Introduction
Disability is defined by WHO (World Health Organization) as the limitation to do an activity, physical impairment and the inability to do something. According to the World Health Organization, impairment refers to any problem that affects the functioning of the body or the body structure, limitation in doing an activity refers to the difficulty that results from an individual in the process of performing a task and the inability to do something is the problem that faces someone when doing something in a life situation. Someone is considered disabled when the person has been impaired in the past or if the person is viewed as being disabled from a personal or group perspective (O’Brien, 2004). Basically, there are different types of impairments which can be classified as, mental, physical, growth, sensory, cognitive and also some chronic diseases like cancer (Fee, 2000).
Normally disabilities occur from birth or during someone’s life. Therefore people with disabilities are less likely to perform tasks that can make a contribution to the economy and as a result of this many disabled people form a group of people that is dependent on the product or the healthy ones. Many issues on the topic of disability have been discussed such as citizenship, social-political rights and the social inclusion of the people with disabilities (O’Brien, 2004). There is therefore a great need to ensure that the disabled have access to resources and education in order to empower them and ensure that they are part of the economic development, this should be especially so in developing nations where close to six hundred million disabled people live. This essay will focus on mental asthma, the impacts of this disorder, and the role of nursing in the provision of health care and how nursing can work with other health care teams to deliver quality health care.
Discussion
Asthma
This is a chronic inflammatory disease that affects the breathing system. According to Crosta (2005), “the disease affects the airways that take air and out of the lung. The airways to the lungs become inflamed and swollen.” The inflammation makes the airways irritate and the patient becomes susceptible to allergy. The swelling of the airways causes the airways to become narrow and as a result, they can only carry little air in and out of the lung. Crosta (2005) also asserts that “the narrow airways cause wheezing, coughing, breathing problems and chest tightness, these symptoms are common at night and early mornings in asthmatics patients.”
Causes of Asthma
Children who are born in unfavorable conditions and environments such as children born of tobacco-smoking mothers, children born of mothers who are drunkards, children born with low birth weight and children who are brought up in poor environments are the ones at risk of asthma. At the age of five, children who are asthmatic start to show signs of wheezing and other respiratory infections. Another risk of asthma in children is allergy and those who are born by asthmatic parents.
Allergy is another cause of asthma. According to Kallstrom, (2004) “recent researches have shown that over twenty-five percent of people who have allergic rhinitis or hay fever develop asthma and that the antibodies in the body trigger allergic reactions which causes airways inflammation.” When one grows with an allergic condition, the more the airways get inflamed hence increasing the chances of asthma (Kallstrom, 2004).
Asthma is also caused by some environmental conditions. Air pollution which predisposes allergy can progress to asthma. Crosta (2005) asserts that “Nitrogen oxide gas is also another environmental factor that can predispose asthma gas that comes from stoves.” People who use stoves for cooking are likely to exhibit breathing problems, wheezing and hay fever making them prone to asthma. Crosta, (2005) also notes that the other environmental factors that can trigger asthma are; cold temperatures, sulfur dioxide, high humidity and general air pollution.” Air pollution results in ozone depletion and this ozone causes difficulties in breathing, chest pain and coughing. Kallstrom, (2004) also notes that, “cold weather conditions causes airways constriction (bronchi-constriction) leading to airways congestion and decreased mucus clearance.”
Obesity is another cause of asthma, people having high body-mass-index ranging between 25 and 30 are 38 percent prone to asthma than those who have less weight (Crosta, 2005). Adults with obesity- having a body mass index of 30 and above are twice likely to have asthma (Crosta, 2005). This is possible because the airways of obese people are likely to be blocked due to congestion (Crosta, 2005).
Pregnancy also contributes to asthma cases. Children who are born by cesarean section are likely to have asthma than those born by the vagina this is because of the bacteria exposure during the cesarean section. Another contributing factor is smoking, children whose mothers smoke during pregnancy develop breathing problems that can lead to asthma.
Impacts and Symptoms of Asthma
Crosta, (2005) asserts that “the major symptoms of asthma are chest tightness, wheezing and dyspnoea also known as short breath, and the onset of the coughing is very sudden, chest constriction happens, difficulty in breathing and wheezing may also occur.” However, coughing is a major character and in severe cases, there is no breathing that occurs at all such that no wheezing occurs. During acute asthma, honchos lung sounds are produced, a high heartbeat occurs, prolonged expiration and wheezing. Kallstrom (2004) asserts that “the accessory muscles of respiration also known as the sternocleidomastoid and scalene muscles of the neck, may be used which is shown as in-drawing of tissues between the ribs & above the sternum and clavicles, and there may be the presence of a paradoxical pulse and over-inflation of the chest.”
Crosta, (2005) asserts that when there is a severe asthma attack the patient may turn blue as a result of little oxygen in the body and the chest pain increases to an extent that it can lead to loss of consciousness.” A patient manifests with constant pain in his or her limbs, begins to sweat profusely on the limbs and the palms and then becomes unconscious. During acute asthma, the patient may have severe symptoms though he/she may not show.
Treatment and interventions
The treatment of asthma involves the reversion of airway obstruction. This can either be done through treatment or it can occur spontaneously (Mintz, 2004). The treatment of asthma takes place when the symptoms start manifesting themselves. Crosta (2005) also asserts that “spirometry is used to diagnose the condition and if the patient is diagnosed as having airway restriction, bronchodilator medication should be administered.” Warrell (2005) noted that “National Asthma Education and Prevention Program (NAEPP) recommend spirometry at the time of initial diagnosis after treatment is initiated and symptoms are stabilized, whenever control of symptoms deteriorates, and every 1 or 2 years on a regular basis.”
