PROMOTING HEALTH AND WELLBEING
Health promotion is an essential factor in enabling the population to control and boost its health status. It can be achieved through the formulation of mechanisms aimed at enhancing the quality of life through patient and family centred care. The patient centred care entails the care that patients are actively involved in the diagnosis, treatment, and management of their conditions to enhance recovery from the illnesses. On the other hand, family centred care describes the optimal healthcare for a family with all members of the family considered in the treatment of one of them. Nevertheless, patient care can also incorporate the person and family centred care in cases in which maximum attention is required to safeguard the health of an individual. It is important to include the medical code of ethics in the formulation of a treatment measure. The code outlines six levels of opinions in improving the relationship between patients and nurses. Nurses should have knowledge and awareness about essential professional values as a measure of providing safe and high-quality ethical care to the patients. People have different values and beliefs based on factors such as personal experiences, culture, and religion. Nurses require ultimate consideration of the values, believes, and behaviours of patients and their families to offer care to smoking patients.
Person-centred care (PCC) is one in which patients are actively involved in the diagnosis, treatment, and management of their conditions to enhance recovery. The model is applied in cases of palliative care, emergency care, and rehabilitation of patients. According to Kirby, Broom, and Good (2014), an enabling PCC must address and maintain people’s dignity, respect, care, and compassion. On that note, the model is characterised by four principles that describe care as coordinate, personalised, enabling, and treatment with compassion, respect, and dignity (Edwards, 2004; Schwartz, 2002). However, the care differs considerably when compared with the family centred care.
On the other hand, family centred care (FCC) describes optimal healthcare for a family with provisions of how to work with all members. This case is carried out with the view that family is crucial in a child’s life. However, personnel and service systems within the FCC usually fluctuate. According to Stewart (2011), the care facilitates child, professional, and family collaboration at all levels of the service. On that note, it is clear that healthcare incorporates the developmental needs of children and their families in enhancing their health care (Tubbs-Cooley et al., 2013; Aiken et al., 2017). Stevenson et al. (2004) show that the FCC is applied when addressing healthcare issues pertaining to paediatric health facilities. Children cannot be treated in absence of their parents since the latter plays a crucial role in their wellbeing.
Patient- and family-centred care (PFCC) offers mutual benefit among nurses, patients, and their families. The collaborative partnership aims at enhancing the health status of patients, their families, and children. According to Stevenson et al. (2004), the care is grounded on principles such as communication, respect and dignity, strength building, and collaboration across all healthcare providers. On that note, PFCC calls for respect in treatment in which the preferences, expertise, and culture of the patients and their families are considered in the medication. The author further indicates that nurses should offer current information to patients for improved and supportive care. Nurses should also offer guidance to the sick and their families on building patient’s strength by participation in the thrilling experience. Stevenson et al. (2004) show that PFCC can be accomplished through the application of family resources such as family resource centre, parent university, spiritual care, and child development. As such, it is evident that nursing healthcare can help in boosting the overall health status of the patients under PCC or FCC care.
The medical code of ethics outlines six levels of opinions in improving the relationship between patients and nurses. As such, PCC and FCC follow the stipulated guidelines of the code of ethics and conduct when nurses are attending to patients (Kizer, 2002). Hesselink et al. (2012) opine that patients, families, and nurses show mutual respect to one another, thus becoming an integral section of the patient- and family-centred care (PFCC). Nevertheless, PFCC emphasizes the respect for a patient‘s beliefs, values, and behaviour in making personal decisions (Higgins et al., 2011). The PFCC also establishes the role of the family as advisors for improved healthcare and enabling the patient to recover quickly.
Nurses should have knowledge and awareness about essential professional values as a measure of providing safe and high-quality ethical care to the patients. According to Poorchangizi et al. (2017), nurses’ should portray an enabling perspective on professional value, which usually affects the delivery of improved patient care and decision-making measures. On that note, it is essential to design educational programs to enhance nurses’ understanding of professional values based on emerging ethical challenges (Halligan, 2008). Nevertheless, it is important to formulate a technique for evaluating the use of values while attending to nurses to enhance care.
