Introduction
The given paper delves into the peculiarities of long-term conditions and how people who have them overcome difficulties that emerge in their everyday life. To support the basic assumptions of the paper with credible evidence from real causes, such long-term condition as a chronic obstructive pulmonary disease (COPD) is discussed. Using this disease as the background for the research, the paper aims to examine how patients attitude, beliefs, and perception of illness impact their lifestyles and ways in which they struggle against the problem.
The focus is made on the ability to cope with difficulties associated with these long-term conditions and preserve the high quality of life. For this reason, factors impacting the choice of coping strategies, and their efficiency are discussed in the paper. Additionally, the role of interpersonal communication and collaboration with health workers is revealed regarding the continuous care and patients ability to resist stress and demonstrate appropriate behaviors needed to support the health status at a high level. In such a way, the paper improves the understanding of long-term conditions and how people live with them using different coping strategies.
Regarding the selected topic, numerous ethical concerns emerge in the course of the study. For this reason, confidential information can be used to prove some assumptions and demonstrate the peculiarities of particular strategies of approaches. This information will be kept confidential, and there will be no violations of patients anonymity in the work (all names are changed). At the same time, incomprehension of the code of nurses and midwives, all statistics provided in the paper will also remain confidential (NMC, 2015). It will help to avoid ethical problems and issues.
Attitude and Perception Impact on the Ability to Self-Care
A persons ability to self-care depends on multiple factors. There are numerous examples of patients having the same health issue but demonstrating different treatment outcomes (Reid, 2018; Carrier, 2015). It is preconditioned not only by the physiological peculiarities of every individual; however, researchers state that attitude to the problem and perception are fundamental factors for coping strategies and their efficiency (Carrier, 2015).
The emergence of long-term conditions preconditions significant shifts in peoples lifestyles and perspectives which are inevitable because of the psychological pressure and health problems (Carrier, 2015). These alterations can have either a positive or negative influence on a persons ability to self-care. For instance, patients with COPD should reconsider their attitude toward smoking as it is one of the central risk factors (Weston et al., 2016).
Statistically, patients who gave up this habit are more successful in struggle and show better outcomes (Davies, 2010). At the same time, the negative attitude to smoking cessation and the lack of belief in its ability to improve the quality of life complicate the task and deteriorate outcomes (Davies, 2010). The given example proves the idea that the positive attitude and strong will become an enabler to empowerment and self-care; at the same time, the negative mood and the lack of belief reduce the ability to self-care and deteriorates the quality of life.
Illness perception is another aspect closely related to coping strategies used by patients with long-term conditions. Multiple research works evidence that the lack of health information regarding positive behaviors and practices can be associated with poorer coping strategies, while the comprehensive and in-depth knowledge contributes to the better self-care abilities (Panagioti, Blakeman, Hann, & Bower, 2017).
Investigating this phenomenon in patients with asthma Gartshore, Waring, and Timmons (2017) noted the fact that individuals with poor health literacy were sure that the disease would precondition drastic alternations in their lifestyles and deprive them of the opportunity to perform various activities. Wrong health perception decreases their motivation to struggle and adhere to simple rules. At the same time, more informed patients remained confident and demonstrated a high level of their self-care abilities. This sample proves the importance of the correct illness perception, which promotes patients ability to live regardless of the long-term condition and struggle against it.
Regarding the importance of attitude and illness perception, one of the central nurses tasks is the empowerment of patients to self-care via the gradual improvement of these aspects. One of the possible methods is a motivational conversation (Reid, 2018). As a specialist who helps patients to cope with their long-term conditions and provides the needed assistance, a nurse should talk to a patient to collect data about factors that causes anxiety to him/her (Potter, Kelly, Hunter, Fitzpatrick, & Peters, 2017).
In many cases, they come from the wrong illness perception and the lack of information about how it impacts the health and what complications it might cause. For this reason, motivational and educational conversations might be an efficient tool to empower patients and eliminate barriers to self-care. It will also help to establish trustful relations between the nurse and a patient to increase the efficiency of their cooperation and attain better results.
The Impact of Events on the Ability to Cope
The existence of long-term conditions also means that a patient may come through different stages of his/her life and experience multiple events that have a significant impact on their ability to cope and struggle against the disease. Researchers report that the psychological state of a patient is crucial for outcomes as it preconditions the level of motivation to follow all guidelines regarding the illness (Dawson, Prior, Barton, Blanchard, & Bennett, 2014).
At the same time, a meaningful event might precondition the emergence of psychological trauma and radical alterations in the ability to cope. For instance, Mr. Smith has severe COPD which means that his breathing is complicated and he depends on his relatives and their support. However, his wife who provided the needed care and supported Mr. Smith if the problems with aspiration emerged died from a heart attack. The given event became a significant shock for the patient and triggered the development of depression, indifference to the world, and unwillingness to follow guidelines for patients with COPD disease.
