NUR3117: Choose ONE of the following case scenarios OR develop a case with your group’s health issue identified, and Identify and critically analyze key health and psychosocial issues affecting the client and/caregiver. Community Integrated Health Care assignment

Module / Subject / School:

NUR3117 Community Integrated Health Care

National University of Singapore

Requirements: 

Individual Written Assignment – Care Management (60%)

• This individual written assignment aims to consolidate the student’s learning by linking theory to clinical practice in the community. The community assessment experience provides students with real life physical and cognitive experiences, assesses community needs and identifies key health issues.
• Using the findings from your group’s community profiling and community assessment done, develop strategies, integrating a health promotion model/ theory, to address one of the health issues that your team has chosen.
• Students shall plan strategies for ONE of the health issues identified during their community assessment from ONE of the following case scenarios OR develop their own case, to promote self-care and management, maintain and sustain health in the community.
• The strategies should take into consideration on the local healthcare system, resources/ services available and restrictions given this current COVID-19 pandemic.

Choose ONE of the following case scenarios OR develop a case with your group’s health issue identified, and address the questions below:

(a) Identify and critically analyze key health and psychosocial issues affecting the client and/caregiver.

(b) Discuss and recommend interventions for monitoring and empowering the client/caregivers to self-manage for a sustainable home care management.

(c) Explore how existing community resources can be integrated into the management of care to deliver effective person-centered care in the community.

CASE 1

Mr Tan is a married 70-year-old, retired Chinese gentleman and lives in a 2-room Flexi Flat with his wife aged 68 years old. They do not have any children. Mr Tan has frequent admissions to the hospital due to multiple episodes of breathlessness. He is a chronic smoker (started in the last 40 years) and he has medical history of hypertension diabetes and hyperlipidemia. In his recent hospital admission, Mr Tan was referred to the Respiratory Medicine department as he experienced persistent shortness of breath despite of inpatient treatment. Mr Tan’s spirometry test suggested of moderate to severe obstruction of airways. His primary diagnosis for admission concluded as Chronic Obstructive Pulmonary Disease (COPD) Stage 2. He was discharged with Salbutamol (Metered Dose Inhaler with Spacer). Prior to discharge, he received patient education on the use and effects of the inhalers, reinforcements of early symptom recognition and management and advice on smoking cessation.

CASE 2

Mdm Lee, a 87-year-old widower who currently lives in a 3-room HDB flat with her Indonesian helper, Kima and her eldest son who is married with 2 children. She has 2 other sons, but they have their own households. Her husband has passed on 2 years ago due to old age. Mdm Lee is independent in her activities of daily living (ADL), but requires occasional assistance from Kima. Mdm Lee does not like Kima very much as she feels that Kima is lazy and always occupied with her handphone. However, Mdm Lee acknowledges that she needs Kima’s assistance to help with her physical needs. Mdm L was recently discharged from the hospital for an unwitnessed fall which resulted in a left humerus fracture and uncontrolled Type 2 Diabetes Mellitus (DM). She also has a past medical history of hypertension, and osteoporosis.

CASE 3

Mr Mohammad, a 94-year-old lives with his 63-year-old daughter Siti, who is single, in a 2-room HDB flat. Mr Mohammad suffered from a stroke nine months ago. He has difficulty feeding himself, is nearly deaf in both ears, and suffers from poor vision. The stroke has left him extremely weak, and he is confined to a wheelchair. Siti has noticed that the stroke has also affected her father’s mental functioning. Mr Mohammad continues to recognize his daughter but has become increasingly confused to place and time. Siti devotes most of her time to attending to his care and is in poor health herself. She has recently been diagnosed with hypertension and hyperlipidaemia.