People have different values and beliefs based on factors such as personal experiences, culture, and religion (Agnew, Flin, & Reid, 2012). Personal values entail the issues and undertakings that relates to personal principles, morals, and ideals considered as the most important. On the other hand, attitudes are the personal views characterised by the manner in which a person behaves. Nonetheless, beliefs are the issues and ideas that a person has faith on such as medication, which may are usually not founded on fact. According to Galloway (2005), due to the changes in societal norms, nurses should consider generational influences and culture in the provision of care to the patients under PCC care. Nurses should also be aware of the patients’ personal values, attitudes, and beliefs so that they can provide nonjudgmental and personalised care to the sick.
The nursing profession is regarded as the largest health care profession with more than 2.7 million registered nurses working daily in the United States as patient advocates. According to Loghmani, Borhani, and Abbaszadeh (2014), nurses should operate within the front lines of offering care and attending to the patient to enhance their health status. On that note, the success of each nurse is based on healthcare availed to the patients and the patient’s recovery time. Berger et al. (2012) opine that the care that nurses give and the decisions they make on the diagnosis and treatment of patients’ disorders are critical. Nurses have a positive effect on the recovery of patients through clinical practice, staff collaboration, care philosophy, and the workplace environment.
I was taking care of a 48-year-old patient known as Elizabeth, who had a history of depression and asthma. The patient presented herself to me with her third episode of acute bronchitis in the past two years. The patient started smoking at the age 17 years old and currently smokes more than 10 cigarettes per day. The patient starts smoking each day shortly after waking up, which shows an increased level of severe nicotine dependence. The woman informed me that she has tried numerous attempts to quit but she usually fails to complete the process. In fact, she uses the nicotine patch to favour cessation of smoking, but fails and gets back to smoking due to strong urges to smoke. Nevertheless, the patient has never used cessation counselling or other medications to boost her aim of overcoming smoking and enhance her health. Elizabeth was bothered by the money she spends on buying the cigarettes, which she could be using to better her lifestyle. In addition, the patient is also worried about the effects of smoking on her three children, who are at risk of developing health complications associated with Elizabeth’s smoking behaviours. The patient is also reluctant to quit smoking through following essential cessation mechanism since she fears she will not succeed.
Smoking is essentially a hard habit to overcome since cigarettes contain the highly addictive nicotine. People smoke due to different reasons such as overcoming stress or addiction. According to Roué et al. (2017), scientists have published numerous articles on the harmful effects of smoking and the importance of the behaviour’s cessation, which enables the recognition and formulation of measures to overcome smoking. However, the adverse effects of smoking on health are well established to favour cessation but the influence of the cessation on health over the years is yet to be fully elucidated (Schane, Ling, & Glantz, 2010). Nurses help in addressing the relationship between smoking cessation and changes in improved quality of health. Smoking cessation cases require a follow-up duration of approximately 6 months especially among the femalesand university students who are highly engaged in smoking and are affected by the activity (Hartmann-Boyce and Aveyard, 2016; Thébaud et al., 2017). Smoking cessation can be achieved through the application of the different forms of pharmacotherapy. The cessation also helps in lowering community’s mortality rate, which helps in increasing working population in the community, thus enabling growth of the society and reduction of dependency ratio.
Holism entails the view of physical, chemical, social, biological, economic, and mental issues as entities rather than as a part of an entity. In nursing, holism is a theory that shows living organisms as wholes rather than the mere sum of elementary particles (Zamanzadeh et al., 2015; Koplan, David, and Rigotti, 2008). In fact, it is referred to as a method of treatment involving complete systems. Using the Holism theory, I focused on the health outcomes and lifestyle interventions that favour the patient to quit smoking. I informed Elizabeth that the more cigarettes she smokes, the worse the quality of life she will always have. It is also clear that smokers will never have a better quality of life than non-smokers will.
Autonomy in the nursing profession entails the ability to have authority to establish decisions and act as per the guidelines of the nursing profession to enhance the healthcare of a patient. As such, understanding autonomy plays a crucial role in the clarification and development of the nursing profession in an enabling health care environment (Efraimsson et al., 2015). Using the personal experience of autonomy in my nursing career, I offered care to the patient through having a holistic view, knowing the patient, understanding the nursing career, and caring to offer care. Autonomy in the nursing care, especially towards smokers, covers the power to make decisions based on patient’s decision and my personal clinical judgments, choices, and actions that will enhance the patient’s ability to quit smoking (The Health Foundation, 2016; Zwar, Mendelsohn, & Richmond, 2014).
