Community Practice Portfolio: Nursing Practice and Family Care, Part 3

This report delves into the crucial role of nurses in empowering patients and their families within a community practice setting. It explores how nurses facilitate patient independence and autonomy through various interventions, especially for individuals with chronic illnesses. The report highlights the importance of patient-centered care, involving families and caregivers in decision-making, and providing resources and support for self-management. It discusses strategies such as health self-management education, shared decision-making, peer support, and family involvement to improve patient outcomes and quality of life. The report also examines the use of the Chronic Care Model (CCM) to organize healthcare and address the economic burdens on families. The role of nurses in recognizing and addressing patient isolation, providing clear post-care instructions, and advocating for staff training in patient communication is also emphasized. The report references several key studies and resources to support its findings, offering a comprehensive overview of family support in nursing practice.

“Assignment 3: Portfolio: Community Practice Portfolio”
“The Community Practice Portfolio”
Name of the Student
Student ID
Name of the University

“Assignment 3: Portfolio: Community Practice Portfolio”
Part 3
“Question: Find out how the nurses in the practice setting, you have attended, support,
prepare and empower family members/ carers in order to care for the patient/client (seek
guidance from your preceptor nurse). Compare/ contrast your findings with the current
recommendations from the literature.”
Self-determination and autonomy-based interventions are based on powerful
guiding principles. Through the promotion of health care, nurses assist to improve patient
independence and autonomy. The nurses cannot offer these sentiments to them but can
help the patients during the empowerment phase. Consequently, empowerment is a
method and an outcome in patient education. Patients and their families will be able to act
independently, to think critically and to develop an improved feeling of self-efficacy
during the empowerment phase (Anderson & Funnell, 2010). Self-effectiveness is a
powerful predictor of self-handling conduct that directly and indirectly influences
behaviour through affecting the target environment, the expectation of results and the
perception of facilitators and impediments. Effective patient care needs a team that puts
the patient at the centre and makes them an active participant. Patients’ advocates are
nurses, and it requires open communication, efficient education, transparent therapy and
responsive care. The nurses are able to empower their clients to take over their own
health. Empowerment of patients and their family members are important for nurses
dealing particularly with patients suffering from chronic illness like diabetes, stroke and
hepatitis B and in such a situation the nurses have to involve with the patients their
families as well as other caregivers. When patients, their families and other caregivers are
associated, their active participation can substantially improve in the areas of care,

“Assignment 3: Portfolio: Community Practice Portfolio”
experience and economic outcomes. When nurses are working to provide patient-
centered intervention for chronically ill patients, it becomes evident that the family offers
the most significant contribution for the daily self-management of the patients and that
family members can play a critical role in the healthcare team.
In empowering patients and their families, nurses play a significant role (Smith et
al., 2013). In addition to providing self-managed self-education strategies for long-term
disease management under chronic diseases, the nurses also provide patients with active
involvement in their care (Rees, 2010). This is done by providing access to information
technology, resources, support for patients and by involving families and caregivers in
the autonomy of the patient in decision-making (Page, 2015). It must be noted that
patient-centred therapy does not simply mean acceptance of all patient demands (Fowler,
Levin & Sepucha, 2011). It includes a major dedication to affordable alternatives for
patient’s awareness by means of sharing information about established facts and
interventions with the patient and the family ("Why The Nation Needs A Policy Push-On
Patient-Centered Health Care | Health Affairs", 2019). The patient, the family and the
health care team must deal with all the problems that affect the care of the patient.
Chronic disease can affect family life in a number of ways. Families can feel
strong emotions, such as guilt, anger, sorrow, fear and anxiety. The nurse can give
emotional and spiritual support, continuous education and support (Langins &
Borgermans, 2016). In particular, four main strategies to involve patients, families and
caregivers can be identified (Ferrer, 2015) as health self-management that involves the
development of knowledge, skills and confidence to manage one's own health (self-care)
and to care for a particular health condition ("CONTINUING PROFESSIONAL

“Assignment 3: Portfolio: Community Practice Portfolio”
DEVELOPMENT", 2017); shared decisions that aid patients in choosing their health,
look at options, including no interventions, consider risks and benefits and evaluate how
available alternatives suit their beliefs and preferences ("Shared Decision-making in
Health Care – Achieving Evidence-based Patient Choice (2nd ed.)", 2009); peer to peer
action support patients to provide and obtain assistance from others in a comparable way
in mutual and shared knowledge ("Peer Support: A Theoretical Perspective", 2010) and
to provide the assistance of family and caregivers. This aims to develop understanding,
skills and actions that enable people to take care of themselves and others.
Patient and family members can combine their efforts to monitor disease symptoms
of the patient, maintain medical appointments and assist patient to adhere to drug regimen
in a chronic disease management approach. Improving health communications and
identifying barriers to self-management of health is the main characteristic of these
programmes (Pulvirenti, McMillan & Lawn, 2012). It can also be a successful strategy to
use technology to maintain behavioral change. Some therapy programmes, which limit
their accessibility, involve frequent travel by patients and relatives. Instead of spending
on travels, patients and their relatives can use technological methods such as the internet
or mobile phone-based programs ("Family members play important role in managing
chronic illness", 2017). The purpose of chronic treatment is not to heal but to improve
functional status, minimize distressing symptoms, extend life and quality of life through
secondary prevention. It is apparent that these goals can not be achieved by the traditional
approach to healthcare, based on a connection between the individual patient and health
practitioners that focuses on individual illnesses. It is equally evident that a patient-
centered strategy needs a model of care by working together with the patient and his

