Physical and Psychosocial needs of Palliative Clients

Physical and Psychosocial needs of Palliative Clients Addressing Physical and Psychosocial needs of Palliative Clients Jaweria Bano Death and dying are certainly unescapable events in human’s life. Palliative is patient and family centered care that enhances quality of life. It is an approach that enhances life of an individual and their families challenging the issues connected with life-debilitating sickness, through the curative action and help of suffering. Palliative mind all through the continuum of sickness includes tending to physical, scholarly, enthusiastic social, and otherworldly needs and to encourage understanding self-sufficiency, access to data, and decision of consideration According to Loscalzo (2008), Institute of Medicine (IOM) report defines palliative care as â€Å"prevention and relief of suffering through the meticulous management of symptoms from the early, through the final stages of an illness.Palliative care attends to the emotional, spiritual and practical needs of patients and those close to them.† A case scenario related with providing palliative care to an adolescent client was encountered in an Ibn-e- Zuhr building. A 16 year old boy was suffering B-cell lymphoblastic leukemia and was admitted in daycare for his third chemotherapy cycle. While taking his interview I came to know that he was in his usual state of health 4 years back, suddenly he developed fever for 4 months on and off, cough at midnight for 1 month and shortness of breath for 2 week for this he went to nearby hospital in Lahore. Where many diagnostic procedures like CBC and bone marrow biopsy were done and doctor referred him in Karachi for chemotherapy. While interviewing, he verbalized that due to chemotherapy he felt nauseated, and had many episodes of vomiting. Moreover, he had complained of weight loss, fatigue, dyspnea and alopecia. He also verbalized that he had feeling of loneliness and anxiety due to the disease. Patient‘s family said that he is not interact in family and isolate himself. This issue caught my attention; I began to feel the same feeling and concern which my patient was going through at that time. My emotions had totally exceeded my ability to think. As a nursing student, it is my obligation to give comprehensive consideration to the patient and also his family. During patient care I recognized many domains which were affected, like psycho-social, spiritual, physical and communication. Here all spaces of palliative consideration are interrelated to one another yet I will highlight the two most influenced areas: psycho-social and physical. These papers will high light on the concerns, interventions and recommendations regarding physical and psycho-social domains of palliative care. Patient history revealed physical suffering that is like paling of eyes, dryness of skin and mouth, dyspnea. Diseased process or medications effects on his activity level and decreased appetite. Due to reduced activity and side effects of treatment her appetite had also decreased. As a consequence of decreased appetite and frequent hospitalizations he had lost significant weight in last six months (5-6kg). The difficulty in breathing did not let him sleep peacefully which in turn caused frequent mood swings and irritability in his personality. He also felt embarrassment in socializing and stayed at home due to alopecia. Referring to the case, symptom relief is the most evident need of the physical domain of palliative care. This is due to the fact that physical problems are closely related with psychological, spiritual and social issues and thus may adversely affect the overall quality of an individual’s life whereas palliative care chiefly aims to improve the quality of life rather than the length of life (Stevens, Jackson Milligan, 2009). For that reason, I approached the patient by focusing my care on the most discomforting issue that is of dyspnea. Firstly, patient’s dyspnea was managed by non-pharmacological methods that include performing deep breathing, pursed lip breathing and coughing exercises for 10 minutes every hour (Viola et al., 2008). Anemia is also a possible cause of dyspnea and fatigue (Borneman, 2013) which was also evident in the current case where hemoglobin level was just 10.3 mg/dl. Patient was positioned in semi fowlers’ position and spirometry exercise s were taught to the patient. Since pain was due to physical exertion so it also improved once dyspnea was settled. To reduce patient suffering and enhancing quality of life I educate patient besides, a teaching session was delivered to client