Facilitating Learning And Assessment At The Workplace

Facilitating Learning And Assessment At The Workplace

Impacts of a Chronic Illness on Day to Day Life

The interviewee is named Louisa (not her real name), a 61-year-old female diagnosed with breast cancer in January 2021, resulting in a double reconstruction and mastectomy. Louisa was diagnosed with Grade 2, Invasive ductal carcinoma ER, PR, and HER 2 positive. She has completed 18 months of chemotherapy, both Taxol and Herceptin. She is now taking Anastrozole for five years and possibly ongoing to suppress the oestrogen in her body and minimize the return of secondary breast cancer. According to the health promotion model, health behaviors are determined by experience with behaviors, personal factors, beliefs and barriers, activity-related effects, self-efficacy, and interpersonal and situational impacts. Two priorities have been identified for the patient, including restorative sleep and eating and drinking re-dependence spectrum. Louisa will be subjected to a health sensitization program to learn about the advantages of eating nutritiously.

Wilson et al. (2018) stated that different health promotion theories are available for use with patients with conditions such as those experienced by Louisa. However, for the sake of the patient, the health promotion model or Pender’s health promotion model has been chosen for application based on the needs identified through the interview. The model is based on the premise that people’s experiences can affect their health outcomes (Khodaveisi et al., 2017). The model explores people’s attitudes on health and their individual experiences. According to Choi and Duffy (2017), the model states that individuals should observe their psychological health, social and cultural environment, and lifestyles to understand most of their health decisions. The model is essential in utilizing a broad framework of factors to identify areas of concern for Louisa, discussing the 12 factors and Louisa’s ability to take independent action regarding her self-care. Louisa is a 62-year-old female, divorced, with two adult children, and has lived a full life of joyful and stressful events. Louisa is also a sole parent who has raised her children to single handily since birth. She is between late adulthood and old age. Her ability to undertake independent self-care should be considered concerning additional factors such as age, gender, developmental state, socioeconomic factors, and cultural and environmental factors. Louisa is a self-funded retiree who enjoys part-time work where she can utilize her management skills to contribute to social justice. Using the Health promotion model should enable me to get a clearer picture of Louisa’s ability at the life stage to take individual independence for her self-care or whether there is a need for independent intervention and support (Aqtam & Darawwad 2018). Progression of a Person alongside a lifespan continuum. 46 -65 years = late adulthood and 66 onwards = old age. Each stage produces different physical, socio-cultural, and life experiences 

After interviewing Louisa, I identified several priorities for her care. The priority for Louisa is obtaining restorative sleep to enable her body to combat and maintain a healthy equilibrium to ensure she is in the best position to inhibit the return of her cancer. Louisa informed me that she was aware that she needed good restorative sleep to enable her to be better positioned to prevent secondary cancer and future cancers from occurring. Curtis et al. (2020) reiterate the importance of getting enough sleep, especially in infections such as COVID-19. She told me that she was fearful, which is normal for such patients, as Hong et al. (2020) stated. Of the 12 Activities of Living that impact me, the greatest ones include insomnia. She stated that her mind would not stop worrying and that she was easily stressed and self-medicated with alcohol for a quick sedative effect much of the time. Louisa was aware that alcohol would not ensure quality sleep but was at a loss regarding other strategies to use. Louisa also stated that she found other calming solutions that did not work. Her mind was ‘hard wired’ to adrenaline, and being able to ‘dump’ this adrenaline was very difficult. At times Louisa indicated self-destructive behaviors or lack of motivation to implement and commit to constructive actions that she is cognitively aware would assist her in maintaining her health and well-being (Golem et al. 2019). I am confident that using the RLT and health promotion models will enable me to gain a bigger picture of Louisa’s lifestyle and self-care ability, which may impact her ability to manage her well-being and remission. 

The consequence of not addressing restorative sleep would lead to her becoming highly likely to have a recurrence of cancer, either secondary or new. Cáceres-Matos et al. (2020) state that pain in patients suffering from chronic diseases emanates from limited regular activities, depression, anxiety, and limited sleep. Among cancer patients, drinking is crucial in mediating their sleep homeostasis through adenosine (Cen et al., 2020). She will also become highly likely to suffer other liver, stomach, and brain issues. Her general well-being and relationships will suffer, alongside her employability, whereby she has stated she enjoys part-time work and money to spend on holidays. Good sleep is crucial for mental and physical health and general health (Chattu et al. 2018). Louisa is aware she has inherited anxiety and depression from her maternal grandfather’s family, dementia from her father and her paternal aunt, and breast cancer from another paternal aunt. Thus very likely to have ongoing significant health outcomes.

