Holistic Physical Wellbeing Assessment And Intervention Package For A Patient With Substance Abuse Disorder

NURS 4540 Nursing Care of Mental Health Patients

Critical biological, psychological, sexual and social health issues

The patient in the case study is named Anton who is suffering from the aftermath of extreme substance abuse and alcohol consumption. Care cues collected from the patient in the case study indicates that he had started substance abuse as early as 14 years of age and by the age of 20 years he has completely lost control to his life. On a more exploratory note, he had been diagnosed with symptoms of psychosis and paranoia due to the excessive substance abuse from such an early age. This section of the assignment requires the exploration and evaluation of the biological, psychological, sexual and social health issues that are prevalent in the patient. Biological health issues can be defined as the health adversities that have a direct or indirect impact on the normal physiological and metabolic functioning of the body. As per the information provided in the case study, Anton, along with continuing with his extreme drug and alcohol consumption, had also been consuming high amount of fried food with beer or high caffeine full sugar soft drink which he consumers at least 4 liters a day. This has led to a drastic weight gain of 15 kg in one year and has made his body weight 97 kg with height of 180 cm; hence his BMI calculated is 29.9 which makes him extremely overweight and on the verge of obesity (Braveman & Gottlieb, 2014). Furthermore, Anton is leading an extremely sedentary life being on disability pension due to his psychosis diagnosis, hence the chances of him acquiring morbid obesity is extremely high. The psychological issues of the patient includes psychosis, which was diagnosed with due to the symptoms of paranoia and delusions or hallucinations. The sexual issues for the patient includes the risk of impotency that he had been embarrassed as well, and it has a significant impact on his social and personal wellbeing as well. Lastly, the social health issues that Anton had been suffering from includes economic instability, unemployment, social exclusion, stress regarding his future, and lastly lack of companionship and intimate relationship.

As per Moos (2017), the primary goal of the concept of holistic nursing is to address overall aspects of health and wellbeing of the patient including the physical, social, psychological, emotional and spiritual health. The basic philosophy of holistic nursing is based on the foundation of three interconnected elements such as care, relationship and interconnectedness. In this case, the key issues faced by the Anton includes being extremely overweight and sedentary lifestyle, substance abuse, psychotic symptoms, risk of impotency and resultant lack of companionship and intimacy, unemployment, lack of social life, and stress.

Nursing issue	Holistic goals	Interventions Save Time On Research and Writing Hire a Pro to Write You a 100% Plagiarism-Free Paper. Get My Paper
overweight and sedentary lifestyle	The patient will understand the impact of obesity  and will take an active effort for improving the lifestyle and reducing the weight	Explore and decide on a diet plan with the active participation by Anton to enhance nutritional intake and reduce fat deposition. Developing a customized physical exercise plan with low to moderate physical exercises as per his preferences (Fatseas et al., 2015).   Enroll him in obesity prevention community engagement programs that will help him stick to the changes in lifestyle.
Substance and alcohol abuse	The patient will comprehend the detrimental impact of the substance abuse and be able to avoid addiction relapse at all costs.	Provide herbal medicines and nutritional therapy that will help Anton overcome the urge to consume drugs or alcohol. Using mindfulness based exercises to overcome acute relapse urges such as yoga, meditation, massages, reiki, acupuncture and acupressure (Volkow et al., 2016). Take the assistance of advanced therapies such as biofeedback and neurofeedback technology
Psychotic symptoms such as paranoia and delusions.	Anton will clearly understand the for non-pharmacological therapies and interventions for the psychotic symptoms facilitated due to substance abuse and agree to a holistic treatment plan.	Provide evidence based patient education for Anton to help him discover the need for psychotherapies and counseling to completely overcome the paranoia and delusions (Braveman & Gottlieb, 2014). Recommend him to psychotherapies for cognitive behavioral therapy, music therapy, and one to one counseling.
Sexual issues and the resultant lack of companionship	The patient will be able to overcome the physical, emotional and psychological impact of the issues	Provide DHEA supplements for the sexual issues he had been facing. Recommend a sexual issues counselor for combating the psychological impact of his impotency such as lack of self-worth, stress and hopelessness. Enroll Anton in a community engagement activities and social work as volunteer to address his loneliness and need for companionship (Agrawal, Budney & Lynskey, 2012).
Unemployment and economic instability and the resulting seclusion, uncertainty, and hopelessness	The patient will understand his options for employment despite his psychotic issues and will understand how to better utilize his disability pension	Recommend Anton to a financial planner and disability empowerment organizations to find different employment opportunities. Help Anton to develop budget planning to ensure better utilization of his disability pension (Dietz et al., 2015). Provide therapeutic interventions for him to better cope with the stress and uncertainty associated with financial instability and unemployment.

