Case Study Sample
Simon is a 38 year old male. He has been discharged from hospital, following a burn to his hand that he sustained while at work. He broke up with his gay partner, Anthony, two weeks ago, and hence, is living alone in a sparsely furnished house. This is an indication that the two were staying together, and shared equipment before Anthony moved out, with his equipment. The house is in a foul state, and it smells of cats, the pets that Simon now lives with. Simon's appearance is unkempt, and he has facial hair, an indication that he has not shaved since he was discharged. He lets me know that he has been dumped by Anthony, and that he feels miserable. He is distraught by the departure of Anthony, and hence has been having trouble sleeping. He also feels like the accident he got at work had something to do with his break up with Anthony. Since moving out, Simon and Anthony have not spoken.
Simon displays symptoms of depression. Depression can be defined as a mood that is low. It evades activities and could affect ones thoughts, behavior, feelings and the physical well-being. Depressed people do not have any interest in the activities that they once enjoyed. They have a hard time concentrating, deciding, or making decisions,and might even consider suicide. (Salmans 1997).
The symptoms associated with depression are various. Some of them include; persistent sadness, guilty feelings, worthlessness, helplessness and hopelessness, interest loss in usual activities, difficulties in concentrating, insomnia or oversleeping, gain or loss of weight, lack of energy, agitation, irritability and anxiety, suicidal or death thoughts, slow movements, slow speech, stomachache, headache and digestive problems among others (Blooms, 2000).
Simon's current situation is a display of depression. This is due to the fact that his normal life and way of living has been disrupted. He does not clean his house. He also doesn't take care of himself. He lives in isolation in the community, and has not had any contact with people from the outside, except for his cats. Simon has difficulties in sleeping and is per-occupied with thinking about Anthony. It is clear that Simon feels guilty for what happened between him and his partner. This guilt has made him lose concentration at work. Lack of sleep has made him very tired at work, and it is obvious that thoughts of Anthony, and this fatigue are what led to the accident at work.
These above issues can be addressed using either a primary health care approach, or a public health care approach. The Primary health care approach came into existence after the Alma-Ata international conference in 1978, that was organized by the World Health Organization (WHO). This is defined as the ''essential health care that is based upon practical, scientifically sound and socially acceptable methods and technology that are accessible universally to families and individuals, by fully participating at a cost that the community and country can afford in maintaining development in the spirit of self-determination'' (WHO, 1978). Primary health care ''represents the first point of contact for individuals with the health care system. It is the key to efficient, timely, quality, family and community care. This is based on continuity and coordination, early detection and action, and better information on needs and outcomes'' (First Minister's Accords; 2000, 2003, 2004, as cited in Stewart, 2005). The functions of primary care include management of acute, episodic care and non-urgent routine care. Other functions are health promotion, disease and injury prevention, and chronic disease management (Stewart, 2005).
The primary health care approach was derived and sustained by the 1978 Alma Ata Declaration, which was in conjunction with the World Health Organization. Primary health care, according to them, is person-focused rather than illness-or problem-focused. It is best implemented with prior knowledge about the persons' family, community or culture. The attributes of primary care include; “First-contact” care which is provided by the primary caregiver either directly or as a facilitator; Continuous or ongoing care, which uses regular care over a given period of time; Coordinated care which links visits and the services that the patient receives; and, Comprehensive care, which avails services in health care , that will promote health (WHO, 1978).
The achievement of the above is followed by three aspects. These are: family centered care, which recognizes the family as being key to assessing and treating the patient. This care focuses on the functions and effects of one health to the structure and function of the family.
The second aspect is Community-oriented care, which is given in the community context. It considers the health care needs of a particular population. It is concerned with the needs of both the family and the entire community. Finally, Culturally competent care respects the cultures, attitudes and beliefs of people and how they influence on health. It uses ways that can interpret certain behaviors in the promotion of health.
Examples of primary care include counseling, couching and caring for illnesses that are chronic or acute. The Australian health minister's council defined the use of primary health care as an extension of the health system from care of the sick to development of health. Its purpose is to protect and to promote the health of communities, and to deal with problems of individuals and hence populate health at an earlier stage. It involves itself in the continuation of care, promotion of health and education, population concern as well as the health of the individual, involvement of the community, and the use of technology that is appropriate (Malcolm, 2000).
