This essay is written as a case study referring to a patient from my practice area. As I will be reflecting on my practice in relation to the case study, use will be made of first person writing where appropriate. Hamill (1999) supports the use of first person writing in academic essays such as case studies and suggests it develops self-awareness, reflection, analysis and critique.
As this essay is focused on a specific patient from my practice area it is important to consider issues of confidentiality. Therefore, throughout neither my practice area nor the patient name will be identified. However to be able to discuss key issues in relation to the patient I will refer to their age, gender and lifestyle, and use a false name to aid the flow of writing.
Asthma affects 5.2 million people in the UK: 1.1 million children and 4.1 million adults according to Asthma UK in their 2004 report. However, depending which report one reads, this number can almost double to 10.1 million (Masoli et al 2003). This wide variation of prevalence maybe explained by the different studies and reports used to gather the data and differing inclusion criteria used. There is nevertheless agreement on the fact that the numbers of cases of asthma are increasing. Asthma UK (2004) reports a 400,000 increase in the number of adults with asthma in the UK between 2001 and 2004. The rising patterns of asthma prevalence however are not explained by current knowledge of causes of asthma, but are paralleled by increases in other allergic conditions such as eczema and rhinitis (Masoli et al 2003).
There is currently no agreed definition of the disease. Widely documented in the literature however, is the National Heart, Lung and Blood Institute (1992) definition who describe it as, ‘a chronic inflammatory disorder of the airways causing widespread but variable airflow obstruction…Obstruction is often reversible, either spontaneously or with treatment.’ The severity of the condition varies significantly (Rees and Kanabar 2000) from mild intermittent asthma, to a distressing disabling condition which results in time off work or school, disturbed sleep, restriction of social and leisure activities and anxiety (Hyland 1998). The main aim of asthma management is to control symptoms, minimise asthma exacerbations and optimise quality of life (Scullion 2005).
As a student of the Acute Care Pathway Degree, one of the specific learning outcomes for my pathway is to be able to manage programmes of care for patients with chronic diseases (St Martins College 2006). Hyland (1998) states that the Advanced Nurse Practitioner has become a major provider of asthma care in the UK. Watkins, Edwards and Gastrell (2003) agree, and suggest that currently the management of long-term conditions, including asthma, are a core component of a Advanced Nurse Practitioner’s work. Therefore it is crucial that I have an understanding of this condition and be able to review patients effectively (Wiggins 1999) using evidence based guidelines, and to have the confidence to provide advice on the management of their condition.
I aim to improve my understanding and asthma management skills through critically reviewing key issues of patient care as a case study. The key issues I intend to focus on relating to a specific patient are: