David’s Targeted Health Condition
The targeted health condition for David involves atherosclerosis. Specifically, atherosclerosis is primarily a chronic inflammatory illness characterized by the formation of plaques within the arteries that narrow arteries. Consequently, the patient is likely to experience high blood pressure, as noted in the case of David. In particular, atherosclerotic plaques comprise lipids that cause an inflammatory reaction within the arteries, potentially leading to the development and progression of ASCVD (Atherosclerotic Cardiovascular Disease). One of the important reasons for identifying atherosclerosis as a targeted illness of David includes acknowledgement of having plaques within the arteries located in his face. David’s atherosclerosis is not one of the eight recognized chronic illnesses in Australia because it does not meet the inclusion criteria, including 61% of the disease burden, 87 % of deaths resulting from the illness and 37% of hospitalizations of the patients diagnosed with atherosclerosis.
Risk factors for developing Atherosclerosis
One of the important risk factors for developing atherosclerosis involves poor sleep quality, which David deduced from his previous working hours. Specifically, David reports that he often began work at 6:00 A.M., which ended at 4:00 P.M. However, it is also essential to note that his work always requires him to participate in overtime, which implies that David must work more than eight hours. This long duration of work is commonly associated with poor sleep quality, which plays a significant role in promoting the development of atherosclerosis. In support of this argument, Lee et al.’s (2022) research showed that poor sleep patterns as a result of working overtime period results in the development of blood hsCRP (High-Sensitivity C-reactive Protein) that causes increased high blood pressure, as reported by David along with his lack of concentration especially concerning his type O-based medication. The other risk factor for David’s condition is obesity. An examination of the video and the subjective evidence he offers concerning bullying indicates that David is an overweight individual, a common risk factor for atherosclerosis (Maksimovic et al., 2020).
Another risk factor for David’s condition involves his age. Specifically, David reports that he is currently in his 50s, specifically 53 years old. According to research conducted by Wu et al. (2022), one risk factor contributing to atherosclerosis development is the patients’ middle age. Moreover, according to van der Werf et al. (2023), one of the crucial contemporary tests used for confirming an accurate diagnosis of atherosclerosis, including ASCVD, involves using EBCT (Electron Beam Computed Tomography) for determining a calcium score necessary for diagnosing the illness. This test is essential because its interpretation is normally grounded on an individual’s age, especially middle-aged persons, to determine the burden of the plaques and conduct early treatment to avoid future adverse complications that might be life-threatening to the patient.
The other risk factors involve unhealthy lifestyles, poor nutritional diets, and lack of exercise. Specifically, lack of exercise, especially among middle- and old-aged persons, is a significant risk factor, as shown by Aengevaeren et al. (2020).
Genetics also play an essential role in contributing to the development of atherosclerosis. Specifically, previous research led by Ugovšek and Šebeštjen (2021) has shown that genetic polymorphisms play an essential role in producing genetic variants on the offspring that stimulate or modulate multiple risk factors for atherosclerosis like augmentation of plasma lipoprotein levels and promotion of vascular calcification and inflammation.
Long-Term Consequences of the Condition
The long-term consequences of atherosclerosis can be potentially life-threatening, especially when the condition is untreated. When considering, the case of David’s condition has not been treated even though he has previously made attempts to visit the doctor, who even offered him medication. However, he did not pay close attention to the medication he refers to as “Type)-based medication.” According to Kiaie et al. (2020), when atherosclerosis is left untreated, it progresses to Atherosclerotic Cardiovascular Disease (ASCVD). The other important life-threatening conditions that might result from untreated atherosclerosis involve complications associated with the illness. For instance, one of the long-term effects of David’s illness involves the potential of an occurrence of a stroke. Specifically, IS (Ischemic strokes are common among people who have failed to be treated for atherosclerosis, which significantly augments adverse health outcomes that threaten the lives of people and their QoL (Quality of Life).
Health Issues/Risks Specific to David
One of the health issues associated with David’s condition involves increased blood pressure that may potentiate the development of hyperattention and progress to CVS (Cardiovascular System) disorders. According to the case study, David narrates that after visiting the doctor, he was told that his blood pressure was extremely high to the extent that he was lucky not to have had a stroke. Extant research has also shown the positive link between CHD (Coronary Artery Disease), stroke and atherosclerosis. Specifically, Bos et al. (2021) noted that atherosclerosis was a significant risk factor modulating the development of coronary artery disease due to increased blood pressure, as well as a significant risk factor for the development of ischemic stroke among the tested sample population of 1,349 persons that included both middle-aged adults and the elderly persons. In this context, David remains susceptible to developing Ischemic stroke and coronary heart disease if an intervention is not conducted early.