In nursing, the principles of holistic, individual, PCC, and patient choice enhances an understanding of what is expected from the nurse. Choices place the patient at the centre of nursing theory and the practice. As an independent nurse, I focused on the effects of the government’s choices on the delivery of improved care. It is important to consider and respect the views and decisions of patients, whether under PCC or FCC since the patients are allowed to make a decision on the healthcare method that will enhance patient recovery (Loefler, 2001; Ogden, Barr, and Greenfield, 2017). As a trained nurse, I must enhance government choices as well as patient choices in improving the healthcare of a patient. This is done by formulating measures to ensure that all the key choices from the government and the patients with their families are addressed adequately before care is provided.
Empowerment in nursing is the freedom given to the patients and their families to choose on the treatment period and location since patients should maintain the autonomy of their treatment decisions (Shearer, 2009). Empowerment entails patients, nurse, and interpersonal attributes between them (Mujika, 2014). The government may intervene in the empowerment of nurses and inclusion of patients in the decision-making panel about their health status. Empowerment can be achieved through the development of initiatives and programs that facilitate the improvement of a patient’s health outcomes (Liljeroos et al., 2017). For instance, the ‘expert patient’ initiative developed to facilitate in the management of diseases among the smokers.
Health lifestyles are used to increase patient’s chances of quitting through several mechanisms (Bohman et al., 2014). As a smoker, the patient should stop mentioning the war against smoking since nicotine addiction is physical and psychological (Clark, 2000; Hartmann-Boyce, Begh, and Aveyard, 2018). In addition, associating with activities that one used to carry out when smoking may also trigger them back to the act. For instance, if one smoke while drinking coffee, when stressed, or with certain people, it is evident that the situations will always provide temptation for smoking. I also informed the patient to get motivated, which enhances focusing on the patient’s quitting, thus boosting self-esteem and motivation.
I offered health information to the patients as well as sites she can use to access more information on quitting smoking and effects of the activity in relation to her health and that of her children. Smoking is a bad habit that affects an individual health, which is a common feature among the young population and females (Milnes et al., 2017; Iacobucci, 2018). In addition, smoking usually leads to the destruction of an individual’s health status and harms most of the crucial organs of the body such as the liver and lungs. Cigarette smoking is the most causative agent of approximately 90% lung cancer and associated deaths. Smoking is also associated with other illnesses such as heart and blood vessel disease, lung disease, stroke, and cataracts.
In the United States, there is about one smoker in every six men, whereby more than 1,200 underages smokes their first cigarette daily. Smoking men have a diminished overall health, increased health care needs and costs, and increased absenteeism from work (Toll et al., 2014). Smoking also causes chronic obstructive pulmonary disease (COPD) in which patients with the condition has trouble in breathing. Smokers are likely to die due to COPD compared to non-smokers who usually live a profound life. For the families, the second-hand smoke may lead to disease and premature death in non-smoking individuals (West, 2017). Living with a smoker usually increases the chances of a non-smoker developing COPD and lung cancer.
As a nurse, I aim at improving the health of the patient am entitled to offer care to and address the most urgent issues. It is clear that smoking patients have a higher risk of developing lifetime complications such as lung cancer, which requires ultimate care to enhance patient recovery from smoking (Aveyard and West, 2007). As such, to avoid worsening of the health of smokers, I advise the patient on a measure to follow to overcome smoking, which is a life-threatening habit that most people fail to quit due to addiction to nicotine.
