Introduction
Early diagnosis of chronic diseases is important in the prevention of disability. Health care professionals should try as much as they can to identify a disease early and start treatment before disability sets in. Besides, disability affects the psychological, social, spiritual and economic life of a person.
This paper presents a report of the interview of a patient with fibromyalgia. It include the summary of the disease, description of the individual interviewed, results of the interview, application of the developmental theories and concepts as well as summary and conclusion.
Brief summary of disability
Fibromyalgia is a condition in which the patient has pain as well as tenderness in most parts of his body especially the joints and the muscular parts (Ostalecki, 2007). It is common in women who are between the ages of twenty five to fifty five. This condition is associated with general malaise, insomnia, frequent headache, stress, anxiety and depression. Health care professionals do not know the exact cause of fibromyalgia.
Clauw & Wallace, (2010) stated that, the risk factors of fibromyalgia are trauma, abnormality of the brain in interpreting pain signals, poor sleep pattern and viral infections. In terms of clinical presentation, conditions like depression, hypothyroidism and sleep disorders resemble fibromyalgia.
The main presentation of fibromyalgia is pain and tenderness, which can be mild, moderate or severe (Ostalecki, 2007). The pain begins on the muscles of the back, neck and the shoulder and then spread to the upper and lower extremities. Although the patient experiences a sharp and burning pain coming from the joints, fibromyalgia does not affect the joints.
Patient may either experience pain during the day, at night or throughout. The pain is aggravated by stress, cold weather, anxiety and vigorous activities. Due to the pain, the patient may not sleep at night and he wakes up feeling exhausted. The patient with fibromyalgia may also present with fatigue, depression, insomnia, cognitive disturbance, tingling sensation, activity intolerance and migraines (White et al., 2012).
The aim of treatment is to promote comfort by alleviating pain, other manifestations and assisting the patient to live with the condition. According to Clauw & Wallace, (2010) the first line treatment is physiotherapy, psychotherapy and exercise programs.
Medications like deloxetin, pregabalin and milnacipran are used with the aforementioned therapies to alleviate pain and induce sleep. Cognitive therapy is imperative because it assist the patient to cope with the condition (Ostalecki, 2007). Other management includes group therapy and good nutrition.
Description of the individual interviewed
According to the demographic data, the person I interviewed was a female patient. She was fifty five years of age. She was married to one husband. She had studied up to high school diploma. Her occupation was housing inspector.
The life development stage of that patient according to Erik Erikson’s theory of psychosocial development is Generativity versus stagnation. This is because the patient is fifty five years old. According to Erik Erikson’s theory of psychosocial development, the aforementioned stage occur in the middle adulthood when a person is between the ages of forty and sixty five (Bernstein et al., 2011).
At this stage of development, the goal of a person is to create those things that will last forever by giving birth to children who can change the society or empowering people with knowledge and skills. Generativity is the ability of a person to guide others to do something that will make their lives better while stagnation is failing to contribute to the society in a positive way (White et al., 2012).
At this stage, a person should not only relate well with the family members but also the people he works with and the community. Generative people are usually happy because their contributions are imperative to the whole universe while those who stagnate feel sad because they are unproductive.
The typical life development task of a person at generativity versus stagnation stage is to guide people and make a positive contribution to the society (Meleis, 2007). Some of the activities that a person should engage in include living a healthy lifestyle, maintaining good relationships with people, being proud of what he has done and adjusting to the biological, psychological and physical changes of middle age.
Additionally, Bernstein et al., (2011) stated that at the above mentioned stage, a person should express love in different ways apart from the physical contact, make the home comfortable and guide as well as counsel children so that they mature into responsible adults.
Results of interview
The patient has had the disability for more than twenty years since the onset of the disease. The condition is severe that she cannot get out of the bed. The condition has negative effects on her life. Prior to the disease process, she could provide for the family members without asking for help from any person. Currently, she cannot perform activities of the daily living on her own.
For instance, she has to ask for help when she wants to tie the laces of her shoes because she has severe pain. Additionally, she cannot take a full time job because she is uncertain of whether she would wake up in the morning with energy to work or exhausted.
Her condition has also affected the life of the family members. To begin with, the life of her daughter has been greatly affected. When the daughter was young, she used to enjoy watching her mother doing things together with her older brother and wishing for that time that she would be the one in his brother’s position.
Unfortunately, when she became old enough, she could not work collaboratively with her because of the disability. As a result, the daughter has been blaming her for anything that goes wrong because she did not spend more quality time with her as she did with the brother.
Her intimate life with her spouse of thirty five years stopped. At one point, the spouse had an affair and he said that the main reason was because she did not have the desire to have sex and she was unable to do so. She said that after two years of separation and many sessions of couple therapy, they are now together and working on how to start their relationship again.
The most difficult adjustments that she had to make were coping with the diagnosis of fibromyalgia and being helpless. She reported that not being able to do anything that she had done before the diagnosis of fibromyalgia was the hardest adjustment. She has handled these adjustments by taking one day at a time and not rushing into anything.
According to the opinions of medical, rehabilitation and other health care providers who have managed her, she was initially told that she had a psychological problem and nothing was wrong with her. To calm her down, the health care providers gave her antidepressants to relieve depression and hypnotic medications to induce sleep. She reported that she felt like they were just trying to put a band-aid on the problem.