In such a way, Mrs. Smiths death became the event that radically impacted the patients ability to cope and his desire to struggle. Firstly, he lost the main caregiver who helped Mr. Smith to cope with problematic breathing if there were problems with it by using oxygen cushion. Secondly, Mrs. Smith was one of the main motivators who provided the patient with the reason for living, remaining active, and trying to give up smoking and resist severe disease.
The given event demonstrates how coping strategies depend on the psychological peculiarities of the patient and his current state. In other words, any stressor might destroy the balance that is needed to guarantee the efficiency of self-care and precondition the emergence of undesired behaviors in patients that will later result in negative outcomes and the appearance of multiple health issues (Reid, 2018). Under these conditions, nurses task is to be able to assess patients in overcoming difficult states and provide them with the help that can eliminate the negative impact of this very factor and overcome existing barriers.
The choice of the method depends on the peculiarities of every case and event that impacts a patient (Price, 2015). For instance, regarding Mr. Smiths case, grief from his wifes death created the basis for the development of depression. It might have tragic consequences because of COPD and complex symptoms affecting the patient during his daily activities. Reports also evidence that suicidal inclinations might emerge in patients with long-term conditions in periods of grief or some losses (Department of Health, 2011). For this reason, counseling can be considered one of the possible recommendations for the patient.
A nurse can help to select the appropriate course and recommend a specialist who will assess the state of Mr. Smith and introduce a plan of actions (Hogston & Marjoram, (2011). This intervention is needed to empower the patient and improve his self-care abilities impacted by the tragic event. Under these conditions, nurses role can hardly be overestimated as they are the first to admit critical changes in patients with chronic diseases and determine their impact on their coping strategies and the ability to overcome multiple challenges arising in their life because of their health status.
Psychosocial Factors
As has already been stated, patients ability to cope with long-term conditions depends on numerous factors and psychosocial aspects of their living belong to these. They include individual-level processes and meanings that affect patients mental states (Goodwin, Curry, Naylor, Ross, & Duldi, 2010). The outstanding significance of these factors is evidenced by numerous research papers stating that patients who have no problems with their social interactions and are satisfied with their closes circle show better results regarding their recovery from multiple diseases (Department of Health, 2006).
The absence of anxiety, fear, depression, isolation, or unsatisfied demands empowers individuals and increases the efficiency of their coping strategies (Department of Health, 2010). At the same time, the problematic communication with relatives, disregard of existing needs, and lack of care reduce patients chances for recovery and contribute to the emergence of new complications caused by the disregard of prescribed guidelines (BLF, n.d.). In this regard, consideration of psychosocial factors acquires the top priority for nurses and patients with long-term conditions.
Returning to Mr. Smiths case, the death of his wife can also be considered a significant psychosocial factor that should be taken into account. His wife was one of the central caregivers who provided the patient with the needed services and motivated to give up smoking. At the same time, Mrs. Smith was also a source of all social interactions that were performed with her assistance because of problematic breathing and the age of the patient.
Their children live in other states and cannot visit Mr. Smith often, which means that the lack of socialization will emerge. The patient will suffer from isolation, feeling of needlessness, and absence of interlocutors who can share his grief and sympathize with him.
These psychosocial factors also include a particular stage of grief as Mr. Smith has died recently. The combination of these aspects will undermine the patients ability to self-care and reduce the outcomes of treatment. In this regard, psychosocial factors become a significant concern that should be considered to empower individuals with long-term conditions and provide them with a chance to cope with the disease.
A nurse becomes responsible for the provision of appropriate assistance. This health worker is one of the individuals comprising a particular social surrounding needed for a patient. For this reason, communicating and demonstrating appropriate feelings, the nurse will be able to outline the existing psychosocial factors that affect a patient and suggest a particular plan to create a beneficial environment characterized by the existence of all elements needed for successful self-care (Hogston & Marjoram, 2011).
There are multiple options available for nurses that can be applied to various cases regarding their peculiarities. For instance, Mr. Smith who is in one of the grief stages can be recommended to visit support groups consisting of people who have some problems and cannot recover from bereavement (Hanson, 2018).
According to NHS (2016), such groups become a potent tool as they not only help patients to share their feelings, discuss them, and understand that other people are living under similar conditions; however, regular meetings provide individuals with social interaction they lack because of the death of close people and isolation. For this reason, nurses should use such methods to assist patients in dealing with their psychosocial factors.
Recognition and Evaluation of Coping Strategies
At the moment, multiple long-term conditions affect patients in different ways. At the same time, all individuals respond to health problems in different ways because of the peculiarities of their mentality, health status, and motivation. For this reason, various coping strategies are used by the patients to improve their self-care abilities, resist disease, and preserve the high quality of life. The existing scientific literature differentiates two types of coping strategies: active and passive (Hogston & Marjoram, 2011).
