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Part A

Impact of Hospitalization on Liam

Hospitalization can possess significant impacts on a teenager like Liam, particularly when they are grappling with chronic anxiety. Liam's hospitalization may intensify feelings of powerlessness (Alzahrani, 2021). The adolescents who experience long-term anxiety often feel powerless and unable to manage their symptoms (Penzenstadler et al., 2020). Their sense of control over their own lives may be undermined by feeling powerless in the face of their illness (Alzahrani, 2021). When Liam is admitted to the hospital, these feelings of powerlessness can intensify. Despite being vital to his treatment, the hospital atmosphere differs significantly from his comfortable home and school environment (Evans et al., 2021). This sudden change in circumstances can exacerbate his pre-existing feelings of helplessness.

During his hospital stay, Liam's autonomy, a crucial aspect of adolescent development is severely hampered. The power of decision-making that he might have had regarding his treatment, daily routines, and personal choices is largely shifted to healthcare professionals and his parents (Khan, 2023). This change may also give rise to a greater feeling of powerlessness as he no longer possesses the control he had at home or school. It is crucial to include Liam in decisions about his care as much as possible in order to lessen this influence (Khan, 2023).

On the other hand, hospitalization can potentially lead to conflicts and power struggles, especially for teenagers like Liam with chronic anxiety (Khan, 2023). The medical staffs and his family may find it difficult to involve him in his care because of his anxiety. It might manifest itself as resistance to the recommended course of treatment (Khan, 2023). As a result, this resistance in turn can arise from this resistance, exacerbating the already stressful situation. So, in such situations, understanding the nature of these conflicts is vital to provide appropriate support (Khan, 2023). Open and empathetic communication should be conducted by the healthcare providers with Liam allowing him to express his concerns and fears (Khan, 2023).

Coping Strategies to Support Liam

Empowerment through decision-making

In order to address Liam's sense of powerlessness, it is critical to empower him through informed decision-making. The healthcare providers and family members should actively involve Liam in decisions about his treatment and care (Penzenstadler et al., 2020). He can reclaim control through offering him choices within the confines of his treatment plan, such as decisions about his daily routines, therapeutic activities, or dietary preferences (Khan, 2023). This empowerment promotes a positive experience during hospitalization by decreasing the impact of powerlessness and providing Liam with a sense of autonomy (Khan, 2023).

Communication and Collaborative Decision-Making

Another important strategy is effective communication and collaborative decision-making. Open and compassionate communication between Liam's medical professionals, family, and other family members can help minimize conflicts and power struggles (Drake et al., 2022). This includes engaging Liam in the decision-making process, discussing treatment options, and addressing his concerns and fears (Drake et al., 2022). It can be said that the healthcare professionals and Liam's family members may reduce Liam's resistance to treatment and encourage collaboration by recognizing and valuing his sentiments (Grad et al., 2017). Preventing power struggles requires creating a secure atmosphere where Liam can communicate his feelings and worries without fearing about being judged ((Drake et al., 2022). This approach promotes a sense of respect for Liam's perspectives and encourages his active participation in his care.

Involvement of support network

Liam's social support system, which consists of friends and his school counselor, is crucial for his emotional well-being during hospitalization. Friends can provide vital emotional support and alleviate feelings of isolation (Holmes et al., 2019). Encouraging visits from friends or maintaining regular communication with them can help combat loneliness (Holmes et al., 2019). Additionally, the school counselor should be kept informed to guarantee continuity of emotional support and continued management of Liam's anxiety (Wenger, 2021). Liam's general well-being and adjustment throughout his hospital stay might be enhanced by the guidance, academic support, and therapy sessions provided by the school counsellor (Wenger, 2021).

Part B

Impact of Hospitalization on the Family

Along with Liam, his family members especially his mother, stepfather, and 8-year-old stepbrother, Chris are all severely impacted by his illness, which has a far-reaching effect on Liam's family (Khan, 2023). During Liam's hospital stay, his family can feel quite hopeless. Witnessing their child undergo treatment and struggle with chronic anxiety can be emotionally draining for the parents. However, their sentiments of hopelessness could be made worse by the uncertainty surrounding Liam's condition and the protracted hospital stay (Alsharari, 2019). Moreover, Liam's recovery may be questioned, and they may wonder how best to assist him. So, it can be said that these feelings of hopelessness may be amplified by the family's desire to see Liam return to a state of well-being (Alsharari, 2019).

