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Lekha was 25 years old and she was a teacher. She studied to become a teacher and recently qualified in primary schooling education. In the beginning of her career she managed to get a job according to her study. But due to the sudden pandemic situation she lost her job that she was doing. After that she became demotivated. She had no family present in UK. After some time she again started to find a job in Warrington. After trying for so long she could not manage to find any job in Warrington. You are telling me a story here - think professional - what has happened, succinct and straight to the point. She had some savings but she had no job to earn more. As she was using her savings, she started running out of her savings soon but she could not manage any job for her. She was about to evicted from her home. For all these ongoing stress she started eating excessively (Taylor et al. 2018). After some time it became a habit of her. She developed eating disorder to a severe level. As she started eating so much she was now classes as obese. And her health condition was detreating day by day. She also became mentally sick in the meantime. She had agoraphobia. Due to this she started having excessive heart rate, heavy sweating, chest pain and pressure. She has no family in UK. She was all alone in the situation. She wanted to meet people to talk about different things but she was worried about them judging her. She could not talk to anyone during her problem.
As her mother was a cancer patient and died, she quitted smoking ‘cold turkey’. She quitted smoking without any help of the professionals and any nicotine replacement.
Here two interventions are chosen. Collaborative Care Planning and Health coaching or Motivational Interviewing.
Reasons behind choosing this case
When all healthcare staff are collaborating with the patient in a difficult situation and caring for the patient it is called collaborative care.
In this case study of Lekha she was suffering from eating disorder and lastly she started to become obese. Her health condition was detreating day by day. She needed a care team at first. In her case she was alone in UK. If her parents were there they would have helped her in this situation. Eating disorder mainly happens due to depression. She was in an immediate need of a health care team. Where she would get doctors and even also a health support team at home when she was unable to get out. She stated that she took initiative by quitting smoking. But if she was under a medical care team it would have support her in this situation.
Health Coaching or Motivational Interviewing is another intervention mentioned in the above case study. It is mainly boosting the mental strength of a patient through discussion and counseling.
In this case study Lekha was suffering from a mental illness. So it is needed to her to share her fears and insecurities with a person who can comfort her or give her motivation. She stated that she wanted to talk to people. But she had a fear that people can judge her hearing her complications. So she is in the much need of Motivational Interview (Greenen et al. 2018). Where she can share all her hesitations with the doctor. And the doctor can help her to change her situation.
In the main body the definition, components, pros and cons of the two interventions and their effects on the case study will be discussed in detail.
In the above case study two main interventions are discussed. They are the Health coaching or Motivational Interviewing and Collaborative care measures (Chapron et al. 2019). These two aspects are very important in the case of healthcare.
Collaborative Care Planning in the healthcare system is something where the doctors, all the well skilled medical staff and the family members of the patient are collaborating with the patient to improve her health condition and to cure that patient (Jiang and Wen 2020).. There are four elements of this Collective Care Planning.
Planning of the Collaboration
Collaboration Within and across teams
At first the medical staff plan the full patient care program according to the situation and the medical history of that particular patient. Then each part of the caring system divides their work and understands their job role and how they will help the patient (Sirintrapun et al. 2018).The third important thing is the interprofessional communication between the different teams collaborating to help the patient. Last but not the least is collaboration within and across the team (De simone et al. 2018). Inter team coordination is very much needed to do any work. There are many pros and cons of the Collaborative care system.
As this is a combined system of different professionals, this gives an admirable outcome in healthcare and with a collective effort it is easier to eradicate a problem.
Many professionals are involved in a process so there are many views of a problem and there are many creative solutions present for that (Schutz et al. 2019). This also increases the understanding of a health emergency and treating it accordingly.
Collective care can also make a skill of balanced decision making.
If the work of the teams are not defined properly in a collective care system, this can create a malfunction (Wastling et al. 2018). The cost of the collaboration may increase and some patients cannot take the help of this system.
Based on this case for Lekha collaborative care is much more needed. As it is seen that in collaborative care process different professionals including family member helps the patient to recover. Here for Lekha she was alone in UK and her mother was also died due to cancer. In her situation she was unable to talk to any people. She needed her family most and apart from that she needed medical team interconnected with the top doctor at home as she was unable to go out. On the other hand it costs a lot to maintain these teams but it is very helpful.
