He admits that especially since his divorce he hasn't been paying much attention to his health.
The percentage of Australians who smoke nowadays is much less than in 1945 according to the Cancer Council (2007) statistics. But smoking is still a huge problem that causes many unhealthy side effects and can lead to death (Heart Foundation, 2002). It also presents a substantial financial burden for the health care system because of the resultant morbidity that is associated with smoking (Australian Bureau of Statistics, 2006; Heart Foundation, 2002; Ministerial Council on Drug Strategy, 2004). The scenario of a smoker who seeks medical care because of a heart condition is very plausible. Smoking and heart disease are often found together (Better Health Channel, 2002). The Australian Bureau of Statistics (2006) lists smoking as a key risk factor for ischaemic heart disease, and other fatal illnesses.
Heart disease itself has a high prevalence. It is the most common cause of sudden death and also the single disease from which the most people in Australia-and most industrialised nations-die (Australian Institute of Health and Welfare 2006). There are many forms of heart disease, but coronary heart disease, or ischaemic heart disease is most common and often presents itself in form of angina (Australian Institute of Health and Welfare 2006), as in the case of our patient, John.
This paper will deal with the actual ...
This paper will deal with the actual and potential health issues in cases such as this one, examining the broader scope of matters to be considered in planning the management of such a case, as well as identifying specific actions that can be taken to improve the patient's situation. It will also reflect on possibilities for primary and secondary preventive measures and take into account as many factors that might be relevant for the overall well-being for this particular patient.
Management Health Issues
The two obvious core health issues of this patient are smoking and heart disease. However, both smoking and heart disease can be connected to other complaints (Heart Foundation 2002, JBI 2005). The first contact with patients is a good time to find out what is worrying them most. In John's case, the overall social situation will be of interest. His performance at work may be seriously impeded by his heart condition. If he is not accustomed to taking care of himself without a wife, his diet may be unhealthy and he may have emotional problems connected to the stress of divorce.
Cigarette smoking has many detrimental effects (Heart Foundation, 2002). The main part of the problem is that many habitual smokers are addicted to nicotine (Ministerial Council on Drug Strategy, 2004). Addiction is a complex health problem, and Tan et al. (2000) report that almost 80% of smokers in Australia have already tried to quit but failed.
In fact, the addiction itself makes it hard for smokers to want to quit. The drug nicotine affects the ability to make a rational decision. Because the brain and body suffer from withdrawal symptoms, quitting is