The NAEPP measures suggested that testing peak expiratory flow as a common screening method is not good because it is variable as compared to spirometry Warrell (2005). However, testing peak flow after an exercise is advisable especially in young patients because they can only show signs of asthma only after an exercise. It is the responsibility of the patient to self-monitor the effects of the disease and the medication.
An alternative treatment measure is the use of bronchi-constrictors which is a kind of substance that helps to unblock the narrowed airways. This method can be useful especially to old people who face difficulties in breathing (Warrell, 2005).
Education for long term treatment
It is advisable for an asthmatic patient to inhale a beta-receptor agonist by the use of a special inhaler that is able to measure the dosage. Asthmatic patients require to be given proper health education and guidance so that they are able to know how to be able to know what to do when an attack comes. They should also be told how to use the inhaler. The patient requires to be seen once every six months in order to determine the possibility of asthma reoccurrence (Holgate, 1999). After asthma has been managed for quite a long time, the use of medication should be minimized gradually.
It is advisable that asthma treatment begins at home so that by the time the patient goes to the doctor, he/she is able to control the disease. Patient education is important so that a patient can be able to recognize the asthma signs as soon as they appear, while those patients with moderate asthma should be taught how to use flow meters. It is important that asthma patients have a written action on how to control the disease if the symptoms become severe. Kallstrom (2004) noted that “recent research has shown that a review of medical studies revealed that patients with self-management written action plans had fewer hospitalizations, fewer emergency department visits, and improved lung function.”
The role of professional
Professionals are people who are specialized in a career. Professionals who treat asthma are specialized in how to diagnosing and providing treatment to asthma patients. A professional should first examine the chest complexity of an asthma patient. The professional should enquire about the family history of allergies and asthma as that information is very relevant if the present signs indicate the presence of asthma. The health practitioner then identifies how air is let out and into the lungs by using a spirometry test. After administering drugs the professional should carry out the test again to check whether the drugs have made any impact. The professional should test the patient’s blood in order to determine whether there are antibodies that fight allergy which is a major trigger of asthma. The professional should carry out spirometry after an exercise so as to induce asthma or a chest x-ray can also help to determine its presence. After treatment, a professional should educate the patient on the home care management of asthma (Wineman, 2004).
Inter professional teamwork
Countries have these days recognized the importance of the involvement of multiple stakeholders in the health care for asthma patients (Boyd and Nihart, 1998). For clinical purposes, asthma health care nursing is divided into two levels; basic and advanced. According to Wineman (2004) “registered nurses in the healthcare delivery should be made to work directly with the communities and families so as to assess and help address the needs of the asthma patients, the nurses should also come up with a clear asthma health plan for diagnosis and actively participate in the implementation of the formulated plan.” At this basic level i.e. the community or family level, the registered nurses are able to work with the rest of the stakeholders so as to evaluate and monitor the nursing care plan for the asthma patients. During this level, nursing involves developing interventions that promote good health and help patients gain energy and skills that prevent any further attack. According to Ingram and Braunwald (2005), “nurses at the basic level assist the psychiatric patients with self-care, administer and monitor bio-psychosocial treatment regimens, teach about health and asthma health individually or in groups”.
The other level of asthma nursing care is where advanced-practice-registered nurses take the role of specialists as clinical nurses. At this level, the clinical nurses have the duty to diagnose and provide treatment to patients suffering from asthma. The clinical nurses have the responsibility to provide primary care to asthma patients in different locations like homes and community health program centers.
Hospital care model
When a patient is diagnosed as being asthmatic, he/she should take should seek treatment measures as early as possible (Waldron, 2007). Patients who have acute asthma should be administered oxygen. Patients should avoid the use of a mechanical inhaler but instead use a beta receptor-agonist which should be inhaled continuously and frequently. Patients are then placed on steroid medication if they fail to get a good outcome from the initial therapy. The steroid therapy which is given to the patient minimizes the chances of asthma reoccurring.
Conclusion
Disability has been found out as having a wide range of negative impacts both to the patient and to the community. The community should understand these impacts and acknowledge the disabled as being part of society; this should be achieved by helping the disabled and involving them in various activities that take place within the community. Disability causes physical impairment individual or restricts an individual from doing something. This essay has considered asthma as one of the disabilities that affect the breathing system of a patient. The essay concludes that education for early treatment is important for the management of asthma and therefore patient education should be emphasized by the professionals in order to minimize the cases of this disability.
References
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Crosta, P. 2005. All about asthma. New York: International Universities Press.
Holgate, S. et al. (1999). Difficult asthma. Informal Health Care. London: Sage Publications Ltd.
Ingram, R. and Braunwald, E. (2005). Dyspnoea and Pulmonary Oedema: Principles of Internal Medicine (16th ed.), New York: McGraw-Hill.
Kallstrom, T. (2004). Evidence-based asthma management and respiratory care. London: Arnold. Publishers.
Mintz, M. (2004). Asthma diagnosis, monitoring, and prevention of disease progression. London: Sage publishers.
O’Brien, R. (2004). Voices from the Edge: Narratives about the Americans with disabilities act. New York: Oxford.
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Wineman, S. (2004). The politics of human services: Radical alternatives to the welfare state. Boston: South End Press.