and family members on importance of good nutrition, in which it was emphasized to take high energy, high protein diet not just to correct dyspnea but also to minimize weight loss and fatigue by promoting repair of damaged tissues (Holmes, 2011). Frequent water intake was also encouraged in order to minimize dryness of mouth. Issue of maintaining functional independence was handled by planning activities and rest periods according to energy level. Assistance was provided in self-care activities (Kumar Jim, 2010). Psychosocial area of palliative consideration alludes to the nearby relationship between the individual and the aggregate parts of any social. The patient was also experiencing psychological distress, anxiety and depression. The suffering was intolerable for the patient. Additionally, he was unable to tolerably cope with him condition as evidenced by him social isolation compromising the psychosocial aspect of patient’s wellbeing. Though the family was not well managed financially, patient’s family constantly kept worrying about the cost implications due to his frequent hospitalizations, treatment procedures, medications and chemotherapy etc. Similarly, humans as social beings, share their joys and burdens through social interactions. The family members of the patient also reported their observation that he doesn’t want to get involved in family gatherings and other such activities and would prefer isolation. However, I encouraging my patient to ventilate and ver balize his feelings, thoughts and views. Similarly, a teaching activity regarding emotional coping was practiced that included anxiety managing and guided imagery (Onyeka, 2010). I also guide the family that welfare is available in AKU. Family was given passionate help and was stressed on own wellbeing support. It is commonly observed that member who is in hospital with patient has distinctive stress related to household chores, children’s and families critical for life. Anxiety may also arise in response to sickness related stressor as saw for our situation that not just patient, family was additionally on edge about support persistent, difficulty process and it disgusting reality (Alacacioglu et al., 2013). The whole journey of palliative care is no doubt a most challenging aspect of nursing profession. Yet, the essence of both palliative care and nursing are fundamentally similar and that is to relieving suffering of mankind by all possible means. In the same way, the task of caring the palliative client was in fact a difficult task. Despite of all the nursing efforts, holistic care was still lacking few aspects due to certain boundaries like time limitation, problem while communicating to patient’s which was resolved to an extent and in capability in dealing with cultural influences on client’s well-being. Furthermore, lack of resources and limited theoretical knowledge also caused hindrance in care and it is the central problem in developing countries. To conclude palliative consideration nursing is another idea. It is additionally developing in our nation yet on a moderate step and uncommon endeavors are obliged to enhance this field. More mindfulness projects and explores ought to be directed to approach comprehensive consideration amid the days ago of an understandings life Nurses must also join this specialty in hospital and community settings to enhance the quality of lives of patients suffering from terminal illnesses. References Alacacioglu, A., Tarhan, O., Alacacioglu, I., Dirican, A., Yilmaz, U. (2013). Depression and anxiety in cancer patients and their relatives. J BUON, 18(3), 767-774. Borneman, T. (2013). Assessment and management of cancer-related fatigue. Journal of Hospice Palliative Nursing, 15(2), 77-86. Holmes, S. (2011). Importance of nutrition in palliative care of patients with chronic disease. Primary Health Care. 21(6), 32-38 Kumar, S. P., Jim, A. (2010). Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian journal of palliative care, 16(3), 138. Loscalzo, M. (2008). Palliative Care and Psychosocial Contributions in the ICU.Pain Management and Supportive Care for Patients with Hematologic Disorders. Pp. 481-490. Onyeka, T. C. (2010). Psychosocial issues in palliative care: A review of five cases. Indian journal of palliative care, 16(3), 123. Stevens, E., Jackson, S., Milligan, S. (2009). Palliative nursing across the spectrum of care. United Kingdom, UK: Wiley-Blackwell. Viola,R., Kiteley,C., Lloyd,N.S., Mackay,J.A., Wilson,J., Wong,R.K. (2008). The management of dyspnea in cancer patients: a systematic review. Supportive Care in Cancer. doi:10.1007/s00520-007-0389-6.