Analysis of the Social Determinants of Health (SHD) Impacting David
SDH (Social Determinants of Health) are generally non-medical forces that contribute to adverse health outcomes, including the surrounding environmental conditions in which individuals are born, grow, work and age. In this context, one of the SHDs that influences David’s condition is the work environment he has previously lived in. Specifically, in his description of this environment, David emphasizes encountering harsh working conditions that greatly stress him. The work required him to do overtime jobs, not characterized by hard, intensive labour. Such conditions can contribute to his development of atherosclerosis because of depriving him of sleep, which is a frequent risk factor associated with this illness.
The other important SDH factor contributing to David’s illness involves the socio-economic policies and systems he has previously experienced in Australia. David is an Aboriginal, and based on his current age, the current socio-economic policies for addressing their concerns are not similar to those before the reforms were implemented. Specifically, the old socio-economic policies favoured segregation and inequities that categorized David and the rest of the Aboriginal community members as marginalized people (Zhang, 2024). Consequently, the Aboriginals retreated to up-country areas and lived in environments surrounded by forests and the wild. As a marginalized population, the Aboriginals have been traditionally labelled poor and uneducated people. David’s upbringing was characterized by this environment, which significantly contributed to his illness. In support of this contention, prior research indicated that poverty and lack of knowledge have significantly contributed to the development of chronic health conditions and health disparities seen in countries such as Australia and Canada.
Finally, David has been brought up in an environment where traditional cultural beliefs and norms play an essential role in nurturing the psychological, social and biological outcomes based on the biopsychosocial model of evaluating how the interplay between nature and nurture influences people’s behaviour and health outcomes. Precisely, aboriginals have traditionally had a distinct cultural belief concerning using Westernized resources or learning their ways of life, such as healthcare. Instead, they believe in traditional healing strategies passed down from generation to generation. In this context, David was raised in a cultural environment that nurtured negative attitudes, behaviours, and perceptions towards Western civilization, along with its programs and initiatives, especially healthcare. David does not pay any close attention to the medical help given to him, which could help him in treating atherosclerosis and preventing its further progression to life-threatening illnesses.
Education Session
David primarily requires an education session with a professional nurse mainly because his condition is generally associated with socio-economic conditions that have established an environment characterized by debilitative living conditions that have exacerbated the development of atherosclerosis. Specifically, David belongs to the Aboriginal community, which has traditionally been affected by segregation and inequality. Consequently, most
Aboriginals need more resources to educate them about the importance of seeking healthcare and adhering to the medication regimens offered to them because of the ideology that they do not need Westernization for their survival (Jayakody et al., 2021). Instead, they believe that their family and immediate surrounding environment provide them with enough resources to solve their health, social and spiritual needs. In this context, David’s contextual and cultural beliefs, in contrast to the predominant Australian cultural setting, play an essential role in contributing to the development and progression of his illness. Such risk factors warrant an education session with a nurse to educate them about how to prevent the progression of their illnesses into potentially life-threatening illnesses.
Topics for Inclusion during the Education Session with David
During the education session with David, one of the important topics discussed with the client included the current cultural context of Aboriginals and the contemporary culture of the Australian setting. As noted in the previous section of this report, David’s assessment suggests that he still believes in the traditional aboriginal ways of life based on his behaviour and attitudes towards access to and use of contemporary healthcare facilities and modern-day pharmacological medications, respectively. In this context, it is evident that David still values the traditional healing strategies emphasized by the abdominal community, which makes him disregard the use of the medication his doctor offers him. This negative perception and attitude towards the use of medications made by the Western civilization can be ascribed to the idea that the Western civilization manufactured resources and products by depleting the natural resources meant to sustain the livelihood of the Aboriginal community.
However, it is important to educate David that segregation and marginalization in Australia have long been abolished and that the Australian government, especially the healthcare sector, has made reforms in different social and economic policies aimed at promoting inclusivity and equal access to healthcare for every person living in Australia, including the aboriginal communities. The other important factor to consider involves the contextual differences between Aboriginals and the Australian healthcare setting related to David’s case. From the case scenario, it is evident that David does not trust the Australian healthcare system, a behavioural approach nurtured by the contextual differences between the two cultures. Nurses must understand diverse cultural differences as contextual by demonstrating cultural competency (Wright et al., 2021). Therefore, as a third-level nurse, it is essential to apply the knowledge learnt concerning contextual differences in addressing the patient’s healthcare needs by focusing on behavioural therapy that will change his attitudes concerning the current healthcare system to a positive one and resume treatment.
