Explore in relation to a client you have nursed psychosocial influences on the individuals perception and response to health and illness
by
sazzle_2001 (student)
Explore in relation to a client you have nursed psychosocial influences on the individual’s perception and response to health and illness
This essay will focus on the psychosocial influences of a seventeen year old female; who for the purpose of the essay will use the pseudonym Katy in compliance with the NMC Code of Conduct (2008) regarding confidentiality, who is non compliant with her type 1 diabetes regime and will look at the psychological and sociological issues that have influenced Katy’s health behaviour and her perception of it.
Psychosocial involves psychological development of an individual and how certain people will react in a social environment (Collins, 2011) and is used to help us understand human behaviour and how experiences relate and contribute to people beliefs and principles (Marks et al, 2002).
Katy left school at sixteen and had recently started college, but was reluctant to carry on with her course, as she felt it was ‘a waste of time’ and was looking for full time employment, as it would provide her with an income and help within the household. Whilst in college she would spend a lot of time with a close network of friends during and after. Katy lives at home with her mother; who works full time and is a single parent and her two younger siblings. After the diagnosis Katy had appearing to be managing well, but on routine follow up check up Katy had stated things that could lead to concern. Katy’s management of her diabetes involved self-administration of long acting insulin in the morning and a fast acting insulin prior to meals and regular check of blood glucose levels. On a routine visit to the home, Katy had stated that she had been omitting her insulin at times, was finding it hard to keep to a healthy diet and was not doing as many blood glucose checks as she should be. She felt under a lot of pressure with upcoming exams and the demands of home life were causing to put her health at the bottom of her priorities.
Katy was diagnosed with diabetes mellitus type one after an admission to hospital three months ago. Diabetes
‘is a chronic metabolic disorder, when cells that produce insulin are unable to secrete insulin, and therefore leads to hyperglycaemia and is treated with insulin replacement therapy’
(World Health Organisation, 2001).
First I will look at the psychological issues that could have an influence on Katy’s health. Psychology is a term used when concerning understanding of groups and individuals and how biological and all external factors can influence behaviour and also looks at the way in which humans behave and why people reason their actions (Adams & Bromley, 1998). This definition shows us that life experiences will have a remarkable influence on the actions we take in life and will use these influential factors to defend these.
When diagnosed with diabetes mellitus there are different ways people will cope and react, there are a lot of emotions involved in the diagnosis process and these will all relate to health beliefs that are held. NHS Diabetes Online stated that in contrast to the people who would be regarded as ‘normal’ and have not been diagnosed with the metabolic disorder; ‘research has found that individuals with diabetes are more likely to experience poor psychological well being.’
One of the reasons which could influences Katy’s behaviour are her health beliefs; health attitudes are said to start at childhood (Tercyak et al 2005), parents, guardians and peers will be influential at this time. Katy has grown up with her mother as a single parent with a full time job and three children; she herself has been diagnosed with the same chronic illness as Katy. Katy’s mother is also negligent with her regime due to ‘more important’ commitments and is overweight. In support of the development of health attitudes it could be that Katy does not physically see her mother or herself suffering through the negative health behaviours so does not see a good reason to continue with a healthy regime; which could suggest that Katy does not understand or realise the possible fatal consequences of her actions in the future.
Becker and Rosenstock (1988) developed a ‘health belief model’, first developed in 1966 it has been updated, to include developments in research, if a highly popular model used for health promotion and education (Glanz et al, 2002) and is used to highlight who are more likely to take up on positive health actions. The key to the model is that decisions are made on peoples beliefs and that there are many things that will influence choices made it explains to us that for an individual to carry out healthy behaviour they must first know how serious their actions could be when partaking in unhealthy behaviour, they must then go on to perceive the benefits of changing their behaviours and then put this into action.
The theory on rational non-adherence could be a factor on why Katy is engaging in risk taking behaviour as people who believe this, do not believe that complying with health needs will be of any benefit and may even cause more problems (Pai, 2011). Katy has been told that she will always have her chronic illness, but it can be managed well, as Katy knows this she may feel there is no point in following her regime as it is something that will never be cured, and if she is going to get ill or health problems in the future it will not be because whether or not she has complied with her insulin regime. Patients who view their illness as less severe are less likely to comply (Becker & Rosenstock, 1984).
