NSG 4055 Illness and Disease Management Across Life Span Discussion

1. The recent research findings suggest that social isolation has the greatest impact on patients suffering from chronic diseases. Primarily, this factor affects the physical and mental condition of patients of different ages. Eventually, the deterioration of the mental and physical condition changes the way the patients’ responses to the social environment (Bobitt, Aguayo, Payne, Jansen, Schwingel, 2019). Doctor-patient communication becomes more convoluted due to the consequences of social violations. Social isolation has a greater effect on the exposure of the individual’s vulnerabilities which are related to health issues such as depression, heart disease, and cognitive decline. When such instances take place, the flow of the chronic diseases deteriorates as well, and patients’ responses are continuously negative. The social stigma, on the contrary, appears to have a temporary effect on the deterioration of the patient’s health and maybe overcome faster depending on the patient’s ability to recognize the origin of the stigma and combat it in a fast-paced manner (Linz, Sturm, 2013). The adult population is particularly vulnerable to the consequences caused by social isolation and they cope with these factors in a more convoluted manner.

One way a twelve-year-old would cope with these factors would be through constant crying and calling adults for help. The sense of helplessness will prevail as an individual of a relatively young age. The 75-year old would most likely stare at the ceiling without any attempts of finding external help to resolve the issue. The adults may develop depression and their response to suffering may become even more critical. The second factor that the 12-year old may observe would be a complete abundance of their peers in their environment. The 75-year old would look for external help and medical assistance and the sense of giving up instantly may prevail within this age group. This factor would be the second most important for the adult population facing social isolation.

NSG 4055 Illness and Disease Management Across Life Span Discussion References

Bobitt, J., Aguayo, L., Payne, L., Jansen, T., & Schwingel, A. (2019). Geographic and Social

Factors Associated With Chronic Disease Self-Management Program Participation:

Going the “Extra-Mile” for Disease Prevention. Preventing Chronic Disease, 16.

https://doi.org/10.5888/pcd16.180385

Linz, S., & Sturm, B. (2013). The Phenomenon of Social Isolation in the Severely Mentally

Ill. Perspectives In Psychiatric Care, n/a-n/a. https://doi.org/10.1111/ppc.12010

A Sample Answer 2 For the Assignment: NSG 4055 Illness and Disease Management Across Life Span Discussion

Title: NSG 4055 Illness and Disease Management Across Life Span Discussion

2. Based on the research, which factor social isolation or stigma have the greatest impact on a patient living with chronic illness? Why?
Contrast at least two ways these factors would affect a 12-year-old with the way they would affect a 75-year-old.

Social isolation occurs when people withdraw and become disconnected from family, friends, and community. This is found prevalent in older populations living with chronic diseases. Social isolation tends to keep the patient from the much-needed help to cope with their illness. According to Frank,2018,” The president of the Association for the Advancement of Retired Persons, (AARP) Lisa Marsh Ryerson stated that social isolation is a problem that receives relatively little attention and sustained focus but it undermines the health and well-being of older adults” (pg.1).

On the other hand, Stigma which is a social process characterized by exclusion, rejection or blame can have a major impact on people living with chronic illness. Depending on age, I think both factors make major impacts on patients. Social isolation can affect older adults but can also affect 12-year-old kids. For older adults, it may present as loneliness, inability to get to where they want and alienation from things that they enjoy doing. 12 year old on the other hand may be more affected by stigma because at that age they tend to run in groups and if the chronic illness prevents them from being active and doing stuff like kids their age, it may lead to their withdrawal and social isolation. Imagine a 12-year-old living with sickle cell anemia, or congenital heart conditions that prevents them from doing what other 12-year old are doing. They cannot be involved in sports or strenuous activities like other kids, this may lead to stigma from friends and eventually make the kid withdraw and be socially isolated. Social isolation may eventually lead to loneliness and death mostly in older adult population while leading to low esteem and maybe suicide in younger population.

NSG 4055 Illness and Disease Management Across Life Span Discussion Reference

Frank, D. AARP, July 3, 2018: The Danger of Social Isolation, How to spot it, fight it and prevent it.https://www.aarp.org/health/conditions-treatments/info-2018/social-isolation-symptoms-danger.html

A Sample Answer 3 For the Assignment: NSG 4055 Illness and Disease Management Across Life Span Discussion

Title: NSG 4055 Illness and Disease Management Across Life Span Discussion

The promotion of health and wellbeing of diverse populations is important in nursing and healthcare. Nurses and other healthcare providers work in collaboration to ensure that high quality care that meets the care needs of their patients is offered. The HealthyPeople 2030 provides guidelines about the prioritized health problems that should be addressed for the promotion of the health and wellbeing of the diverse global populations. One of the critical health problems addressed in the HealthyPeople 2030 is depression in adults. Accordingly, it is identified that depression in adults is a critical public health concern in the US that affects the quality of life of the patients as well as their significant others. Therefore, the purpose of this paper is to explore the issue of depression in adults, its morbidity and comorbidity and impacts on the population.

