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NURS FPX 6030 Assessment 3 Intervention Plan Design
Major Components
Among the most important elements of my psychological hospice care intervention, I can mention cognitive therapy, music therapy, breathing exercises, art therapy, and supportive-expressive group therapy. The pain indicators of the elderly who are dying will be alleviated with these parts. Cognitive therapy will assist in dealing with the patient’s complaints of pain by altering the patient’s perception and feelings about pain during treatment. Other elements that will also be used to ensure that the patient’s mind is diverted from the ailment include art therapy, breathing exercises, and music therapy among others. NURS FPX 6030 Assessment 3 supportive-expressive group treatments will aid the patients’ mental health by informing them that they are not alone in enduring pain complaints. The participants will be allowed to discuss their lives, their joy, their experiences of loss in the final stage of life, and their fears as well as how they manage them.
As for the solution of the given problem, these parts are the most suitable because radiotherapy, invasive treatment, and highly effective chemotherapy cannot be applied to patients who are already fatally ill and the sickness has progressed to the extent that they are no longer productive. Since chemotherapy and radiation therapy that has stopped being effective can worsen the patient’s suffering, psychological palliative care is the most effective way of managing the suffering that is associated with cancer.
Cultural Needs and Characteristics
Population
Palliative care is provided to older persons because of their needs and characteristics. NURS FPX 6030 Assessment 3 treatment measures are, however, part of palliative care where both physical and psychological management is used. Thus, considering the needs of people in regard to culture will assist in the development of a more effective plan of action. The people’s cultural needs will influence the kinds of action plans that will be adopted and the way they will be implemented. There are characteristics of the people in the community that will influence the formulation of action plans including; the people will be resistant to change and will not easily embrace new methods and ideas for improving on health and mental health care. Supportive talk groups and music therapy are two activities that will be influenced by the characteristics of the population.
NURS FPX 6030 Assessment 3 Target Population
The target population of California Cancer Care Center is patients with terminal diseases. Such patients are of different cultural backgrounds including Hispanic black population, white population, Muslim, and African among others; they have different beliefs and cultural needs. They cannot undergo music therapy and supportive-discussion group therapies due to their cultural belief systems. The following cultural factors hinder the provision of intervention components like music and supportive-discussion group therapy. The potential cultural characteristics of the setting include prejudice of the healthcare providers towards Hispanic black and Muslim patients which will affect the intervention plan.
Theoretical Foundation
Nursing Models
The following theories are related to my intervention plan: The theories include the Model for Nursing Based on a Model of Living through music and art, breathing exercises, and communication; Nursing Problems Theory insisting that care must be on the patient not the ailment; the Human-to-Human Relationship Model supported by cognitive therapy and supportive-expressive group therapy; and the Peaceful End-of-Life Theory postulating that patient reception at the time of death must be good, offered support psychologically and be granted peaceful demise (
The major theories that will impact on the formulation of the action plan are the Peaceful End-of-Life Theory and the Human to Human Relationship Model.
Strategies from other Disciplines
NURS FPX 6030 Assessment 3 optimism effect, positive social support, cognitive reframing, and listening is some of the theories from other disciplines that can be applied in psychological palliative care. Indeed, the strategies that will impact the manner in which the action plan is made are the positive social support and cognitive reframing strategies (Crum, 2021).
Some of the medical instruments that are applied in palliative care include; smartphones, voice commands for patient-controlled environments, electronic health records, telemonitoring, meditation applications, and wordless technology. Among the two tools, the Tech-assisted silent communication and the tablets, it is seen that the tablets will have more impact on the making of the action plan (Potz et al., 2018).
Justification from literature
Palliative care service delivery models as identified by Rumbold and Aoun (2021) were supposed to provide terminal illnesses patients with care, companionship, and comfort to mitigate their suffering. This notion is supported by the Nursing Problems Theory discussed by Murali, et al., in 2020 and would be useful in giving patient-centered care. The concept was to provide client specific care (Osterlind & Henoch, 2021). The Human-to-Human Relationship model attempted to assist those who were on the verge of death to manage their pain through a process of altering their perception of pain through use of cognitive therapy. It was also considered that the group talks assist these patients by making them feel better because they perceived that they had a good life (Lo Monaco et al., 2020).
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Strategies used by other professions assisted me in perceiving the issues that the dying patients encounter most especially, their complaints of pain. These tactics assisted me in introducing changes by influencing cognitive restructuring and effective social support factors. The discomfort that the patients experience shall be aggravated by both of these (McPherson et al. , 2020).