Malaysian :: Business and Management Studies

Malaysian PROTON'S bonnet badge shows a tiger, but a fish might be more appropriate because the state-backed Malaysian car-maker is going from being the largest resident in the small pond of its protected local market to being a minnow in the deep waters of the global car industry. the state-backed Malaysian car-maker is going from being the largest resident in the small pond of its protected local market to being a minnow in the deep waters of the global car industry Malaysia becomes a richer, more discerning car market with lower trade barriers Southeast asia's economy is growing again, and that has triggered record vehicle sales. in Southeast Asia Malaysia is second hootest market after china is clearly the biggest [sales] opportunity for car manufacturers anywhere in Asia. Just 1 in 35 Indonesians owns a car, compared with 1 in 14 Thais and 1 in 7 Malaysians. Right now car purchasers can get loans on a new model with as little as 5% cash up front. That compares with the 20% down payments common just a few years ago. Unlike in China and India, big global auto makers aren't rushing to build manufacturing capacity in high-risk Indonesia. Proton and Perodua are Malaysia's two main domestic manufacturers, claiming over 70 percent of a market where demand is estimated at around 500,000 cars this year. Two other companies also assemble cars locally. While the government continues to encourage small and medium-scale players, there may also be a need to consider steps to consolidate among the many vendors (suppliers) in the automotive industry in order to gain scale, financial strength and managerial talent to expand internationally," Najib Razak told the conference. Political system 1. government While the government continues to encourage small and medium-scale players, there may also be a need to consider steps to consolidate among the many vendors (suppliers) in the automotive industry in order to gain scale, financial strength and managerial talent to expand internationally," Najib Razak told the conference. That suppliers power 2. Malaysia drops duties, adds tax Import duties on cars from outside Southeast Asia will be lowered to 35 percent for knocked-down models, and to 80 percent to 200 percent on fully built models, the government said. Malaysia said it would wait until 2008 to further reduce motor vehicle import duties, to the required range of zero percent to 5 p â€Å"On this basis, the government does not expect major price changes in the cars produced or assembled in Malaysia during 2005.† ercent. Market 1. Malaysia's market is too small to sustain more than one or two domestic car makers, given increasing competition from imports. 2. Malaysia Market Summary Malaysia is a member of the Association of South East Asian Nations

Southwest Airlines

Southwest Airlines is a passenger airline based out of Dallas, Texas that provides air transpiration throughout the United States. Southwest is currently the 6th largest U. S. airline based on revenue. It currently has more than 3,100 flights in 73 cities, making it the largest U. S. carrier passenger airline. They provide good options, such as early check-in, hotel packages, car rental, and free luggage up to two bags, which are one of their techniques to provide bad news to the customers. Summary: Southwest Airlines is the largest carrier in the United States and they get the high satisfaction ratings of the country’s best customer service providers from business week’s ranking. The reason why they can do so is that they contain good policies for the customers. For example, a case in St. Louis, an ice storm had stocked the plane for several hours. The flight attendants and pilots walked through the plane like usual, trying to answer questions that customers had and they provided the information for the passengers about connecting flights. Passengers who were on the flight were surprised by the letter they got after few days. They got a free round-trip flight. Fred Taylor is a senior manager of proactive customer communications who has a daily meeting with his department to talk about the problems that may happen and develop the methods to minimize them. For example, Southwest Airlines use twitter to send the information and official announcements for their customers. If passengers know more about the policies, it helps them a lot. The other part of Fred Taylor’s job is to deliver bad news and responding to customer’s complaint. According to the article (2011), Fred Taylor says that â€Å"it’s not something we had to do. It is something we feel our customers deserve. † He writes about 20,000 apology letters to passengers in a year. The letters have his direct phone number and many of them include a free flight voucher. The motto of Southwest Airlines is â€Å"share the spirit† and they do what they say. Course concepts: Bad News disappoints, Irritates, and sometimes angers the receiver, such messages must be written carefully. The Bad feelings associated with disappointing news can generally be reduced if the receiver: A) Knows the reason for the rejection. B) Feels that the news was delivered sensitively C) Believes that the matter was treated seriously and fairly While many people may claim to prefer directly delivered bad news, the source cannot be said in a particular situation. For example, if those people are directly responsible for the situation resulting in the bad news, they may not be so found of hearing it directly. Or if the bad news is personally serious and damaging, they may prefer a buffer Again this comes to the first phase of the writing process: assessing and analyzing both the situation and audience. Once this is done, it will be clear whether to deliver bad news directly and indirectly. Using the indirect strategy is a smart way to lessen the blame and the importance of negative news. However, there are still possibilities of negative ramifications. If, for example the sender takes too long to finally deliver the main point the recipient can be aggravated. The key to delivering news effectively knows the audience. For example, some people prefer direct communication for the good news and the bad, while others prefer indirect and good communication skills. In dealing with delivering bad news, the 3*3 writing process still maintains its purpose and assistance. In the prewriting phase of the writing process (phase1) the aspects include 3 As: analysis, anticipation, and adaptation. In completing this phase, the writer determines that a negative message must be sent how the news will be received, and how to appropriately draft that message. Third, aspect(Adaptation) that the choice between direct and indirect messages comes to play. Even though it may seem impossible to make the receiver happy when delivering negative news, it is possible to reduce bad feelings and resentment by the use of a buffer, a buffer is a device used to reduce shock or pain. The following are various buffer possibilities A) Start with the part of the message that represents the best news. B) Show that the reader is important and cared. C) Provide objective information that introduces the bad news. The most important aspects of delivering negative messages are explaining the reasons and how to increase the benefits. In developing audience benefits and building goodwill, we should increase new value and better features, make it more efficient or make customers’ lives easier. Southwest got high performance from USA airlines services. When flight was delayed, Southwest Airlines will inform their customer directly by appropriate ways. Moreover, Southwest Airlines will give promo code discount or free one-way tickets when any flight was cancelled. Therefore, customers feel happy and satisfied even when they face the problem because they have another thing to compensate such as give cards, cash back, VIP cards, and so on. Moreover, Southwest Airlines will offer more options that make each customer more convenient. When customers reserve the tickets and then they have a late flight. Southwest Airlines provides the option that customers can fly early if another flight is available. â€Å"Customers will hear an announcement in the gate area and will be able to purchase an available [early] boarding position via credit card from a customer service agent,† Furthermore, this option is useful because Southwest Airlines got positive feedback back from the customers. From my real experience, I am one of the loyal customers who traveled with Southwest Airlines. In addition, this Airlines always has a good deal when I would like to travel somewhere in the United States. So, Southwest Airlines is the best choice for me not only they offered cheap tickets, but also provided free two luggage promotion. The last time I chose Southwest Airlines, my flight was delayed because of bad weather. Unfortunately, I also missed the next flight that I actually had to transfer to. Nevertheless, Southwest Airlines tried to find another flight for me. Furthermore, Southwest Airlines paid me for the hotel, meals, and cash back during I was in New York. According to this experience, I always choose Southwest Airlines no matter how expensive I have to spend. In conclusion, Southwest Airlines knows how to respond and handle unpredictable problems, and inform its customers directly with proper ways. From the above reasons, Southwest Airlines is one of the successful airlines company in the US.