On the other hand, another impact on the family due to Liam’s hospitalization is the experience of guilt (Alsharari, 2019). The family members of Liam might grapple with guilt for not recognizing his anxiety initial stage or for any perceived role in his condition (Alsharari, 2019). Liam's mother, for example, might blame herself for the family's problems and wonder if her split from Liam's biological father caused him to become anxious. In addition, his stepfather might also feel responsible for not providing enough support and for not being able to alleviate Liam's emotional distress. Also, Young Chris, Liam's eight-year-old stepbrother, might also feel guilty for not knowing what Liam is going through and for the attention Liam requires, leading to feelings of inadequacy. Therefore, it can be said that this guilt can weigh heavily on the family members, impacting their emotional well-being and their relationships with Liam and each other (Alsharari, 2019).

Coping Strategies to Support the Family

Family counselling

 Addressing feelings of guilt and hopelessness in the family can be greatly aided by offering family counselling (Gabriel et al., 2020). The mental health specialist can collaborate with Liam's family to help them better comprehend his illness, about his anxiety reasons, and the role of them in Liam’s speedy recovery. So, this can help reduce feelings of hopelessness by giving the family a better knowledge of the situation and the possibility of recovery (Gabriel et al., 2020). By enabling family members to express their worries and get advice on how to best support Liam, can also help with their guilt (Alsharari, 2019).

Support groups

Connecting the family members with support groups can provide invaluable emotional support to them and a sense of community (Wenger, 2021). Support groups are made up of people who have experienced similar events in the past or are presently experiencing them (Wenger, 2021). A sympathetic and comfortable environment can be provided to Liam’s family where they can share their thoughts, fears, and emotions (Wenger, 2021). The family members may feel instantly relieved from their emotional burdens by freely expressing their experiences without being judged (Holmes et al., 2019). Moreover, connecting with support group can also combat the sense of isolation faced by family due to Liam’s hospitalization by providing opportunities for social interaction and community building (Franck & O'Brien, 2019).

Regular Communication and Updates

 Regular communication between healthcare providers and Liam's family is required to keep them updated on his progress (Franck & O'Brien, 2019). Regular updates on Liam's therapy, achievements, and any modifications to his health can be obtained from medical professionals (Reddy & Gupta, 2020). This transparency can help reduce feelings of hopelessness by providing concrete information about Liam's improvement and recovery prospects (Franck & O'Brien, 2019). By allowing the family to actively participate in Liam's care and decision-making, it additionally decreases their sense of guilt.

Part C

Liam's discharge planning following his hospitalization for chronic anxiety is a vital stage in his recovery. It is also crucial to think about the support that Liam and his family will require after he gets back home.

Ongoing Mental Health Services for Liam

 The discharge plan should prioritize the continuity of mental health services for Liam. This can entail regular counseling sessions, medication administration, and follow-up appointments with mental health specialists (Tyler et al., 2019). In order to ensure Liam's continual progress after discharge from hospital, these services are essential. The plan should also include instructions on how the family can make appointments and use these services, allowing them a greater sense of control over Liam's continuing care (Tyler et al., 2019).

Psychoeducation for the Family

 In order to give Liam the best assistance possible, his family must be aware of his condition, his treatment strategy, and how to create a supportive environment at home (Katsuki et al., 2022). The discharge plan should include psychoeducation for the family. This can include training sessions, educational materials, and resources like video manuals to help the family understand chronic anxiety and how to manage it (Katsuki et al., 2022). By empowering the family with appropriate knowledge, they can create a supportive and comfortable environment for Liam (Katsuki et al., 2022).

School Reintegration for Liam

 Since Liam is of school-age, so the discharge plan should take his return to school into account. Any support or accommodations needed for Liam's reintegration into the school environment should be covered. This may involve collaboration with the school counselor, teachers, and peers to ensure a smooth transition back to academics and social life.