Type of Education Session
The most suitable type of education session includes a group-based interventional approach. Specifically, Aboriginals are generally not recognized as individuals but as a community because their values, norms, traditions and cultures are similar within the community (Gibson et al., 2020). Moreover, the disparities associated with healthcare access and delivery are primarily associated with the entire Aboriginal community and not a single individual. Therefore, as a training nurse, it is essential to address the identified topics above using a group-based education session that involves Davida and his community members to advocate for inclusivity in healthcare delivery and access for all Aboriginals. The educational group session will account for advocating relationality, positive attributes and establishing good relationships that centre on honesty.
Duration, Time of Day, Location, and Literacy Level
The group session will take a maximum of four sessions, each lasting 45 minutes. The time of day is another important factor to consider when performing the group sessions. In particular, according to the Aboriginal culture, time is considered a cycle and not sequential. This cultural approach allows for flexibility since the Aboriginals believe time shifts based on their needs and roles to sustain their families. In this context, it is essential to conduct the group sessions during the afternoon periods between 3:00 P.M. and 3:45 P.M. Finally, the health literacy level of the information communicated to the group will be considered during the education sessions. Since David is an Aboriginal and understands English well, he will be requested to translate all information into the Aboriginal language to ensure all attendees can get the message.
References
Aengevaeren, V. L., Mosterd, A., Sharma, S., Prakken, N. H., Möhlenkamp, S., Thompson, P. D., … & Eijsvogels, T. M. (2020). Exercise and coronary atherosclerosis: observations, explanations, relevance, and clinical management. Circulation, 141(16), 1338-1350.
Bos, D., Arshi, B., van den Bouwhuijsen, Q. J., Ikram, M. K., Selwaness, M., Vernooij, M. W., … & van der Lugt, A. (2021). Atherosclerotic carotid plaque composition and incident stroke and coronary events. Journal of the American College of Cardiology, 77(11), 1426-1435.
Gibson, C., Dudgeon, P., & Crockett, J. (2020). Listen, look & learn: Exploring cultural obligations of Elders and older Aboriginal people. Journal of Occupational Science, 27(2), 193–203.
Jayakody, A., Carey, M., Bryant, J., Ella, S., Hussein, P., Warren, E., … & Sanson-Fisher, R. (2021). Exploring experiences and perceptions of Aboriginal and Torres Strait Islander peoples readmitted to hospital with chronic disease in New South Wales, Australia: a qualitative study. Australian Health Review, 45(4), 411–417.
Lee, W., Yim, H. W., & Lee, Y. (2022). A cohort study of long working hours and increased blood high-sensitivity C-reactive protein (hsCRP) concentration: Mechanisms of overwork and cardiovascular disease. Journal of Occupational Health, 64(1), e12359.
Maksimovic, M., Vlajinac, H., Radak, D., Marinkovic, J., Maksimovic, J., & Jorga, J. (2020). Association of overweight and obesity with cardiovascular risk factors in patients with atherosclerotic diseases. Journal of Medical Biochemistry, 39(2), 215.
Nutbeam, D., & Lloyd, J. E. (2021). Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health, 42(1), 159-73.
Ugovšek, S., & Šebeštjen, M. (2021). Lipoprotein (a)—the crossroads of atherosclerosis, atherothrombosis and inflammation. Biomolecules, 12(1), 26.
van der Werf, N. R., Dobrolinska, M. M., Greuter, M. J., Willemink, M. J., Fleischmann, D., Bos, D., … & Leiner, T. (2023). Vendor Independent Coronary Calcium Scoring Improves Individual Risk Assessment: MESA (Multi-Ethnic Study of Atherosclerosis). Cardiovascular Imaging, 16(12), 1552-1564.
Wu, T. W., Chou, C. L., Cheng, C. F., Lu, S. X., & Wang, L. Y. (2022). Prevalences of diabetes mellitus and carotid atherosclerosis and their relationships in middle-aged adults and elders: a community-based study. Journal of the Formosan Medical Association, 121(6), 1133–1140.
Zhang, L. (2024). Structural change and the governance of Indigenous schooling in Australia: What is the problem? Policy Futures in Education, 14782103241226522.
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