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Introduction
Adam dropped out of school at 19 years old to join the music. He traveled the country with his music band. In his twenties, he met his wife when h but the marriage did not last for long. Adam has been drinking excessively and suffers from long periods of depression, has been unemployed for three and a half years. Tom, who loves his father, Adam, is reluctant to visit because he feels nervous staying overnight, especially when his father has been drinking excessively, and is occasionally aggressive in his manner. Adam was referred by his GP for psychiatric assessment. He has been diagnosed as Bipolar. He now has a key worker called Patrick, who intends to refer him to a rehabilitation center. Adam feels he can talk to his key worker Patrick, whom he feels listens to him and wants to support him. However, he often feels he cannot talk about his mental health condition to other people, as he feels it is misunderstood. This impacts him socially and he avoids going out too often. In this essay, we shall discuss therapeutic communication, psychosocial and socio-political influences, health determinants, and service provision to Adam’s condition.
Effective therapeutic communication
According to Esmeralda, Eugjen, and Erinda (2013), the concept of ‘therapeutic communication’ refers to the process in which the nurse consciously influences a client or helps the client to a better understanding through verbal or nonverbal communication. Therapeutic communication involves creating avenues that allow patients to express themselves. Therapeutic communication uses verbal and nonverbal approaches (Esmeralda, Eugjen, and Erinda, 2013 ). Therapeutic communication is the interaction between the patient and the health worker which is meant to help the patient. (Esmeralda, Eugjen and Erinda 2013). To achieve effective therapeutic communication; nurses must exercise the component of privacy and confidentiality facilitating free expression by the patients. (Esmeralda, Eugjen and Erinda 2013). It is therefore important that in any healthcare setting, communications are effective to effectively advance care to patients. It is based on effective communication that the different issues that arise in inpatient care can be understood. Most patients need to be able to communicate with physicians and other caregivers to be well understood. The use of both verbal and non-verbal communication must at all times be applied in the healthcare setting to help patients communicate their health issues.
When analyzing therapeutic communication between nurses and patients it’s important to adhere to maintaining a standard procedure to treat patients adhering to a standard procedure facilitates information exchange, and creates bonding and respect between the patient and nurse. (Esmeralda, Eugjen and Erinda 2013). Taking the case study of Adam, I can conclude that Adam is facing barriers to effectively communicating his condition. Adam is experiencing stress. Adam has a failed marriage and has been unemployed for more than three years. The accumulating stress levels pushed Adam into excessive drinking such that his conduct has made him aggressive to his family members such as his son Tom and his parents. Because of this, his siblings and son are reluctant to visit him because of his aggressive nature. Therefore, being professional is one of the main issues that must at all times be put into consideration. In so doing, patients are assured that information shared with their caregivers will be held with utmost privacy and that it will be well synthesized and put to effective use. The above will help in proper care advancement since the basis of the patient’s communication will at all times be understood.
Moreover, Adam is suffering from depression which is a barrier to ineffective therapeutic communication. Depression is a symptom of bipolar disorder that Adam was diagnosed with. As a result, Adam is not willing to listen to people around him which also presents a huge communication barrier. He is withdrawn and this can be evidenced by the fact that he lives alone and also that he has only one confidant who goes by the name Patrick. Depression makes Adam reserved and unwilling to open up to the people around him. However, given the health condition that Adam shows, Patrick must be the only person that Adam confides provides psychosocial support to Adam. This will help Adam understand his condition better, as well as help, him learn how to maintain the stability of his condition.
Therapeutic communications help in providing good health care to patients. For quality health care, there must be a good relationship between patients to have improved well-being of the patients (Amoah, Anokye & Boakye, 2019). Therapeutic communication is also nonverbal by the use of cues. Therapeutic communication is recognized for improving adherence among patients, trust, giving comfort, making patients control their emotions, and providing patients with knowledge about their health. (Amoah, Anokye. & Boakye, 2019). According to Dejan and Zlatko (2017), therapeutic communication eliminates negativity amongst healthcare users in solving healthcare problems by providing channels that help improve health conditions. Nurses are mandated to protect patients who cannot make good health choices. Effective therapeutic communication acts as a form of treatment for patients. Effective communication is guided by the following principles; (1) Set clear ideas, having a clearly defined idea will make it easy to communicate (2) use appropriate language that simple and is easily understood. (3) Consistency and conformity to standard practices at the hospital. (4) Adequate and complete to avoid incomplete information affecting adherence and other outcomes. (5) communication should come at the right time when it is most needed. (6). Communication should go through the right channels to remove the element of doubt from the recipient.
Psychosocial and socio-political influences
Education is an important psychosocial variable. According to Cousin, Mast, Roter, and Hall, (2012) when tackling education, two questions are raised that is; how long did one stay in school, and the award attained from school? It is also evident that the quality of education is relevant to the health of a person such as mortality, morbidity, health behaviors, and functional limitations. People with lower levels of education are more susceptible to poor health throughout their entire lives. Taking the example of Adam, he dropped out of school at the age of 19 (Cousin, Mast, Roter, Hall, 2012). Due to the low levels of education he attained, he was not able to find a job for more than three years. As a result of being stressed, he resorted to heavy drinking.
According to the survey carried out by Popa-Velea & Purcărea (2014), infants born to Caucasian mothers with fewer than 12 years of schooling are 2.4 times more likely to die before their first birthday than infants born to mothers with 16 or more years of education. The above is true for other ethnic groups African American, Hispanic, American Indian, and Asian/Pacific Islander infants. Making education compulsory in the different states in the United States suggests that higher education standards will lead to better health thereby reducing the rate of mortality.
