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1.What are the chronic illnesses that Daniel is likely to have? Explain your answers using the information from the scenario.

2.What model of care would suit Daniel's needs? Explain your answer using information from the scenario. Describe the process that needs to happen to establish this model. Support your discussion with relevant literature.

3.Consider that Daniel has agreed to the service model you have proposed in part two. You now need to provide some documentation for the receiving health care agencies.


1.Individuals of the present generation are seen to suffer form a large number of co morbid disorder which are chronic and tend to destroy the quality of life for many individuals. It is found that not only biological factors but also a large number of psychological and social issues also play a very big role and therefore it is very important for the health professionals to develop a bio-psycho-social model of care for the patients so that they may live better lives. This assignment will show the various ailments that Daniel has and how the diagnosed ailment will affect him and his family. It will also discuss how a perfect model of care would help him to overcome the health issues and keep them under control.

One of the most important chronic ailments that Daniel is facing is the issue of obesity as the case study shows that he is overweight with the presence of abdominal fat. He has another chronic ailment of hypertension and therefore he was prescribed antihypertensive medication but he seldom takes them. He also has chronic issues like lower back pain and arthritic knees which have mainly occurred due to his intensive working schedules and his playing football in the younger years. Another important chronic disorder found in the patient is the continuous recurring bronchitis which is actually the earlier form of emphysema.


It is seen that Daniel is suffering from a large number of chronic ailments. The presence of his ailments had taken away his power to work better as an unhealthy human being can never provide the same productivity like that of a healthy human being (Hamine et al., 2015). He often tends to miss out his hypertension medication. From this it is evident that he is not literate enough to understand the importance of his medication on his health. Moreover, as he had not completed his education, he is not being able to properly guide his life with the correct lifestyles. Improper diet and lifestyle have made him to gain weight and the situation had become worse as fat accumulation is even found now in the arteries disrupting the flow of blood through the blood vessel and hence occurrence of myocardial infarction took place (DelRio et al., 2013). However the financial condition of Daniel does not support him to take rehabilation as he has no earning members of the family. This would make him more susceptible to ill health and he might face any adverse situation at any unfortunate moment in life. His partner Alma had lost her job and unable to get new one. Hence she had developed depression. Therefore it is seen that both the partners are suffering massively which had a negative impact on emotional and mental health (Zwerink et al., 2014). As Alma is herself depressed, she is not being able to provide the best companionship to her partner and therefore a sense of detachment and issues are found among the partners (Zwar et al., 2017). Therefore, Daniel is not only at risk of cardiovascular disorders due to his chronic ailments like obesity, emphysema due to his smoking habits, arthritis and low back pain due to his strenuous workloads but is also at a risk of developing mental disorders.

2.In the present decade, western healthcare has been seen to adapt the technique of biopsychosocial model of care. It is entirely different form the biomedical model of care which looks at disorders of human beings as the reason of microbial attacks or due to different physiological or metabolic failures (Pincus et al., 2016). Bio-pshyco-social model of treatment not only provided treatment interventions to overcome the biological symptoms of the patients but also helps to care for the different psychological issues faced by the patients . It also tends to develop an idea about the social lives of the patients so that important social aspects that often produce negative impacts on the patients are attended and interventions are therefore designed keeping the tree aspects in mind. It helps in providing a comprehensive care which helps to attain the best quality lives (Suls et al., 2013).

In the case study, it is seen that Daniel is suffering from obesity due to improper lifestyle. Due to his lack of education about taking correct diet and financial instability, they are not being able to buy quality foods. Excessive work load has resulted in muscle tear ad wear causing lower back pain and arthritis. Continuous alcohol drinking and addiction has resulted in the recurrence of chronic bronchitis which will lead to emphysema. Besides, he is also a sufferer of hypertension. Therefore, the nurse have to prepare interventions for chronic ailments by properly helping in medication administrations, conducting health education meetings with him and frequently setting up appointments to evaluate the condition of his health (Litten et al., 2015). Rehabilitation in the presence of interdisciplinary team is excessively important but however the patient would not be able to afford it. The nurse should fix up a proper counseling sessions where he can reveal his frustrations and anxieties. He is seen to have many grudges against his wife and hence this open discussion would help to develop idea about his inner feelings and his mental state. The counselor would try to help him to manage his life properly with the ailments and at the same time lead a cheerful life. Moreover the nurses should also have discussions with the families about how to cope with the situation successfully so that everyone may help each other to come out of the strenuous financial crisis (Van Wormer & Davis, 2016). Besides, he also needs to consult an addiction counselor. He is highly addicted to alcohol and therefore various therapies need to be introduced so that he can overcome the habit of drinking. Besides medications, the patient should be advised with cognitive behavioral therapy, motivational enhancement therapy, marital as well as family counseling therapy and also brief intervention therapies. Besides, the nurse should introduce proper health education for the family members and also encourage them to go for social meetings together in order to develop the bonds. Low income, alcohol addiction and lack of education are the recognized social determinants of health for the patient and therefore the nurse should introduce interventions which accommodates in their financial income, help him to overcome addiction with therapies and properly provide them health literacy education to give them good quality life.


Therefore from the discussions, it can be seen that patients who suffer from co morbidity disorders are affected not only physically but they also suffer from different social as well as psychological issues. Daniel’s co morbid disorders were affecting him as well as his son and wife. His wife also had depression. All these had resulted in poor quality life of the family. Hence treating him with bio- psycho -social model of care and addressing different facts of the diseases individually helps him to gain stability in his life.