Identified Chronic Illness

The identified health problem is depression in adults. According to HealthyPeople 2030, depression is a common problem that is affecting adults in the USA. The existing statistics shows that about 17.3 million adults in the US have experienced at least a major depressive episode. The population of adults with history of a major depressive episodes constitutes 7% of the adults in the US. The rate of depression is reported to be higher females (8.7%) when compared to the males (5.3%). The prevalence is also higher in adult individuals aged between 18 and 25 years (13.1%) when compared to any other age groups of the adults (NIMH, n.d.).

Depression among adults was chosen because of its severe health impacts to the population. Depression is associated with severe impairment in adults. Accordingly, it is estimated that 11 million adults with age above 18 and above experienced episodes of major impairment that were associated with severe impairment (NIMH, n.d.). Depression is also associated with decline in the quality of life of patients. The evidence shows that depression increases the costs of care incurred by patients and their significant others in seeking the care that they need. It also lowers the productivity of the affected populations (CDC, 2019). Nurses have a critical role to play in ensuring that the health needs of the adults affected by depression are met (Weinberger et al., 2018). Therefore, a critical analysis of its morbidity, comorbidity and impacts should be explored to increase the need for interventions to promote their health-related needs.

Questionnaire

Over the last 2 weeks, how often have you experienced the following problems? (Tick to indicate the answer that aligns the most with your experiences)

	Not at all (0)	Several days (1)	More than half the days (2)	Nearly every day (3)
I have little or lack interest in doing things
I feel down, depressed, and hopeless
I sleep too much or have difficulties in sleeping or maintaining sleep
I feel tired and lack energy
I have poor appetite or over eat
I feel bad about myself or feel a failure or have let yourself and others down
I have difficulties in concentrating
I am slow in talking or doing things and people have noticed it
Feeling that you would have hurt yourself or kill yourself
Total

The guideline for diagnosis is that the healthcare provider should ask the above questions and mark accordingly based on the responses by the patient. A patient is diagnosed with a depressive disorder if there are at least four ticks in the statements rated two or three. A patient is diagnosed with major depression if there at least four ticks in the sections rated two or three. A patient is diagnosed with other depressive disorder if there are at least 2-4 ticks in the regions rated 1.

Morbidity and Comorbidity

Major depression in adults is reported to be a critical public health concern in not only the US but also other global states too. The global risk of developing major depression is reported to be between 15 and 18%. Major depression is associated with adverse effects that include the lowering of the psychosocial functioning as well as quality of life of the affected populations. The existing evidence shows an increased interconnectedness of depression with other health problems. Accordingly, the risk of patients experiencing other health problems that include anxiety and substance abuse disorders is high in those diagnosed with depression. Patients diagnosed with depression have about 50-60% risk of developing at least one anxiety disorder. There is also the high risk that 14% of the adults with major depression are likely to be diagnosed with alcohol use disorder while 4.6% of them have drug use disorder. The lifetime prevalence of alcohol abuse disorder is reported to be 40% and 17% for drug use disorder (Steffen et al., 2020). There is also the evidence that depression is an independent risk factor as well as negative prognostic factor for somatic disorders that include cardiovascular disease, diabetes, chronic respiratory disorders, hypertension and arthritis (Gutiérrez-Rojas et al., 2020). Due to the above comorbidities, diabetes is linked to poor quality of life, higher functional impairment as well as disability, higher medical costs, increased utilization of care services, worse course of disability, and enhanced risk for mortality.

According to Baldessarini et al. (2017), morbidity in depressive disorders is significantly high. The high rate morbidity can be seen from the fact that up to 50% of the patients with major depressive disorders experience illnesses even after their discharge from the hospital. The high rate of morbidity is attributed to a number of risk factors. They include recurring manic depressive states and predominance of depression that cause inferior response to treatment and outcomes. In addition, patients may present with depression with mixed features, which has been associated with poor response to recommended treatments such as the use of antidepressants. Treatment interventions such as rapid cycling may also increase the risk of morbidity due to reduced efficacy of medications in stabilizing mood and un-sustained therapeutic effectiveness of antidepressants (Baldessarini et al., 2017). Therefore, psychiatric mental health nurse practitioners should be aware of the risk factors for morbidity for them to adopt favorable interventions that will optimize the care outcomes of the patients.