Outline of a holistic nursing plan

Allied health professionals are the health care and related service providers with expertise in providing therapeutic, diagnostic, curative, preventative, and rehabilitative service delivery. They have a considerable contribution to the art and science of holistic care and is extremely needed to provide interventions that address the overall health needs and requirements of a patient. As per the case study, Anton, the patient in the case study is exhibiting a few key care needs which will be more effectively and holistically managed with the aid of allied health professionals as well (Chandrasekaran et al., 2012). In this case, a community nurse that is addressing to his care needs in a holistic manner will have to refer him to a nutritionist firstly. A nutritionist will help him decide on a diet plan that is nutritional and can also target weight-loss for the patient. The second health professional that the patient will need to be referred to is a physiotherapist or a fitness expert so that Anton can decide an exercise plan for him that will help him evade the risk of obesity and will also help in improving his sedentary lifestyle. Furthermore, to combat his psychotic issues, he will need the aid of a psychotherapist as well to help him overcome his paranoia and hallucinations. Lastly, Anton will also need the referral to an occupational therapist for recognizing modifications his lifestyle and adhere to his activities successfully (Ganguly & Moustafa, 2018).

Most psychosocial health issues require unconventional treatment interventions which address the overall health of the patient. Community engagement and social work volunteering are two options that often are found to be extremely helpful to improve the social and psychological health issues of the patient effectively. In this case, social exclusion, lack of self-worth, hopelessness and uncertainty, and lastly lack of intimate companionship are a few key issues that were affecting the overall health of the patient (Dossey & Keegan, 2012). Hence, interventions like community engagement and social involvement as volunteers in different social work issues will not only help in improving the psychological condition but will also help in changing his views regarding challenges and coping strategies in turn improving his expectations and facilitating an optimistic take to life. A few community resource groups that can be of extreme help to the Anton includes Bankstown community resource group, community resource network, Drug and alcohol rehab center in Melbourne, etc.

This case study represents the case of a young man named Anton who has suffered severe unfortunate consequences due to his substance addictions, which has significantly destroyed his health and wellbeing. The holistic care planned for him focused more on non-pharmacological and therapeutic interventions which proved to be extremely helpful for Anton. The Psychotherapy and counseling sessions exhibited promising signs of improvement and he responded optimistically to the community engagement activities too. Sticking to a strict diet and exercise plan had proved to be a struggle for Anton, however, mindfulness based interventions helped him overcome any urge for relapse. Anton exhibited positive signs of improvement and with the holistic care provided to him exhibited signs of recovery for Anton 

Allied health professionals

Cat, the patient in the case study is a 21 year old women who had resorted to substance abuse following a history of prolonged childhood sexual abuse. She had been using methamphetamine for a prolonged period of time which has given rise to a number of health issues for her. Firstly, the biological health issues that she had been facing includes extreme and drastic weight loss, which is a very common side effects of prolonged and excessive consumption of methamphetamine or meth. Another key health issue she had been facing includes her disrupted menstrual cycle along with her binge eating problem. According to O’connell and Dowling, (2014), prolonged consumption of meth can have a significant impact on the sex hormone signaling pathway of the body. As a result, the impact of the altered hormone signaling pathway can lead to excessive bleeding, prolonged menstrual cycle and disruption to the menstrual cycle as well. The psychological issues that Cat is exhibiting includes borderline personality disorder, suicidal tendency, and urges for self-harm or self-injury. The impact of the prolonged childhood sexual abuse can lead to psychotic issues such as suicidal and self-harming tendencies in most cases. The prolonged methamphetamine consumption could also be a contributing facilitating factor to her psychological issues. The sexual health issue of the patient includes her absolute disregard for sexually transmitted diseases by casually engaging in unprotected intercourse. Along with that, the lack of an active menstruation cycle for close to a year is another huge sexual health issue that can lead to severe consequences in the future. Lastly, the social health issues exhibited by the patient in the case study includes lack of self-worth leading to suicidal and self-harming tendencies, estrangement from family, loneliness and lack of companionship (Shea & Frisch, 2014).

