Living with Ankylosing Spondylitis: A Case Study of Chronic Illness
This paper presents a case study of Barnard "Barney" West, a 70-year-old Vietnam veteran living with ankylosing spondylitis for over 30 years. The paper identifies his support needs in descending order, discusses how the Healthy People 2030 initiative's chronic pain objectives can be applied to improve his health outcomes, examines the nursing advocacy role in encouraging his acceptance of diagnosis and treatment, and analyzes how his home environment affects his daily functioning. The case highlights challenges common to patients with chronic inflammatory back disease, including pain management, medication reluctance, and reduced quality of life, while identifying practical interventions available through VA and Medicare providers.
- Introduction: Overview of patient and paper objectives
- Support Needs of the Patient: Daily living, recreation, and medication support needs
- Healthy People 2030 and Chronic Pain Management: Applying federal chronic pain objectives to patient
- Nursing Role as Patient Advocate: Advocacy strategies addressing barriers to treatment
- Impact of the Environment on Patient Health: Home environment modifications for safety and access
- Conclusion: Summary of findings and recommended interventions
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What makes this paper effective
- Grounds abstract clinical concepts in a richly detailed, individualized case, making conditions like ankylosing spondylitis tangible and relatable for the reader.
- Directly connects the patient's lived experience to a policy framework (Healthy People 2030), demonstrating applied knowledge of national health objectives.
- Maintains a consistent nursing perspective throughout, using the patient's specific barriers — addiction history, distrust of VA providers — to frame advocacy strategies realistically.
Key academic technique demonstrated
This paper demonstrates patient-centered case analysis, a core technique in nursing education in which clinical data, behavioral observations, and policy frameworks are integrated to develop a holistic care plan. Rather than discussing ankylosing spondylitis in the abstract, the student anchors every claim to the patient's documented history, preferences, and barriers, producing recommendations that are specific and actionable.
Structure breakdown
The paper follows a clear four-part analytical structure after the introduction: (1) a prioritized list of support needs, (2) application of the Healthy People 2030 framework, (3) a nursing advocacy discussion, and (4) an environmental assessment. Each section builds on the previous one, moving from immediate physical needs outward to systemic and environmental factors. The conclusion synthesizes findings without introducing new material, consistent with standard nursing case-study format.
Introduction
Today, approximately 300,000 adults in the United States — representing less than 1% of the American adult population — suffer from ankylosing spondylitis, also known as inflammatory back disease (Ankylosing Spondylitis, 2022). One adult American who has lived with this chronic illness for more than 30 years is Mr. Barnard "Barney" West of Tulsa, Oklahoma, a 70-year-old married Vietnam veteran who is rated 100% service-connected disabled for this condition and multiple others.
This paper provides information on this individual, including a list of his support needs in descending order and a discussion of how to implement relevant objectives of the Healthy People 2030 initiative to increase health in similarly situated individuals. The paper also examines the nursing role from the perspective of an advocate for Barney's acceptance of his ankylosing spondylitis diagnosis and needed treatments, followed by a discussion of the impact of the environment on his health.
References
Ankylosing Spondylitis. (2022). University of Washington Orthopedics and Sports Medicine. Retrieved from https://orthop.washington.edu/patient-care/articles/arthritis/ankylosing-spondylitis.html
Reduce chronic pain and misuse of prescription pain relievers. (2022). Healthy People 2030. Retrieved from https://health.gov/healthypeople/objectives-and-data/browse-objectives/chronic-pain
Tymms, K., Butcher, B. E., Sletten, T. L., Smith, T., O'Sullivan, C., Littlejohn, G., Sadler, R., Tronnberg, R., & Griffiths, H. (2022). Prevalence of sleep disturbance and the association between poor disease control in people with ankylosing spondylitis within the Australian clinical setting (ASLEEP study): a real-world observational study using the OPAL dataset. Clinical Rheumatology, 41(4), 1105–1114.
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