Cardiovascular Case Study Management

Cardiovascular Case Study

Case study evaluation

An analysis of the disorder

One of the leading causes of death in the U.S. is Cardiac arrest. It accounts for almost 50% of all fatalities each year and affects nearly 14 million Individuals in America. This number contains those with angina pectoris (chest pain) and individuals with congestive heart failure, resulting in inadequate blood circulation to the tissues. Nearly 1.5 million Individuals in America have heart attacks annually, and about a third of them die. In addition, every year, more than 700,000 patients with cardiovascular disease go through either surgery or balloon angioplasty (American Association of Cardiovascular, 2013). Treatment for individuals with cardiovascular disease is multi-dimensional and contains quitting smoking, cholesterol reduction, exercise training, and blood pressure control.

Best-practice management of cardiovascular disease involves multidisciplinary care. There is effective proof that, among those who have been hospitalized with the disease, those who receiving collaborative care have better health results than those who do not. The multidisciplinary care described in this paper is designed primarily for patients with symptoms of cardiovascular disease. Such patients have a history of hospitalization for the disease and have a high risk for further exacerbations and negative clinical results. Patients with cardiovascular disease require comprehensive care, including medicinal therapy, non-pharmacological interventions, education, and support for self-care as appropriate, and control of other related conditions. Models of multidisciplinary cardiovascular care applied in Australia and elsewhere informed this paper. While there is no specified model of best-practice multidisciplinary care for cardiovascular patients, current proof asserts broad doctrines that include synchronization of care and patient involvement in self-care. Further, a variety of recommended components can be identified from the most successful organized cardiovascular interventions. Preliminary proof suggests that programs that apply a range of evidence-based treatments are associated with reduced rates of negative cardiovascular events than lower-intensity programs (Jowett & Thompson, 2007).

Physical and psychological demands the disorder places on the patient and family

Some physical conditions are underreported. Severe side effects of cardiovascular disease can lead to serious consequences, and even death. Relatively minimal attention has been given to constipation. Diet and lifestyle factors contribute to the occurrence of constipation in cardiovascular patients. Anxiety and depression are commonly experienced by cardiac patients and are associated with reduced life quality and death rate. However, the proof of the usefulness of medical and psychological therapies for depression has been combined. Preliminary proof indicates that providing a range of psychological therapies might be an effective way of meeting cardiac patients' psychological needs (Watson & Preedy, 2013). Specific psychological therapies included psycho-educational classes dealing with behavioral risks and modification, brief personal treatment for patients with mild, moderate, and severe mental sickness, group sessions, and individual treatment, using cognitive-behavior treatment for anxiety, depression, and modification of negative life events.

Cardiac rehabilitation is a multi-disciplinary activity. It is designed to accomplish psychological, physical, and emotional recovery. This enables patients to achieve and maintain improved health. Cardiac rehabilitation attendance is also lower among patients with depression and dropout rates are higher. Psychosocial therapies have been developed in cardiac rehabilitation programs and are endorsed by the Coronary Heart Disease foundation. Despite this, only a minority of patients who are depressed receive treatment for their depression. A strong proof base prevails for the effectiveness of psychological therapies in dealing with depression and anxiety in the general population. Several studies have analyzed the potency of psychosocial therapies in patients with cardiac disease with mixed results. A Cochrane review in 2012 determined that, while psychological therapies revealed no proof of the effect on total or cardiac death rate, they did show some small reduction in depression and anxiety, in cardiovascular patients (Holloway, 2014).

Key concepts that must be shared, with the patient and family, to achieve optimal disorder management and outcomes

Evidence-based medicine (EBM) refers to the integration the best evidence available from a systematic analysis with physician skills to treat patients; consequently, researchers contend that both are essential. Lack of the incorporations of evidence-based care becomes outdated. On the other hand, without medical skills, physicians might be led by empirical evidence when it is not suitable for or applicable to an individual patient. However, the EBM view confines to a biomedical approach that does not clearly incorporate the individual's viewpoint. When a physician does not actively engage the patient, EBM can effectively reduce therapy decisions to just the "evidence" (Lock, Keane & Perry, 2010). To prevent a new reductionist strategy to medical practice, medical skills and the precise addition of patient preferences and principles are needed to temper how the proof is applied to the individual patient. Moreover, in this medical situation, evidence may be sparse or not available. Under this circumstance, the individual's viewpoint is critical if we are to avoid paternalism.