Primary health care is involved with primary care, but also broadly focuses on providing a range of services that include GPs, nurses, allied health professionals and other health workers. Examples of health workers are the multi-cultural and indigenous health workers, health education, promotions, community development workers, and also family and individual services. Also operating at the levels of the community are the Public Health Care (PHC) services (Donna & Ann, 2005).
In Simon's case, the best primary approach remedy that could be applied is counseling. This is because his problem is more of an emotional problem than a physical one. Simon is psychologically tormented and hence his problem should be solved from a psychiatric point of view. Therefore the nurses qualified to counsel should be able to handle Simon's cases perfectly. However before that, the first step that should be taken is to ensure that Simon's environment is clean. He would also be required to groom and clean up so as to change the mood of the surroundings from paleness to liveliness.
Primary assessment tools are used to measure the attainment of the attributes of primary care. The assessment tools that will be used in the above scenario is limited to the patients characteristics, and also the description of the surrounding environment. In this case, the community will be used to assess Simon's situation because he does not have his family around (Macinko, 2007).
The public health care approach involves different stages that can be applied to problems that are associated with health in populations. These stages are; Defining the problem; Identifying risk and Protective factors; developing and testing prevention strategies; assuring widespread adoption;
implementing these interventions, in improving the health of the population; and finally, Monitoring to assess whether these interventions are effective. In summery, the public health approach collects, analyzes and interprets data in defining what the problem is. It answers the questions What, Where, When, Who, and, How (Glyn and Caldwell,2006).
In applying Simon's problem, the Public health approach can be used in solving his case. Simon's problem is that he has been dumped by the partner. He has been left alone at his place of residency, with only the company of two cats. This happened two weeks ago, and the involvement was with Anthony. By having all this information, it is easier to come up with ways on how to deal with Simon's case.
Health promotion or illness prevention strategies are important in helping both the patient and his family. Prevention and Health promotion programs have an aim of reducing the impacts of health determinants by altering the patterns in behavior, addressing the circumstances in the setting, and reducing the effects of being exposed to the environment. These can be done through sponsoring of events such as sports, promotion of mental health programs to decrease the rates of discrimination, among others. Health promotion and disease prevention activities have been defined in different ways by organizations. They often differentiate between education of the patient, prevention of disease, and promotion of health. The patient's education involves teaching him to comply with procedures for medication and therapy, to aid in managing minor ailments (Podger and Hogan, 2000).
Health promotion activities are acts that enhance behavior change, and hence will improve health. In this case, trends should be increased towards self-care, and therefore integrate these teachings and practices in the settings of primary care. By so doing, Simon will be able to take care of himself and improve his health status in the absence of his partner. Members and providers should also be able to access marketed initiatives for health promotion (Perrot, 2000).
This access will further educate them on the importance of specific matters. Other activities that health organizations get involved in, include following the few initiated actions that they have implemented so that the measurable objectives of the initiative can be realized. Health promotion also focuses on a particular group in the population. By so doing, maximum attention is given to these people with their families. This further aids in the quick recovery of the patient. Giving undivided attention to Simon will not only isolate the thoughts of being lonely and miserable, he will also be able to focus on getting his life back on track. Health Organizations also reward health behaviors that are positive, and this not only helps the patient, but also their families. This positive reinforcement motivates the patient and hence changes will be seen more rapidly than expected (Haggerty, 2008).
Health organizations also have a strong commitment to the promotion of health. By so doing, values and resources for finance are equally distributed. This helps the patients and their families to focus on the recovery of their patient, and not on the amount of money they will spend. These organizations also have developed policies which provide services that are beneficial to all members (Kawachi, 2000).
Ozcare is an institution that is involved in emotional support. Simon is emotionally disturbed following the break up, and the organization will not only help Simon to speak up about his issues, it will also help him in the recovery process. This is because Simon will be able to engage in community activities and participate in them, instead of focusing on his current situation. Simon will also be required, with time, to be able to speak with Anthony, as a way of solving his situation. By being able to engage in these activities, future occurrences of accidents will be prevented. This is because, not only will Simon be emotionally stable, he will be able to deal with these problems without having a break down (Deeds, 1985).
The primary and Public approaches to solving problems both work interchangeably in solving community problems. Both approaches when applied, have different strategies of approaching a given situation, as shown above in dealing with depression and isolation.
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