Nursing Adults with Complex Needs

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Nursing Adults with Complex Needs
Chronically ill adults’ educational needs on self-medication The patient chosen for this essay is a sixty year old man. This patient was one of the palliative care patients that the team of district nurses I was allocated to work with in my community placement care for. The patient has terminal liver cancer. The patient lives with his wife whom is his main carer. The district nurses had to visit him every day of the week. The patient had a syringe driver on situ which needed to be filled with a new dose of medication every 24 hours. Also the extension set needed to be changed to the other side of the patient’s body when the side it was on became sore. The main care needs for the patient were to palliate physical symptoms and maintain independence for as long and as comfortably as possible. The main focus of patient care was to control the patient’s pain. Also the patient experienced nausea, vomiting, and constipation .These symptoms were unwanted side effects of the opioids he was taking. During my placement the condition of the patient worsened. Pain increased, along with the side-effects of the medication taken by the patient. Some of the activities that the patient was able to perform independently became difficult, such as getting to the toilet and maintaining personal hygiene. The patient became restless at night time due to the increase of pain. At this point the amount of opioids taken by the patient was increased by the doctor, so that as well as the medication in the syringe driver the patient could take a set amount of strong opioids when required by mouth to relieve the pain. I will relate this care issue to the research article I have chosen to critique and discuss. These oral opioids where always administrated by his wife. The patient was unable to do it himself due to his physical deteriorated condition. However was always the patient that asked to take the medication when he felt he needed it. I have chosen this patient because cancer is a chronic illness for many people and more people are living with cancer for longer. Also I have a personal interest in the subject. The article I have selected to critique is called   “Chronically ill adults’ educational needs on self-medication” Kawkab Shishani, (2008). The critique framework I will use to critique this article methodology and methods is Polit (2006). In this article the language and style used overall is clear and easy to understand. Some research and statistic language is been used which can make some smalls parts of the text difficult to read and understand for any reader that is not familiar with that language. According with  Macnee (2004)  not been able to understand some terms in a research report can be frustrating and creates barriers to use of the research in practice. These show that recognizing and understanding some of the research language will make it easier to use it in practice.  The aim of the study is clearly stated within the first parragras of the text. Shishani (2008) explains clearly why the research study was needed, why it was carried out in the manner it was and also decribes the gap in knowledge that is adressed by his research study. Shishani (2008) included several paragraphs of background information that help him to justifie the proposed study. These paragraphs present the significance of the problem along with supporting documentation from the literature (Boswell, 2007). According with Macnee (2004) the literature review identifies where the gaps in knowledge maybe and also give the reader a picture of what has already been studied in relation to the problem. In Shishani (2008) article studies and surveys were presented to highlight the significance of the problem under investigation. They stated that despite the benefits of chronically ill adult’s education on self-medication the evidence presented suggests it is not being addressed. According with Macnee (2004) the method used in a...
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