Patient care is an essential attribute of enhancing health care providers with aim of achieving a high degree of quality care and patients’ satisfaction. This can be achieved through the rise in medical malpractice litigation, increasing demand for better care, greater awareness among the public, enhanced competition, more health care regulation, and concern about poor outcomes. Patient care is determined by the quality of infrastructure, training, personnel competence, and the efficiency of operational systems. Patient care is offered through numerous means such as the PCC and FCC among others. PCC occurs when patients are actively involved in the diagnosis, treatment, and management of their conditions to enhance recovery from the illnesses. It is utilised in cases of emergency care, palliative care, and rehabilitation of in and out patients. On the other hand, FCC describes the optimal healthcare for a family with provisions of how to work with all members. PCC and FCC interrelate to form the PFCC, which is governed by the medical code of ethics. Nurses should be aware of the essential professional values as a measure of providing safe and high-quality ethical care to the patients. Evidently, people have different values and beliefs towards healthcare offered by the nurses. As such, nurses should stick to the stipulated code of ethics and enhance their understanding of the patients’ needs and the requirements by the government to offer high quality health care services to the patients.
The nursing profession is the largest health care profession utilised to offer healthcare facilities and services to the ill with an aim of improving patients’ health status. As a nurse, I offer care to Elizabeth, who was a 48-year-old patient with a history of depression and asthma. Elizabeth has been smoking over the years since she was seventeen years old. She had tried numerous attempts to quit but she usually fails to complete the process. As such, I was entitled to offer care and inform Elizabeth of the best measure to apply to quit smoking and improve her lifestyle.
Holism entails the view of physical, chemical, social, biological, economic, and mental issues as whole entities rather than as a part of an entity. The theory calls for the use of living systems as whole entities rather than elementary particles. On that note, holism has been depicted as a treatment mechanism that entails the use of complete systems rather than parts of it. I used the theory of holism in enhancing the healthcare of a smoker known as Elizabeth. Elizabeth used to smoke more than ten cigarettes in a day, which called for my intervention to assist the patient in quitting smoking. Evidently, smokers will always have a worse life than non-smokers due to the emergence of life-threatening complications. It is also clear that smokers will never have a better quality of life than non-smokers. I addressed her smoking challenges through holism, maintaining autonomy, making informed choices, empowering her abilities to quit smoking, and improving lifestyle. Nevertheless, I offered health information to the patients as well as sites she can use to access more information on quitting smoking and effects of the activity in relation to her health and that of her children. Smoking is a life-threatening habit associated with the development of complicated health lifestyles and health complications such as COPD and lung cancer. As a nurse, I aimed at improving Elizabeth’s health through offering information to the patient and showing her that smoking may lead to the development of lifetime complications. The complications require ultimate care to enhance patient recovery from smoking. In addition, I also advised her on measures to uptake in smoking cessation to overcome smoking and boost her health.
Agnew, C., Flin, R. and Reid, J., 2012. Nurse leadership and patient safety. BMJ, 345(aug09 1), pp.e4589-e4589.
Aiken, L., Sloane, D., Ball, J., Bruyneel, L., Rafferty, A. and Griffiths, P., 2017. Patient satisfaction with hospital care and nurses in England: an observational study. BMJ Open, 8(1), p.e019189.
Aveyard, P. and West, R., 2007. Managing smoking cessation. BMJ, 335(7609), pp.37-41.
Berger, Z., et al., 2012. Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. BMJ Quality and Safety in Health Care, 23, pp. 548–555. DOI: 10.1136/bmjqs-2012-001769 549
Bohman, T., et al., 2014. Does healthy lifestyle behaviour influence the prognosis of low back pain among men and women in a general population? A population-based cohort study. BMJ Quality and Safety in Health Care, 4(12). DOI: 10.1136/bmjopen-2014-005713
Clark, N., 2000. Management of chronic disease by practitioners and patients: are we teaching the wrong things?. BMJ, 320(7234), pp.572-575.
Edwards, R., 2004. The problem of tobacco smoking. BMJ, 328(7433), pp.217-219.
Efraimsson, E. Ö., Klang, B., Ehrenberg, A., Larsson, K., Fossum, B., and Olai, L., 2015. Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care. European clinical respiratory journal, 2, 27915.
Galloway, J., 2005. Dignity, values, attitudes, and person-centered care. [online] Available at: < https://www.esht.nhs.uk/wp-content/uploads/2017/08/Dignity-values-attitudes-and-person-centred-care.pdf> [Accessed on 6 December 2018]
Halligan A., 2008. The importance of values in healthcare. Journal of the Royal Society of Medicine, 101(10), pp. 480-1.