Crisis Intervention Plan

Liam's condition might become better after being released, but he might still have crises or relapse tendencies. The discharge plan should include a crisis intervention strategy, including emergency contact information and measures to take in the event of a crisis (Varghese et al., 2020). For Liam's safety and the family's peace of mind, it is essential to make sure they are aware of these services and know what to do in high-stress circumstances.

References

Alsharari, A. F. (2019). The needs of family members of patients admitted to the intensive care unit. Patient Preference and Adherence, 465-473. https://doi.org/10.2147/PPA.S197769

Alzahrani, N. (2021). The effect of hospitalization on patients' emotional and psychological well-being among adult patients: An integrative review. Applied Nursing Research, 61, 151488. 10.1016/j.apnr.2021.151488

Drake, R. E., Cimpean, D., & Torrey, W. C. (2022). Shared decision making in mental health: prospects for personalized medicine. Dialogues In Clinical Neuroscience. https://doi.org/10.31887/DCNS.2009.11.4/redrake

Evans, R. A., McAuley, H., Harrison, E. M., Shikotra, A., Singapuri, A., Sereno, M., ... & Cairns, P. (2021). Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. The Lancet Respiratory Medicine, 9(11), 1275-1287. https://doi.org/10.1016/S2213-2600(21)00383-0

Franck, L. S., & O'Brien, K. (2019). The evolution of family‐centered care: From supporting parent‐delivered interventions to a model of family integrated care. Birth defects research, 111(15), 1044-1059. https://doi.org/10.1002/bdr2.1521

Gabriel, I., Creedy, D., & Coyne, E. (2020). A systematic review of psychosocial interventions to improve quality of life of people with cancer and their family caregivers. Nursing Open, 7(5), 1299-1312. https://doi.org/10.1002/nop2.543

Grad, R., Légaré, F., Bell, N. R., Dickinson, J. A., Singh, H., Moore, A. E., ... & Kretschmer, K. L. (2017). Shared decision making in preventive health care: what it is; what it is not. Canadian Family Physician, 63(9), 682-684. https://www.cfp.ca/content/63/9/682.short

Holmes, L., Cresswell, K., Williams, S., Parsons, S., Keane, A., Wilson, C., ... & Starling, B. (2019). Innovating public engagement and patient involvement through strategic collaboration and practice. Research Involvement and Engagement, 5, 1-12. https://doi.org/10.1186/s40900-019-0160-4

Katsuki, F., Watanabe, N., Yamada, A., & Hasegawa, T. (2022). Effectiveness of family psychoeducation for major depressive disorder: systematic review and meta-analysis. Bjpsych Open, 8(5), e148. https://www.cambridge.org/core/journals/bjpsych-open/article/effectiveness-of-family-psychoeducation-for-major-depressive-disorder-systematic-review-and-metaanalysis/9D33BE241F2B838D4985A55B4E226836

Khan N.T, (2023). Impact of Hospitalization on Patients' Mental Health. Archives of Pharmacy & Pharmacology Researchhttps://doi.org/10.33552/APPR.2023.03.000565

Penzenstadler, L., Gentil, L., Grenier, G., Khazaal, Y., & Fleury, M. J. (2020). Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions. BMC Psychiatry, 20(1), 1-14. https://doi.org/10.1186/s12888-020-02835-2

Recio‐Saucedo, A., Dall'Ora, C., Maruotti, A., Ball, J., Briggs, J., Meredith, P., ... & Griffiths, P. (2018). What impact does nursing care left undone have on patient outcomes? Review of the literature. Journal of Clinical Nursing, 27(11-12), 2248-2259. https://doi.org/10.1111/jocn.14058

Reddy, B. V., & Gupta, A. (2020). Importance of effective communication during COVID-19 infodemic. Journal Of Family Medicine And Primary Care, 9(8), 3793. 10.4103/jfmpc.jfmpc_719_20

Tyler, N., Wright, N., & Waring, J. (2019). Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis. BMC Health Services Research, 19, 1-24. https://doi.org/10.1186/s12913-019-4658-0

Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62(Suppl 2), S192.  10.4103/psychiatry.IndianJPsychiatry_770_19

Wenger, G. C. (2021). The supportive network: Coping with old age. Routledge: UK

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