Patient-Centered Care
Population health improvement initiatives (PHII) attempt to transform people’s lives by making it healthier and fulfilling. These initiatives mainly focus on human health challenges that are persistent and emerging. Outcomes from these initiatives are significant as they help in the development of patient-centered care. The present paper will critically analyze a specific PHII then try to extract meaningful learning and outcome information from it to be used in Mr. Nowak’s care. The PHII is carried out by Safe Headspace, founded by Alicia Balewa. The initiative involves taking care of the elderly suffering from mental problems. On the other hand, Mr. Nowak suffered from a traumatic brain injury (TBI) years ago, has hypertension (HTN) and distress.
Outcomes
According to Balewa, her project has helped several individuals. It has managed to realize several outcomes and failed to achieve others. In realizing the outcomes, the project involved performing numerous treatment regimens ranging from exercise, medication, therapy, strength training, and meditation. Through the exercise regimen, they helped individuals between the ages of 45-80 improve their muscle control, memory, and mood. In the medication and therapy regimen, they also improved the patients’ mood and memory. They also observed patients taking medications – antidepressants and antipsychotics – continued to contact their therapists regularly. Balewa’s group was able to help 21 individuals and study the impact of meditation on mood, memory, and muscle control. Lastly, they were able to compare the effect of strength training with other physical activities. However, participants in this group were less compared to those who partook in the aerobic exercises.
Nonetheless, Balewa’s group was shocked to find out that other memory exercises like crossword puzzles and Sudoku did not significantly impact. Though strength training had an outcome, it was significantly low compared to other treatment plans. It improved muscle control by 4% while aerobic exercise improved it by 15%. The initiatives achievement fell short because the elder veterans rarely partake in health initiatives.
Attracting Veterans to Mental Health care
Veterans are unwilling to go for care due to several reasons. Previously, it was due to organizational and logistics barriers, but these were eliminated by the Department of Veterans Affairs (VA) of America. Currently, social barriers are the main factors. Many veterans are skeptical about treatments’ effectiveness. Others fear being stigmatized, and others see seeking help as a sign of weakness (Herbst, 2013). The best measure to be used in correcting this stand of veterans is frequently exposing them to healthcare and social work services during their military service. The exposure entails offering healthcare on-site and making them undergo medical appointments of mental health. Besides, they will need to be trained and educated.
This notion is attested by Herbst’s (2013) report. These authors highlight ways of overcoming veteran care barriers and leverage on the student veterans in college campuses. The report analyses how onsite healthcare, mental health services, and education dimensions overcome the veteran barriers. The health services offered to them include psychiatric evaluation, psychotherapy, and medication management. The education aspect involves two agencies – National Centre for PTSD and The Community Provider Toolkit – that develop educational toolkits. These toolkits guide the faculty and staff on ways of helping the veterans appreciate health and wellness. This initiative made approximately 46% of veterans to be seen in healthcare in 2013 compared to 7% in 2011 (Herbst, 2013).
Developing personalized Patient care
In developing personalized care for Mr. Nowak, it is wise to understand his health status and different treatment methods that can be employed. After this, the PHII can be used to choose the best option from the different treatments.
Mr. Nowak has suffered from TBI, has hypertension, and is in distress. Concerning TBI, it can be mild, moderate, or severe. Going by Mr. Nowak’s condition, his condition can be considered mild, and the symptoms associated with mild TBI in the cognitive aspect include mood changes and memory problems (Mayo Clinic, 2019). Rehabilitation specialists are employed to help individuals to cope with this condition. They include a physiatrist, physical therapist, occupational therapist, social worker, vocational counselor, among others.
Regarding hypertension, individuals can have symptoms, and others lack them. The symptoms are blood spots in the eye, facial flushing, loss of balance, and dizziness. Mr. Nowak had balance problems. Mayo Clinic recommends several strategies individuals can use to manage hypertension. They list strategies like increasing physical activity, eating healthy foods, managing stress, stopping smoking, and regular monitoring of blood pressure at home. They mention numerous physical activity techniques like aerobics, brisk walking, and muscle-strengthening activities. In managing stress, they state coping techniques that include meditation, physical activity, and muscle relaxation.