Legal and Ethical Issues Essays - 844 Words

Running head: LEGAL AND ETHICAL ISSUES IN MY SISTER’S KEEPER Legal and Ethical Issues in My Sister’s Keeper Detra Smith Med 149: Medical Ethics Abstract In this paper I am going to identify some the legal and ethical issues in My Sister’s Keeper. Some of those issues include emancipation of a minor, genetic engineering, and limited termination of parental rights. I will be giving my opinion on these matters also. My Sister’s Keeper is about a family who conceives a child strictly for the use as bone marrow donor for her gravely ill older sister. Kate is diagnosed with Acute Promyelocytic Leukemia at the age of two. As their doctor tells them of their options, he asks Sara and Brian, the parents, have they thought about†¦show more content†¦She left her morals at home on the kitchen table that day and kept leaving them behind. In this movie, it seemed that the mother is putting one child’s quality of life over the other children. Jesse is being neglected because he has a selfish mother. He is just a shadow that sulks and creeps throughout the house and the city. As parents how they can they do that. I know that when you are dealing with a seriously ill family member, some things do get neglected or put on the back burner. But that thing should not be your child. Sara and Brian did not even realize that Jesse was suffering with dyslexia. Anna and Kate have came u p with a bunch of reasons as to why Anna wants to be emancipated. At the age of eleven, Anna and her older brother, Jesse, go hire a lawyer to sue their parents for the rights to Anna’s body. The lawyer takes the case because he knows what it is like to live a life where you have no control of your body. The lawyer suffers from epilepsy. Anna wants to become a medically emancipated minor. The courts had never heard of such a case and there is no such term as medically emancipated, legally defined. With Anna becoming medically emancipated, it means that Sara and Brian’s parental rights have been terminated within limits. They still had to provide shelter, food, clothing, and other basics, but they could not tell her what to do medically. In my opinion, an eleven year old is not responsibleShow MoreRelatedThe Legal And Ethical Issues1532 Words   |  7 Pages Introduction This essay will address the Legal and Ethical issues in relation to the case study. It will outline the four elements of valid consent and applicable issues needed to prove and defend the claim for all parties involved. The Universal declaration of bioethics and human rights identifies three relevant principles to this case study. 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