Textbook of Medical-Surgical Nursing 3e

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Unit 3   Applying concepts from the nursing process

PATIENT EDUCATION Learning to cope with disabilities

CHART 10-8

be involved and to take the patient home on weekends and on holidays. CLINICAL REASONING EXERCISES 1  A 25-year-old graduate student is diagnosed with fibro­ myalgia after several years of visiting doctors and being told that his symptoms were ‘all in your mind’. Due to chronic fatigue and pain, he often missed days from university and eventually withdrew from university. His wife is not very supportive because she too thinks the illness is ‘in his head’. How would you help this man learn to cope with his con­ dition and the damage to his self-esteem? How would you involve his wife in the process? 2  A 43-year-old Indigenous Australian woman tells you she is always tired and thirsty and has frequent yeast infec­ tions. She also tells you that she has not had a Pap test or any kind of physical examination since her last child was born 8 years ago because she does not have access to trans­ port and lacks the money to pay for a taxi service. What would you tell this woman? How would you advise her to find the resources to obtain healthcare?  ONLINE RESOURCES  A wide range of additional resources to enhance teaching and learning and to facilitate understanding of this chapter may be found online at http://thepoint.lww.com, including videos, animations, journal articles, review questions, quizzes and the e-book. Subscribers may also access Lippincott’s extensive online point-of-care procedure guide LNPS, which provides a wealth of evidence-based, reliable information. REFERENCES AND SELECTED READINGS Books **Double asterisk indicates classic reference. Boogaerts, M. & Merritt, A. (2008). Psychosocial care. In Chang, E. & Johnston, A. (Eds), Chronic illness and disability: Principles for nursing practice . Sydney: Elsevier. Conserve energy • Rest before undertaking difficult tasks. • Stop the activity before fatigue occurs. • Continue with an exercise conditioning program to strengthen muscles. Control your environment • Try to be well organised. • Keep possessions in the same place, so that they can be found with a minimum of effort. • Store equipment (personal care, crafts, work) in a box or basket. • Use energy-conservation and work-simplification techniques. • Keep work within easy reach and in front of you. • Use adaptive equipment, self-help aids, and labour-saving devices. • Recruit assistance from others; delegate when necessary. • Take safety precautions.

are taught how to use equipment and are given a copy of the equipment manufacturer’s instruction booklet, the names of resource people, lists of equipment-related supplies, and loca­ tions where they may be obtained. In the written summary of the care plan, the patient and family members are reminded about the importance of routine health screening and other health promotion strat­ egies. A network of support services and communication systems may be required to enhance opportunities for indepen­ dent living. The nurse uses collaborative, administrative skills to coordinate these activities and pull together the network of care. The nurse also provides skilled care, initiates additional referrals when indicated, and serves as a patient advocate and counsellor when obstacles are encountered. The nurse continues to reinforce prior teaching and helps the patient to set and achieve attainable goals. The degree to which the patient adapts to the home and community environment depends on the confidence and self-esteem developed during the rehabilitation process and on the accep­ tance, support and reactions of family members, employers and community members. There is a growing trend towards independent living by people with severe disabilities, either alone or in groups that share resources. Preparation for independent living should include training in managing a household and working with personal care attendants as well as training in mobility. The goal is integration into the community—living and working in the community with accessible housing, employment, public buildings, transportation and recreation. State rehabilitation administration agencies provide services to assist people with disabilities in obtaining the help they need to engage in gainful employment. These services include diagnostic, medical and mental health services. Counselling, training, placement and follow-up services are available to help people with disabilities select and obtain jobs. If the patient is transferred to a long-term care facility, the transition is planned to promote continued progress. Independence gained continues to be supported, and progress is fostered. Adjustment to the facility is promoted through communication. Family members are encouraged to visit, to Take control of your life • Face the reality of your disability. • Emphasise areas of strength. • Remain outward looking. • Seek inventive ways to tackle problems. • Share concerns and frustrations. • Maintain and improve general health. • Plan for recreation. Have well-defined goals and priorities • Keep priorities in order; eliminate nonessential activities. • Plan and pace your activities. Organise your life • Plan each day. • Organise work. • Perform tasks in steps. • Distribute heavy work throughout the day or week.