Patient Case
Patient H is a 50-year-old female seen with symptoms suggestive of liver disease with associated habitual uncontrollable addiction to alcohol. She presented with jaundice, a massively distended abdomen, and confusion. On further inquiry, a significant alcohol history was elicited and assessed for severity in order to inform the management plan. A Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) is helpful in identifying the addiction level of a patient and, therefore, informs the management approach (Steel et al., 2021). The CIWA-Ar score was low and insignificant, incongruent with the findings on clinical examination and historical probing. Given the positive history of heavy alcohol consumption with the partner, the patient requires a comprehensive approach to management to attain the desired goals of hepatic and substance management.
Patient Needs
Patient H is a case requiring a combination of advanced substance abuse management and clinical approach management for liver disease. The outcome of clinical diseases can be significantly affected by unstable mental or substance use circumstances (Wan et al., 2020). Critical analysis of clinical needs and alignment to the implementation of therapy in patients with superimposed clinical disease can significantly improvesignificantly improve the care outcome (Mo et al., 2020). Patient H requires a multifocal approach to management to provide solutions to the substance use challenges and the liver disease.
The Turning Point Website
The Turning Point website is a free resource website available to practitioners, learners, and general users to improve the understanding of issues related to mental illnesses and substance abuse (Turning Point, 2023). It is developed by professionals in therapy to critically analyse the client’s needs and provide a better understanding of the patient’s needs and, therefore, craft better solutions. The use of additional technology resources in the management of substance abuse and behavior change offers a synergistic effect in the management of these cases (Bandawar et al., 2018). Patient H will have a better experience with her management and be involved centrally in her process of behavior change.
Thranstheoritical Model
The transtheoretical model of behavior change presents a stepwise approach to behavioral adoption. These stages include pre contemplation, contemplation, preparation, action, maintenance, and termination (Prochaska & Velicer, 2017). This model is appropriate for creating a change therapy model that encourages patients to monitor their progress actively through therapy. Healthcare providers applying the transtheoretical model also find it easy to plan the application of desired change strategies to help the client meet their management goal (Rahimi et al., 2019). This model of behavior change can be intertwined into the use of the Turning Point website to help the client acclimatize to every management phase, ensuring a positive prognosis of their health condition.
Challenges and the Role of Nurses
Creating a management plan for the therapy of clients with multiple health issues can be challenging. This requires the assistance of a clinician to guide the patient through the implementation and to record improvement (Yosep et al., 2023). Nurses will establish existing clinical and social challenges and include modalities in therapy to address these issues (Tanoue et al., 2018). In Patient H’s case, combining therapy that addresses the clinical, substance, and social challenges is critical to meeting the management goals.
Conclusion
Patient H presents with hepatic symptoms and a significant history of heavy alcohol consumption. In this case, management’s goal is to create an energy that allows the management goals to thrive. Applying the turning point website will help identify the extent of the patient’s challenges and support health professionals in creating a working plan. The transtheoretical model of behavior change provides specific progress phases through which healthcare workers will monitor the client. Patient H will benefit from the therapy approach by applying technology tools combined with the transtheoretical model.
References
Bandawar, M., Narasimha, V. L., & Chand, P. (2018). Use of digital technology in addiction disorders. Indian Journal of Psychiatry, 60(Suppl 4), S534–S540. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_21_18
Mo, G. H., Wang, Z. X., Chen, X. S., & Jiang, Q. (2020). The prognosis and prevention measures for mental health in COVID-19 patients: through the experience of SARS. BioPsychoSocial Medicine, 14(1). https://doi.org/10.1186/s13030-020-00196-6
Prochaska, J. O., & Velicer, W. F. (2017). The Transtheoretical Model of Health Behavior Change. American Journal of Health Promotion, 12(1), 38–48. https://doi.org/10.4278/0890-1171-12.1.38
Rahimi, A., Hashemzadeh, M., Zare-Farashbandi, F., Alavi-Naeini, A., & Daei, A. (2019). Transtheoretical model of health behavioral change: A systematic review. Iranian Journal of Nursing and Midwifery Research, 24(2), 83–90. https://doi.org/10.4103/ijnmr.IJNMR_94_17
Steel, T. L., Giovanni, S. P., Katsandres, S. C., Cohen, S. M., Stephenson, K. B., Murray, B., Sobeck, H., Hough, C. L., Bradley, K. A., & Williams, E. C. (2021). Should the CIWA-Ar be the standard monitoring strategy for alcohol withdrawal syndrome in the intensive care unit? Addiction Science & Clinical Practice, 16(1). https://doi.org/10.1186/s13722-021-00226-w
Tanoue, H., Yoshinaga, N., Kato, S., Naono-Nagatomo, K., Ishida, Y., & Shiraishi, Y. (2018). Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study. International Journal of Nursing Sciences, 5(3), 218–222. https://doi.org/10.1016/j.ijnss.2018.06.005
Turning Point. (2023). Turning-Point.co.uk. https://www.turning-point.co.uk/#:~:text=This%20free%20online%20learning%20has
Wan, Y., Wu, J., Ni, L., Luo, Q., Yuan, C., Fan, F., Liu, H., Zhang, C., Xiang, Y., & Xie, Q. (2020). Prognosis analysis of patients with mental disorders with COVID-19: a single-center retrospective study. Aging, 12(12), 11238–11244. https://doi.org/10.18632/aging.103371
Yosep, I., Mardhiyah, A., Ramdhanie, G. G., Sari, C. W. M., Hendrawati, H., & Hikmat, R. (2023). Cognitive Behavior Therapy by Nurses in Reducing Symptoms of Post-Traumatic Stress Disorder on Children as Victims of Violence: A Scoping Review. Healthcare, 11(3), 407. https://doi.org/10.3390/healthcare11030407
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