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Provide an evidence-based answer to the following questions:

1. Identify one Functional Health Pattern relevant to a health problem for James. Briefly explain why this FHP was identified and use references to support your response.

The complex relationship of factors affecting James's health considerably impacts his general well-being; Gordon's Functional Health Patterns explain the Activity-Exercise Pattern. This pattern explores an individual's activity level, workout regimens, and independent living capacity (Butcher & Jones, 2021). The consequences of James's weight gain, worsened by his treatment for prostate cancer, go far beyond his appearance and include severe limitations to his movement and ability to take care of himself. Even with their infrequency, pain episodes make it harder for him to exercise. These indications of impaired functional health highlight how crucial a thorough evaluation is.

Empirical findings from studies by Anderson and Durstine (2019) and Langhammer et al. (2018) underscore the fundamental relationship between insufficient physical activity and heightened health risks, a connection particularly noteworthy for individuals managing chronic conditions like diabetes and cancer. In James's case, his confrontations with accessibility challenges have translated into dependence on unhealthy living options. This highlights the urgency for a focused assessment and intervention in his activity and exercise patterns. Prompt attention to these aspects is pivotal for mitigating immediate health risks and instigating enduring positive changes in James's daily routines, promoting a more sustainable and health-conscious lifestyle.

Therapeutic communication between nurses and clients differs from social conversations/interactions. Below are three responses a person might say during a social interaction. These examples are inappropriate in the therapeutic interaction between a nurse and a client. 

Example response 1: “Don’t worry, everything will be better soon.”

Example response 2: “Look on the bright side. You have Alice to help you at home.”

Example response 3: “Try not to worry. This is nothing compared to what other people go through.”

2. Choose ONE of the examples above and say why the response is not appropriate. Provide an alternative answer that could be used during therapeutic interaction.

"Look on the bright side. You have Alice to help you at home." This response is considered inappropriate in a therapeutic context due to its potential to minimise the client's concerns and emotions. Encouraging someone to "look on the bright side" can inadvertently dismiss the validity of their feelings, creating a communication barrier. Additionally, assuming that external support, in this case from Alice, is sufficient oversimplifies the complexities of the client's situation, possibly neglecting individual needs and challenges.

Therapeutic communication prioritises acknowledging and validating a client's emotions (Sharma & Gupta, 2021). An alternative, more appropriate response could be, "I understand that having support from Alice is important to you. How would you like me to involve her in your care or address any concerns you may have about your support system?" This alternative recognises the significance of the client's support network and invites them to share their preferences and concerns, empowering them to engage in decisions about their care actively. In a therapeutic relationship, open communication is pivotal for adequate care. This approach ensures that the client feels heard and understood, promoting a collaborative atmosphere that enhances the overall effectiveness of the communication process in the healthcare setting (O’Brien, 2022).

3.What could have been a barrier to communication during your interview with James? Provide an evidence-based explanation for this barrier to exist during the interview. 

During the interview with James, a potential barrier to communication could have been his emotional state, marked by his recent prostate cancer diagnosis, divorce, and deteriorating health. Emotions play a crucial role in communication, effectively influencing one's ability to express thoughts, concerns, and needs (Kane et al., 2019). Evidence from studies, such as the work by Heyn et al. (2023), highlights the impact of emotional factors on communication dynamics between healthcare providers and patients. Individuals dealing with significant stressors, like a cancer diagnosis, may experience emotional distress that hinders their cognitive processing and communication abilities (Seiler & Jenewein, 2019).

James's recent depression diagnosis further complicates the communication process. Depression can diminish one's motivation to articulate thoughts and engage in discussions about personal matters, as observed in studies on emotional communication in medical settings (Grahek et al., 2019). Recognising emotional barriers is crucial in healthcare communication to foster a supportive environment where patients feel comfortable sharing information. Addressing these barriers enables healthcare providers to understand the patient's perspective more comprehensively, leading to more effective patient-centred care (Kwame & Petrucka, 2021).



Anderson, E., & Durstine, J. L. (2019). Physical activity, exercise, and chronic diseases: A brief review. Sports Medicine and Health Science, 1(1), 3-10.

Butcher, S., & Jones, D. A. (2021). An integrative review of comprehensive nursing assessment tools developed based on Gordon's Eleven Functional Health Patterns. International Journal of Nursing Knowledge, 32(4), 294-307.

Grahek, I., Shenhav, A., Musslick, S., Krebs, R. M., & Koster, H. W. (2019). Motivation and Cognitive Control in Depression. Neuroscience and Biobehavioral Reviews, 102, 371.

Heyn, L. G., Løkkeberg, S. T., Ellington, L., & Eide, H. (2023). Understanding the role of positive emotions in healthcare communication – A realist review. Nursing Open, 10(6), 3447-3459.

Kane, H. S., Wiley, J. F., Schetter, C. D., & Robles, T. F. (2019). The effects of interpersonal emotional expression, partner responsiveness, and emotional approach coping on stress responses. Emotion (Washington, D.C.), 19(8), 1315.

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20.

Langhammer, B., Bergland, A., & Rydwik, E. (2018). The Importance of Physical Activity Exercise among Older People. BioMed Research International, 2018.

O’Brien, P. G. (2022). The Nurse–Client Relationship and Therapeutic Communication.

Seiler, A., & Jenewein, J. (2019). Resilience in Cancer Patients. Frontiers in Psychiatry, 10.

Sharma, N., & Gupta, V. (2021). Therapeutic communication.

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