Developing a Self-Management Plan for a Patient Essay

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Table of Contents

Introduction and SMART Goals
Consumer Directed Care and Self-Management
Conclusion
References

Introduction and SMART Goals

A 32-year-old male patient, Peter Dawson, is admitted to the hospital. A background check reveals that he works from home as a software developer and enjoys playing online games with friends and staying up late at night. Peter’s height is 177cm, and he weighs 57kg; therefore, his calculated BMI is 18.1. Peter was diagnosed with Crohn’s disease in his early 20s and since then has lived healthy while managing the acute symptoms on his own. Peter lives alone, while his closest relative lives in Queensland. Currently, a new colostomy bag has been fixed due to the acute and severe symptoms of the disease that emerged.

Crohn’s disease is a chronic inflammatory bowel illness that causes the gastrointestinal system to be persistently inflamed. The disease causes several health concerns which need prompt intervention. First, the disease causes chronic pain, especially in the abdomen, due to the inflammatory process (Bakshi et al., 2021). Chronic pain can cause a disruption in one’s daily activities. Therefore, it is essential to design a plan to help these patients manage their pain even when at home. Another vital aspect that should be included in the self-management plan is the control of diarrhea, evidenced by hyperactive bowel sounds and gases (Torres et al., 2017). The disease exposes one to a risk of losing a lot of fluids, resulting in dehydration. Another significant health concern that comes in handy with Crohn’s disease is weight loss due to excessive fluid loss. Even with proper calorie intake, weight loss may still ensue due to inflammation. Inflammation may result in increased use of the energy stored by the body and disintegration of bodily tissues- both can contribute to weight loss (Elburki et al., 2017). Hence, in preparing a self-management action plan for Peter, it is of essence to outline ways of ensuring that he has a significant weight gain for the next month.

An essential goal in managing Crohn’s disease is the alleviation of chronic pain. For that reason, the first goal is that pain will be managed at a scale of 3-4/ 10 for the next month. To guarantee pain management is effective, the client will go home with a prescription for pain relievers such as paracetamol and Endone. Another goal is that after a month of intervention, the patient will report reduced stool frequency and restored stool consistency to normal levels. In order to ensure that this is achieved, the patient will be discharged and given prescriptions for diarrhea-controlling medications such as Flagyl and Amoxicillin. The last goal is to increase the target of a normal BMI range of 18.5- 26 from 18.1 and an absence of indications of malnutrition. This must be accomplished by ensuring that the patient maintains healthy eating habits. Additionally, the patient will be given medications that help reduce diarrhea which can cause weight loss. For instance, he will be given antibiotics.

Consumer Directed Care and Self-Management

A self-management program is an assistance offered to persons with chronic diseases to help them monitor their health on an everyday level following discharge from the hospital. Self-management support may encourage individuals to understand more about their problems and play an active part in their health care. Support for clients’ self-management extends beyond merely providing information. In addition to a dedication to patient-centered care, it invites for the provision of meaningful and concise information to patients, the assistance of patients in setting goals and making plans to live a healthy lifestyle, the establishment of a crew of healthcare professionals, and the utilization of office platforms to support client follow-up. Individuals’ capacity to enhance their health is the goal of all self-management intervention initiatives.

Patients with long-term diseases make frequent use of healthcare services. Therefore, individuals’ responsibility in maintaining their long-term illness is significantly crucial. By increasing awareness and assistance for individuals living with a chronic ailment, healthcare professionals empower them to take an active role in managing their health, transforming them into ‘expert patients.’ This includes individuals taking steps to enhance their healthcare and well-being and collaborating with their health providers to improve their ability to manage day-to-day challenges. Furthermore, by empowering the patient with the confidence to manage the condition on his own, he will be able to make optimum use of their medications and treatments, resulting in adherence to the drugs and hence achieving the most significant potential results.

Through self-management, the patient will be able to identify the factors that aggravate or alleviate his condition. For example, according to a new study, patients suffering from severe pain may get depressed or scared and wish to end their lives (Michaelides et al., 2019). In addition, patients are often unable to perform many of the activities they could perform previously without discomfort. This condition of living in despair impacts their interactions with others and their ability to continue employment in some cases. Hence, a self-management plan helps the patient understand the factors that might cause the pain to increase, thereby forcing the need to control and reduce it.

