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Unit title: HSNS363 Unit coordinator: Reshin Maharaj Assessment number: Assessment 1 Due date: 18 th December Word Count: 1662

Introduction The theme of this essay will be the case study of Ben, a 28-year-old former member of the defence force who now lives in a small rural village, after losing his mining job Ben's mental health is deteriorating. Medical and situational complexity are usually associated with multimorbidity which therefore is affected by which way healthcare providers deliver care to their patients. Patient-centred care delivery is required to ensure that the patient's expectations are met holistically. The ability to detect and effectively manage complex cases is required for a comprehensive an all-encompassing approach to patient-centred care. This essay will investigate the complexity of multi-morbidity, Ben's

nursing care plan for any treatment and management contraindications, as well as study the intricate network of multi-morbidity. Medically Complex Case Three years ago, Ben was in a training accident that resulted in a L4-L5 spinal fusion. This procedure entails the L4/5 disc to be removed and the lumbar spine's L4/5 vertebral bones to be fused together (Peloza, 2023). An extra strain on the discs above and below the fusion site causing chronic pain can be a complication of having this surgery, the effects of which are permanent (Peloza, 2022). Due to his spinal problems and his fusion surgery, Ben has had chronic lower back pain since this treatment, which is exacerbated by spending a lot of time in a vibrating automobile. His injuries also led him to leave the ADF on medical grounds, resulting in increasing pain medication use such as Ibuprofen and Panadeine Forte and, if required, Oxycodone, all PRN prescribed by his GP along with experiencing a decreased nighttime sleep quality. Ben also suffers from depression, a common mental health condition. It is distinguished by a prolonged period of low mood, loss of enjoyment, or lack of interest in activities (World Health Organization, 2023). When individuals experience these depressive episodes, they experience moments of feeling angry, sad and even empty which can last for a while normally up to two weeks, almost everyday (World Health Organization, 2023). Due to his social complexities aggravating his mental illness of

depression Ben has had to start taking an antidepressant known as Sertraline. Ben was diagnosed with Post-Traumatic Stress Disorder (PTSD) after leaving the military. PTSD is a mental health disorder which causes fear, nightmares, anxiety and memories of a traumatic event that they have witnessed or experienced. People who suffer from PTSD tend to have extended periods of times where these feelings interfere with how they cope on a daily basis (Health direct, 2019). Ben’s PTSD tends to flare up when he was at work and above-ground explosives were utilised, his PTSD. People suffering from PTSD have a variety of therapeutic options available to them. For example, cognitive behavioural therapy after receiving psychological and psychiatric assistance as seen used by Ben where he has had some success. Along with his mental illnesses Ben has noted an increase in his alcohol consumption both quantity and frequency. There are many health concerns that arise from alcohol when it’s not consumed in moderation, there are many harmful repercussions which include mood changes inclusive of anxiety and irritability, sleep disturbances, lowered immune system, increased chance of getting ill, drop or changes in sex drive and function, weight fluctuations, memory problems, lowered concentration, difficulty focusing on certain tasks, hypertension, liver cirrhosis, heart diseases such as heart attacks and alcohol induced psychosis (Pietrangelo & Raypole, 2018). Ben meets the criteria for a medically complex patient because of his combined medical disorders and clinical presentation. When treating individuals with complex medical needs, it's critical to pay close attention to detail (Peters et al., 2020).

Situational Complexity Situational complexity takes into account involvement, actions, and both personal and environmental elements. When giving Ben medical care, there are numerous situational difficulties to address in order to provide the best care possible. First of all, the fact that Ben currently lives in a rural area that is being affected by droughts is considered as an environmental variable. This could lead to greater living costs and a decrease in the need for workers, as indicated by the closing of the mine where Ben worked (Australian Institute of Health and Welfare, 2019). Ben's personal factors include his unemployment due to being laid off from his mining job six months ago, which left him without income. As a result, he is now dependent on his parents for both home support and financial help as he is still unemployed. These personal factors would create a negative impact on anyone’s overall health however, unemployment can cause more stress and a deterioration in mental health especially when someone suffers from multiple mental

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