Hartmann-Boyce, J. and Aveyard, P., 2016. Drugs for smoking cessation. BMJ, p.i571.
Hartmann-Boyce, J., Begh, R. and Aveyard, P., 2018. Electronic cigarettes for smoking cessation. BMJ, p.j5543.
Hesselink, et al., 2012. Are patients discharged with care? A qualitative study of perceptions and experiences of patients, family members and care providers. BMJ Quality and Safety in Health Care, 21(1). DOI: 10.1136/bmjqs-2012-001165
Higgins, J. P., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A., Cochrane Bias Methods Group, Cochrane Statistical Methods Group, 2011. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed.), 343, p. d5928. DOI:10.1136/bmj.d5928
Iacobucci, G., 2018. Stop smoking services: BMJ analysis shows how councils are stubbing them out. BMJ, p.k3649.
Kirby, E., Broom, A. and Good, P., 2014. The role and significance of nurses in managing transitions to palliative care: a qualitative study. BMJ Open, 4(9), pp.e006026-e006026.
Kizer, K., 2002. Patient centred care: essential but probably not sufficient. BMJ Quality and Safety in Health Care, 11(2), pp. 117-118.
Koplan, K., David, S. and Rigotti, N., 2008. Smoking cessation. BMJ, 336(7637), pp.217-217.
Liljeroos, M., Ågren, S., Jaarsma, T. and Stromberg, A., 2017. Dialogues between nurses, patients with heart failure and their partners during a dyadic psychoeducational intervention: a qualitative study. BMJ Open, 7(12), p.e018236.
Loefler, I., 2001. Managing chronic disease. BMJ, 323(7306), pp.241-241.
Milnes, S., Corke, C., Orford, N., Bailey, M., Savulescu, J. and Wilkinson, D., 2017. Patient values informing medical treatment: a pilot community and advance care planning survey. BMJ Supportive & Palliative Care, pp.bmjspcare-2016-001177.
Mujika, A., 2014. Nurses and smoking: a qualitative study. European Journal of Public Health, 24(Suppl. 2), p. 242
Ogden, K., Barr, J., and Greenfield, D., 2017. Determining requirements for patient-centred care: a participatory concept mapping study. BMC health services research, 17(1), 780.
Poorchangizi, B., Farokhzadian, J., Abbaszadeh, A., Mirzaee, M., and Borhani, F., 2017. The importance of professional values from clinical nurses’ perspective in hospitals of a medical university in Iran. BMC medical ethics, 18(1), 20.
Roué, J., Kuhn, P., Lopez Maestro, M., Maastrup, R., Mitanchez, D., Westrup, B. and Sizun, J., 2017. Eight principles for patient-centred and family-centred care for newborns in the neonatal intensive care unit. Archives of Disease in Childhood – Fetal and Neonatal Edition, 102(4), pp.F364-F368.
Schwartz, L., 2002. Is there an advocate in the house? The role of health care professionals in patient advocacy. Journal of Medical Ethics, 28(1), pp.37-40.
Stevenson, J., Abernethy, A., Miller, C. and Currow, D., 2004. Managing comorbidities in patients at the end of life. BMJ, 329(7471), pp.909-912.
Stewart, M., 2001. The patient should be the judge of patient centred care: Towards a global definition of patient centred care. BMJ, 322, 444. DOI: 10.1136/bmj.322.7284.444
The Health Foundation, 2016. Person-centered care made simple: What everyone should know about person-centered care. [Online] Available at: <https://www.health.org.uk/sites/default/files/PersonCentredCareMadeSimple.pdf > [Accessed on 12 December 2018]
Thébaud, V., Lecorguillé, M., Roué, J. and Sizun, J., 2017. Healthcare professional perceptions of family-centred rounds in French NICUs: a cross-sectional study. BMJ Open, 7(6), p.e013313.
Tubbs-Cooley, H., Cimiotti, J., Silber, J., Sloane, D. and Aiken, L., 2013. An observational study of nurse staffing ratios and hospital readmission among children admitted for common conditions. BMJ Quality & Safety, 22(9), pp.735-742.Zwar, N., Mendelsohn, C. and Richmond, R., 2014. Supporting smoking cessation. BMJ, 348(jan14 4), pp.f7535-f7535.