As an example of tertiary preventive measures, self-management will help the client include his tertiary preventive initiatives at his level of functional status. In addition to teaching problem resolution and creativity in the management of sickness, these treatments may be used in various contexts and enhance the utilization of facilities in the community. These effective self-management interventions can be used in all stages of prevention and health, not only tertiary prevention (Anekwe et al., 2021). The ability to intervene at the individual level through self-management may have a favorable impact on health and wellness practices. A method based on self-management customized to diverse situations may conceivably be beneficial in preventing difficulties, establishing a healthy lifestyle pattern, and giving tools for reducing and managing sickness in later life.

Perfect health and the effectiveness of any therapy or intervention can only be achieved if patients actively participate in their care. A self-care plan may assist the patients in establishing and specifying realistic, attainable objectives for the client and provide a quantitative marker for achievement and satisfaction that these goals are fulfilled (Vernon-Roberts et al., 2018). As a nursing intervention, it successfully incorporates clients in their care and management, and it may help patients who are at threat of anxiety or are showing signs of stress. For example, in this case, Peter demonstrates a feeling of fear when he says that sometimes he is in shock due to worsening his condition. In this case, a proper care plan for managing anxiety will help him once he is discharged. With a self-management plan, the patient may enhance his treatment experience, gain more control of the disease, and feel more empowered in making self-care behavior adjustments.

The self-management plan also makes it possible for the patient to understand better how to handle and care for invasive devices. With appropriate healthcare education on the management of the device, he will be able to handle it and clean it at home without much assistance from healthcare workers or relatives. For instance, in the scenario, Peter has a temporary stoma inserted. According to the findings of a recent study, the training of stoma-management competencies at an early age is a significant issue for the health facility stoma care nurse (Kirkland-Kyhn et al., 2018). To guarantee that no important parts of educating and learning are overlooked, teaching should be done systematically, underpinned by solid foundations of education and understanding. It is essential to develop realistic learning outcomes in conjunction with the patient, taking into consideration their readiness and aptitude to learn (Kirkland-Kyhn et al., 2018). A structured exchange of knowledge between the hospital and the patient will confirm that learning and support are provided to patients after they have been discharged from the hospital, approving positive changes to stoma formation. As a result, this will enable them to complete their rehabilitation successfully.

Self-Management Care Plan.