In this above figure it is showing the different factors of the collaborative care system and the parameters dependent on the factors. Collaborative care factors are patient related factor, external factor, Interpersonal factor, organizational factor and professional factor. Sub factors of Patient factor are active goal of the patient, participation and language of the patient and the collaborative care team members. In this whole process the family and the patient plays a great role. In the whole process the patient participation is very important. Members of the collaborative support team must be skilled to treat the patient properly. Organizational factor means how the organization works. Work efficiency, leadership and the work view of the organization is very important in case of collaborative care (Santana et al. 2018). Interpersonal factor means how much the patient and the family trusts on the organization and the staff. Professional related factors of collaborative care system means the knowledge of the staff in a particular domain, motivation and individual competences. Last but not least the external factors are finances, law and regulation, culture. The most important factor is the relation between the staff at home and the organizational staff.
It is done to motivate a patient to change his/her behavior through counseling. When a patient is mentally devastated for the treatment ongoing then each and every medical staff is trying to help her (Uddin et al. 2018). They are introducing the patient to the other patients who are going through the same patch. Health Coaching or Motivational Interviewing has four steps.
Understanding the patient’s view
Giving empathy to the patient
Resist the righting reflex
Empower the patient
If it is needed to mentally boost a patient it is needed to understand the medical background of the patient. Why is the patient facing challenges? What is his/her mind thinking about that particular illness the patient is suffering from. Understanding a patient is the main thing here (Remillard-Boilard et al. 2021).Professionals have to be empathetic to the patient. They should avoid advising the patient about good health and good life. It is the best way to give hope that due to this illness the patient’s life is not ending. Still there are chances to live life to their fullest. The professional should not be harsh to the patient. They have to motivate the patient, give him/her positive ideas to live life. The main idea is that a particular disease cannot take the enjoyment away from the life of a person.
Four stages of the motivational interviewing are plan, evoke, focus and engage. First the physician has to plan according to the medical history of the patient, again to recall how the history of one patient is separate from the other patient’s (Griffith et al. 2020). The next step is to focus on the problems and thoughts related to that particular patient. Last step is to work according to the plan.
There are pros and cons of motivational interviewing.
It boosts the mental strength of a person who is devastated mentally. It helps the patient to think out of the box. To feel good about their own life.
This type of treatment can change many high-risk lifestyle behaviors of a patient.
Motivational interviewing makes people more self-reliant, self-confident and responsible. It is a healthy habit.
Motivational interviewing or health coaching can be dangerous for the people who have bipolar disorder and Schizophrenia.
This cannot help the patients who have chronic depression. In this medical case the motivation may be not enough for that patient.
Motivational interviewing does not work for the people who are already motivated enough to make a change in their life.
Same type of motivational words may not work on different people.
One sided communication is never healthy in this process. It needs double sided participation, and the patient needs to be free while telling the professional about their own fears.
In the above case study Lekha was dealing alone with her problems. She wanted to talk to people but could not. So for her care planning Motivational Interviewing is much more needed. If she would have consulted a doctor who can talk to her or take a counseling of her she would recover easily. In this type of case doctor can identify the pattern of the patient easily and can introduce her to the other patients who have recovered from the same situation. This is very much needed to build up the mental strength of the patient. A health coach also can make a person aware about the health situation of a patient and can tell how to improve it. In case of Lekha it was also same.
In the portion of introduction a case study is given. Two interventions are derived for that study and it is explained how they are connected with the case study. In the main body portion the interventions are explained in detail with their definition, course of action, advantages, disadvantages and relevance with the case study. These two interventions may be helpful for the patient in the case study.
The two interventions chosen here, both are separately useful for a patient. Motivational interviewing and Collaborative care planning both are used to treat a patient. Collaborative care is for either physical treatment or mental treatment. But motivational interviewing is only for mental treatment purposes. According to the case Health coaching or Motivational interview will be more helpful for Lekha. As she was suffering from food disorder due to depression and through motivational interviewing her depression can be removed. This will remove her other problems.
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