The active one includes behavioral or psychological responses made by a patient with the primary aim to alter the nature of factor that impacts the health or change its perception to attain positive results and improve the ability to self-care (Hutchinson, 2016). Active coping strategies are traditionally considered an efficient way to struggle against long-term conditions and preserve an appropriate quality of life. Patients use their resources and control their activities on themselves to attain success.
Thus, the reliance on external resources and on other individuals to resolve stressful events or situations is determined as passive coping (Brien, Lewith, & Thomas, 2016). It is also associated with feelings of helplessness, anxiety, fear. People who engage in passive coping prefer others, in the majority of cases family members or close people, control their lives, and suggest responses to factors affecting their health (Lorig, 2014).
Specialists also give preference to active coping strategies. They are more efficient and demand active patients position and participation, while if a passive approach is chosen some problems remain unresolved (Hutchinson, 2016). However, these two should be differentiated from harmful coping strategies that have only a pernicious impact on individuals and can precondition the emergence of new health problems (Hutchinson, 2016).
For instance, a patient with COPD avoids all physical activities trying to exclude attacks of the disease, shortness of breath, and preserve the high quality of life (Hutchinson, 2016). However, the approach is inefficient as the total lack of activity results in obesity, problems with cardiovascular systems, and high blood pressure. In many cases, the choice of harmful coping strategies is explained by poor health literacy (McVeigh, 2016).
Under these conditions, a nurse, as a specialist possessing an extensive knowledge related to the issue, should recognize inappropriate methods by interviewing patients how they cope with their long-term conditions focusing on health strategies (Mendels & Shore, 2015). It is critical to stop patients in the first stages to prevent further harm.
At the same time, the nurse should also assist patients in selecting and adopting beneficial coping strategies that will help them to recover. All factors affecting a patient at the moment should be considered to choose the most effective way to struggle against the disease. The individuals readiness to engage in various activities should also be analyzed as it determines whether passive or active coping will be efficient (Meerabeau & Wright, 2011). In general, a nurse should suggest a list of strategies he/she considers beneficial to discuss with a patient and select the most appropriate one.
Role of Communication
Speaking about factors critical for continuing care and affecting the state of patients with long-term conditions, communication should be given special attention. The fact is that regardless of the state of patients, coping strategies used by them, and their ability to self-care, it remains one of the most efficient tools to motivate individuals, provide them with the needed information regarding the disease, and outline the existing barriers to recovery.
Specialists working with this category of patients assume that communicating with them, they can create an environment beneficial for their recovery by outlining perspectives of care and fundamental element that should be observed (Nicol, 2015). At the same time, communication remains a potent tool for the investigation of patients needs and approaches used by them to resist the deterioration of their health status (NHS, 2015).
On the other hand, communication is one of the fundamental aspects that affect patients who have long-term conditions. By the latest research, the lack of social interactions that include communication reduces patients ability to self-care and decreases the efficiency of coping strategies (NHS, n.d.a). It is preconditioned by the fact that individuals start to feel lonely and forgotten because of their unusual health status. As has already been stated above, these feelings negatively influence their ability to cope and outcomes.
In this regard, nurses working with this category of patients should be ready to recognize specific communication needs to ensure that positive outcomes can be achieved. They play a central role in this process as being responsible for the delivery of care, they are the first to communicate to patients and admit the existence of the deficit of communication. It might be signaled by depressed mood, lack of confidence, feeling of helplessness, and isolation (NHC, n.d.b).
Health workers should give special attention to patients who do not have families because of their loneliness. This category comprises a risk group as the chance for the development of depression is especially high in them (NHS, 2015). In such a way, recognition of their needs for communication becomes an important nurses task to improve their ability to self-care. At the same time, specialists should be ready to provide options for a patient to engage in social interactions and enjoy talking to other people. There are the special focus or support groups where people with similar problems or lack of communication share their feelings and acquire new friends (Snoddon, 2010). It can be an appropriate option for this category of patients.
Finally, the focus on patient-centered care means that nurses should select communicative patterns the meet patients requirements for communication and provide them with the needed level of attention. In other words, these health workers should adapt their approach to every patient because of the radical differences in individuals needs, cultures, and mentalities. A nurse should be ready to communicate regarding a particular case and its unique peculiarities avoiding standardized patterns as they demonstrate poor efficiency under these conditions (Owens et al., 2017).
Conclusion
Altogether, the paper discusses fundamental aspects associated with long-term conditions and patients ability to self-care in different situations. From the work, one can understand that the efficiency of coping strategies depends on multiple factors impacting a patient at the moment. These include attitudes, illness perception, psychosocial aspects, and meaningful events. They contribute to the creation of a particular environment that can have either a beneficial or negative impact on patients.
