The Educational Needs of Caregivers of Stroke Survivors - Assignment Example

REHABILITATION, RECOVERY AND NURSING INTERVENTION DURING CLINICAL PLACEMENTS (Family Education) Introduction Today's health care system has turned to become so specific and disjointed that a lot of needs, most of them very basic, have not been dealt with thoroughly. Those who have been propelled into it, either through infirmities, injuries or behavioral malfunctions caused by alcohol and substance abuse, usually have a dearth of information that could have assisted them in making sense of their physical, mental and emotional health circumstance (O'Connell 2003). The Joint Commission on Accreditation of Healthcare Organisations (JCAHO), in a unified declaration, stressed that patients (including members of their families) are entitled to get the necessary education so that they can involve themselves in the decision-making process; likewise, health care practitioners, most especially nurses, are duty-bound to impart detached and evidence-based data thereby educating individuals most especially during clinical placements with regards to their health condition, therapeutic alternatives and after-care needs. In addition, the responsibility of health care professionals of informing patients and their family members meant the giving out of the right information to the right people at the right time. In essence, it is only through education that people can partake in the entire health care process, formulate clued-up decisions and eventually take on behavior and lifestyle changes. In short, patient-family education leads to improved health outcomes (American Academy of Family Practitioners 2000; Close 1988). Therefore, to cope with health problems and deal with health-related decision-making courses of action, people have to have knowledge coupled with pertinent objectives and therapeutic targets specific to Medication, Activity, Nutrition, Treatments, Risk factors and Aftercare or MANTRA (Pestonjee 2000). Family Education-Definition/Description Family education is a continuing and enduring progression of different processes and practices in instructing family members about the poor health or regarding the grave illness of a relative so as to enhance their abilities of handling the situation and their facility in assisting the affected family member (Fuller 2001). In UK, the United States and likewise in other countries, countless individuals with unbearable physical illness, debilitating mental problems and extremely destructive behaviours reside with their relatives and immediate families and rely on them for monetary aid, housing, encouragement and sincere collaboration. Because of this reality, it is imperative for families to obtain knowledge and skills so that they can assist their ill or emotionally distressed relative and evade deterioration, gain from the treatment and attain recovery. Particularly, family members need to know about the illness and whatever caused it, how they can communicate with the sick relative and health care practitioners, the advantages and disadvantages of diverse therapeutic remedies, the different medications and their corresponding uses and side effects, notable signs of degeneration, accessibility of community services and support, methods of how to obtain benefits and entitlements and how to cope and deal with strange and highly upsetting conduct. Since living on a daily basis with a very sick person exceedingly nerve-racking and tracking, family education should also concentrate on instructing families on the value and significance of people taking care of themselves (U.S. DOH 1999). Family Education as a Constituent of CBT Studies reveal that family education as a component of Cognitive-Behavioural Treatment is strongly linked with valuable and clinically meaningful positive changes specifically when treatment and rehabilitation are provided by qualified and skilled practitioners (Waldron and Kaminer 2004). CBT's family education technique has been effectively employed on many settings like within schools, churches, support groups, treatment agencies, prisons, community-based organisations and with different age ranges and roles (students, parents and teachers). Likewise, the said method has been proven to be appropriate to people with diverse capabilities and from disparate types of social backgrounds. Behavioral therapy focuses on particular acts and scenarios that either transform or preserve behaviours (Skinner 1974; Bandura 1977). For example, when an individual desperately wants to withdraw from drugs or wishes to stop excessive drinking, they are usually encouraged to alter their daily habits or customary behaviour. Like in the case of an alcoholic, instead of groping for the bottle when one has a big problem, which will only aggravate his/her alcoholism dilemma, this person is urged to talk it out calmly and sensibly with someone he/she trusts. Substituting harmful conduct with constructive behaviors is a recognised approach to help alter behaviours especially when one is already in a clinical placement. A fusion of cognitive analysis and behavioral treatment method has been established to be extremely favourable and advantageous, not just to the person who is in clinical placement but also to his/her immediate family. The unique qualities of Cognitive-Behavioral Therapy include: That it is the most evidence-based form of psychotherapy; It is active, problem focused, and goal directed. In contrast to many "talk therapies," CBT underscores the present, concentrating on what the problem is and what steps are needed to alleviate it. It is easy to measure. Since the effects of the therapy are concrete (i.e., changing behaviors) the outcomes tend to be quite measurable. It provides quick results. If the person is motivated to change, rehabilitation and recovery can occur immediately. Patient-Family Education as a Nursing Intervention Assisting people and motivating them to make lifestyle changes is a practice that has become an institution in the field of nursing. One intervention approach that has been employed by nurses to effect behavioral change is patient and/or family education, a technique of conveying information and advice to patients or to the patient's family members (Saarmann, Daugherty and Riegel 2000; Piper and Brown 1998; Potter and Perry 1997). Nurses' instructions with regard to therapeutic remedies, including the psychological and emotional aspects of a person's illness, boosts and enhances an individual' knowledge -- not just of the infirmity but likewise on his/her coping mechanisms and outlook in life - and countless studies have revealed this reality (Theis and Johnson 1995). The Nurse and the Family Through the health care professional in charge, in most cases, the nurse, families need to know that there is always hope for their sick relative. In cases of drug addiction and alcoholism, rehabilitation process is most of the times rigorous and painful; however, the family must be taught how to make their patient understand that there is "light at the end of the tunnel." Further, they have to be trained on how to remain positive at all times in their points of view, not just for the sick person but likewise for themselves. In like manner, the nurse has to provide information about the existing programmes and special classes that are offered for patients and family members who are all going through the rehabilitation/recovery