Healthcare Access and COPD Pathophysiology

Introduction

Healthcare is improvement or maintenance of health through diagnosis, treatment, prevention, recovery or cure of illness, diseases or other types of mental or physical impairment in individuals. The delivery of effective healthcare is accomplished by professionals and nurses through execution of person-centred, family-centred or evidence-based care. In this study, the difficulties faced by patients in accessing healthcare are to be discussed, with a focus on how healthcare dissertation help can address these challenges. Moreover, the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD) is to be discussed.

LO2

The patients while accessing healthcare may face different problems that create hindrance for them to avail effective quality care. As mentioned by Gonden et al. (2017), the presence of intension to follow traditional care pathways by health professionals instead of usual care is one of the problems faced by patients in accessing person-centred healthcare. This is because such intention leads the healthcare professionals avoid working in a flexible way and neglect to determine person-centred care or treatment strategies for the patients. It leads the service users fail in accessing enhanced healthcare specific to their heath which is required for their speedy recovery. As criticised by Moore et al. (2017), patients in person-centred healthcare at times experience problem of failing to speak their personal needs and demands of care to access specific support. This is because health professionals do not always have adequate time in discussing and identifying the needs and demands of the patients through effective communication to keep the care plan centred to the needs of the patients. Thus, the patients in such condition are unable to mention their personal needs and form partnership with the health professional or nurses in turn making them fail to avail person-specific care required in their healthcare. The lack of commitment or knowledge of the healthcare professionals or nurses in delivering person-centred care creates problem for the patients in accessing it. This is because the lack of attitude of the health professionals or nurses who are the key caregivers of the patients to form partnership with the patients and keep them in the centre of the care plan leads to create hindrance in practising person-centred care (Oppert et al., 2018).

The family-centred healthcare is the approach used to plan, deliver and evaluate healthcare which is grounded to create mutually beneficial support for the healthcare providers, family members and the patients (Ekberg et al., 2020). As mentioned by Kiwanuka et al. (2019), the presence of abusive family members in the patient’s family leads the patient experience problem in accessing family-centred healthcare. This is because abusive family members show lack of dignity and respect towards the patients while offering them care which makes the patients avoid accessing care from them or comply with them. Moreover, abusive family members are intended to harm the patients during care that creates deteriorated health scenario for the patient and it leads health professionals or nurses become solely responsible in delivering care to the patients showing failure or problem in delivering family-centred care (Ekberg et al., 2020). As argued by Lloyd et al. (2018), the feeling of burden of care by the family members for the patient leads the service users face problem in accessing family-centred care. This is because feeling of care burden makes the family members confused and avoid engaging in planning, delivering and evaluating healthcare approaches to the patients, in turn, creating problem in delivering family-centred care. The problem faced by patients in accessing family-centred care is hindered collaboration between the family members and nurses to deliver care to the patient. This reason creates the problem for accessing care by the patients as without effective collaboration of the family members with the nurses they are unable to execute enhanced ways of delivering care support to the patients, in turn, failing to provide appropriate care (Ekberg et al., 2020).

LO3

The Chronic Obstructive Pulmonary Disease (COPD) is progressive disease of the lungs that causes obstructive airflow in the lungs out of inflammation of airways leading the people experience hindrance in breathing (Hardin et al., 2017). The symptoms of COPD include shortness of breath, chest tightness, chronic cough with sputum, lack of energy, unintended weight loss, swelling legs and others (Wang et al., 2018). One of the major causes of COPD in patients is extensive cigarette smoking for prolonged years. This is because harmful chemicals present in the cigarette smoke damage the air sacs, inner lining of lungs and airways which injuries the lungs in performing their function and creating trouble towards moving air in and out of the lungs (van Eerd et al., 2016). The other likely factors that cause COPD is exposure to air pollution, dust, smoke and others. In rare cases, COPD is seen to occur due to genetic disorder where low level of alpha-1-antitrypsin is released from the liver into the bloodstream. The Alpha-1-antitrypsin has the key function of protecting the lungs of the body from any inflammation caused due to infection or irritants that are inhaled such as tobacco smoke and others (Foreman et al., 2017).

The respiratory system maintains homeostasis of the body in two ways which are maintaining effective gaseous exchange and regulating the concentration of pH in the blood. In normal condition, the oxygen is taken inside the lungs through the air tube that is trachea which has smooth inner lining. The oxygen on entering the lungs leads to the air sacs in the lungs known as alveoli which are surrounded by blood capillaries where the gaseous exchange occurs (McNicholas, 2016). However, in COPD patients, it is seen that the airways in the lungs that are the bronchial tubes are narrowed and inflamed which leads to collapse of the lungs during breathing out. The alveoli in the lungs are also inflamed which creates the condition known as pulmonary emphysema in the COPD patients and develop disruption of effective exchange of gases (Rocha et al., 2017). In homeostasis state, the blood pH remains above 7 due to presence of enhanced oxygen in the blood and low amount of carbon dioxide (Zhang et al., 2020). The lack of effective inflow of oxygen in the blood from the lungs leads to increase the acidity of the blood leading to lower the blood pH and increase pCO2 level, in turn, disrupting the homeostasis of the body (NICE, 2019).

