The purpose of this essay is to demonstrate knowledge and understanding of both psychological and sociological factors that may impact on the patient/client and also relate to psychological and sociological theories and National Policies. The real name of the client has been changed to protect the patients confidentiality (Nursing and Midwifery Council 2008) NMC. The patient I will be discussing is Mark, a 42 year old man who has worked for a construction company for the past 20 years. Mark is married and has three children ages 3, 4, and 8. Following an incident at home in which Mark fell 15 feet off a roof, he has had persistent chronic lower back pain. Two surgeries over the past 12 months have failed to alleviate his pain. Mark is currently out of work because of this and his wife has had to take on a second job working evening and weekends to make ends meet. Mark has no previous medical history and he classifies himself as being generally healthy. Prior to his accident, Mark was very active; playing football with his mates on weekends, jogging every morning, going to the pub, holidays with family and having fun with the kids. Presently Mark is unable to stand for long periods of time; this has affected his quality of life as a whole. The reason I have chosen this patient is because he has a condition that I may encounter in my own personal life and I am highly interested to learn about the impact it may have psychologically and sociologically on individuals.
The psychological factors that Mark may encounter because of his physical condition may include depression, anxiety/anger, sleep disturbances and possibly low self-esteem. According to Abramson et al (1989), depression is caused by internal stable and global attributions for bad events and external unstable and specific attribution for good events. Depression may occur with mark because of the lowered pain tolerance and may decrease his willingness or ability to comply with medical advice. Mark may also be heightened with his perception of pain; he may become reluctant to carry out treatment modules provided to him because of fear of encountering more pain or injury. The combination of immobility and depression can lead Mark to be irritable, nervous or anxious and have an unhealthy desire for isolation; marital conflicts may also develop and escalate. As the depression sets in, Mark may become more angry, easily frustrated, moody, and plagued with feelings of hopelessness. Anxieties may interfere with Marks ability to concentrate; he may find himself worrying about his health and other life stressors such as finances, providing for his family etc. Anxious thoughts such as catastrophizing (e.g. ruminating about the negative impact of pain and worrying about whether the pain will get worse), may increase his pain further and encourage disability. After having two unsuccessful operations on his back, Mark may also have doubts about recovering and therefore may also lose hope. As pain often prevents sleep, Mark may also be affected with constant state of tiredness because of sleep deprivation. According to Lamberg (1999), sleep disorders and persistent pain mutually interact, and it is often a clinical challenge to determine if the pain is due to poor sleep quality or whether sleep disturbance is due to night pain. For example, sleep deprivation can trigger a decrease in pain tolerance and pain thresholds (Onen et al 2001). Conversely, chronic pain may lead to non-restorative sleep and sleep fragmentation, as well as unpleasant consequences such as impaired thinking and greater proneness to accidents. Mark may also experience low self-esteem, having feelings of being unworthy or not measuring up to others and feeling incapable of achievements or successes in life. Body image disturbances such as weight gain may also be a contributing factor to Marks psychological well being. Weight gain can be...