Mr. Nowak is stressed about his fall years ago that led to TBI. This is comparable to anxiety or post-traumatic stress disorder (PTSD). Treatment of this condition mostly involves psychotherapy. The specifics of it include exposure therapy, cognitive therapy, and eye movement desensitization and reprocessing. In addition, there is a coping mechanism like patients should take care of themselves (they should exercise, eat healthily, and relax). Also, staying connected to caring and supportive individuals is beneficial, and medications that can be used are antidepressants and anti-anxiety drugs (Mayo Clinic, 2018).
The PHII shows that exercising (notably aerobic is superior to the other forms of exercising), antidepressants, psychotherapy, and meditation work effectively in treating mental conditions, inclusive of TBI and anxiety-related ones. Therefore, the personalized care of Mr. Nowak will involve these four elements. His TBI condition will be managed by psychotherapy, mediation, and aerobics (the last two help improve memory, mood, and muscle). Mediation and exercise will also manage HTN as they will reduce stress (or any high cholesterol issue) and solve his balance problem. All the four elements will work in the managing of distress. Another aspect that helps in the PHII is family involvement in treatment. Dehghan et al. (2015) mention several benefits family involvement have on treatment. These include specific activities like reducing stress, facilitating the following of medication regimen, and regular monitoring of blood pressure. Therefore, family involvement should be incorporated into the care.
Justifying Evidence
The statements reported by Balewa are important to personilized care. It is because the data provided by her is of value and relevance. The data is extracted from mental cases, which is what Mr. Nowak suffers from. Also, it shows techniques that are working well than others. For instance, muscle strengthening, and playing Sudoku and crossword puzzles are inferior, while aerobic and meditation are superior in cognitive improvements.
Data from the Mayo Clinic helps show the overview (symptoms, treatment plan) of the diverse illnesses and disorders Mr. Nowak has. This evidence is relevant as it offers the treatment alternatives, which are then compared to the superior treatments of PHII to come up with personalized care.
The family involvement evidence provided by Dehghan et al. (2015) creates value by showing the aspects that the patient’s family play in improving treatment. The evidence is appropriate to Mr. Nowak’s case as he is an elderly individual, and the report of PDL revolves around the elderly patients.
Evaluating the Outcomes
Several criteria can be used to evaluate the outcome of personalized patient care. They include blood pressure, stress, and memory.
Measuring blood pressure will be achieved by the use of an inflatable arm cuff. Normal blood pressure will show that the care was a success. It will indicate that physical activity reduced stress, which reduced blood pressure.
The Perceived Stress Scale will measure stress. It quantifies the magnitude to which an occasion in one’s life is appraised as stressful. This evaluation style is efficient as it involves posing direct queries to the patient that are general in nature and easy to understand to any subpopulation group. For Mr. Nowak’s case, it will show if his distress emancipating from TBI has reduced or disappeared.
A framework to measure memory is the General Practitioner Assessment of Cognition. The framework comprises of two aspects – informant interview and cognitive test – which enhance the predictive power of determining cognitive impairment in individuals. This will show whether the treatment plans for TBI are beneficial to Mr. Nowak. If the patient scores 9 it will indicate that his memory is fine.
References
Dehghan Nayeri, N., Gholizadeh, L., Mohammadi, E., & Yazdi, K. (2015). Family involvement in the care of hospitalized elderly patients. Journal of Applied Gerontology, 34(6), 779-796.
Herbst, E. (2013). Overcoming barriers to care for returning Veterans: Expanding services to college campuses. Journal of rehabilitation research and development, 50(8), VII.
Mayo Clinic. (2019, March 29). Traumatic brain injury – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557
Mayo Clinic. (2018, July 6). Post-traumatic stress disorder (PTSD) – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967