Adam was diagnosed as being bipolar. This is a lifelong mental illness that is characterized by mania and depression. Kornhaber, Walsh, Duff & Walker (2016) point out that issues such as lack of finances and unemployment will lead to low self-esteem, self-esteem, loss of identity, and lowered self-confidence making it hard for the patient to cope with society. Overall men that are employed will demonstrate better mental health compared to unemployed men. This can also be noted in the case of Adam who is unemployed, suffers from depression, and has been diagnosed as Bipolar. According to David and Sheri(2010), lack of social support will lead to increased levels of depression among people with bipolar disorder. BD patients are sensitive to reward and the more they pursue their goals and attain them, the more they are likely to suffer from mania. (David and Sheri 2010). When BD patients experience negative events, it increases the likelihood of developing depressive symptoms, as do levels of familial expressed emotion. Psychosocial interventions can speed recoveries from episodes and delay recurrences over 1–2-year intervals. (David and Sheri 2010)
Considering Adam’s economic status, it is evident that he was not financially stable. According to Kornhaber, Walsh, Duff & Walker (2016), there is a correlation between income and mortality. Unhealthy habits such as alcohol abuse and smoking are more pronounced among people with low incomes. This assumption holds for the case of Adam who has unhealthy practices of excessive drinking and it is evident that income inequality is inversely related to good health.
Social care services
Adam has developed a drinking problem, I would refer him for alcohol support services within his area of residence. Quitting or reducing alcohol consumption requires help or even coming up with a plan that will help Adam live an alcohol-free life. Similarly, Adam can be encouraged to join groups such as Alcoholics Anonymous (AA) that can be easily accessed within his area of residence and can help him manage his addiction. Adam can also be initiated into alcohol treatment. There are different types of treatment programs such as; (1) residential where a client is on treatment from 30 to 90 days and resides at the treatment facility. (2) Partial hospitalization, a person is monitored for 4-5 hours a week at the hospital. The above strategy would, in the end, help to address the extent of his current addiction tendencies. Moreover, more emphasis needs to be placed on understanding the main cause of his daily drinking behavior. It is from the above background that better methods of addressing his situation can be adopted. Also, the family plays a vital role in this kind of condition. It would, in the end, help him to overcome his habit given the above-suggested treatment programs.
Adam was diagnosed as being bipolar. I would immediately refer him to a health facility for the support given that his mental condition is a lifelong illness that needs immediate attention to mitigate severe effects. To address the issue of bipolar disorder, there are mainly three aspects that need to be taken into consideration. The main treatment strategy that he needs to adopt in this particular case is the use of antipsychotics, mood stabilizers, and the use of antidepressants. The whole treatment process often is associated with a combination of mood stabilizers and psychotherapy. Valproic acid and lithium are the most common treatment drugs for patients with bipolar disorder. In the same manner, I would encourage him to disclose his condition to the family as well as request his family members to offer psychosocial support in helping him manage this mental condition.
Conclusion
Therapeutic communication is intended to ease communication between patients and healthcare professionals by creating an atmosphere where patients can express their opinions. Health professionals should use therapeutic techniques to give the best medical treatment to the patients. Bipolar disorder is a lifelong mental illness that is characterized by symptoms of mania and depression. Bipolar patients find challenges in communicating with people around them because of their mental disorder. Patients with Bipolar disorder need support from trained health professionals and people around them. While analyzing Adams’s condition, he must be directed to the right places to receive social service. Given the above, he can be properly attended to help him recover from alcohol addiction and stress disorders. As discussed in the essay, the level of education attained, and the income status of a person have a strong correlation with the quality of health of a person. As elucidated in the above paragraphs, more research needs to be done to better understand the general parameters that can be adopted to address the issue of bipolar disorder among many people across the world.
References
- Amoah, V.M.K., Anokye, R., Boakye, D.S., et al (2019). A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients. BMC Nurs 18, 4[online] (updated 2019). Available at https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-019-0328-0#citeas [Accessed March 13, 2020]
- Cousin G, Schmid Mast M, Roter DL, Hall JA.(2012). Concordance between physician communication style and patient attitudes predicts patient satisfaction. Patient EducCouns. 2012;87(2):193–197
- David and Shari. L . J (2010). Social and Familial Factors in the Course of Bipolar Disorder: Basic Processes and Relevant Interventions: National Center for Biotechnological Information.[online], available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727612/#R8 [ Accessed March 13, 2020]
- Dejan, Zlatko .C , (2017). Therapeutic Communication in Health Care: Researchgate.[online] (updated 2017) available at https://www.researchgate.net/publication/320245946_Therapeutic_Communication_in_Health_Care[ Accessed March 13, 2020]
- Esmeralda, Eugen. S, Erinda L, (2013). Therapeutic communication [online available at
- file:///C:/Users/HAZZ/Downloads/27_Shreko_Sortiri_Lika%20(2).pdf [Accessed March 13, 2020]
- Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review. Journal of multidisciplinary healthcare, 9, 537–546. https://doi.org/10.2147/JMDH.S116957
- Popa-Velea, O., & Purcărea, V. L. (2014). Issues of therapeutic communication relevant to improving quality of care. Journal of medicine and life, 7 Spec No. 4(Spec Iss 4), 39–45.
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