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Foundations of Nursing Practice

Introduction to Osteoarthritis

Osteoarthritis is the most common disease from which the Australian population is suffering the most. From the reports, it is observed that one in three Australians, they have problems in their musculoskeletal system. Around 1.9 million Australians are suffering from this disease amongst them the adults of the age above 50 years show the signs of Osteoarthritis from radiological investigations (Basedow, Williams & Shanahan et al., 2015). This is the major cause of loss of productivity, chronic pain, and disability in individuals. It is also described as wear and tear of bones and degenerative arthritis. In this essay, we will discuss the points that reflect the problem of Osteoarthritis in older adults. This is the chosen topic because the older Australians facing problems in their health due to advancements in nutrition, medications, and healthcare conditions. It is said that increased longevity of disease leads to a decline in the mental and physical state and the impairments related to aging that results in a reduction of life expectancy.

Issues Associated with Osteoarthritis and Impact on Patient's Safety in The Clinical Environment

The joint pain of Osteoarthritis is associated with exacerbation of relieving stress and reduction of physical activity by an individual. The more common form of Osteoarthritis causes night pain and restlessness that leads to loss of sleep and further exacerbates pain. The cardinal symptoms of Osteoarthritis include reduced functioning, joint instability, reduce movement of patients, swelling, stiffness, pain that persists to psychological distress, and physical inactivity. The impact on patient’s safety includes confusion and deterioration in mobility. This is detected through the physical examination of a patient that includes an assessment of body mass index and body weight, ligament stability, location of tenderness, and muscle strength. The person faces problems in both standing and walking. There are the psychological impacts of Osteoarthritis patients that are sleep disturbance that is related to fatigue cycle and reduction to pain, 31-41 % of patients are experiencing anxiety, 20% of Osteoarthritis patients are experiencing depression, mood disturbances due to irritation and catastrophizing, sexual difficulties due to loss of mobility and pain, lowered self-esteem and self-efficacy, and changed roles due to depression such as the need of social support and not able to care for others (Charlesworth, Fitzpatrick & Perera et al., 2019). The chronic pain also puts the patient at risk of falls, unpredictability, load-bearing feeling.

Conditions that Affect the Older Person’s Ability to Safely Perform Activities

Osteoarthritis affects the older person’s majorly towards economic and societal implications. The most common affect the activities of daily life and impairments in quality of life. They further lead to an increase in healthcare costs, dependency on others, and institutionalism. Older adults depend on others due to impairments and limitations in the functioning of life areas. The comprehensive concept is involved in functioning that includes rest, leisure, self-care, and productivity. These are the groups that require rehabilitation and physical medicine activities along with occupational and physical medicine therapists (Duong, Bennell & Deveza et al., 2018). Moreover, this results in the person in the development of anxiety and depression because the person feels lonely and burden to others. This is the very unpleasant feeling of sad and despairing patients. This can vary in a person from no self-worth, loss of confidence to the thought of wanting to end life. The mood of the patient is affected as the person feels tired and without the energy that drives the person to enjoy their life. The person faces a reduction in concentration and difficulty in decision making. The short-temperedness is the common condition that the person faces due to irritability with family and friends. The person usually comes with the thoughts of suicide and self-harm as the consequence of comorbidities. This is because the patient suffering from Osteoarthritis feel that they are a burden to family and of no importance on earth. This results in more than one disease at a single time as a consequence of others (Finch, Kemp & Clapperton et al., 2015). The older adults face problems in mobility and household activities to demonstrate the functional assessment and related interventions that could help in preventing the patients from getting affected due to further social, health, and activities of daily life.

Implications for Patient Safety in The Development of A Nursing Care Plan

Nursing professionals play a great role in recovering patients from minor as well as serious complications. The implications for patient safety to improve the condition of Osteoarthritis patients by effective nursing care plans are cognitive behavioral therapy, enjoyable activities, the inclusion of Mediterranean diet, diet supplements, effective communication, and patient-centered care. Effective communication is the holistic approach that includes the assessment of patients to understand an individual's social, medical, and psychological needs (Ackerman, Pratt & Gorelik et al., 2018). Patient-centered care is the tool that is used to play an active role in evaluating and monitoring the treatment options and improving accordingly as per patient choices. Diet supplements play a major role in treating Osteoarthritis patients as based on the advice of physicians the patient is said to add fish oil supplements, vitamin D, vitamin K, and Calcium. The Mediterranean diet is a healthy Australian diet that includes healthy fats such as nuts, fish, and extra virgin olive oil to maintain bone and joint health. Moreover, the green leafy vegetables are rich in Vitamin K that reduce inflammation in the blood. The enjoyable activities build social-connection, self-esteem, and self-efficacy. Cognitive Behavioral Therapy is the best option to get relief from depression and anxiety. These will help in affecting the person’s functionality, quality of life, and maintaining relationships (Ackerman, Bohensky & Zomer et al., 2019).

Conclusion on Osteoarthritis 

The common form of arthritis is Osteoarthritis that leads to chronic pain in individuals, loss of productivity, and disability. Here, there is an extensive role of nursing professionals to play so that they can build on their existing patient management skills to improve care delivery systems as well as the quality of patient life. Non-pharmacological interventions should be used to treat patients with evidence-based practice in healthcare. The encouragement of patients here will include management of pain by following biological approaches such as 'cake pain tool'. The nursing professionals along with a multidisciplinary team should be involved to assist the patients in moving, being healthy, and active by developing realistic goals.

References for Osteoarthritis 

Ackerman, I. N., Bohensky, M. A., Zomer, E., Tacey, M., Gorelik, A., Brand, C. A., & De Steiger, R. (2019). The projected burden of primary total knee and hip replacement for osteoarthritis in Australia to the year 2030. BMC musculoskeletal disorders20(1), 90.

Ackerman, I. N., Pratt, C., Gorelik, A., & Liew, D. (2018). The projected burden of osteoarthritis and rheumatoid arthritis in Australia: a population‐level analysis. Arthritis care & research70(6), 877-883.

 Basedow, M., Williams, H., Shanahan, E. M., Runciman, W. B., & Esterman, A. (2015). Australian GP management of osteoarthritis following the release of the RACGP guideline for the non-surgical management of hip and knee osteoarthritis. BMC research notes8(1), 536.

Charlesworth, J., Fitzpatrick, J., Perera, N. K. P., & Orchard, J. (2019). Osteoarthritis-a systematic review of long-term safety implications for osteoarthritis of the knee. BMC musculoskeletal disorders20(1), 151.

Duong, V., Bennell, K. L., Deveza, L. A., Eyles, J. P., Hodges, P. W., Holden, M. A., ... & Vicenzino, B. (2018). Attitudes, beliefs, and common practices of hand therapists for the base of thumb osteoarthritis in Australia (The ABC Thumb Study). Hand Therapy23(1), 19-27.

Finch, C. F., Kemp, J. L., & Clapperton, A. J. (2015). The incidence and burden of hospital-treated sports-related injury in people aged 15+ years in Victoria, Australia, 2004–2010: a future epidemic of osteoarthritis?. Osteoarthritis and cartilage23(7), 1138-1143.

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