For this reason, nurses, as caregivers responsible for the monitoring of these patients states, should be ready to assess their states to determine factors that impact individuals and determine their nature. Positive elements should be cultivated; however, it is critical to ensure that all barriers to the delivery of care and improved self-care are eliminated. The paper also evidences the need for appropriate nurses interventions and assistance to ensure that patients adhere to efficient coping strategies and can resist the pressure associated with long-term conditions. In this regard, these health workers role in the provision of continuous and patient-centered care could hardly be overestimated as they become the central actors responsible for patients outcomes and their readiness to keep struggling.
References
BLF. (n.d.). 6 tips for living well with COPD. Web.
Brien, S., Lewith, G., & Thomas, M. (2016). Patient coping strategies in COPD across disease severity and quality of life: A qualitative study. NPJ. Primary Care Respiratory Medicine, 26, 16051. Web.
Carrier, J. (2015). Managing long-term conditions and chronic illness in primary care: A guide to good practice. Abingdon, UK: Routledge.
Davies, N. (2010). Improving self-management for patients with long-term conditions. Nursing Standard, 24(25), 48-56. Web.
Dawson, T., Prior, F., Barton, J., Blanchard, A., & Bennett, P. (2014). Family guide to long term conditions: A performance guide book. London, UK: Rescon.
Department of Health. (2006). Self care. A guide to developing local strategies and good practice. Web.
Department of Health. (2010). Personalised care planning. Web.
Department of Health. (2011). What motivates people to self care. Web.
Gartshore, E., Waring, J., & Timmons, S. (2017). Patient safety culture in care homes for older people: A scoping review. BMC Health Services Research, 17(1), 752. Web.
Goodwin, N., Curry, N., Naylor, C., Ross, S., & Duldi, W. (2010). Managing people with long-term conditions. Web.
Hanson, A. (2018). Live your life, not your diagnosis: How to manage stress and live well with your new health condition. London, UK: Morgan James Publishing.
Hogston, R., & Marjoram, B. (2011). Foundations of nursing practice: Themes, concepts and frameworks. London, UK: Palgrave Macmillan.
Hutchinson, D. (2016). Long term conditions: A manual for general practice nurses. London, UK: CreateSpace Independent Publishing Platform.
Lorig, K. (2014). Self-Management of long-term health conditions. London, UK: Bull Publishing Company.
McVeigh, H. (2016). Fundamental aspects of long term conditions. London, UK: Mark Allen Group.
Mendels, E., & Shore, S. (2015). Marriage and lasting relationships with Asperger’s syndrome (autism spectrum disorder): Successful strategies for couples or counselors. London, UK: Jessica Kingsley Publishers.
Meerabeau, L., & Wright, K. (2011). Long-term conditions: Nursing care and management. Oxford, UK: Wiley-Blackwell.
Nicol, J. (2015). Nursing adults with long term conditions (2nd ed.). London, UK: Sage.
NHS. (n.d.a). Coping with long term physical health conditions. Web.
NHS. (n.d.b). Dealing with the challenges of long-term illness. Web.
NHS. (2015). Strategic framework for the management of long term conditions. Web.
NHS. (2016). Living with chronic obstructive pulmonary disease (COPD). Web.
NMC. (2015). The code. Professional standards of practice and behaviour for nurses and midwives. Web.
Owens, J., Entwistle, V., Cirbb, A., Skea, Z., Christmas, S., Morgan, H., & Watt, I. (2017).”Was that a success or not a success?”: A qualitative study of health professionals’ perspectives on support for people with long-term conditions. BMC Family Practice, 18, 39. Web.
Panagioti, M., Blakeman, T., Hann, M., & Bower, P. (2017). Patient-reported safety incidents in older patients with long-term conditions: A large cross-sectional study. BMJ Open, 7(5). Web.
Potter, C., Kelly, L., Hunter, C., Fitzpatrick, R., & Peters, M. (2017). The context of coping: A qualitative exploration of underlying inequalities that influence health services support for people living with long‐term conditions. Sociology of Health & Illness, 40(1), 130-145. Web.
Price, B. (2015). Understanding attitudes and their effects on nursing practice. Nursing Standard (Royal College of Nursing (Great Britain) : 1987), 30(15), 50-60. Web.
Reid, P. (2018). Coping with a long-term health condition. Web.
Weston, C., Gilkes, A., Durbaba, S., Schofiled, P., White, P., & Ashworth, M. (2016). Long term condition morbidity in English general practice: A cross-sectional study using three composite morbidity measures. BMC Family Practice, 17, 166. Web.
Snoddon, J. (2010). Case management of long-term conditions: Principles and practice for nurses. London, UK: Wiley-Blackwell.