Primary health care (PHC) is the first stage of contact between clients and the health care system. The main aims of PHC are health promotion, prevention of illnesses, promotion of equity, training on self-management and community development. This paper will address the chronic illness nursing role. The chronic illness nursing role entails managing, treating and caring for clients with chronic illnesses. The specific region of the study will be Townsville LGA.
Key attributes of chronic illness nursing roles
Chronic illness nursing role entails management of conditions such as diabetes, chronic heart diseases, chronic lung diseases and hypertension. The first key characteristic of this role is the focus on the aging population. The prevalence of chronic diseases tends to increase with an increase in age (Fisher and McCabe, 2005). Hence, this nursing role requires the nurses to understand the specific needs of the elderly population. Another attribute is improving care for individuals with multi-morbidities. A patient might develop another disease or complication due to their condition. Empirical evidence suggests that older adults suffer from more than one chronic illness. For instance, the common complications of diabetes are cardiovascular disease, and kidney disease (Deshpande et. al., 2008). Due to this aspect, an Interprofessional relationship is needed to care for chronic heal patients. A nurse who handles this role should collaborate with other care providers to develop treatment plans for the specific patients. Interdisciplinary treatment plans are inevitable in chronic nursing roles.
Why chronic illness nursing is considered a PHC nursing role
Restoring and enhancing self-management in individuals which chronic illnesses is the key element of the chronic illness nursing role. Hence, this role is considered as a PHC because the providers focus on sustaining independence in the patients. Nurses conduct various roles which can be considered as primary care. They are often involved in follow-up home visits. Individuals with chronic illnesses benefit from follow-up visits by nurses. Frich (2003) highlighted the example of diabetes patients whereby follow-up improved health and psychosocial outcomes. Nurses focus on promoting the quality of life of the chronically ill patient by educating them. For example, nurses train the patients on behavioral change. Most of the behavioral changes for chronically ill individuals are exercises, diet and lifestyle changes. Besides, healthcare providers educate the patients on treatment adherence. Chronic illness nursing role requires a comprehensive understanding the patient’s condition. The role of the nurse is to alleviate the symptoms of the condition and prevent mortality.
General characteristics and relevant demographic information of the clientele
The clients for the chronic illness nursing role are the general public. Thus, the selected local government area (LGA) is Townsville. There is a high prevalence of chronic illnesses in Townsville. COPD, diabetes, coronary heart diseases and stroke are the leading causes of deaths and hospitalization in Townsville. Figure 1 and 2 shows the mortality rate and hospitalization rates in Townsville Health Service District (HSD) compared to Queensland health district (Qld).
The socio-demographic characteristics of these clients increase the risk and prevalence of chronic diseases. Approximately 6.7 percent of the total population is classified under the least disadvantaged quintile. Only 18.7 percent of the total population is classified under the most disadvantaged quintile. The unemployment rate at Townsville continues to rise substantially. In 2011, the unemployment rate was about 5.1 Percent. This figure rose to 10.7 in September 2015 (Townsville.qld, 2016). About 32% of the population earns less than the standard state wage per year (Primaryhealth.com, 2016). The average family income per annum is $74,207 while the median personal income per year is $31,739. The high unemployment rate is linked to low social, emotional well-being and poverty. It is evident that low social-emotional well-being when worsened by low income, causes mental health disorders.
Health literacy is relatively lower in Townsville LGA. Less than 15% of the entire population has attained a bachelor degree while over 21% of the entire population has attained a certificate (Townsville.qld, 2016). These statistics insinuates that health illiteracy is high in this LGA.
Figure 1: Deaths linked to selected chronic illnesses in Townsville between 2005 and 2007
Source: (Health.qld, 2012)
Figure 2: Hospitalization rates linked to selected chronic illnesses between 2007 and 2010
Source: (Health.qld, 2012)
The health issue of concern
The health issue of concern that has been identified in Townsville LGA is the high numbers of obese and overweight adults. About 57% of the women are either obese or overweight. 72% of all men in this LGA are either overweight or obese. The nurse should engage in action to address this issue because of its health implications. The concern of overweight and obese adults is the risk of increasing the prevalence of chronic illnesses like diabetes, heart diseases and cancers (Fock & Khoo, 2013). An increase in the prevalence of chronic illnesses will likely increase the demand for disease management.
Three initiatives available to support health promotion activity
Several programs have been implemented to manage and control the issue of overweight and obesity which is the issue that has been identified in Townsville LGA. The first initiative is the Evidence-based promotion of healthy lifestyles. This program entails relevant nutrition and regular exercise for those diagnosed with a chronic illness. The primary cause of obesity is the consumption of excess calories. Hence, obesity can be managed through physical exercise and dieting (Fock and Khoo 2013). Second, there is a Medicare Benefits Schedule. This program offers subsidies for patients. Most of the subsidies are directed towards planning and managing the chronic condition. Individuals who are suffering from obesity can be screened for other medical conditions. The screening is aimed at detecting, diagnosing and introducing a treatment plan for the specific condition. The third initiative is the Pharmaceutical Benefits Scheme. This program offers funds for the treatment and control of symptoms of chronic illnesses (Health.gov, 2017).