The most important health education that the patient requires is healthy nutrition education. The reason is that this will assist her in recovering quickly (Neuhouser, 2019). Consistency in eating patterns has also been linked to preventing and controlling chronic diseases. Louisa has mentioned that she sees a clinical psychologist every month, attends 2 exercise physiologist sessions per week, maintains a gym membership at the community gym, and enjoys massages, facials, and other pampering pursuits. For Louisa, these appear to be strategies that support a theoretical attempt at well-being but are evidenced by a lack of commitment or genuine motivation. The use of alcohol as a self-medicating tool is also perturbing as it counters the positive steps that Louisa is taking. Louisa is fully consignment to this anomaly. Due to her lifestyle, health education should be supplemented with the regular physical education (Koehler & Drenowatz, 2019). I suggest to Louisa that she seek a referral to a rehabilitation center or a well-being resort to break her habit of self-medicating with alcohol and address more specific issues concerning sleeping and relaxation. This would enable her to take time out without stress or demands to address the other identified lifestyle factors (RLT). This, in turn, may assist her in making a greater commitment to exercise and reduce stress through more healthy choices than alcohol. Louisa is a self-funded retiree with access to knowledge, information, and private health options. I believe this is a realistic option to pursue.

The second priority selected for Louisa is the eating and drinking re-dependence spectrum. Louisa has shared with me that she has oesophageal issues due to acid reflux inherited from her mother, which has caused Barretts Syndrome. She is taking the medication Pariet daily to manage her reflux. Pituitary adenylate cyclase-activating polypeptide (PACAP) is essential for feeding control, according to Gargiulo et al. (2020). It is recommended for the patient due to her current condition. She has also been identified as having a range of food intolerances through discussions with a dietician. Under the dietician’s supervision, Louisa was able to identify and implement her specific FodMap requirements and has benefited from this ongoing. Fodmap diet is crucial in enhancing her immune functions (Wark et al., 2020). Louisa has also stated that she is an emotional eater with a limited ability to moderate food consumption. She has also stated that her mother modeled a tiresome disinterest in preparing food and serving meals to the family. Louisa is aware of this possible impact on herself and struggles to recalibrate herself to enjoy and research positive and healthy eating. Blanco-Gandía et al. (2020) maintain that research has shown a close relationship between eating disorders and drug abuse. Louisa has also inherited her mother’s osteoporosis and is aware of the need for appropriate eating of certain food groups but remains uncommitted and unmotivated. Louisa appears overwhelmed by the need to manage osteoporosis, acid reflux, her FodMap requirements, cholesterol and healthy heart issues associated with aging, and the varied and conflicting information about dietary requirements post-cancer.

There are great consequences in failure to address the problem of eating and drinking for patients such as Louisa. It is essential to a person's health to eat and drink. They can be directly related to a person’s ability to resist and manage chronic illness and maintain physical and mental health (Matsui et al., 2020). Louisa has advised that she has spoken to 2 dieticians who gave her varied advice about preventive cancer eating choices. Bioactive foods directly impact managing cancer (Islam & Siddiqua, 2020). Louisa’s lack of commitment to consistently eating well will disadvantage her in the future and may not enable her body to combat further cancer appearing in other sites. Lowers et al. (2019) maintain that stopping eating hastens death. Aside from this, it is likely that Louisa will revert to her use of alcohol for sustenance and stress relief in the absence of other more nutritious food choices. These choices are likely to compromise Louisa’s health and well-being severely.

Given that Louisa has already spoken to 2 dieticians and is aware of her need for healthy food choices and her compromised health and immunity status. I would suggest a similar recommendation to her priority, whereby she attends a rehabilitation or resort community where healthy eating is modeled and consumed. According to Fairbanks et al. (2020), pathological use of alcohol requires a specialized eating program for the recommendation to become effective. I would also suggest that the choice of the venue includes cooking classes, discussion around quick, healthy, and nutritious meal planning, and how to incorporate food intolerances into an eating regime. This recommendation is based on Louisa’s socioeconomic ability to resource and attend such a venue and her ability to implement these suggestions based on her cognitive, education, and knowledge base. I would not recommend reading or further individual research be suggested for Louisa, but I would endeavor to locate specific resources for her concerning healthy eating post-cancer. This may include referral or connection with the Breast Cancer Foundation and support groups where discussions and accountability may create a simple but renewed interest in quick, exciting, and nutritious options for food and drinking. This also helps counter her mother’s modeling regarding the preparation and serving of food, especially if she can see the benefits of not being engaged in laborious and traditional food preparation, serving, and clearing up of meals. As Chen et al. (2020) maintain, healthy eating also needs to be supplemented with regular exercise.

In conclusion, using the theoretical frameworks of the health promotion model and the RLT model, I was able to interview Louisa. I also used her health care framework as an individual with specific circumstances to identify areas of priority for health care for her chronic illness, cancer. My recommendations have been based on her circumstances and various factors specific to her. The factors influenced my choice of recommendations for her sleep issues, use of alcohol as a sedative, and the need for greater engagement with more dynamic sources of information for food choices. I have also noted that Louisa should be mindful of aging issues, weight gain, increased fitness, bone health and cholesterol, and heart issues. I have also included in my recommendations an awareness of prevention, comforting, and seeking information on behaviors, and her ability to source and implement information.

References

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