Petz et al. (2018), they argue that the integration of technologies in health care, especially smartphones, voice control settings for patients, NURS FPX 6030 Assessment 3 Electronic health, telemonitoring, meditation as well as tech-assisted silent talk can help improve hospice care. These tools are not only for surveillance of the patient but also made for mental illness management with the help of a granted playlist, meditation application, muscular stimulation, and video calls of friends and relatives (Mills et al., 2021).
Impact of Stakeholder Need, Regulation, Healthcare Policy, and Governing Bodies
They are the patients, the personnel working for clinics and offices including physicians and administrative staff, the owners of hospitals and healthcare businesses, the hospice nurses, and investors interested in the latter business. Counseling will also be offered to the patient to address psychological discomforts to offer relief. The increase in the number of healthcare staff will ensure that the current healthcare workers get more assistance to enable them to distribute the new challenges among many people. An increase in the number of people requiring the services of palliative care management will enhance more monetary appliances in the management, owners, and investors.
WHO Medicare and Medicaid
The NURS FPX 6030 Assessment 3 WHO, Medicare, and Medicaid all ensure that end-of-life patients residing in the US receive adequate care. Besides informational and therapeutic support of healthy and sustainable behaviors, they wish to provide loving care during the final stages of a person’s sickness (WHO, 2020).
CMS has put out regulations concerning how to deliver and structure palliative care for those nearing the end of their life. These rules establish the hospital and outpatient hospice care for the patients who are dying and assisting with pain management. This makes the patients spiritually, psychologically, physically, and mentally at rest. Note that those who are on Original Medicare can also partake in hospice care on Medicare Advantage. Furthermore, the United States of America’s health care system, specifically the ACA, has regulations in regards to how end-of-life hospice care can be delivered. These rules provide the patient with other medical options in the final stages of the illness that will improve the Quality of live and reduce pain-related treatment by applying Cognitive Therapy (Parikh & Wright, 2018).
To accomplish the action, the support of governing groups will be mobilized. They will assist in laying down the foundation that will lead to the implementation and completion in the selected hospital.
Ethical and Legal Implications
This is particularly for psychological hospice care which some patients do not accept because of their culture, hence the ethical difficulties with the strategy. This is done in the following manner; One of the activities, for example, is music therapy classes. Some faith believers should not indulge in taking music as therapy as it will not be advisable for them. Yet another social issue of music therapy that can prevent it from being implemented in intervention plans is that patients sometimes receive music therapy unwillingly due to the fact that it evokes unpleasant emotions in them, gives them headaches, or reminds of misfortune. With ethical issues like group discussions patients may referred there is no need to discuss issues in their lives and what they go through. Perhaps, these problems may prolong the period the hospital will take to make the change they desire to make due to the dilation of classes, which patients would not wish to attend. NURS FPX 6030 Assessment 3 moral concerns will be experienced in the aspects concerning the conduct of group talks and the application of music therapy (Schofield et al., 2021).
Some of the legal concerns in the healthcare practice will arise include the following: disclosing a patient’s information on their mental health to other persons, without the consent of the patient; infringement of the code of privileged communication; treating a patient without their authorization or permission; and the staff of the hospital refusing to administer psychological palliative care to patients. These problems definitely can cause the hospital not to want to change because implementing a solution that has no support from the staff can be more of a hindrance than a help. The hospital would change how the intervention plan is carried out because they do not comprehend and respect the lawful aspects of patient safety, care, and their right to special care in regards to psychological treatment. This has the implications on the parts of treatments as for example cognitive therapy and supporting discussion group therapy (Bipeta, 2019).
Conclusion
The goal of implementing the strategy is focused on assessing and controlling pain complaints in dying patients as well as providing them with adequate comfort. NURS FPX 6030 Assessment 3 Hospice care could be enhanced with the help of voice commands, electronic health, telemonitoring, meditation apps, and technology-facilitated physical communication. Ethical and legal issues set cross that need to be overcome to attend to the patient’s needs and therefore hinders good care.
References
Bipeta R. (2019). Legal and ethical aspects of mental health care. Indian Journal of Psychological Medicine, 41(2), 108–112. https://doi.org/10.4103/IJPSYM.IJPSYM_59_19
Crum J. (2021). Understanding mental health and cognitive restructuring with ecological neuroscience. Frontiers in Psychiatry, 12, 697095. https://doi.org/10.3389/fpsyt.2021.697095
Lai, X. B., Wong, F. K. Y., & Ching, S. S. Y. (2018). The experience of caring for patients at the end-of-life stage in non-palliative care settings: A qualitative study. BMC Palliative Care, 17(1), 116. https://doi.org/10.1186/s12904-018-0372-7
Palliative Medicine, 35(2), 315–334. https://doi.org/10.1177/0269216320974277
World Health Organization. (2020, August 5). Palliative care. World health organization. https://www.who.int/news-room/fact-sheets/detail/palliative-care