Bharat, A., Curtis, J.R., Kavanaugh, A.F., Kremer, J.M., Moreland,
L.W., O'Dell, J., Winthrop, K.L., Beukelman, T. and Bridges, S.L., 2012. 2012 Update of the
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research, 64(5), pp.625-639.
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B., Cutolo, M., de Wit, M., Dougados, M. and Emery, P., 2010. Treating rheumatoid arthritis to
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