3.Dear Daniel,

As per the meeting we had on Thursday evening, we had come to the conclusion that we will be providing you the bio-pshyco-social model of care. This care will have a comprehensive approach and will help you to cope with not only the physical issues that you are facing but will also help you to overcome your mental and emotional turmoil. As per the discussion we had, you would be directed to the dietician who would be providing you with a detailed nutritious diet plan to maintain your diet and will also educate you with right kind of exercise needed. We will also advice you with proper medication for your low back pain and arthritis and also advice you with light exercises to overcome the pain. Besides, if you allow us, we will fix up physiotherapy sessions with you for your benefit. Proper medication for hypertensions would be advised to you and you need to be very careful with it. Otherwise you may face serious conditions with your cardiac system.


Besides, we will also be fixing up therapy sessions with you to make you overcome your drinking habits as they are affecting your condition of the respiratory system. Besides this, I would also provide you details about how you can manage your symptoms properly and understand how you will be able to prevent any adverse effects on your health in the future. Moreover, you would also be undergoing counseling sessions along with your family members separately so that you can disclose your feelings and overcome any emotional or mental turmoil faced by you. The counselor would also help you to gain a new insight of your life which is very necessary for you to overcome the stress and the anxiety you are facing. Following the above mentioned procedure will help you to regain back a quality life



Your nursing attendant.

Referral letter to mental health clinic for appointment with the counselor:

Respected Sir,


235 Bloomsberry lane, avenue 3

20th September 2017

Dear Mr. Lee,

I am thankful for your acceptance in providing care for Daniel and making his mental condition stable. He is a 52 year old man and had gone though acute myocardial infarction. He is also going through financial crisis.


His father suffered from cardiovascular disease.


He is overweight.

He has a strenuous relationship with his wife and often engages in heated arguments.

Loss of his wife’s job created financial pressure on him.

He is highly concerned about his son.

He has stated that he does not have time to participate in his rehabilitation program.

He is a chain smoker.

Requested service:

Although the biological and physical symptoms are cared for by us, I request you to develop a plan for him to overcome his addiction.

It would be also helpful if you engage in a counseling session with the patient and try to help him regain his mental stability and help him with his personal problems. I hope a patient with more mental stability will respond fast to any treatments.

It would be helpful if you meet him in his working place and have your sessions.

I look forward for your conclusions.

If you are in need of more information, please feel free to contact me.



Registered nurse,

XYZ Healthcare center.



Clark, N. M., Gong, M., & Kaciroti, N. (2014). A model of self-regulation for control of chronic disease. Health Education & Behavior, 41(5), 499-508. Doi:

Del Rio, D., Rodriguez-Mateos, A., Spencer, J. P., Tognolini, M., Borges, G., & Crozier, A. (2013). Dietary (poly) phenolics in human health: structures, bioavailability, and evidence of protective effects against chronic diseases. Antioxidants & redox signaling, 18(14), 1818-1892. Doi:

Dowling, N. A., Cowlishaw, S., Jackson, A. C., Merkouris, S. S., Francis, K. L., & Christensen, D. R. (2015). Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: a systematic review and meta-analysis. Australian & New Zealand Journal of Psychiatry, 49(6), 519-539. Doi:

Fock, K. M., & Khoo, J. (2013). Diet and exercise in management of obesity and overweight. Journal of gastroenterology and hepatology, 28(S4), 59-63.

Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. Journal of medical Internet research, 17(2). Doi   10.2196/jmir.3951

Lim, L., Goh, J., Chan, Y. H., & Poon, S. H. (2016). Attitudes toward utility, effects and side effects of treatment for anxiety and depression. Australasian Psychiatry, 24(6), 556-560. Doi:

Litten, R. Z., Ryan, M. L., Falk, D. E., Reilly, M., Fertig, J. B., & Koob, G. F. (2015). Heterogeneity of alcohol use disorder: understanding mechanisms to advance personalized treatment. Alcoholism: Clinical and Experimental Research, 39(4), 579-584.Doi :

Pincus, T., Chua, J. R., & Gibson, K. A. (2016). Evidence from a Multidimensional Health Assessment Questionnaire (MDHAQ) of the Value of a Biopsychosocial Model to Complement a Traditional Biomedical Model in Care of Patients with Rheumatoid Arthritis. Journal of Rheumatic Diseases, 23(4), 212-233. Doi: 

Suls, J., Krantz, D. S., & Williams, G. C. (2013). Three strategies for bridging different levels of analysis and embracing the biopsychosocial model. Doi:

Tay, A. T., Peh, A. L., Tan, S. N., Chan, H. N., Guo, S., & Chan, Y. H. (2016). Alcohol Use Disorders amongst Inpatients in a General Hospital in Singapore: Estimated Prevalence, Rates of Identification and Intervention. Ann Acad Med Singapore, 45, 138-47.

Van Wormer, K., & Davis, D. R. (2016). Addiction treatment. Cengage Learning.

Zwar, N., Harris, M., Griffiths, R., Roland, M., Dennis, S., Powell Davies, G., & Hasan, I. (2017). A systematic review of chronic disease management.

Zwerink, M., Brusse?Keizer, M., van der Valk, P. D., Zielhuis, G. A., Monninkhof, E. M., van der Palen, J., ... & Effing, T. (2014). Self management for patients with chronic obstructive pulmonary disease. The Cochrane Library

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