Chronic Kidney Disease: A Case Study

As of 2012, approximately half of all adults in the United States (U.S.) had at least one chronic health condition and one fourth had more than one chronic health condition (Ward, Schiller, & Goodman, 2014). Self-care is recognized to be an important component in the management of chronic illnesses (Ausili, Masotto, Dall'Ora, Salvini, & Di Mauro, 2014; Coleman & Newton, 2005; Kennedy, Rogers, & Bower, 2007). As knowledge in this area grows, there is a need for theories to guide research and practice. The middle-range theory of self-care of chronic illness (MRTS-CCI) is a theory intended to clarify the concepts, assumptions, propositions, and factors affecting self-care in the context of chronic illness (Riegel, Jaarsma, & Strömberg, 2012).

Pain is a condition that is determined and described by the person reporting it. There are several components to pain including the emotional, psychological, and physical aspects. Many health professionals struggle to understand this phenomenon and thereby insert their own perspectives into the pain assessment of patient reporting pain. The Affordable Care Act (ACA) (2010), also titled the Patient Protection and Affordable Care Act H.R. 3590, was passed by Congress and signed into law on March 23, 2010 (U.S. Department of Health and Human Services (DHHS), 2013). Hospital value based purchasing programs (VBP) were developed to align patient quality care and outcomes to the support initiatives from the ACA. A component of the VBP includes patient satisfaction. Patient satisfaction is a self-reported response to questionnaire administered by a third party. Many hospitals utilize Press Ganey to administer the survey for the inpatient and outpatient patients. One component the survey includes patient’s self-reporting how well their pain was managed during their hospitalization. This measure of satisfaction can have an adverse effect on patient outcomes and increase opioid use in this setting. Patient satisfaction and pain management are both subjective however pain management while within scope of healthcare professionals should not be included in the patient satisfaction survey.

The Pain Assessment Survey was developed to assess whether registered nurses are using evidence-based standards to assess and manage pain for special populations. Descriptive statistics were used in this study. The sample group surveyed included registered nurses currently enrolled in an on-line Baccalaureate program. A quasi-non-experimental study was utilized to allow the collection of a large amount of data at one time, while allowing the researches to compare and contrast the use of evidence based practice standards when preventing medication errors. This study contained both dependent and independent variables. The independent variable present is the use of evidence-based practice standards in the assessment of pain in special populations. The dependent variable is the management of pain in special populations of different cultures and chronic pain syndromes. The researchers concluded that out of the 50 participants of the survey, the majority use the verbal pain scale. The researchers concluded that registered nurses are using evidence-based standards of practice when assessing pain in special populations such as those with different cultural backgrounds and those with chronic pain

The information is presented in a direct manner, lacking unnecessary information, and written in a style which is easy for a range of readers to understand. They provide a thorough description of the development of the instrument, the norm population used, and an example of the survey, thus enabling the study to be replicated. A table of the frequencies and percentages of respondents’

Sadly, for some patients chronic musculoskeletal pain (CMP) can feel like a life sentence. All to often in clinical settings we see patients who psychologically combine chronic pain with resistance, the outcome often being suffering, this suffering, however, is a choice. Whilst there are behavioural and psychological components involved, recent research has looked into various patient-led forms of self-help or management of pain, one such method being mindfulness. Although limited, the current evidence in this field suggests that there is a place for such interventions for the acceptance or management of pain in chronic musculoskeletal conditions. Further research may wish to look at the quality of research into this area including a superior level of randomised controlled trials (RCTs) to test pain acceptance specific mindfulness interventions in matched subjects.

