Hodges' Model: Welcome to the QUAD: chronic

Hodges' model is a conceptual framework to support reflection and critical thinking. Situated, the model can help integrate all disciplines (academic and professional). Amid news items, are posts that illustrate the scope and application of the model. A bibliography and A4 template are provided in the sidebar. Welcome to the QUAD ...

Showing posts with label chronic. Show all posts
Showing posts with label chronic. Show all posts

Wednesday, November 06, 2024

Dear Doctor, I have a list . . .

It seems reasonable to suggest that my trips to see the GP as a child:

"What's the problem Mrs Jones?"
"It's Peter, he's not eating!"
"Well, does he seem ill? ... Is he lying down all the time?"
"No, he's running around all day"
"Well he sounds OK but let's check" ... ... ...
"Say arr!"
 (That's to me - not you reader!)
"Argh!"
"Mmm.. ok, ok. ... What does he eat?"
"Tomato soup, chips, chicken, beans on toast, raw carrot, boiled egg."
"Oh! And jam butties!"
"Well he's of slim build, no doubt underweight, but he's fine. Keep the jam butties rolling, and I suspect he'll keep running around."
- were in the days pre-one-problem-per-visit to the surgery. Even now I wonder is this an urban (rural) myth. But then it rears itself with a comment by family, or overheard. The 1960s and 1970s were a different time, a different age. We always saw the same doctor. Continuity mattered then. Thankfully, I was not a regular 'visitor', or the more derogatory term frequent flyer.

individual
|
INTERPERSONAL : SCIENCES
humanistic ------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group

Ever since starting in the NHS as a nursing assistant, you became aware of the anxiety provoked by many patients when it is their turn to see the doctor. Being asked to bring the patient and any relative(s) through. It often entailed a walk.


I remember one instance their being 12 professionals. Learners can soon increase numbers and restrictions were imposed. Voices were raised. Patients did see the doctor separately.

Back in 1980s, I became a CMHN (CPN) in 1985, I used to encourage patient's to prepare, to make notes of points - questions they wanted to ask. I framed it as their time, their opportunity. A learning opportunity too.

Of course, humour always needs to be used carefully, but on occasion we would joke about walking into the meeting with a list.*


In case of long-term mental illness families are also greatly involved. Sometimes a case review would take place in the patient's home. If it's care in the community, delivered by the community team then surely the administration can be organised in support? 

At times, I would offer to assist and the team were always responsive. This role of advocacy has changed, transformed over the decades, but it is still there. As a nurse you listen for the voice: but have to be ready to 'pick this up' on another's behalf. Ready 

*Lists: Long a tool for safety and situational awareness.

Thursday, September 17, 2020

The Pain of Parity of Esteem

"Chronic pain is defined as pain that lasts more than 12 weeks or persists beyond the usual healing time (Treed et al., 2015)."
individual
|
INTERPERSONAL : SCIENCES
humanistic ----------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
|
group - population

"Functional magnetic resonance imaging studies of the brain have shown that emotional pain stimulates the somatic pain system, and the somatic pain system activates the nuclear accumbens and ventral tegmental areas, which are the seats of emotion and reward pathways (O'Connor et al., 2008). This biological evidence underscores the complex and bidirectional association between physical and emotional pain." (p.14).

12 weeks

"the mesocortico-limbic dopaminergic pathway and endogenous opioid system"


 

Majeed MH, Naveed S. Chronic Pain in Youth: Can Mental Health Services Provide Relief?. J Psychosoc Nurs Ment Health Serv. 2018;56(11):13-16. doi:10.3928/02793695-20181012-03

See also:

Morton, J., & O’Reilly, M. (2019). Mental health, big data and research ethics: Parity of esteem in mental health research from a UK perspective. Clinical Ethics, 14(4), 165–172.

https://doi.org/10.1177/1477750919876243
 

RCN: Parity of Esteem – Delivering Physical Health Equality for those with Serious Mental Health Needs

https://www.rcn.org.uk/professional-development/publications/pub-007618