Holistic care can be defined as the care planning and intervention procedure which leads to healing the whole person. Holistic care is one of the greatest requirements for an ideal care procedure and patient centered care procedures (Obembe, 2012). The holistic nursing plan for Cat is as follows:

Health issues	Holistic goals	Interventions
Inexplicable Weight loss	The patient will understand the impact of drastic weight loss on her health and will participate actively in improving her weight.	Providing Cat with evidence based education on impact of Meth addiction on facilitating sudden weight loss and the possible interventions to improve her weight. With the aid of a dietician, decide on a high carbohydrate high protein diet to help with her weight gain (Katsakou et al., 2012). Decide on additional nutritional supplements including multivitamins and minerals. Recommending counseling sessions for her so that she can overcome her binge eating urges and the resultant vomit inducing as well.
Methamphetamine addiction	The patient will be able to comprehend with clarity the impact of the addiction on her health and will actively cooperate in overcoming the addiction.	Discuss with the patient the impact of the addiction, the health issues resulting from it and the future risks; encouraging her to overcome addiction and revert to mainstream lifestyle (Shen et al., 2014). Provide the aid of holistic non-pharmacological interventions including nutritional therapy, vitamin therapy, music therapy, yoga and meditation, acupuncture and acupressure to overcome urges to indulge in meth. Refer Cat to a childhood sexual abuse counselor and arrange one to one counseling to help her find the cause of her addiction and overcome it (Henry, Minassian & Perry, 2012)
Borderline personality disorder Suicide and self-harming tendencies.	The patient will understand the value of life and will regain the optimistic expectations from life and will be able to overcome the need for inflicting pain on herself or taking her own life.	Apply therapeutic patient engagement and talk based therapy with her in order to encourage her to be comfortable in sharing her issues (Hill, 2015). Provide psychotherapeutic interventions such as cognitive behavioral therapy, dialectical behavioral therapy, and mindfulness based therapies and administer antipsychotic medication for her bipolar disorder and suicidal tendencies. Encourage her to join community engagement activities and social work involvement to enhance her attachment to life and establish a desire for healthy living in her (Morris et al., 2018). Recommend her to a psychiatrist and arrange for one to one counseling sessions for her to overcome her psychological issues.
Unprotected sexual intercourse and sexual health issues	Cat will understand the risk associated and will consciously refrain from it.	Educate Cat regarding the risk of sexually transmitted diseases with the help of valid and authentic evidences to help her understand the risk. Educate her regarding the different protective measures that can be used to entertain in safe intercourse for her (Visser, 2017). Refer her for diagnostic testing to check whether she is already carrying any sexually transmitted disease or infection and investigate her disrupted menstrual cycle with a gynecologist.
Lack of self-worth, loneliness and lack of will to live	Cat will understand the value of life and will cooperate in the activities to enjoy living overcoming her social issues.	Recommend Cat to join in various recreational community engagement activities to help her overcome her depressed mental state. Encourage her to rekindle her relationship with her immediate family to aid in her recovery. Discuss employment opportunities and community aids that she is eligible for to improve her living conditions (Visser, 2017). Enroll her in peer support groups for victims of childhood sexual abuse and suicidal to help her learn coping strategies and gain a sense of belonging. Encourage her to maintain reflective journal writing that will help her keep track of progress and will encourage her further (Obembe, 2012).

Patients with known psycho-social health issues often require additional support that addresses the overall health issues rather than just addressing the disease or disorder; that can be provided by the allied health professionals. Cat will also require the aid of a few allied health professionals including a nutritional expert or a dietician. The aid of this professional will help Cat regain healthy weight and will also help her manage her health and avoid the frequent fainting episodes. Secondly, the aid of a psychotherapist is a fundamental requirement for Cat as she desperately requires therapeutic intervention for her trauma of childhood sexual abuse, addiction to meth and her suicidal or self-harming urges. Lastly, she will require the aid of a sexual health advisor to help her gain better understanding of the risks that she has exposed herself to and how to safely avoid the risks of unprotected casual intercourse (Hurd et al., 2014).

Community resources group

Community resource group is another key requirement for Cat which will provide her with the opportunity to engage in socially uplifting optimistic activities which will not only help her divert her mindset from her past sexual abuse experience, but will also help her entertain a positive take to life. She can benefit from institutions such as BeyondBlue, Healthline for bipolar disorder, SANE Australia, and Griefline (Communitiesmatter.suicidepreventionaust.org, 2018).

The impact of sexual abuse is extreme on the psyche of the victim; and especially for the victims that have encountered such abuse in childhood, the impact of the trauma is tremendous. The case of Cat is a conspicuous example of the aftermath of such a tragic past which led her to a life of hopelessness, addiction and uncertainty. Although, the holistic planning helped her regain control if her life and she exhibited promising signs of improvement. Although, overcoming her addiction to meth and gaining weight had been challenging for her, the aid of community engagement and peer support from similar victims helped her make steady progress towards recovery. 

References: 

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