Several studies outline the use of an acceptance based protocol in the treatment of chronic pain. Each protocol emphasizes the importance of living a valued life despite the presence of pain and pain related cognitions. Rather than using the approach of another empirically supported intervention, CBT, ACT interventions use a more values driven approach. Vowles and McCracken (2008) studied the use of an ACT consistent group treatment for chronic pain. In their study, two of the core processes (acceptance and values-based action), were used as outcome variables. This study involved completion of a 3 week treatment which included ACT based principals and treatment methods in addition to mindfulness exercises. The treatment began with acceptance

After hip fracture, patients are faced with many problems and that incident will affect their quality of life, especially the mobility. Although health care providers provide the patients with information about treatment, patients need to adapt to the new situation such as doing self-care and changing their lifestyle. One of the models that can contribute to self-care is Orem self-care model. “In the theory of self-care, Orem explains self-care as the activities carried out by the individual to maintain their own health” (Current Nursing, 2011). For example, patients need to do range of motion exercises to increase the ability to perform activity daily

The independent variables are self-efficacy and the stage of cancer survivorship. Self-efficacy which is the central construct in the theoretical framework of the research and the stage of the cancer survivorship, which in this study, focused on women in the extended survival stage are independent variables because their effect or contribution to the outcome is not dependent on any variable. Symptoms experience is another independent variable. However, the outcome, which is the quality of life is a dependent variable because it depended on the self-efficacy and cancer survival phase of each participant.

Among the patient sample receiving acupuncture, there was a significant reduction of reported pain score immediately after the procedure. More than three-quarters of patients receiving acupuncture in outpatient setting reported a significant improvement of their pain state (Lu et al., 2014). In a review of non-pharmacological approaches to SCD pain management, Williams and Tanabe (2016) reported that all the reviewed studies on acupuncture had yielded reductions in pain but at insignificant levels. It should be noted, however, that the Williams and Tanabe (2016) review only found 2 studies on acupuncture. There are other studies that have cited challenges in the integration of acupuncture as an adjunctive therapy for SCD pain; Bhushan, Conner, Ellen, and Sibinga (2015) concluded that although acupuncture had some pain reduction effects, only 5% of eligible patients (n= 40) agreed to receive the therapy.

The Chronic Disease Self-Management Program (CDSMP) is a community based self-management program created to help individuals gain their own confidence and skills to help manage their chronic illnesses. This self-management program is to collect data from the Chronic Disease Self-Management Program in English speaking countries, and determine the program’s effects on health behaviors, physical and psychological health status, and health care utilization at 4 to 6 months and 9 to 12 months after baseline. Small to moderate improvements in psychological health and selected health behaviors that remain after 12 months suggest that Chronic Disease Self- Management Program delivered in small English-speaking groups produces

Another obstacle that may be faced by the health care providers is assessing the pain of the arthritis patients with cognitive problems. The health care providers often will dismiss complaints of pain in patients with cognitive impairment due to the inconsistent pain reports. There are some findings from studies suggest that the verbal complaints by the patients with cognitive impairment are reliable and valid. However, some investigations also show that verbal reports of pain tend to decrease as the cognitive impairment increases. This will, in turn, affect the patients’ ability to respond to direct questions. Lack of pain assessment among this category of patients will increase the risk of under-recognition and undertreatment of pain (Herr

Results: The doctor-patient relationship can promote resilience indirectly through ensuring that the patients perceive that their pain is validated, they acquire new skills and knowledge related to their condition and become

According to Orem's theory of self-care, hemodialysis patients must be able to perform self-care tasks in order to provide continuous effective care. Through vigorous research, it is apparent that Orem's theory of self-care seems to be the most applicable theory when utilizing self-care management in hemodialysis patients. According to Orem: "Self-Care is the practice of activities that maturing and mature persons initiate and perform within time frames, on their own behalf in the interest of maintaining life, healthful, functioning, continuing personal development and well-being" (Orem, 1995, p. 101). Educating clients in their hemodialysis treatment has been found

To ensure efficacy and validity in this study, this writer has ensured that the questionnaire items were measured based on a scale of nominal, ordinal, interval or ratio scale (Abramson, & Abramson, 2008). Naturally, informed consent was provided to all survey participants as they were properly educated on search parameters.

Pain is a basic mechanism in life that helps the body identify that something is wrong or dangerous. Without pain, the body would be severely damaged without realizing it. Pain can become an inconvenience when it spirals out of control; chronic pain, for example, leaves many miserable and unable to enjoy life to its fullest extent even with traditional medical intervention. Around 80% of people report chronic pain in their lifetime (Holtzman & Beggs, 2013). People afflicted by chronic back pain turn to modern medicine for relief, but even these alternatives are not always 100% effective.