process. Conceptual Framework - Family Education vs. Person Needing Rehabilitation The principal and the most important socialisation framework that a person has is the family unit that he/she belongs to, the reason why it can exert huge influence on him/her (Simons et al. 1998). The speculative basis for this association is by and large founded on the premise of social control believing that aberrant, anti-social and felonious acts are expected to take place when an individual's attachment or link to society is fragile or shattered. In this context, the family acts as a socialising force by instituting and engaging children to traditional standards and values. It then contends that a robust and loving bond between child and parent is an essential means for instituting and ascertaining this societal link and therefore shielding adolescents from delinquency and other problematic behaviours (Brook, Whiteman, Finch, and Cohen 1998). Regrettably, reduced family functioning or non-traditional family structures can hinder or impede the progress of parental bond thereby breaking the link from society, leaving individuals without the internal controls that deter unlawful and damaging deeds. Gottfredson and Hirschi (1990) further assert that as a consequence of inefficient and of a bungled kind of parenting, young people are apt to be reckless, insolent, physical, and extremely risk-taking (Stewart et al., 2002). These types of young people are compellingly drawn to criminal acts than are those who have been socialised to have formidable and effective internal controls. Nonetheless, unsuccessful parenting is viewed as a consequence of two significant elements (Simons, Chao, and Conger, 2001), one is that, parents and children are apt to have identical character and disposition, preferences, and cognitive capacities (Plomin, Chipuer, Loehlin, 1990). Hence, there is strong probability for brash, irresponsible and violent children to have parents who also have similar characteristics, and these qualities are apt to stand in the way of good and productive parenting. Second, contemporary studies show that parent-child interaction is a mutual process. Meaning, not only does inept parenting heighten the likelihood of child conduct instability and tumult, but that antagonistic, unsympathetic and inflexible child behavior usually results to negative parenting behavior that correspondingly leads to ineffective parenting (Patterson, Reid, and Dishion, 1992). Therefore, the innate qualities of the parents merged with the brash and difficult behavior of the child will create a turbulent and highly explosive jumble of hostile relationships. Subsequently, it is important to note that that delinquency prevention programmes strengthen the parent-child association as an approach to prevent aberrant and dangerous behavior which usually leads to substance abuse or alcoholism. A method of strengthening the parent-child relationship is to lower down risk factors and augment protective components for delinquent behavior through parent training, education and family strengthening programmes. These initiatives deal with significant family protective factors like parental supervision, attachment to parents, and consistency of discipline (Huizinga, Loeber, and Thornberry, 1995). They also tackle several of the most imperative family risk factors namely poor supervision, excessive family conflict, family isolation, sibling drug use, and poor socialisation (Kumpfer and Alvarado 1995). Impact These approaches and techniques focus on altering and totally changing the maladaptive patterns of communication and relations within families in which young people already display behavioural problems. Likewise, some family strengthening efforts employ multi-faceted intercessions which cover behavioural parent education, child social skills training, and family therapy. These initiatives are known as family skills training. Family strengthening programmes normally are executed with people diagnosed to have emotional and behavioral problems such as conduct disorder, depression, and school or social problems. The initiative is usually carried out by professional therapists in clinical settings with the parents and child. Kumpfer (1999) pointed out some types of family strengthening techniques. They include the: Structural family therapy (Powell and Dosser 1992) which highlights families' coping skills and strategies as well as learning new ways to respond; Strategic family therapy (Szapocznik and Kurtines 1989) which is down-to-earth and objective-focused; Structural-strategic family therapy (Stanton and Todd 1982), as the name suggests is a combination of concentration on patterns of family interactions with goal-specific approaches; Behavioural family therapy programmes (those with a health care professional working with one family) or behaviour family training (those with a health care practitioner working with several families in a group) contains separate skill-building training for parents and children during part of the session (Rosenthal and Bandura 1978); here, the family is brought together for activities during the last part of the therapy session; Functional family therapy (Alexander and Parsons 1982) is a short-term approach designed to engage and motivate youths and families to change negative affect (Alexander et al. 2000); Multi-systemic family therapy which deals with delinquent behavior within the context of the family, school, and community. In this initiative, interventions are goal oriented and stress the development of family strengths (Henggeler and Borduin 1990). Conclusion Family education as a behavioural nursing intervention in a clinical setting is a significant and an effective approach to deal with dominant health-related behaviors like lack of physical activity, poor diet, substance (tobacco, alcohol, and illicit drug) use and dependence, and risky sexual behavior that lie beneath a considerable proportion of avoidable morbidity and mortality in different countries of the world. Significant improvements and developments in the methods that primary care interventions have been put together resulted from the past twenty years relentless study and exploration. Most importantly, brief interventions crafted to fit into everyday practice have been found to create clinically meaningful transformations in the population for a growing number of behavioral risk factors. Future progress will depend on further modifications and enhancements of the science backing up behavioral and likewise cognitive interventions in clinical care through continuing behavioral research and further upgrading of standards and methods for the reporting and systematic review of behavioural interventions. These developments will pave the way for subsequent recommendation development for behavioural subject areas and themes. They will likewise lead to the identification and recognition of common, as well as unique, major components of behavioural interventions across behaviours and populations and, thereby, improve their practical implementation by real clinicians and real patients in everyday clinical settings. References /Readings O'Connell, B., Baker, L. and Prosser, A. 2000. The educational needs of caregivers of stroke survivors in acute and community settings. Journal of Neuroscience Nursing, 35 (1), pp. 21-28. American Academy of Family Practitioners. 2000. 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