Impact of the Chronic Illness

Depression in adults is associated with a number of adverse health impacts. Depression is estimated to affect one in every five people in the world, making it among the conditions with high prevalence and incidence rate. The prevalence of depression among adults in not only the USA but also globally makes it the leading cause of disability across the world (Filatova et al., 2021). The impacts of major depression on the population is reported to be higher than that seen in conditions that include rheumatoid arthritis, coronary heart disease, and diabetes mellitus (Gutiérrez-Rojas et al., 2020). Major depression is also associated with significant impairment in psychosocial functioning in the affected populations and their significant others. The impairment in psychosocial functioning is seen in the inability of the patients to engage in their daily social and occupational roles. There is also the fact that patients’ experience diminishes in the quality of life due to the effects of depression. The decline in the quality of life is attributed to the loss of productivity and independence in the society (Malhi & Mann, 2018). Patients and their significant others also suffer from the economic burden of depression management. The economic burden of depression is largely attributed to the increased need for hospital visits and hospitalization for the management of depression symptoms (Malhi & Mann, 2018). Greenberg et al., (2021) showed in their study that the economic burden of adults suffering from major depression rose by 37.9% ($US 236.6 billion) in 2010 to 326.2 billion in 2020. The increase could be seen in different variables of depression management that included direct costs, workplace costs, and suicide-related costs (Greenberg et al., 2021). According to Armbrecht et al. (2021), adults with major depression in the US suffer from adverse health effects of the disease that include increased per patient inpatient visits on an annual basis, office visits, annual drug costs, total medical costs, and emergency department visits. When combined, the above effects have a significant psychosocial toll on the patients, hence, adverse health outcomes.

NSG 4055 Illness and Disease Management Across Life Span Discussion Conclusion

Depression among adults is one of the public health concerns being experienced in the USA. Depression is associated with poor health outcomes in the affected populations. It predisposes patients to poor quality of life, disability, and premature mortality. Evidence based interventions can be used to lessen the impacts of major depression on the population. Therefore, it is critical that interventions that minimize the impacts and severity of major depression in the population be embraced.

NSG 4055 Illness and Disease Management Across Life Span Discussion References

Armbrecht, E., Shah, R., Poorman, G. W., Luo, L., Stephens, J. M., Li, B., Pappadopulos, E., Haider, S., & McIntyre, R. S. (2021). <p>Economic and Humanistic Burden Associated with Depression and Anxiety Among Adults with Non-Communicable Chronic Diseases (NCCDs) in the United States</p>. Journal of Multidisciplinary Healthcare, 14, 887–896. https://doi.org/10.2147/JMDH.S280200

Baldessarini, R. J., Forte, A., Selle, V., Sim, K., Tondo, L., Undurraga, J., & Vázquez, G. H. (2017). Morbidity in Depressive Disorders. Psychotherapy and Psychosomatics, 86(2), 65–72. https://doi.org/10.1159/000448661

CDC. (2019, June 7). Products—Data Briefs—Number 303—February 2018. https://www.cdc.gov/nchs/products/databriefs/db303.htm

Filatova, E. V., Shadrina, M. I., & Slominsky, P. A. (2021). Major depression: One brain, one disease, one set of intertwined processes. Cells, 10(6), 1283.

Greenberg, P. E., Fournier, A.-A., Sisitsky, T., Simes, M., Berman, R., Koenigsberg, S. H., & Kessler, R. C. (2021). The economic burden of adults with major depressive disorder in the United States (2010 and 2018). PharmacoEconomics, 39(6), 653–665. https://doi.org/10.1007/s40273-021-01019-4

Gutiérrez-Rojas, L., Porras-Segovia, A., Dunne, H., Andrade-González, N., & Cervilla, J. A. (2020). Prevalence and correlates of major depressive disorder: A systematic review. Brazilian Journal of Psychiatry, 42(6), 657–672. https://doi.org/10.1590/1516-4446-2020-0650

Malhi, G. S., & Mann, J. J. (2018). Depression. The Lancet, 392(10161), 2299–2312. https://doi.org/10.1016/S0140-6736(18)31948-2

NIMH. (n.d.). NIMH » Major Depression. https://www.nimh.nih.gov/health/statistics/major-depression

Steffen, A., Nübel, J., Jacobi, F., Bätzing, J., & Holstiege, J. (2020). Mental and somatic comorbidity of depression: A comprehensive cross-sectional analysis of 202 diagnosis groups using German nationwide ambulatory claims data. BMC Psychiatry, 20(1), 142. https://doi.org/10.1186/s12888-020-02546-8

Weinberger, A. H., Gbedemah, M., Martinez, A. M., Nash, D., Galea, S., & Goodwin, R. D. (2018). Trends in depression prevalence in the USA from 2005 to 2015: Widening disparities in vulnerable groups. Psychological Medicine, 48(8), 1308–1315. https://doi.org/10.1017/S0033291717002781