She went for a physical therapy but stopped because it was too painful. Eventually, one doctor did some more investigations and made a diagnosis of fibromyalgia. Since then, she has had a good therapeutic relationship with the doctor and she will continue to visit him for reviews.
Application of developmental theories and concepts
According to the stage model by Kubler Ross, the patient is at the acceptance stage. In acceptance stage, a person is ready to face any challenge (Bernstein et al., 2011). The patient reports that she takes one day at a time. This shows that she is ready to face challenges as they come. Although this stage varies depending on the condition of a person, many people usually come to term with their morals or any catastrophic event.
For example, the patient has accepted the fact that she has fibromyalgia and that she cannot do most of the things for herself. This is the reason why she is not ashamed to ask someone to tie the shoelace for her. Meleis (2007) stated that a sick person usually enters this stage before any family members.
This is because the sick person is the one experiencing the physical, psychological and emotional effect of the disease while the others are trying to cope with their grieving mechanisms.
From the report of the patient, it is evident that she accepted her condition and all the negative impacts before any other family members. This is the reason why she does not complain when other family members are against her. For instance, she does not complain when her daughter accuses her for negligence and when the husband cheats on her.
The husband of the patient is currently at the acceptance stage. Bernstein et al., (2011) stated that, the acceptance stage is a creative period where people try to explore new ways of doing things. The patient reports that they are working together on how they can start a new relationship.
This shows that the husband has accepted the condition of her spouse and is ready to do what it takes to make her happy. In this stage, people are usually optimistic and believe that there is light at the end of the tunnel.
The daughter of the patient is at the anger stage. In the anger stage, the person directs his anger to any object or a person (White et al., 2012). From the patients report, the daughter is directing his anger to her. Besides, at this stage, the person has feelings and believes that cannot be changed easily. For example, the daughter believes that the mother is responsible for any mistake that she commit because she neglected her.
The patient’s condition has affected the life developmental stage by causing a crisis between generativity and stagnation. When an individual is willing to help the society but he cannot because of some barriers a crisis occur. The patient is willing to help the society but she cannot do anything because of her disease condition. For instance, she cannot go to work and as a result, she cannot participate in activities that build the nation.
When an individual is experiencing a crisis between generativity and stagnation, he cannot help other people build the nation and as a result he present with signs and symptoms of depression (Bernstein et al., 2011).
According to the patients report, she is in the aforementioned crisis because she cannot counsel her daughter so that she becomes a responsible adult. Additionally, she cannot take good care of herself and maintain good relationship with the others.
The condition of the patient will also have a great effect on the life development stage of integrity versus despair if she does not receive quality care. This is because, at this stage, people usually reflect about their past life to determine if it was meaningful (White et al., 2012). Someone with regrets is likely to have a feeling of despair.
Summary and conclusions
The interviewees experience support the theoretical and conceptual information covered in the course. To begin with, the interviewee and the family have passed through the five stage model by Kubler Ross. The interviewee was at the denial stage when did not believe that she could not do what she used to do before the diagnosis.
She was at the depression stage and presented with symptoms of depression and that is the reason why she was given antidepressants. Eventually, she accepted the reality and entered into acceptance stage. As a result, she has a positive attitude towards life. On the other hand, the husband of the interviewee started with a denial stage by not believing that his spouse sexual life can change.
He then entered into acceptance stage after several sessions of couple therapy. The daughter of the interviewee is at the anger stage. She is projecting her anger towards the mother. The experience of the interviewee also supports the life stages of development by Erickson. It is clear that the patient is at the stage of generativity versus stagnation. This is because of her age and the life goals that she wishes she could accomplish.
From this project, I have learned that health care professionals play an important role in the life of a patient. This is because the patients depend on their diagnosis and treatment. In the event that they make a mistake, the life of a patient is at danger. The life of the interviewee was in danger because most of the health care professionals could not diagnose fibromyalgia.
The care that health care professionals provide to a patient can make that patient comply with the treatment regimen. For instance, the interviewee trusted the doctor who diagnosed fibromyalgia and was ready to follow any instruction given by him.
Secondly, I have learned that the theories and concepts that are taught in class are imperative in the management of patients. This is because when one understands the stages of adjustment that the patient and the family are at, he can provide quality care. For instance, if one knows that the patient is at the denial stage, he can counsel him accordingly.
Thirdly, I have learned that the stages of life development by Erickson apply in the real life situation. This is because the interviewee was presenting with crisis between genrativity and stagnation. Therefore, health care professionals should always ask for the age of a person, evaluate the stage of life development, and address any issue that arises.
Finally, I have learned that it is important to involve family members in the care of a patient. This is because family members stay with the patient most of the time and they have an influence in the prognosis of the disease. For instance, if the daughter of the patient continues to blame her, she may go into depression and this will worsen the disease process. Therefore, she requires counseling.
References
Bernstein, D. A., Penner, L. A., Clarke-Stewart, A., & Roy, E. J. (2011). Psychology. London: Cengage Learning.
Clauw, D., & Wallace, D. (2010). Fibromyalgia. Oxford: Oxford University Press.
Meleis, A. I. (2007). Theoretical Nursing: Development and Progress. Baltimore: Lippincott Williams & Wilkins.
Ostalecki, S. (2007). Fibromyalgia: The Complete Guide from Medical Experts and Patients. Australia: Jones & Bartlett Learning.
White, L., Duncan, G., & Baumle, W. (2012). Medical Surgical Nursing: An Integrated Approach. London: Cengage Learning.