CASE 4

Mdm Shamila, a 75-year-old female divorcee, is living alone in her 1-room rental flat. She has been having recurrent UTIs and frequent readmissions, with a past medical history of depression, hypertension, hyperlipidaemia, bilateral knee osteoarthritis, and ischemic heart disease. She leads a sedentary lifestyle, does not walk around the neighborhood nor engage in social activities. Instead, she prefers to stay at home and watch television programmes. Mdm Shamila is mentally alert, cares for herself and is independent at 75 years of age. She has 2 daughters and 4 grandchildren who visit her for about 2 to 3 times a week, with packaged food that serve as Mdm Shamila’s meals for a week. Her grandchildren will visit her when necessary and help to do housework for her in order to keep the house clean and neat

CASE 5

Mdm Mary, a 62-year-old female lives in a 3-room HDB flat with her husband and 2 grown up sons with mental illness aged 20 and 18 years old. She is on hemodialysis treatment every Tuesday, Thursday, and Saturday at the nearby dialysis center. She has medical history of end-stage kidney failure, uncontrolled diabetes, hypertension, and right eye cataract. Her husband is her main care giver. He is 70 years old, retired and has hypertension and diabetes. Mdm Mary’s eldest son works as a part-time security guard. His mental illness is under controlled. Mdm Mary’s youngest son is homebound and has behavioral issues. He defaulted treatment from the Institute of Mental Health (IMH) due to financial constrain and lack of caregiving from his father.

CASE 6

Mr Tan, a 92-year-old man lives in a 2-room HDB flat with his daughter aged 65 years old. Mr Tan has Advanced Dementia, hypertension, diabetes, and mild stroke. Mr Tan’s daughter is his main care giver. His daughter shared that Mr Tan has been wandering around the living room and kitchen at night lately and knocks on her bedroom door every 2-3hours and asked her to attend school. He was admitted in the hospital last week after a fall at home. He sustained multiple abrasions over his frontal head and left forearm. His daughter verbalised that her health is poor as well. She had an episode of systolic blood pressure reading of 200mmHg last month that resulted in hospitalization for several days. Mr Tan frequently missed his medication taking because of his daughter’s forgetfulness to serve according to the regime.

What we score:

78%

Our Writer’s Comment 

This assignment tests students on their understanding of the theories of clinical practice.

Based on the assignment requirements provided, here are some comments to help students score well on this assignment:

To excel in this individual written assignment, you need to demonstrate a strong understanding of how theory can be applied to clinical practice in the community. Focus on the chosen case scenario and the specific health issue identified by your group during the community assessment.

Start by identifying and critically analyzing the key health and psychosocial issues affecting the client and/or caregiver in the chosen case. Provide a comprehensive evaluation of the challenges and considerations that need to be addressed to promote self-care and management in the community.

When discussing and recommending interventions for monitoring and empowering the client/caregiver to self-manage home care, make sure to integrate a health promotion model or theory. Consider the local healthcare system, available resources/services, and the current COVID-19 pandemic’s restrictions while developing these strategies. Provide evidence-based solutions and cite at least five journal articles or book chapters, excluding the textbook, to support your recommendations.

Furthermore, explore how existing community resources can be effectively integrated into the care management plan. Emphasize person-centered care to ensure the solutions are tailored to the client’s needs and preferences.

In your essay, aim for a well-structured and coherent discussion, incorporating critical analysis and thoughtful evaluations. Avoid descriptive approaches and instead prioritize analytical arguments and evidence-based conclusions.

Since this assignment requires integration of theory and clinical practice, focus on aligning your proposed strategies with relevant theoretical frameworks. Your understanding of these theories and their application to the case scenario will be crucial in achieving a high score.

As you write the essay, pay close attention to the word count. Stick to the required word limit to ensure you cover all essential aspects while maintaining clarity and conciseness.

Finally, remember to cite all sources and provide complete references in APA style for any external information or research findings you use.

Good luck with your teaching efforts! Encourage other students to thoroughly analyze the case scenario, apply theory appropriately, and develop evidence-based strategies to address the identified health issue effectively.

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Sample Assignment

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