Patient-centered care, by contrast, invites the patient to be an active member in his care. Patient-centered care focuses on the patient's experience with his sickness. As such, physicians practicing patient-centered care consider the biopsychosocial factors of the disease and treatment choices are made with the person and consideration of the individual's values and preferences. Studies suggest that patient-centered care increases therapy adherence and leads to improved outcomes. However, some argue that patient-centered care does not have the evidence and is a "fuzzy concept." At its most extreme, physicians might be considered as just "advisors" or technical deliverers of service. The idea is to improve the health and health outcomes of the patient. One of the main reasons of patient-centered care is the facilitation of shared decision-making.

At either extreme, it is important to identify that the doctor and the cardiac patient may approach the medical experience with different priorities. The doctor often aims to identify and cure the illness based on the individual's signs and objective information obtained from physical exams, lab assessments, or the individual's health background. Conversely, the client may only search for care when signs indicate there is an issue because of interruption of his work or social interaction or when others notice an issue. Often, these information-seeking actions of the patient are motivated by a desire to understand and "make sense" of his condition. Researchers have described these self-explanations or the beliefs the patient holds about his condition as the Patient Explanatory Design of Illness (Miller & Taylor, 2005). Explanatory designs can considerably affect the medical experience, as well as an individual's overall health actions. For example, if the individual considers his sickness or symptoms are signs of "male trouble," he might be willing to share information with the doctor as it facilitates this supposition or description. This perception may lead an individual to decide not to explore the pain with the doctor. Explanatory designs, therefore, are based on lived sociocultural encounters, as influenced by family and friends.

Key interdisciplinary team personnel needed, and how this team will provide care to achieve optimal disorder management and outcomes

By the time an individual is registered in a cardiac arrest management program, the diagnosis of his cardiac arrest, the first choices about diagnostic techniques, and the start of standard treatments have usually been completed. These are well detailed in recommendations for the evaluation and treatment of cardiac arrest. The essence of chronic cardiac arrest management can be found in the systemic approach to sequential evaluation and response to changes in the patient's status.

The care team must always be alert to aspects that may aggravate cardiac dysfunction. These aspects may be additions of the initial cause of cardiovascular diseases, such as uncontrolled hypertension, active ischemia/infarction, or heavy consumption of alcohol. Pneumonia and viral infections frequently induce decompensating periods that can usually be changed, but may require several weeks of close guidance. Atrial fibrillation, which results from chronic cardiac arrest, merits the recovery of cautious control of ventricular rate in the course of routine activity. Being obese symbolizes both a primary cause and an aggravating element for cardiac disease (Miller & Taylor, 2005).

Regular outpatient assessment of cardiovascular patients is in the blood circulation position at rest and with exercise. Orthopnea is the most delicate and indication of raised filling pressures and it tends to parallel filling pressures in a given individual. Exertional or nocturnal coughing is often a dyspnea "equivalent." Jugular venous distention gives the most delicate sign of raised resting filling pressures, peripheral edema exists in some patients, and rales exist in relatively few patients with constantly raised filling pressures. High right-sided pressures are efficient almost 80% of the time for the recognition of raised left-sided pressures in patients with a primary diagnosis of chronic cardiovascular disease (Lock, Keane & Perry, 2010). Elevated right-sided pressures often do not indicate left-sided pressures in the existence of serious pulmonary disease.

The individual patient has very reproducible styles of signs and symptoms as filling pressure increases; these styles should be recorded and available to all on the care team. In the office, physical proof of congestion is used to validate signs of congestion, whereas, over the phone, more use is made of the concordance of improved signs with excess weight gain linked to fluid. Although the severities of congestive signs may be similar, medical evaluation should be instructed to determine whether there is accompanying proof of cardiovascular disease. Physical proof of cardiovascular disease contains the narrow pulse pressure, cool arms, and legs, and sometimes changed mentation, with supporting proof sometimes provided by reducing serum sodium level and deteriorating renal function. Cardiovascular disease is frequently difficult to recognize through phone contact but may be suspected when previously effective diuretic increases fail, nurses report lower blood pressure, or patients explain improved lethargy.