“Assignment 3: Portfolio: Community Practice Portfolio”
family and other staff to optimize health results. Chronic disease confronts patients with
a variety of requirements that require them to change their behaviour, to participate in
physical and psychological wellbeing operations, communicate with medical
professionals and follow therapy regimens, to monitor their health status, take associated
care decisions and to manage the impact of the illness on physical, psychological and
social functioning. In order to investigate the above problems, the Chronic Care Model
(CCM) is used to organize healthcare to improve the outcomes for chronic disease
patients (Stellefson, Dipnarine & Stopka, 2013). In short, the model consists of four
system elements which are deemed essential to excellent chronic disease care namely:
support for self-management, delivery system design and support for decision-making
and clinical information systems. These are set in the context of the health system in
which a well-organized delivery system is interconnected with complementary
community funds and policies of the society (Stellefson, Dipnarine & Stopka, 2013).
Another significant element that should be given due significance is the
economic burden on the family. The loss of a parent on account of chronic disease can
have deep implications for the family unit in individual households. In the workplace, the
growing economic burden of chronic disease will be borne by employers, and society as a
whole will need to better comprehend how to cope with the emergence issue, in particular
through healthcare systems (Golics, Basra, Salek & Finlay, 2013). Healthcare providers
have not yet identified processes for adapting to the burden of chronic illness through the
development of disease prevention schemes or chronic disease management pathways.
The respective governments have to come forward with schemes for supporting such
cases through aids or low-cost financing.

“Assignment 3: Portfolio: Community Practice Portfolio”
The following steps can help the empowerment of patients significantly. Nurses
can recognize behaviour that isolate patients and make them feel that the situation is not
controlled. Solutions can be tried for each item. Instead of offering vague and confusing
post-care instructions, interactive patient education models can be developed to
concentrate on what to do. The administration should be urged to provide patient
communication and commitment training for the entire nursing staffs so that they get
confidence in dealing effectively all patients and their families with whom they come in
contact during their visits.

“Assignment 3: Portfolio: Community Practice Portfolio”
References
Anderson, R., & Funnell, M. (2010). Patient empowerment: Myths and misconceptions. Patient
Education And Counseling, 79(3), 277-282. doi: 10.1016/j.pec.2009.07.025
CONTINUING PROFESSIONAL DEVELOPMENT. (2017). Retrieved 21 September 2019,
from
https://pdfs.semanticscholar.org/4376/19e37016c7fd0c3988a391f097ee42884fa6.pdf
Family members play important role in managing chronic illness. (2017). Retrieved 21
September 2019, from
https://www.sciencedaily.com/releases/2017/10/171016132642.htm
Ferrer, L. (2015). Retrieved 20 September 2019, from
http://www.euro.who.int/__data/assets/pdf_file/0004/290443/Engaging-patients-carers-
communities-provision-coordinated-integrated-health-services.pdf
Golics, C., Basra, M., Salek, & Finlay. (2013). The impact of patients' chronic disease on
family quality of life: an experience from 26 specialties. International Journal Of
General Medicine, 787. doi: 10.2147/ijgm.s45156
Langins, M., & Borgermans, L. (2016). Strengthening a competent health workforce for the
provision of coordinated/ integrated health services. International Journal Of Integrated
Care, 16(6), 231. doi: 10.5334/ijic.2779
Page, P. (2015). Critical illness trajectory for patients, families and nurses - a literature
review. Nursing In Critical Care, 21(4), 195-205. doi: 10.1111/nicc.12199
Peer Support: A Theoretical Perspective. (2010). Retrieved 21 September 2019, from
https://pdfs.semanticscholar.org/8670/0b983d7db6d8716180b26c05a42d6e0ff07b.pdf

“Assignment 3: Portfolio: Community Practice Portfolio”
Pulvirenti, M., McMillan, J., & Lawn, S. (2012). Empowerment, patient centred care and self-
management. Health Expectations, 17(3), 303-310. doi: 10.1111/j.1369-
7625.2011.00757.x
Rees, A. (2010). Promoting and supporting self-management for adults living in the community
with physical chronic illness: A systematic review of the effectiveness... - PubMed -
NCBI. Retrieved 21 September 2019, from
https://www.ncbi.nlm.nih.gov/pubmed/27819974
Shared Decision-making in Health Care – Achieving Evidence-based Patient Choice (2nd ed.).
(2009). International Journal Of Health Care Quality Assurance, 22(5). doi:
10.1108/ijhcqa.2009.06222eae.003
Smith, M., Saunders, R., Stuckhardt, L., McGinnis, J., America, C., & Medicine, I. (2013).
Engaging Patients, Families, and Communities. Retrieved 20 September 2019, from
https://www.ncbi.nlm.nih.gov/books/NBK207234/
Stellefson, M., Dipnarine, K., & Stopka, C. (2013). The Chronic Care Model and Diabetes
Management in US Primary Care Settings: A Systematic Review. Preventing Chronic
Disease, 10. doi: 10.5888/pcd10.120180

“Assignment 3: Portfolio: Community Practice Portfolio”