The treatment for COPD includes complete smoking cessation through the use of medication and/or psychological therapies. This is because the cigarette smoke in the main irritant that deteriorates the lung functioning creating hindered deteriorated COPD condition (NICE, 2019). At the initial stage, the use of medicine such as Bronchodilators is to be made for treatment of COPD patients. This is because the medication acts on the bronchioles of the lungs to enlarge them so that free flow of oxygen in and out of the lungs is maintained and the individuals do not experience breathing issues (NICE, 2019).

Conclusion

The discussion mentions that problem with accessing healthy by patients is non-participation of family members, inappropriate attitude of health professionals and others. The COPD disrupts the lungs functioning and it can be resolved by cessation of smoking and use of bronchodilators.

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References

• Ekberg, K., Schuetz, S., Timmer, B. and Hickson, L., 2020. Identifying barriers and facilitators to implementing family-centred care in adult audiology practices: a COM-B interview study exploring staff perspectives. International Journal of Audiology, pp.1-11.
• Foreman, M.G., Wilson, C., DeMeo, D.L., Hersh, C.P., Beaty, T.H., Cho, M.H., Ziniti, J., Curran-Everett, D., Criner, G., Hokanson, J.E. and Brantly, M., 2017. Alpha-1 antitrypsin PiMZ genotype is associated with chronic obstructive pulmonary disease in two racial groups. Annals of the American Thoracic Society, 14(8), pp.1280-1287.
• Gondek, D., Edbrooke‐Childs, J., Velikonja, T., Chapman, L., Saunders, F., Hayes, D. and Wolpert, M., 2017. Facilitators and barriers to person‐centred care in child and young people mental health services: A systematic review. Clinical psychology & psychotherapy, 24(4), pp.870-886.
• Hardin, M., Cho, M.H., Sharma, S., Glass, K., Castaldi, P.J., McDonald, M.L., Aschard, H., Senter-Sylvia, J., Tantisira, K., Weiss, S.T. and Hersh, C.P., 2017. Sex-based genetic association study identifies CELSR1 as a possible chronic obstructive pulmonary disease risk locus among women. American journal of respiratory cell and molecular biology, 56(3), pp.332-341.
• Kiwanuka, F., Shayan, S.J. and Tolulope, A.A., 2019. Barriers to patient and family‐centred care in adult intensive care units: A systematic review. Nursing open, 6(3), pp.676-684.
• Lloyd, B., Elkins, M. and Innes, L., 2018. Barriers and enablers of patient and family centred care in an Australian acute care hospital: perspectives of health managers. Patient Experience Journal, 5(3), pp.55-64.
• McNicholas, W.T., 2016. Chronic obstructive pulmonary disease and obstructive sleep apnoea—the overlap syndrome. Journal of thoracic disease, 8(2), p.236.
• Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M. and Wolf, A., 2017. Barriers and facilitators to the implementation of person‐centred care in different healthcare contexts. Scandinavian journal of caring sciences, 31(4), pp.662-673.
• NICE 2019, Chronic obstructive pulmonary disease in over 16s: diagnosis and management, Available at: https://www.nice.org.uk/guidance/ng115 [Accessed on: 17 September 2020]
• Oppert, M.L., O'Keeffe, V.J. and Duong, D., 2018. Knowledge, facilitators and barriers to the practice of person-centred care in aged care workers: a qualitative study. Geriatric Nursing, 39(6), pp.683-688.
• Rocha, A., Arbex, F.F., Sperandio, P.A., Souza, A., Biazzim, L., Mancuso, F., Berton, D.C., Hochhegger, B., Alencar, M.C.N., Nery, L.E. and O’Donnell, D.E., 2017. Excess ventilation in chronic obstructive pulmonary disease–heart failure overlap. Implications for dyspnea and exercise intolerance. American Journal of Respiratory and Critical Care Medicine, 196(10), pp.1264-1274.
• van Eerd, E.A., van der Meer, R.M., van Schayck, O.C. and Kotz, D., 2016. Smoking cessation for people with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (8).pp.90-112.
• Wang, C., Xu, J., Yang, L., Xu, Y., Zhang, X., Bai, C., Kang, J., Ran, P., Shen, H., Wen, F. and Huang, K., 2018. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. The Lancet, 391(10131), pp.1706-1717.
• Zhang, J., Dou, Q., Chen, J., Liang, Y. and Huang, Z., 2020. Analysis of clinical effects of early enteral nutrition standardized treatment process management on patients with acute exacerbation of chronic obstructive pulmonary disease on invasive mechanical ventilation. Zhonghua wei zhong bing ji jiu yi xue, 32(1), pp.67-71.