Facilitators and barriers to optimal disorder management and outcomes

Environmental factors and cultural beliefs; motivators and hinders

In this case, the client thought he was suffering from a heart attack and feared to come to the hospital. The symptoms had presented for four days before the patient sought help. The patient had been suffering from similar symptoms for the past six months, but thought that he just out of shape. It was worse upon admission to the hospital. Prior to this, the symptoms disappeared with the rest.

There is proof that cardiovascular patients suffer from social discrimination that is associated with a higher death rate. Although studies outlined that the social assistance is not highly associated with better self-care, a review research mentioned that social assistance was prognostic in cardiac patients. Empirical evidence shows that a supportive atmosphere is crucial for creating positive emotions and enhancing almost all self-care elements in the patient. Patients who have the opportunity to discuss their problems and those who get involved in social activities reveal enhanced self-care. By way an example, eating alone reduces someone's inspiration to cook and share foods resulting in an improved intake of 'microwave dinners' often with high sodium content

Cultural principles might give the patient a misdirected perception of cardiac disease. Majority of cardiac patients think, for example, that cardiac disease results from stress or simply associated with old age. As a result, the patient tries to get over a traumatic situation by not following medical training. In addition, cultural preferences often trigger problems with adherence to a healthy diet plan. However, personal values and cultural beliefs may assist some factors of self-care such as medication adherence. Dickson and her associates revealed that the spirituality influences self-care favorably (Gulanick, 2007).

Psychological factors

Evidence reveals that depressive disorders in patients with cardiovascular disease are more prevalent than in the general population. On the other hand, depressive disorders leading to lack of energy results in negative effects on self-care. Additionally, depressive disorders may increase the risk of death in this group of patients. Whereas experiencing positive feelings allows people to engage in behaviors that secure their positive condition. Previous studies indicate that depression and hopelessness are a serious problem for patients with cardiovascular disease (Miller & Taylor, 2005). This affects self-care confidence, self-care management, though; adherence to medication does not affect depression levels. Offering conditions in which the patient may continue with his leisure activities and supporting him to have a better quality life can result in enhanced moods and self-care ability.

Strategies to overcome the identified barriers

The patient with the cardiac disease is facing a stressful situation and changes in life conditions. As such, they employ a range of defense systems and coping techniques that can either be enabling or not. Common responses of such a patient, suffering from cardiac disease include denial then approval. Denial and avoidance reduce the ability of the patient to take good care of himself. Disavowal helps the patient to deal with his mental stress without neglecting the reality of his disease. Acceptance is a coping strategy that has both positive and adverse effects on the different personality under different cultural environments.

In order to handle contextual problems such as cultural issues, educators, and health providers need to have good interaction abilities such as reflective listening, concern, and recognizing patients' individual principles. Effective interaction abilities and trust have a mutual relationship; by enhancing one, of the variables increases the other variable. However, poor doctor-patient interaction is an important barrier to self-care in cardiovascular patients. Beliefs in medication are the most powerful forecaster of adherence than socio-demographic factors and medical situation. A lack of believe in medical professionals along with individual principles and cultural beliefs may stop patients from looking for help when symptoms intensify because the signs can be culturally recognized to be unmanageable and have to be approved stoically (Bunting-Perry & Vernon, 2007).

Care plans synthesis

Cardiovascular Risk Factors and Healthy Behaviors

Cardiac risk factors are the conditions, actions, or aspects that increase an individual's chance of developing cardiac arrest. Factors such as age, race, or genetics are risk factors that cannot be changed. However, many more risk factors can be changed to prevent damage to the patient's arteries. This plan offers multiple strategies and settings to target these changeable risk factors to be effective in managing cardiovascular health.

Hypertension (high blood pressure)

High blood pressure is a common diagnosis among Americans, affecting at least 50 million individuals. It causes widespread damage to multiple organs like kidneys, brain, heart, also including the arteries. High blood pressure does not generate symptoms until late when the damage has already happened.

Smoking

Smoking is a key risk factor in patients suffering from cardiovascular diseases. Compared to non-smokers, smokers are double expected to develop a stroke, leading to hemorrhagic stroke. Population strategies like hygienic laws and price increases seem effective in decreasing smoking.