Introduction
PTSD is one of the most widespread diagnoses that affect both the individual’s mental health and physical state, making it worth precise attention from healthcare professionals. At the same time, every person has an individual experience connected with trauma, which means that the reactions to the stressful situation can be completely different among several patients with the same diagnosis. This paper focuses on the existing policies concerning care coordination among patients who have PTSD, emphasizing the need for the individual approach to treatment articulated in the “Healthy people 2030” document. The personal character of trauma and how the patient reacts to it justifies the need to design patient-centered interventions to address this healthcare problem.
Discussion
The patient-centered health intervention plan and timeline are designed for a 64 years old woman diagnosed with PTSD. She has become the victim of long-term physical and emotional abuse from her ex-husband’s side. Now, the woman lives alone and receives medical assistance to alleviate the symptoms of the trauma. The woman is now retired, her adult child lives in another city, she has no friends, and her integration into society is comparatively low, aggravating her emotional state. She also suffers from chronic headaches, mainly migraine pains, and high blood pressure. The current plan should address three healthcare issues the patient faces depression, high blood pressure, and migraine. Addressing these health issues while coordinating care for PTSD is essential because all three diagnoses influence the patient’s state.
Therefore, the intervention for each health issue should be based on the patient’s individual requirements. High blood pressure is the first health issue to address in care coordination for a patient with PTSD. Combining drug therapy with the necessary lifestyle changes is vital, including supporting healthy weight, regular moderate physical activity, healthy eating habits, avoiding alcohol, and having enough sleep (Stafford, 2018). Regular blood pressure checks are also vital in managing the therapy of this diagnosis. High blood pressure starts from 130/80 mmHg, meaning the patient should pay precise attention to her state (Stafford, 2018).
Using drugs daily to avoid the critical situation with blood pressure is an essential therapy component. They include using calcium channel blockers that protect the blood vessels and heart’s muscle cells; angiotensin-converting enzyme inhibitors that do not allow blood vessels to narrow excessively, which is the cause of high blood pressure; and beta blockers that support the heart rate (Stafford, 2018). Therefore, the complex approach to managing the patient’s high blood pressure is essential in creating the individual care plan and schedule.
The community resources for this health intervention are the local hospital, the drug store, and the park. The woman can check her blood pressure in the local drug store and buy all necessary medications there. She can ask for professional help in the hospital, where the nurse and the physician will provide her with qualified assistance. The local park is where the patient can exercise lightly to support the moderate physical activity critical for managing high blood pressure. The objectives, as mentioned earlier, are consistent with the ideas articulated in the document “Healthy people 2030.” For instance, the recommendations concerning healthy eating, moderate physical activity, and blood pressure control are among the most vital parts of the description of older adults (ODPHP, 2022). The patient, whose case is discussed in this health provision plan, belongs to this age group, and the recommendations correspond to her needs.
The second health issue is depression, among the most common consequences of PTSD when the person cannot cope with the trauma they experienced. The patient reports her loneliness because she lives alone, and her contacts with the adult child are rare. Her memories of communication with her ex-husband are traumatic for her, which leads to her lack of desire to make new acquaintances. The woman requires regular interaction with the psychologist who helps her to cope with the traumatic memories and to integrate into society (Zhang et al., 2018). According to the document “Healthy people 2030,” physical activity and social integration are vital parts of mental health (ODPHP, 2022). As a result, the patient should receive recommendations about regular physical activities to reduce the symptoms of depression. In addition, she needs moderate outdoor workouts to control her blood pressure.
Treatment of depression is impossible without appealing to community resources. The patient with the symptoms of depression suffers from loneliness and hesitates about integrating into the community. The previous trauma in communicating with people makes this process challenging. It is possible to assume that the church community, the gatherings of the older adult people from the neighborhood, and visiting the psychologist are three community resources that might help the patient in this health intervention. Religion and psychological help provide the person with depressive signs and spiritual and moral support that are vital in finding inner balance (Zhang et al., 2018). Communication with people of the same age might have a therapeutic effect due to the common memories and experiences these people share.
The third issue is migraine, the chronic neurological diagnosis that causes recurring pain and significantly reduces the quality of the patient’s life. The diagnosis is complex, and the patient does not receive medical treatment for this hype of headaches (Burch, 2019). It is possible to propose that the woman receive preventive migraine treatment, but they do not eliminate the headache. They make the severity and the frequency of the attacks comparatively rare (Burch, 2019). Another option for managing migraine is taking painkillers when the first symptoms of the headache appear, which makes the pain less severe (Burch, 2019).
Managing chronic pain is the essential objective of the report “Healthy people 2030” because it spoils human life significantly (ODPHP, 2022). The community resources that can help in this health intervention are similar to the previously described ones. The patient should introduce the physical activity, communication with other people, and regular visits to the hospital to alleviate her health state.
Patient-centered health interventions concentrate on the patient’s needs and desires. Ethical controversy might arise when the patient disagrees with the prescription and does not want to follow the recommendations. For example, the woman from this case study has suffered from migraines for many years and does not want to use preventive therapy due to its insignificant effect. It might be more ethically justified to insist on managing high blood pressure and depressive symptoms because the results of these decisions are more practically measurable. The ethical question that generates uncertainty about the decisions made in this treatment plan is connected with the will of the patient and the prescription. The question is whether it is justified to insist on preventive therapy for acute headaches if the patient does not want it.
The relevant health policy implication for the coordination and continuum of care is connected with wellness. Promoting a healthy lifestyle that includes physical activity, diet, supporting healthy weight, and regular sleep is consistent with the measures described in the healthcare plan. The World Health Organization report defines collaborative care planning and shared decision-making (WHO, 2018). The priorities that a care coordinator needs to establish while discussing the treatment plan with a patient are connected with the practical opportunity of the person to follow these recommendations and their readiness to do it. It is essential to listen to the patient in the shared decision-making, which is a significant change in composing the treatment plan because when the patient does not want to follow specific recommendations, they ignore them.
Conclusion
It is critical to adapt care to the needs of the particular patient because meeting the person’s requirements constitute the basis of the patient-centered approach. Patient-centered health interventions require an individual timeline, which means that the nurse has to find ways of applying general principles to every patient’s case. It might be a complicated task for the nurse, foregrounding the need to appeal to the patient’s family to support the initiative and alleviate the patient’s state by unifying the powers. At the same time, the care coordinator should listen to the patient’s desires in all situations because not all people want their family members to assist them in the hospital environment or avoid showing their weaknesses to people they love. Therefore, all healthcare policies affect patient-centered care because they determine the approach to nursing and care coordination.
References
Burch, R. (2019). Migraine and tension-type headache: Diagnosis and treatment. The Medical Clinics of North America, 103(2), 215–233. Web.
ODPHP. (2022). Healthy people 2030. US Department of Health and Human Services. Web.
Stafford, R. S. (2018). New high blood pressure guidelines: Back on track with lower treatment goals, but implementation challenges abound. American Journal of Preventive Medicine, 55(4), 575–578. Web.
World Health Organization. (2018). Continuity and coordination of care. WHO. Web.
Zhang, Y., Chen, Y., & Ma, L. (2018). Depression and cardiovascular disease in elderly: Current understanding. Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia, 47, 1–5. Web.