Goals and corresponding intervention	SMART GOAL 1: Management of pain on a scale of 3-4/10 every day until the next appointment in a month.	SMART GOAL 2: The patient will report reduced stool frequency and restored stool consistency.	SMART GOAL 3: Increase in weight by attaining a normal BMI range of 18.5- 26 from 18.1 and an absence of indications of malnutrition.
Self-Management Intervention 1 and Rationales	Encourage the patient to take pain medications as prescribed without skipping days. Analgesics such as panadol act by inhibiting pain mediators such as prostaglandins (Peritore et al., 2020). Adherence to pain medications will ensure that the pain level does not exceed a scale of 4/10.	Encourage the patient to take oral fluids gradually and avoid cold liquids. Gradual fluids rest the colon by avoiding or reducing the stimulant effect of meals and water. Taking liquids gradually may minimize cramps and relapse of diarrhea; nevertheless, cold drinks may promote intestinal motility activity (Costa et al., 2017).	Teach the patient how to advance with his diet. For instance, Clear liquids then develop to the minimal residue; then high-protein, increased calorie, caffeine-free, non-spicy, and low-fiber drinks. The rationale is to reintroduce the intestinal system to the digestion process. Protein is required for the integrity of the regenerating tissue (Trentesaux et al., 2020). Reduced mass reduces the peristaltic response to meals.
Self-Management Intervention 2 and Rationales	Teach the patient non-pharmacological pain relievers such as proper position, music therapy, companionship, and deep breathing techniques, among others. Non-pharmacological methods help minimize side effects and drug dependence (Duff et al., 2018). Additionally, they aid in reducing stress, discomfort, and despair.	Encourage the patient to take adequate bed rest and avoid heavy activities. Adequate rest is essential since it slows intestinal motility and metabolic activity (Costa et al., 2017). In addition, the need to defecate may arise without indication and be uncontrolled, raising the threat of incontinence.	Educate the patient on the essence of maintaining good oral hygiene. The flavor of food may be improved by keeping the mouth clean, and this may increase the appetite. Therefore, dentures must be clean, comfortable to use, and present in the patient’s mouth to stimulate eating.
Self-Management Intervention 3 and Rationales	Assist the patient in making proper dietary choices that limit their consumption of dairy products, caffeinated beverages, alcohol, and fiber-rich foods. The rationale is to relieve pain radiating in the abdomen, reduce cramping and promote healthy eating habits.	Identify and advise the client to avoid foods and liquids that cause diarrhea—for instance, dairy products, sauces, and carbonated beverages. Intestinal relaxation and reduced effort are promoted by eliminating intestinal irritants (Costa et al., 2017).	Teach the patient to aim for six nutrient-dense foods instead of three big meals each day to avoid feeling stuffed. Eating small, regular meals reduces the sensation of being stuffed and reduces the desire to vomit after eating.
Self-Management Intervention 4 and Rationales	Advise the patient to take a sitz bath at least twice a day. Crohn’s disease can result in complications such as anal fissures; therefore, enhancing cleanliness in the perineal area would be vital in reducing pain.	Educate the patient to look for warning indicators, including fever, dehydration, tachycardia, and anxiety. Teaching the patient the danger signs will enhance prompt medical attention since the patient can contact the hospital immediately once they arise.	Consult with a dietitian for a comprehensive nutrition evaluation, as well as a plan for obtaining nutritional assistance. Specialists such as dieticians can assess nitrogen balances as a measurement of the dietary state of the patient. For example, a low nitrogen balance can signify protein deficiency (Burd et al., 2019). Dieticians may also assess the daily patient needs for certain nutrients to ensure appropriate nutritional intake.
Self-Management Intervention 5 and Rationales	Together with the patient, determine what factors contribute to or relieve pain. The purpose is to ascertain triggering or exacerbating aspects such as stressful situations or dietary intolerance and monitor emerging issues.	Encourage the patient to take medications for alleviating diarrhea as Flagyl and Amoxicillin. Flagyl is an antibiotic that helps treat infections by disrupting the DNA and protein synthesis of the organisms (Szöke-Nagy et al., 2019). Amoxicillin kills infection by causing cell death in a susceptible organism (Szöke-Nagy et al., 2019).	Encourage the patient to seek out the social company at mealtimes if possible. It is critical to consider the social aspects of eating since family and friends can help encourage one to eat. Family and friends can also understand the preferences of the patient’s needs.
Self-Management Intervention 6 and Rationales	Teach the patient how to properly clean the perineal area with light soap and water after excretion and how to care for their skin. Protects the skin from intestinal acids, so reducing excoriation and alleviating discomfort.	Recommend foods high in potassium to the client, such as potatoes and dates. A person who suffers from diarrhea will have hypokalaemia because their gastric contents are washed out of their digestive system into their excrement and out of their body (Bazerbacih et al., 2017).	Encourage the patient to eat in a comfortable environment while also assuming a comfortable position. A pleasant environment reduces stress and makes eating more comfortable. At the same time, maintaining a good posture improves swallowing and decreases the risk of aspiration when eating (Aguila et al., 2020).
Self-Management Intervention 7 and Rationales	Teach the patient the importance of having periods of rest. It’s possible that discomfort is made worse by exhaustion. However, rest and pain relief may be achieved in a peaceful, distraction-free environment.	Emphasize hand cleaning after bowel movements and before food preparation to clients and the patient. Contaminated hands have the potential to transmit germs and lead to further complications. Additionally, the maintenance of proper hygiene increases one’s appetite.	During the acute period of sickness, encourage the patient to have adequate bed rest and minimal exercise. Additionally, recommend a period of relaxation prior to meals. Reduced metabolic requirements assist in avoiding caloric exhaustion and energy conservation (Lacourt et al., 2018). As a result, peristalsis is slowed, and potential feeding energy increases.

Conclusion

In general, physicians and other healthcare professionals, particularly nurses, can play an essential role in promoting self-management in their clients by strengthening their ability to control their condition through positive reinforcement and education. It is also vital that they pay attention to the nature of their interaction with their clients of all ages as well as the nature of their conversation with them. Assessing and providing opportunities for people with IBD to interact with other clients through support network programming may be beneficial in boosting self-management, both directly and indirectly, through increased self-efficacy in the treatment of their disease. Assessing and providing opportunities for people with IBD to interact with other clients through support network programming may be beneficial in boosting self-management, both directly and indirectly, through increased self-efficacy in the treatment of their disease. Research demonstrates that it is possible to effectively administer treatments aimed at improving treatment adherence and general self-management, even though these techniques require effort and time on the part of the medical team.

References

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Szöke-Nagy, T., Porav, A. S., Coman, C., Cozar, B. I., Dina, N. E., & Tripon, C. (2019). Characterization of the action of antibiotics and essential oils against bacteria by surface-enhanced Raman spectroscopy and scanning electron microscopy.Analytical Letters, 52(1), 190-200. Web.

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