Learning Outcomes

Care plan for Paul:

Issues/problems	Person-centred Goal	Interventions/ Actions Save Time On Research and Writing Hire a Pro to Write You a 100% Plagiarism-Free Paper. Get My Paper	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 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)	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.
Depression and social isolation because of discrimination and poor satisfaction with health services (Psychosocial issue)	To provide effective health and social care support to client by addressing discrimination and providing holistic and culturally appropriate care	1.To implement individualized interventions like coordinated 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 services as Aboriginal staffs can easily related with social and culture issues affecting health of the client.	Health service and community support staff	Good mental health outcome, positive physical state and overall satisfaction with the service will indicate success of the care plan

 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 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.

Case Scenario

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 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).

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), 

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, 

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. 

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 discussion. Journal of clinical psychology in medical settings, 18(1), 99-107, doi: 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, Decisional Conflict, and Satisfaction. Ophthalmic Epidemiology, 22(6), 387–393

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 Australians: A Qualitative Study. Journal of Medical Internet Research, 18(3), e65. 

Resnick, I., & Brener, L. (2010). Hepatitis C and the Aboriginal population. National Centre in HIV Social Research, the University of New South Wales. 

Rosdahl, J. A., Swamy, L., Stinnett, S., & Muir, K. W. (2014). Patient education preferences in ophthalmic care. Patient Preference and Adherence, 8, 565–574

Singh, A., & Misra, N. (2009). Loneliness, depression and sociability in old age. Industrial Psychiatry Journal, 18(1), 51–55. https://doi.org/10.4103/0972-6748.57861

Surjadi, M., Torruellas, C., Ayala, C., Yee, H. F., & Khalili, M. (2011). Formal Patient Education Improves Patient Knowledge of Hepatitis C in Vulnerable Populations. Digestive Diseases and Sciences, 56(1), 213–219. 

Theodore I., (2017). Aging In Grace and the Effects of Social Isolation on the Elderly Population. OAJ Gerontol & Geriatric Med. Vol. 1, No. 4, DOI: 10.19080/OAJGGM.2017.01.555566

Umfress, A.C. & Brantley Jr, M.A., (2016), July. Eye care disparities and health-related consequences in elderly patients with age-related eye disease. In Seminars in ophthalmology(Vol. 31, No. 4, pp. 432-438). Taylor & Francis, 

Yang, M., Rao, H.-Y., Feng, B., Wu, E., Wei, L., & Lok, A. S. (2017). Patient Education Improves Patient Knowledge and Acceptance on Antiviral Therapy of Hepatitis C in Rural China. Chinese Medical Journal, 130(22), 2750–2751.