How the initiatives related to promotion strategies outlined in the Ottawa Charter
These programs are related to healthy public policy and creation of supportive environments as advocated by Ottawa Charter. Under the public policy, health promotion is viewed as an approach that combines different elements of the legislation, taxation, and organizational change. The Pharmaceutical Benefits Scheme as well as Medicare Benefits Schedule exhibit the promotion of health through policies. These two initiatives are policies that govern the health care sector. Another health promotion strategy that has been outlined by Ottawa Charter is the creation of a supportive environment. This strategy views the community as a complex institution that integrates social and environmental factors. When creating a supportive environment, there should be a change in the patterns of life. The Evidence-based promotion of healthy lifestyles is related to the aspect of creating a supportive environment (WHO, 2017).
Two responses the PHC nurse could initiate to address the identified health issue for their client group
Personal development programs
Nurses should initiate personal development programs to help the clients to manage obesity and overweight. Personal development programs should include pertinent resources on body weight management. These resources include diet guides, physical activity guides, and self-management guidelines. The self-management guides should specifically include ways of coping with the obesity. Ideally, when addressing the issue of overweight, mental health issues should be addressed (BeLue et. al., 2009).
Goals and objectives: The client development programs will aim at increasing the client’s knowledge on body weight management. Regardless of the client’s health literacy level, they will be educated by the nurse on how to improve their condition. Additionally, personal development programs will have a goal of helping patients to accept their condition and installing coping strategies.
Strategies: The main strategies should entail the introduction of a website that has all the needed resources, a helpline and mobile app for self-monitoring. The website should classify resources according to the age of the client, body weight and existence of other health conditions. On the other hand, the helpline will connect clients to nurses who will offer assistance on demand. Finally, the mobile app should allow the clients to track their weight loss bi-monthly. According to Chen and Wilkosz (2014), mobile technologies might provide a practical and appropriate method of managing obesity.
Health care system program
The health care system program will increase the utilization and quality of clinical services. The nurses will develop initiatives for access the progress and condition of people with obesity. After examining the clients, nurses will determine whether the patient has a chance of developing a secondary complication. Some of the complications that are associated with obesity and overweight are hypertension, heart disease, cerebrovascular disease and dyslipidemia (Segula, 2014).
Objective and goals: This initiative will aim at preventing and reducing the development of the complications associated with obesity and overweight. Besides, the program will have a goal of detecting the development of chronic conditions in clients with obesity.
Strategies: The nurses will develop care centers across the Townsville LGA. Clients will then visit these centers to be registered in the program. The use of IT tools such as mobile phone reminders will help the clients to adhere to the timelines of the program. Burke et. al. (2011), notes that self-monitoring for weight loss should be integrated into the care program. Hence, there will be self-monitoring initiative for the clients.
Chronic illness nursing role requires a comprehensive understanding of the client’s condition and the available treatment options. This essay has found that there is a high prevalence of chronic illnesses in Townsville LGA. Besides, the paper has identified obesity and overweight as the main health issue of concern in this area. A personal development program and health care system program have been proposed to address this health issue.
BeLue, R., Francis, L. A., & Colaco, B. (2009). Mental health problems and overweight in a nationally representative sample of adolescents: effects of race and ethnicity. Pediatrics, 123(2), 697-702.
Burke, L. E., Wang, J., & Sevick, M. A. (2011). Self-monitoring in weight loss: a systematic review of the literature. Journal of the American Dietetic Association, 111(1), 92-102.
Chen, J. L., & Wilkosz, M. E. (2014). Efficacy of technology-based interventions for obesity prevention in adolescents: a systematic review. Adolescent health, medicine and therapeutics, 5, 159.
Deshpande, A. D., Harris-Hayes, M., & Schootman, M. (2008). Epidemiology of diabetes and diabetes-related complications. Physical therapy, 88(11), 1254-1264.
Fisher, H. M., & McCabe, S. (2005). Managing chronic conditions for elderly adults: the VNS CHOICE model. Health Care Financing Review, 27(1), 33-45.
Fock, K. M., & Khoo, J. (2013). Diet and exercise in management of obesity and overweight. Journal of gastroenterology and hepatology, 28(S4), 59-63.
Frich, L. M. H. (2003). Nursing interventions for patients with chronic conditions. Journal of advanced nursing, 44(2), 137-153.
Health.gov.au. (2017). Chronic Conditions. Retrieved 21 July 2017, from: https://www.health.gov.au/internet/main/publishing.nsf/Content/chronic-disease
Health.qld.gov.au. (2012). Townsville Hospital and Health Service: Health Service Plan 2012-2017. Retrieved 21 July 2017, from: https://www.health.qld.gov.au/__data/assets/pdf_file/0021/158232/hsp-bp1-demo.pdf
Lee, S., Huang, H., & Zelen, M. (2004). Early detection of disease and scheduling of screening examinations. Statistical methods in medical research, 13(6), 443-456.
Primaryhealth.com.au. (2016). Description of Health Service Use, Workforce and Consumer Need for Northern Queensland Primary Health Network. Retrieved 21 July 2017, from: https://www.primaryhealth.com.au/wp-content/uploads/2016/06/NQPHN-Health-Needs-Assessment-June-2016.pdf
Segula, D. (2014). Complications of obesity in adults: a short review of the literature. Malawi Medical Journal, 26(1), 20-24.
Townsville.qld.gov.au. (2016). Townsville Community Profiles. Retrieved 21 July 2017, from: https://www.townsville.qld.gov.au/__data/assets/pdf_file/0012/12090/TCC_Community-Profiles_Division-8_Web.pdf
WHO. (2017). The Ottawa Charter for Health Promotion. Retrieved 21 July 2017, from: https://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html